Inside ‘Inside View’: reflections on stimulating debate and engagement through a multimedia live theatre production on the dilemmas and issues of pre-natal screening policy and practice

Background The role of applied theatre in engaging both lay and professional publics with debate on health policy and practice is an emergent field. This paper discusses the development, production performance and discussion of ‘Inside View’.1 Objectives The objectives were to produce applied theatre from research findings of a completed study on genetic prenatal screening, exploring the dilemmas for women and health professionals of prenatal genetic screening, and to engage audiences in debate and reflection on the dilemmas of prenatal genetic screening. Methods ‘Inside View’ was developed from a multidisciplinary research study through identification of emergent themes from qualitative interviews, and development of these by the writer, theatre producer and media technologist with input from the researchers. Findings Inside View was performed in London and the Midlands to varied audiences with a panel discussion and evaluation post performance. The audiences were engaged in debate that was relevant to them professionally and personally. Knowledge translation through applied theatre is an effective tool for engaging the public but the impact subsequently is unclear. There are ethical issues of unexpected disclosure during discussion post performance and the process of transforming research findings into applied theatre requires time and trust within the multidisciplinary team as well as adequate resourcing.

Development and deployment of an autonomous micro-drilling system for cochleostomy

This thesis describes the design and development of an autonomous micro-drilling system capable of accurately controlling the penetration of complaint tissues and its application to the drilling of the cochleostomy; a key stage in the cochlea implant procedure. The drilling of the cochleostomy is a precision micro-surgical task in which the control of the burr penetration through the outer bone tissue of the cochlea is vital to prevent damage to the structures within and requires a high degree of skill to perform successfully. The micro-drilling system demonstrates that the penetration of the cochlea can be achieved consistently and accurately. Breakthrough can be detected and controlled to within 20µm of the distal surface and the hole completed without perforation of the underlying endosteal membrane, leaving the membranous cochlea intact. This device is the first autonomous surgical tool successfully deployed in the operating theatre. The system is unique due to the way in which it uses real-time data from the cutting tool to derive the state of the tool-tissue interaction. Being a smart tool it uses this state information to actively control the way in which the drilling process progresses. This sensor guided strategy enables the tool to self-reference to the deforming tissue and navigate without the need for pre-operative scan data. It is this capability that enables the system to operate in circumstances where the tissue properties and boundary conditions are unknown, without the need to restrain the patient.