j m laidlaw ualitative research

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Designed and produced by theEducation Development UnitNHS Education for Scotland

Initial development sponsored by theScottish Higher Education Funding Council

QQQQQ ualitative Research

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E A Hesketh

J M Laidlaw

Instructional Design

J M Laidlaw

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L E BellM C Gunn

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N K McManus

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Units SSSSS nippets on qualitative research

The value of qualitative research, as developedby social researchers, is that it offers a way ofgetting close to peoples’ feelings, values andreactions. It allows insight into these issueswithout the researcher imposing their ownconceptual framework on them. Qualitative researchusually focuses on events, processes, experiences,actions, feelings, values etc from the perspective of thosebeing studied. It is therefore a useful method for exploringperceptions and beliefs, for understanding complexprocesses and for developing theories. As with traditionalresearch it involves sampling, developing a studyinstrument, collecting and analysing data, and checking thevalidity of your findings.

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If you are a doctor you are already likelyto be familiar with quantitativeresearch, which is about collecting andanalysing data in numeric form, andperhaps wary about qualitativeresearch. However, quantitativeresearch offers limited informationabout peoples’ experiences, values anddoes little to help you understand howorganisations or teams function. Thisis where qualitative research has a keyrole to play.

“”

Why usequalitative research?

Qualitative research can provide richdata – it can reach the ‘parts’ otherresearch methods cannot reach.

An in-depth interview with one personcan be far better and reveal far morethan 500 shallow questionnaires.

Qualitative research can help you findout why people do what they do andwhat they need to change.

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Units IIIII ntroducing qualitative research

In today’s world the healthcare profession facesmany challenges. These include increasedexpectations from the government, Trusts andpatients. There are also economic problems tobe faced, as well as changing relationships withother professions and the users of the service.Quantitative research methods, which are thenorm in medical research, are often inappropriate toaddress such complex issues.

Qualitative research, however, can be extremely useful incapturing the interactions between people and accessing theirsubjective worlds. It offers a means of exploring perceptionsand beliefs, understanding complex processes, identifyingimportant issues, exploring problem areas and suggesting waysof tackling them.

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Many researchers often combinequalitative and quantitativemethods in their studies. Forexample a researcher might plan asurvey through interviews butanalyse some of the content usingquantitative analysis.

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Units QQQQQ ualitative research in action

The aspects listed below take you through the various steps of theresearch process.

What should theresearch question be?

Research methods

Tools for collecting data

Study settings

Selecting the sample

Analysing, interpretingand validating the findings


Click the appropriateoption if you wish tofind out more

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The research question is likely to be moreopen than in traditional research. Defineclearly what you want to find out.Remember qualitative methods are bestsuited to addressing questions aboutwhat, why and how events are occurring.Also think about the level of detail yourequire in your investigation in order toilluminate or answer your questions.


Research methods


Study settings



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Qualitative research methods include:

! using case studies to explore specificsituations then developing andexpanding theory about the issuebeing studied.

! undertaking research at the same timeas a real problem is being solved or aprocess is being implemented.Theresearcher is involved in the event orprocess and intervenes in it. Problemsare identified and addressed as theyarise. Changes are then implementedand evaluated.

! focusing on describing and analysingbehaviour and beliefs. This comesunder the heading of ‘EthnographicResearch’.


Research methods


Study settings




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Below are typical data collection tools.To learn more about a tool, click on theoption of your choice.

Observation

Interviews

Focus groups

Critical incident

Diaries/self-reporting


Research methods


Study settings




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ObservationThrough either participant or non-participant observation a researcher cangain an insider’s or outsider’s view of asituation and elicit information onrelationships, behaviour and events.

Interviews

Focus groups

Critical incident



Research methods


Study settings




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Observation

InterviewsThese provide data in the interviewee’sown words. This assists in ‘seeing theworld’ from their perspective.

Focus groups

Critical incident



Research methods


Study settings




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Observation

Interviews

Focus groups

This is simply any group discussion thatgenerates data. The discussion may bemade to follow a defined agenda, or bean open discussion on a topic. It canprovide insight into attitudes, views andbehaviour and is a useful method forexploring sensitive issues.

Critical incident



Research methods


Study settings




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Observation

Interviews

Focus groups

Critical incident

These are events, usually ‘dilemmas’ butcan be ‘master performances’, which arediscussed in detail and theircharacteristics explored. It is useful forstudying rare occurrences.



Research methods


Study settings




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Observation

Interviews

Focus groups

Critical incident


Self-reporting can provide a rich pictureespecially when participants are askedto reflect and make sense of theirexperiences.


Research methods


Study settings




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Before deciding on thestudy setting, think:

Is the selection of one location likely togive you sufficient information?

Would one setting be a typical setting?

Is a contrast between settings required?

Are you likely to elicit crucialinformation by using different settings?



Research methods


Study settings



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For qualitative research the main aim isto select cases rich in information in thearea being researched. The size andrepresentativeness of the sample are ofless importance than the quality of theinformation elicited from it.

Commonly used non statistical samplingmethods include:

! purposive ( judgmental): handpicking subjects to gain themaximum relevant information forthe research study.

! convenience (incidental): choosingcaptive audiences or readilyaccessible subjects

! quota: setting quotas within eachstrata for subjects with theappropriate characteristics

! advertising: relying on volunteers.



Research methods


Study settings



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Units Methods of analysing data involves twoprocesses:

Reducing the data Abstracting from itso that you can what you feelreport on it is important.

So how does this work with, for example,an interview transcript? Data is sorted andreduced through coding or annotating interms of key concepts that emerge.Alternatively you might compare answersto specific questions to find if any keyconcepts and patterns emerge.

Interpreting the data involves you puttingmeaning to the data you have collectedand analysed. Methods to ensure yourinterpretation is not biased include:

! triangulation: using multiplemethods of data collection, datasources and researchers

! respondent validation: verifying thefindings with the researchparticipants themselves.



Research methods


Study settings



&

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Units EEEEE xamples in practice

Studies of compliance, life style and health service utilisation arewell suited to qualitative methods.The example below outlines thesteps taken in an asthma qualitative research study.

Defining theresearch question

Deciding onresearch methods

Deciding on toolsfor data collection

Deciding on thestudy setting



Click for moreinformation onthe steps takenin the researchstudy

Qualitative Research... Examples: 1 of 7

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A review of the literature found only twopapers on patient goals in asthma. Given thislack of information on patient goals aquestion was developed “what are thetreatment goals of adults with asthma andwhy?”








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In view of the lack of other research onasthma goals and the form of the researchquestion which wanted to know if treatmentgoals existed and why, qualitative methodswere chosen. It was not necessary to knowhow many people had asthma goals.








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In order to understand patient goals in theirsocial context it was decided to interviewsubjects at home.

The interviews were tape-recorded andtranscribed word for word – ‘verbatim’ – inorder to accurately record what was said.








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As most people with asthma are seen inprimary care and most general practitionershave registers of people with asthma, aprimary care population was selected.

As the study was exploratory, a single generalpractice was chosen.








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Purposive sampling allowed subjects to beselected of different ages and gender.Disease severity was limited to steps 2-4 ofthe British Thoracic Society Guidelines toallow an in-depth analysis of the goals ofthose people using a small sample size.








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Several researchers with differentperspectives read the transcriptions of theinterviews. From reading the transcripts andthe relevant literature a coding system wasdeveloped. Codes included ‘asthma goals’and ‘life goals’. Three researchers coded afew transcripts. Differences in coding wereexplored and negotiated until agreement wasreached. This process continued until alldifferences had been resolved. The finalcoding system was applied to all thetranscripts. The data was then explored forpatterns and a theory developed.

Sometimes respondents are sent a copy oftheir transcript or a copy of the analysis tomake sure it is valid. Focus groups can alsobe used to validate the results of an interviewstudy.








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Discuss your research idea with a colleaguewho may point out some of the pitfalls or tellyou if it is a waste of time. If you are new toqualitative research, you should seek out anexperienced researcher to act as acollaborator or supervisor.

Think about some topic ‘short cuts’ egcomparing practice with other published workor trends.

Outline your thoughts in writing. Jot downwhat the proposal is about (introduction),what you want to do (method), what you thinkyou might find (results) and what it mightmean (discussion).

PPPPP ractical tips

continued. . .

Qualitative Research... Practical Tips: 1 of 2

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Ensure you are adequately trained forqualitative research. Get some practice on datacollection methods (observation, interviewing)and data analysis through trying the methodsout on colleagues or assisting in anotherinvestigation.Keep an on-going list of full references ofarticles/books relevant to your research. It willsave a lot of time when writing the final report.Don’t rely on solely one method for datacollection.

Transcribing interviews is a lengthy process andtape recorders can make interviewees nervous.If you decide to use note-taking for an interview,practise - asking questions, listening and takingnotes.

Qualiltative Research... Practical Tips: 2 of 2

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Qualiltative Research... Practical Tips: 3 of4

When using observation ensure you observe forlong enough to capture a true picture ofevents.

If you are using an observation schedule torecord events and actions, give it a trial run andsimplify your categories if necessary.Don’t let your own expectations orpreconceived ideas influence your dataanalysis. Step back from your data for a week

or two and see if you come back to it, with thesame thoughts.Be honest when interpreting your results. Ifthey do not support your original thoughts, ordiverge from those of others in the field, seekan explanation - think why.

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Qualiltative Research... Practical Tips: 4 of 4

Take the opportunity to share your findingswith others at a seminar, academic meeting.This can help to support your perspective, oradvance understanding of what your researchindicates.

When your paper or report is nearingcompletion seek constructive criticism from acolleague.

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Units OOOOO ther learning opportunities

There are many books and other resources on Qualitative Research.Here is a short resume of our suggestions.

Click the appropriatebutton if you wish tofind out more

Qualitative Research... Opportunities: 1 of 5

Books

Study

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Blaxter L, Hughes C, Tight M (1996) How to research Buckingham,Open University PressAlthough covering quantitative as well as qualitative research thisis an excellent, jargon free book about doing research in the socialsciences as well as in related subjects, eg education, health andsocial care. It offers lots of practical advice for all stages of thequalitative research process.

Strauss A, Corbin J (1996) Basics of Qualitative Research:techniques and procedures for developing grounded theoryLondon, SageThis is one of the most widely read and used basic texts ofqualitative research. The book itself is very much a “how to” guidewhich systematically takes the reader through the importance ofqualitative research and its relationship to quantitative methodsthrough the development of a research question, sampling anddata collection. The majority of the book concentrates on thepreviously enigmatic process of analysis by providing a clear andalmost mechanical guide for new researchers.


Books

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Centre for Medical Education (1997) Research awareness (unitR:1), Approaches to Research (unit R:2), Sampling (unit R:3),Designing and administering questionnaires (unit R:4) in theDiploma in Medical Education, Dundee, Centre for MedicalEducation, University of DundeeThese stand-alone units are an excellent ‘next step’ to this andthe quantitative research units. You can also go on to gainaccreditation towards a postgraduate certificate/diploma/Mastersin Medical Education.


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The international database TimeLIT (Topics in Medical EducationLiterature) www.timelit.org gives free access to articles relatingto education in medicine, dentistry, nursing, patient health andthe professions allied to medicine.

Other useful websites for those interested in Medical Educationare that of the Association for the Study of Medical Educationwww.asme.org.uk and that of the Association for MedicalEducation in Europe www.amee.org

Qualititative Research... Opportunities: 4 of 5

Books

Study

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http://www.timelit.org/

http://www.asme.org.uk/

http://www.amee.org/

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You might now wish to look at the related unit on QuantitativeResearch.

Quantitative ResearchClick the option totake you to a summaryof the unit


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Units GGGGG roup activities

Have a go with some colleaguesat designing an ObservationDiary to record events relevant tothe team-working skills oftrainees in your unit. Discuss thekind of thing you might want toobserve and record in order togain insight into good and poor teamworking skills. Afterwards discuss how you wouldproceed to code the data.

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Qualitative research, when carriedout properly, is a systematic andrigorous form of research.

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j m laidlaw ualitative research

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