Visualizing the invisible: applying an arts-based methodology to explore how healthcare workers and patient representatives envisage pathogens in the context of healthcare associated infections

Background: While efforts to enhance healthcare workers' knowledge and behaviours in the prevention and control of healthcare-associated infections (HAIs) have been considerable, little is known about how staff visualize pathogens and their relationship to HAIs. This study, therefore, sought to explore how healthcare workers envisage pathogens in the context of HAIs. Method: Ten hospital-based healthcare workers and two patient representatives participated in a workshop combining risk identification, making activities and in-depth interviews. This methodology was informed by Sullivan's Dimensions of Visualization framework. A descriptive cross-case analysis approach was used to summarize and synthesize the data. Results: Few of the participants reported actively visualizing pathogens in their mind's eye; however, the study elicited mental images of pathogens from all participants and all were able to create related models during the making activity. Conceptions appeared to be influenced primarily by microbiology and infection control campaigns. Conclusion: Our adaptation of Sullivan's Dimensions of Visualization framework proved useful in structuring this initial enquiry and merits wider application and evaluation by qualitative health researchers.