Engaging Northern Ireland secondary school students on organ donation and kidney transplantation awareness

Abstract

Purpose:

To assist in efforts to tackle the rising public health crisis of chronic kidney disease, we designed and delivered a research engagement workshop, Transplantation Tales, with secondary school students and teachers in Northern Ireland on the topic of organ donation and kidney disease. The event was a collaborative effort with community stakeholders, including six local secondary schools, two local hospitals and the regional public health agency. A new engagement strategy was piloted with young people which involved storyboarding developed with animation experts.

Methods:

Approximately 130 students participated and designed their own educational kidney health storyboard. A pretest-posttest design was employed to evaluate changes in students’ knowledge, attitudes and perceptions regarding kidney disease and transplantation using an online survey.

Results:

Forty-three students completed both surveys, with statistically significant improvements (p < .001) observed across all measured domains. The workshop was evaluated as inspiring and educational by the students. Students particularly enjoyed the storyboarding activity, with key learning outcomes including a greater understanding of CKD and kidney transplantation, as well as positively impacting mindsets regarding lifestyle choices. Similarly, teachers reported that they enjoyed the event, specifically appreciating the attendance of healthcare professionals to provide insight into different careers involved in renal care.

Conclusion:

Overall, the workshop resulted in a high-quality educational experience for students, leading to improvements in students’ knowledge, attitude and perceptions regarding kidney disease and transplantation. The findings from the evaluation support a new storyboarding engagement method with young people, helping to increase public health awareness of kidney disease and organ donation.

Keywords

Chronic kidney disease health education kidney transplantation organ donation participatory research

Background

According to a recent editorial published in Nature Reviews Nephrology (2024), the international prevalence of kidney disease currently surpasses that of any other non-communicable disease prioritised by the World Health Organisation. Approximately 18 million children globally have chronic kidney disease (CKD), which will eventually result in the need for dialysis or transplantation. Despite the availability of modifiable risk factors, such as hypertension, obesity and poor diet, low awareness contributes to the disease’s progression (Okwuonu et al., 2015). Kidney transplantation, particularly from a living donor, is the best form of treatment for kidney disease, leading to increased quality of life and life expectancy (Bailey et al., 2016). However, the demand for kidney transplants far exceeds the number of available donor organs, with a global shortage of kidney donors (Matas et al., 2023; McCormick et al., 2018) driven by limited awareness and a lack of both living and deceased donors. As a result, patients can wait years for a transplant, with many suffering serious health complications or dying while on the waiting list (Kidney Care UK, 2024).

In Northern Ireland, the Department of Health introduced recent law changes in relation to organ donation. The system has switched from ‘opt-in’ to ‘opt-out’ (NI Direct, 2023). This new law, known as Dáithí’s Law, stipulates that individuals aged 18 years or older will automatically have their organs donated after death unless they choose to opt out of this system. Young people aged 14 to 18 living in Northern Ireland can register their decision to donate upon death online, while parents of children under the age of 14 can register on their behalf if their child has expressed a desire to donate. Although research indicates that transitioning to an ‘opt-out’ policy may contribute to increased donor rates (Ahmad et al., 2019; Ugur, 2015), global awareness and understanding of such policies remain limited (Molina-Pérez et al., 2019). This knowledge deficit may impede the public’s capacity to make informed and autonomous decisions and, in part, accounts for the variable effectiveness of opt-out systems observed across 35 countries (Arshad et al., 2019).

Evidence suggests successful organ donation cannot be solely attributed to a country’s ‘opt-out’ policy and may depend more on a combination of comprehensive legislation, public education and healthcare infrastructure (Etheredge, 2021; Jansen et al., 2022; Molina-Pérez et al., 2022). Thus, to enhance the effectiveness of the opt-out policy, there is a need to continue to engage communities, address misconceptions as to how organ donation works and strive to improve the understanding of the donation process (McLaughlin et al., 2024). Public education has been identified as a key factor in the success of opt-out consent models (Ahmad et al., 2019; Byrne and Ashcroft, 2020; Shepherd and O’Carroll, 2013).

The recent NHS Blood and Transplant (2021) report outlines a 10-year strategy for improving organ donation and transplantation in the UK, focusing on increasing both living and deceased donations, utilising new technologies, research and innovation. Key initiatives include leveraging public support through the ‘opt-out’ consent law for organ donation. The report also emphasises collaboration among stakeholders to improve outcomes, aiming for long-term improvements in organ donation and transplantation practices for both the patient and donor. However, although education is an important component of this strategy, it is currently limited to healthcare professionals only.

Educating young people about the opt-out organ donation law is crucial, as they are key to shaping future attitudes and behaviours around donation. Irrespective of whether a system is opt-in or opt-out, the importance of communicating one’s decision remains a fundamental hurdle to greater access to organ donation. When a person’s wishes are unknown, families tend to ‘veto’ donation at the point of death (Mclaughlin et al., 2025; Toews and Caulfield, 2016). Empowering young people to understand the system and to talk with their families about their preferences is therefore essential (Coad et al., 2013; Luyckx et al., 2021). Empowerment ensures that individual choices are known, respected and more likely to be upheld (Coad et al., 2013; Luyckx et al., 2021).

In addition, education can also empower individuals with the knowledge and tools to manage their health that can also prevent the onset of chronic diseases and improve renal health across various communities (Thio et al., 2020). Formal school education on the topic of organ donation has been successfully implemented in countries such as England and the Netherlands, yet the long-term impact of such education on donation consent rates remains unknown (Jansen et al., 2022). Encouragingly, studies conducted with young people in the Netherlands (Reubsaet et al., 2005), the United Kingdom (Byrne et al., 2019) and Brazil (Corsi et al., 2023) have demonstrated the effectiveness of educational interventions in improving awareness of organ donation and increasing willingness to register as donors.

While education and knowledge can be disseminated through multiple methods, social media has emerged as a prominent source of health information for young people, who are among its most active users. A key source of information on organ donation (Al-Salhi and Othman, 2024; Boadu et al., 2024; Kituuka et al., 2023), social media also presents risks associated with the spread of misinformation, particularly through negative reader-generated comments that have been shown to reduce the willingness to donate (Boadu et al., 2024; Faherty et al., 2022). This misinformation, linked to reduced trust in public health agencies (Boadu et al., 2024; Faherty et al., 2022), highlights the need for accurate public health education.

The school years are considered an optimal period for promoting health and wellbeing in young people, fostering healthier lifestyle choices and reducing the risk of chronic diseases (Pulimeno et al., 2020). However, modern education calls for innovative pedagogies to engage students and improve health learning outcomes, including participatory methods such as group work, co-created projects and artistic approaches like roleplay, storytelling and creative workshops (WHO, 2003; Wilson et al., 2007).

Engagement in artistic approaches has a range of additional learning benefits, from improved performance on standardised tests (Ishiguro et al., 2023) to fostering traits like creativity, empathy, emotional regulation and resilience (Grosz et al., 2022). Such benefits may occur because arts education challenges students to think creatively, collaborate with peers and express themselves in innovative ways. In addition, from an educational perspective, experiential learning through art-based learning enhances these outcomes by actively involving students in hands-on, real-world experiences. This approach shifts education from passive instruction to dynamic participation, fostering deeper understanding, critical thinking and holistic development (Kong, 2021). Given the established benefits of artistic and experiential learning, an art-based, experiential approach to health education was delivered through an engagement event. Using this approach, complex concepts relating to organ donation and kidney transplantation can be conveyed in an accessible, stimulating and memorable format for young people.

The aim of this study therefore was to investigate how a co-creative, story-based workshop could influence young people’s awareness, attitudes and engagement with kidney health and organ donation. The central research question guiding this work was: how can participatory storytelling activities with healthcare professionals and researchers affect young people’s knowledge, perceptions and attitudes towards CKD and transplantation? This question was addressed through three sub-questions:

How effective is a storyboard-based engagement strategy in fostering dialogue and participation among young people?

What impact does the event have on young people’s knowledge, attitudes and perceptions (KAP) of CKD and kidney transplantation?

How do participants perceive and learn from the event, and to what extent does it influence their attitudes, lifestyle choices and interest in healthcare careers?

Methods

Research design

A pretest-posttest design was employed, in which participants completed an online survey immediately before and after the event, allowing for the systematic measurement of changes in attitudes and perceptions towards kidney transplantation. Ethical approval for the study was received from the Faculty of Medicine and Health Sciences, Queen’s University Belfast (QUB) (MHLS 24_208).

Participants and recruitment

Eligible participants were Key Stage 5 (16–18 years) secondary school students from Northern Ireland. Using convenience sampling, students from eight secondary schools across the region were invited to participate, with the number of schools reflecting the maximum feasible within the available funding and logistical constraints. Identification of schools for recruitment was assisted by the QUB Widening Participation Unit. The aim of this unit is to enhance access to higher education through targeted outreach, pre-entry programmes and sustained engagement. Involving the unit helped to ensure that students invited to the event would be from a range of cultural and socioeconomic backgrounds. Recruitment was facilitated by teachers in February 2025, with students required to provide written informed consent prior to attending the event and completing the first survey. A total of 130 students consented to participate in the study and attended the event, accompanied by teachers and support staff (n = 12) on the day of the event.

Transplantation Tales event

Development

The development of the engagement event was informed by the National Co-ordinating Centre for Public Engagement’s (NCCPE) definition of public engagement as a ‘two-way process, involving interaction and listening, with the goal of generating mutual benefit’ (NCCPE, 2024). Employing a participatory research design through the involvement of key stakeholders, the engagement activity contributed to shared endeavours to deliver local impact (Higgins et al., 2023) regarding kidney health and organ donation. A collaborative approach facilitated the creation of an educational experience that was engaging, meaningful and contextually appropriate for the target audience (Vaughn and Jacquez, 2020). Secondary school educators, animators and renal healthcare providers worked together on the planning and design of the event, activities and materials. Educators involved in a Key Stage 5 enrichment module on organ donation contributed insights to tailor content for upper-secondary students. An animator assisted in creating an engaging storyboarding activity, and healthcare providers reviewed the activity and materials (Table 1) for accuracy and comprehensiveness regarding the kidney transplant process. The development and refinement of materials and activities were led by the authors, ensuring that no stakeholder group held greater influence or power over others.

Table 1.

Educational topics included as part of the activity brief.

Educational topic	Description
The basics of kidney disease	What the kidneys do, what kidney disease is, how to treat kidney disease, etc.
What is a kidney transplant?	What it means to have a kidney transplant, living and deceased donation, medications, etc.
Preparing for transplant	How to stay healthy for transplant operation, tissue typing/matching, identifying a donor, etc.
Transplant operation and recovery	What happens in a transplant operation, time in hospital, recovery period from transplant surgery, etc.
Living with a transplant	Taking your medications, keeping active and staying healthy, transplant sport, etc.

Delivery

The Transplantation Tales event took place in February 2025 and involved researchers from the Renal Arts Group (RAG) based in the School of Nursing and Midwifery at QUB. The RAG was established in 2016 as a collaboration between academics, patients, carers, clinicians and artists to improve the lives of individuals with kidney disease (https://www.qub.ac.uk/sites/renal-arts-group/).

In addition to schoolteachers, the event was attended by six renal healthcare providers from local hospitals, the animator, the organ-donation-promotion manager from the HSC Public Health Agency and four individuals with lived experience of CKD and renal transplantation. Individuals were sourced through a local charity involved in renal care, the Northern Ireland Kidney Research Fund, to ensure local expertise. The event was organised as a single half-day research engagement workshop and was held at QUB.

To open the event, the purpose of the workshop, Dáithí’s Law and an example of an animated video series currently in development by the research team aimed at educating CKD patients on the process involved in undergoing transplantation was presented to participants. Healthcare professionals, who would play an active role in supporting student learning, introduced their role. They came from a range of specialist areas and covered topics including surgical procedures, kidney diseases in young people, information on organ donation and the transplant waiting list, why tissue typing is important in transplantation, advancements in transplantation, supportive services throughout the transplant process, post-transplant care and lifestyle changes and the emotional and mental health aspects of the transplant journey.

Students were also provided with patient educational handouts and visual materials depicting key medical information. This dual approach, combining independent study with real-time engagement, allowed students to connect new knowledge with practical insights from experienced practitioners, enhancing their understanding of the healthcare environment and building relationships that could support their educational journey. During the opening presentations, an animator conducted a ‘live scribe’¹ to generate images based off the information provided by each of the speakers (Figure 1.)

Figure 1.

Live scribe image based on presentations given during the opening of the event.

The structure and process of the event was informed by the principles of experiential learning and involved a collaborative storyboarding activity. Experiential learning facilitates greater engagement and motivation, improves the transfer of knowledge and skills to real-world contexts beyond the subject being taught (Kong, 2021) and enhances learners’ ability to understand and retain the material more effectively (Varman et al., 2023). Storyboarding, as an experiential learning strategy, can facilitate deeper engagement and critical thinking (Ghafar et al., 2023; Maharmah, 2021). Prior to engaging in the storyboard activity, the animator gave a 5-minute lesson on ‘how to draw’. In groups of 6–8, students were provided with instructions on the storyboard activity through an activity brief. The first half of the activity involved students producing an idea for a 2-minute storyboard of an educational video related to kidney transplantation. Each group then received one of the five educational topics and a lookbook of images that they could use for storyboarding, with an additional option to manually draw/write. All students in attendance engaged with the storyboard activity.

Each group member was delegated a ‘clinician role’ (e.g. surgeon), with one receiving the role of a patient. Each group member received a worksheet detailing ‘what they know’ or ‘what they should focus on’ regarding patient education and support to ensure that each member would possess slightly different knowledge, requiring them to work together to create the storyboard. In addition to the brief, healthcare professionals circulated the room to offer their expert knowledge. During the activity, healthcare practitioners, researchers and individuals with lived experience of CKD approached each student group to answer questions on various aspects of the pathway to kidney transplantation and to help students design their story.

In the second half of the activity, students finalised their storyboards by drawing or cutting and pasting images. The top three storyboards were chosen by expert stakeholders, and the winning storyboard was professionally re-imagined by the animator (see Figure 2). A voucher was offered to the winning student group.

Figure 2.

Professionally re-imagined storyboard for the winning group.

Data collection

The online survey aimed to evaluate the impact of the event on secondary school students’ KAP towards CKD and kidney transplantation. The KAP survey, focused specifics on renal transplantation, was adapted from a previous study conducted with CKD patients and carers in Bangladesh (Iqbal et al., 2018). The original survey comprised 33 items. For the purposes of this study, we chose to retain only 25 items as these were included in the scoring framework. The remaining eight, which consisted of non-essential follow-on questions, were excluded in order to reduce survey fatigue and enhance attentiveness among the school-aged participants.

Although initially developed in Bangladesh, the survey items are broadly generalisable, addressing core aspects of CKD and transplantation relevant across populations. The 25-item survey (see Online Supplementary Material A) comprised four subscales: (1) knowledge of kidney disease, (2) knowledge of transplantation, (3) attitude towards transplantation and (4) perception of transplantation. As applied previously (Iqbal et al., 2018), student responses were provided on a 3-point Likert-type scale (Yes = 4/No = 2/Don’t know = 0). Total scores are calculated for each subscale, with a maximum score of 100 possible once all subscales are combined, producing a ‘total KAP score’. For example, a total score of 36 is available for the subscale ‘knowledge of kidney disease’ if a participant was to respond ‘yes’ (= 4) for each of the nine items.

Participants in the current study were required to complete the pre-test 1 week prior to attending the event, and post-test within 2 weeks post attendance. Student demographics, including age, gender, ethnicity and year of study, were collected during the pre-test survey. In addition, students and teachers were asked to complete an evaluation survey post attendance at the event. The survey aimed to assess participants’ overall perceptions, engagement, educational impact and potential influence on attitudes and future intentions regarding organ donation, lifestyle choices and interest in healthcare careers. Tailored questions were created for both the students and teachers to capture their distinct perspectives (see Online Supplementary Material B and C).

Data analysis

All quantitative data was uploaded to SPSS v.30. for statistical analysis. Descriptive statistics were analysed and presented for all participants using frequencies and percentages. Pre- and post-test survey responses were analysed at the individual level to assess changes in KAP following the intervention using paired t-tests and Cohen’s d for effect size. As the assumptions of normality were not met for two subscales, attitudes towards transplantation and perceptions of transplantation, the non-parametric Wilcoxon signed-rank test was conducted. As the survey had not previously undergone psychometric evaluation, internal consistency was assessed using Cronbach’s alpha (α) for all items combined (total KAP score) and each subscale. Results of the student and teacher evaluation, including responses to the open-ended questions, are reported descriptively. A formal qualitative analytic approach was not undertaken as this was beyond the scope of the study.

Results

Of the 130 consenting participants, 103 (79%) completed the pre-test survey (Table 2). Most students were 17 years old (n = 59, 57%), female (n = 84, 82%), white (n = 79, 77%) and in lower sixth form at school, the first of 2 years associated with completing their A-Level studies (n = 68, 66%). The number of eligible students from each school that declined to participate in the current study is unknown.

Table 2.

Participant characteristics.

Measure	Item	Number (N)	Percentage (%)
Gender	Female Male Non-binary	84 18 1	81.6 17.4 1
Age (years old)	16 17 18	20 59 24	19.4 57.3 23.3
Ethnicity	White Black Arab Asian Mixed Other	79 2 1 12 8 1	76.7 1.9 1 11.7 7.8 1
Year of study	Lower Sixth Upper Sixth	68 35	66 34

KAP scores

In total, 48 participants completed the post-test survey. Only data from participants who completed the survey at both time-points were included in the analysis. In total, 43 participants (42%) were included in the pretest-posttest analysis. Paired t-tests revealed significant improvements for total KAP scores, knowledge of kidney disease and knowledge of transplantation following the intervention. Mean total KAP scores increased from 65.49 (SD = 16.75) to 84.60 (SD = 12.94) post event (t42 = −9.28, p < .001, Cohen’s d = 1.42). Knowledge of kidney disease increased from a pre-event mean of 27.26 (SD = 6.31) to 32.33 (SD = 5.76, t42 = −5.46, p < .001, Cohen’s d = .83). Similarly, mean scores for knowledge of transplantation increased from 18.84 (SD = 6.86) to 27.35 (SD = 4.02, t42 = −9.45, p < .001, Cohen’s d = 1.44). Scores for attitudes towards transplantation and perception of transplantation, through the non-parametric Wilcoxon signed-rank test, showed a significant improvement for both subscales. Median scores improved from 6 to 12 (z = −3.62, p < .001, r = .71) and 10 to 16 (z = −4.43, p < .001, r = .80) post event for attitudes towards transplantation and perceptions of transplantation, respectively.

The 25-item survey demonstrated good internal consistency for the total KAP score (Cronbach’s α = .86), but with subscale analysis revealing considerable variability from poor (Cronbach’s α = .57) to acceptable (Cronbach’s α = .78) (Table 3).

Table 3.

Cronbach’s alpha values and classifications.

Scale/subscale	Cronbach’s alpha	Classification
Total KAP score	.86	Good
Knowledge of kidney disease	.66	Questionable
Knowledge of transplantation	.78	Acceptable
Attitude towards transplantation	.60	Questionable
Perception of transplantation	.57	Poor

Event evaluations

Students

All the students who completed the post-test survey provided feedback on the event. Students described having a highly positive experience, with 87% (n = 40) rating the event at least 4 out of 5. Direct engagement with renal healthcare professionals was described as an inspiring learning opportunity. Firsthand accounts from individuals affected by kidney disease also made the topic more relatable and helped cultivate a deeper sense of empathy among students. Participants noted that the event was enjoyable and interactive, particularly appreciating the storyboarding activity, which was seen as a highlight. Key learning outcomes included a greater understanding of CKD, the steps involved in dialysis and kidney transplantation, the interdisciplinary nature of care for those with CKD and the impact of lifestyle choices on the risk of developing the disease.

When asked if the event changed students’ thoughts about organ donation, some participants indicated a positive shift towards a greater openness to donation. However, most participants reported no change, with many stating that they were already willing to donate prior to their attendance. Participants reported a positive shift in mind-set regarding lifestyle behaviours, with most stating that the event has made them more aware of the importance of physical activity and healthy food choices for reducing their risk of developing CKD. Finally, for some participants, the event successfully reinforced their future career plans, strengthening their desire to work within the healthcare sector, including nursing, medicine and allied health profession roles.

Teachers

Of the 12 teaching and support staff that attended the event, five provided feedback. Similar to the student experience, teachers reported that they enjoyed the event and would recommend the event to others. Specifically, teachers appreciated the inclusion of healthcare professionals working within renal care, providing students with a true insight into what is involved in renal care. Recommendations for future application of the event include the provision of greater detail regarding the procedures involved in kidney transplantation and statistics on the annual number of kidney transplants and associated waiting times.

Discussion

This paper has described the delivery and evaluation of a research engagement workshop, Transplantation Tales, aimed at stimulating youth dialogue on organ donation and treatment of CKD, presenting various medical and academic career pathways to young people and improving KAP regarding CKD and transplant. Total KAP scores revealed statistically significant improvements for students’ knowledge of kidney disease and transplantation, as well as their attitudes and perceptions, post event. Overall, the survey demonstrated strong internal consistency, supporting its reliability as a measure of the overarching construct. However, subscale performance varied greatly and suggests that, while the total scale is robust and that the Knowledge of Transplantation subscale was acceptable, the results of the remaining subscales must be interpreted with caution.

Prior research specifically addressing educational interventions aimed at improving KAP regarding CKD and transplantation remains limited, which constrains the ability to draw direct comparisons with the findings of this study. However, in the context of general organ donation education, our results align with international evidence, demonstrating improvements in knowledge (Byrne et al., 2019; Cárdenas et al., 2010; Corsi et al., 2023; Elassas, 2023; Reubsaet et al., 2005; Selvanathan et al., 2021), attitudes (Byrne et al., 2019; Cárdenas et al., 2010; Elassas, 2023), and perceptions (Selvanathan et al., 2021) of organ donation. Of note, high rates of attrition resulting in a small sample size post test means these findings should be interpreted with caution.

It was anticipated that the event would enhance engagement with students through creative storytelling and active participation in the storyboarding activity. Feedback from both students and teachers indicated that the event was highly engaging, educational and inspiring, with the inclusion of healthcare perspectives and interactive activities enhancing both learning outcomes and interest in healthcare careers. Assessing attitudes towards organ donation remains an important topic due to its direct influence on an individual’s willingness to donate, which subsequently impacts the success of organ donation programmes (Dibaba et al., 2020; Wakefield et al., 2010). Recent research has reported favourable attitudes towards organ transplantation (Al-Salhi and Othman, 2024; Boadu et al., 2024; Kituuka et al., 2023; Soqia et al., 2023), with several studies highlighting a sense of altruism among the public who wish to donate in the hope of saving a life (Al-Salhi and Othman, 2024; Soqia et al., 2023).

School systems have called for greater health and health literacy promotion in the education curriculum (Auld et al., 2020). Researchers emphasise incorporating health education into curricula to better prepare students for real-world public health and wellness challenges (Vassilikopoulos et al., 2021). A recent call to action by Vanholder et al. (2021) highlights the long-overdue need for progress in kidney disease, emphasising the importance of raising awareness about kidney disease. Despite the call for greater awareness of CKD, the paucity of prior studies targeting knowledge improvement regarding CKD and transplantation among school-aged children underscores the need for further research and intervention to achieve this aim. Positively, the quantitative findings suggest that integrating the approach taken in this study into the curriculum may enhance KAP regarding CKD and transplantation. However, given the limited sample size, further evaluation is needed to assess its impact on a broader population. In addition, the potential outcomes and consequences for early prevention, self-management skills, wider societal benefits and the future healthcare landscape require further engagement and research.

The Department of Health Northern Ireland (2024) notes that it will likely take several years to fully assess the impact of Dáithí’s Law. However, the positive views towards organ donation identified in this study likely reflect the success of public health programmes in Northern Ireland. In turn, this may indicate the potential success of the new law, particularly among young people, opting to remain ‘in’ as donors. A recent study by McLaughlin and colleagues (2025) suggests that, despite the implementation of the soft opt-out system, families still face significant emotional and ethical challenges when making decisions about organ donation. In the first large-scale qualitative research on families approached during the process of reconciling the deceased’s wishes, the study found that families often struggle to support organ donation, particularly when the deceased’s preferences are unclear. The findings highlight the need for more frequent reassurance, improved communication and better education about organ donation to increase consent rates. The Transplantation Tales event sought to positively contribute to this multi-faceted approach, aligned with the strong support for incorporating lessons on organ and tissue donation into the curriculum (Siebelink et al., 2017).

Feedback from the teacher evaluations focused heavily on the benefits of having healthcare practitioners at the event. Teachers reported that real-life examples of careers in renal medicine were effective in inspiring young people to choose a career pathway in treating kidney disease. This was supported in the student feedback, with some students stating that the event reinforced their desire to pursue a career in healthcare. Currently, there is a growing shortage of renal healthcare professionals in many countries (Riaz et al., 2021), with the National Health Service (NHS) facing a recruitment and retention crisis (Moscelli et al., 2024) across all multiple areas of provision. Long-term solutions include investing in training a larger pool of healthcare workers (Goldfarb et al., 2020). Engaging, informing and motivating young people to pursue healthcare careers is essential for addressing future workforce shortages, with the feedback from this event suggesting its potential to act as a catalyst for inspiring future students to consider healthcare careers.

Furthermore, the Transplantation Tales even align with the shift towards experiential learning in health professions’ education, whereby authentic, participant-centred approaches are recognised as fostering greater empathy, professional identity and learner engagement. Such approaches have been shown to support the development of more empathetic and responsive healthcare practitioners (Lazari et al., 2023; Zhou et al., 2023). In addition, storytelling, grounded in real patient experiences, is linked to enhanced emotional intelligence and communication across varying clinical contexts (Maity et al., 2025) as direct patient contributions enrich understanding and extend learning beyond theoretical knowledge (Coe et al., 2021). Thus, the approach taken in our event reflects these best-practice principles, not only fostering school students’ interest in healthcare careers but also providing them with a foundational understanding and empathetic perspective essential for success in the field.

Limitations

While the Transplantation Tales workshop demonstrated promising outcomes, there are several limitations to be acknowledged. First, the high attrition rate between the pre- and post-event surveys may limit the generalisability of the findings. Future research may benefit from greater engagement with teachers during both the planning and follow-up stages. Teachers play a pivotal role in classroom activities and can encourage participation in a supportive, non-coercive manner. Teachers are also well positioned to remind students about the importance of the study and can provide structure for completing follow-up tasks within the classroom. In addition, the sample was comprised primarily of 17-year-old white female students from Northern Ireland. While the Northern Irish population is predominately white (96.55%) (NISR, 2022), the findings may not represent the views and experiences of boys or more diverse student population.

Second, although the survey demonstrated strong internal consistency overall, the reliability of several subscales was weaker, impacting the strength of the subscale-level findings. Further psychometric testing (e.g. factor analysis, test–retest reliability and item refinement) is recommended to enhance the survey’s validity and ensure its appropriateness for assessing KAP towards kidney disease and transplantation. Third, the lack of a control group can restrict the ability to attribute observed improvements solely to the student’s attendance at the event. Finally, the post-event evaluation was conducted within 2 weeks of attending the event. Thus, the long-term retention of knowledge and sustained changes in attitudes or perceptions remain unknown.

Conclusion

This research engagement workshop, Transplantation Tales, was successfully delivered through a collaborative approach with key stakeholders, resulting in improvements in young people’s knowledge, awareness and perceptions towards CKD and transplantation. The workshop demonstrated the value of interdisciplinary collaboration in health education, combining healthcare expertise with arts-based learning to foster meaningful student engagement. Feedback from both students and teachers supports the potential of a novel method of engaging with young people in research, storyboarding, to enhance public understanding and interest in renal health and healthcare careers. There is potential for storyboarding, as a method of engaging with young people, to be applied across a diverse range of engaged research practices and disciplines. However, future research is required to determine the potential scalability of this strategy due to the limited sample size, as well as the long-term impact of the event on study outcomes.

Supplemental Material

sj-docx-1-hej-10.1177_00178969251381935 – Supplemental material for Engaging Northern Ireland secondary school students on organ donation and kidney transplantation awareness

Supplemental material, sj-docx-1-hej-10.1177_00178969251381935 for Engaging Northern Ireland secondary school students on organ donation and kidney transplantation awareness by James McMahon, Tayler Truhan, Grace McCall, Catherine McKeown, Helen Noble and Clare McKeaveney in Health Education Journal

Supplemental Material

sj-docx-2-hej-10.1177_00178969251381935 – Supplemental material for Engaging Northern Ireland secondary school students on organ donation and kidney transplantation awareness

Supplemental material, sj-docx-2-hej-10.1177_00178969251381935 for Engaging Northern Ireland secondary school students on organ donation and kidney transplantation awareness by James McMahon, Tayler Truhan, Grace McCall, Catherine McKeown, Helen Noble and Clare McKeaveney in Health Education Journal

Supplemental Material

sj-docx-3-hej-10.1177_00178969251381935 – Supplemental material for Engaging Northern Ireland secondary school students on organ donation and kidney transplantation awareness

Supplemental material, sj-docx-3-hej-10.1177_00178969251381935 for Engaging Northern Ireland secondary school students on organ donation and kidney transplantation awareness by James McMahon, Tayler Truhan, Grace McCall, Catherine McKeown, Helen Noble and Clare McKeaveney in Health Education Journal

Footnotes

Funding

The authors disclosed receipt of the following financial support for the research, authorship and/or publication of this article: this research was funded by Public Health Agency (grant no. 566924) and Queen’s University Belfast (grant no. 566925).

ORCID iD

James McMahon

Supplemental material

Supplemental material for this article is available online.

Notes

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