Qualitative Research Methods and Data Collection

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Presentation transcript:

Qualitative Research Methods and Data Collection Research and Development in Medical Education: Educational Skills Workshop Arianne Teherani, PhD Bridget O’Brien, PhD

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Overview of Workshop Evaluation of qualitative research Definition of qualitative methods Types of qualitative data Design of qualitative data collection methods Overview of qualitative research will address underlying assumptions of qual research (slides 3, 4, 5, 6). Slide 5 is a brief comparison between quan and qual research. Slide 6 includes sample qualitative questions

Qualitative Research Research about lives, behavior, organizational functioning, interactional relationships Exploratory Open-ended Data = Words Analytic procedures are interpretivist Analysis is concurrent with and post data collection -Research about perceptions, beliefs, behavior, social interactions and relationships, organizational processes -often exploratory or descriptive -Data=descriptions, narrative accounts, observed behaviors -Analytic procedures are interpretive and interact with data collection (moving back and forth between development of concepts or frameworks and inquiry through data collection) -Data collection is complete when saturation is achieved – no new themes, no new areas of inquiry

Multiple Purposes of Qualitative Methods Research Evaluation Instrument Development Curriculum Development

Qualitative Research Questions What are the qualities of an ideal mentor? How are attending physicians prepared and trained to perform the tasks and duties after transitioning to their new positions? How do clerkship students characterize the struggles they face when transitioning to the clerkships? How do clinical teachers characterize students’ struggles? How do residents describe the contributions of their fourth year experiences to their professional development.

Qualitative Paradigms Sets of beliefs that guide action Qualitative research takes place within a vast spectrum of paradigms: Positivism Post-positivism Interpretivism / Constructivism Critical Theory *Ginsburg article mentions a constructivist grounded theory approach. *NOTE: Often authors are not explicit about this and may not even be mindful of the paradigm. But it is important to be mindful of ontology (what is reality), epistemology (what is the nature of knowledge), and methodology (research approach). For our purposes, the distinction btwn post-positivist and interpretive / constructive are most relevant. PP is hypothesis testing – assumes there is one truth / reality, but we can’t know it completely so we make hypotheses and measure as precisely as possible to approximate truth. Strive for objectivity. Constructivist assumes multiple realities and truths, knowledge is subjective, tries to capture multiple different perspectives and interpretations; inductive approach, purpose is understanding. See: Bunniss & Kelly. Research paradigms in medical education. Medical Education, 2010, 44: 358-366.

Qualitative Approaches Explore social processes through interpretation of data Four Most Common in Medical Education: General Inductive Approach Ethnography Grounded theory Case study Phenomenology / Phenomenography Hermeneutics Narrative research Action research NOTES on general inductive approach: Often used to analyze evaluation data i.e. responses to open ended questions on evaluation forms; notes or transcripts from focus groups No pre-existing framework or hypothesis, though may be organized around a set of questions Purpose is typically to condense extensive and varied raw data (comments, transcripts, notes) into a brief summary or key points Involves detailed review of raw data for frequent, dominant, or significant themes (REF: Thomas, 2006) Ethnography – purpose is to understand the nature of the culture (or certain cultural elements such as notions, beliefs, representations) of a group based on the point of view of different members, on observations of their actions and how they function, and/or on analysis of relevant documents. Phenomenology – purpose is to understand the meaning or significance of a phenomenon based on the experience of those who go through it (e.g. continuity with a patient, reflective writing, witnessing or contributing to a medical error) Grounded Theory – purpose is to understand a process or interaction (e.g. clinical teaching, formation of professional identity, development of a new skill or competency) – no theory or hypothesis guides the work.

Sampling “Participants are not recruited on a representative basis, but rather because of their expert knowledge of the phenomenon under inquiry” (Green & Thorogood, 2005) Purposeful Seeking the best sources of information about the phenomenon of interest Theoretical Seeking the best sources of information to confirm / disconfirm your developing explanatory model Ginsburg article mentions: Sample size was estimated to be sufficient based on the principle of theoretical saturation and our previous experience with this methodology (i.e. relatively homogenous population). ALSO note: invited all students in the class and took first 15 volunteers (not sure this is really theoretical sampling? I guess because there is no theory to expect differences?) Green J, Thorogood N. Qualitative methods for health research. London: Sage; 2005.

Qualitative Data Collection Observation Interview Focus groups Open-ended prompts Artifacts (documents, photos)

Observation Spend time with a group of people as they carry out their daily activities, to understand their way of life and how they make sense of the world in which they live. To understand experiences of group members, their activities, interactions, discussions To understand how contextual factors influence the activities and decisions of group members Example: How do students participate in ambulatory clinic? What influences students’ level of participation? -

Observation Types of observation Field Notes Sketches Relation diagrams Role of Researcher Continuum of roles that range from complete participation to complete observation Type of role adopted depends on research question To understand process of change To generate hypotheses Roles can change over time in research setting

Interviews Types of Interviews Structured: verbal questionnaire, scripted questions Semi-structured: outline of topics guides questions Informal: conversational, questions arise in context Retrospective: focuses on past events Participants express their understandings and experiences in their own terms Ginsburg – pretty scripted, response to video prompts. Extent to which wording and sequencing ought to be predetermined depends on purpose of interview To understand daily experiences and the meanings of those experiences

Focus Groups Small groups with a moderator Concentrated data on topic of interest in short time span Group interview with insight into interactions on topic (compared to interviews) Important that topic of interest would be easy for participants to discuss in a group

Exercise 1: Designing Instruments Each group will be charged with developing a qualitative instrument to answer the following research question: How do students’ roles in patient care change over the course of the clerkship year? Group 1: Observation tool Group 2: Interview protocol Group 3: Focus group protocol

Exercise 2: Interviewing Skills We will role play 2 interviews between a qualitative researcher and participant. After each interview, discuss: How you feel the interview went Thoughts about the questions asked and the responses elicited What you think was done particularly well and/or what could be improved

Data Collection Decisions Methods Types of Data How Interactive? Researcher’s Role? Focus groups Interviews Open ended prompts Observations Collect Artifacts Audio Recording Notes Transcripts Written response Typed response Notes Video Documents Photos / Visual Video

Example: How does participation in a teamwork & communication skills curriculum improve small group process in Year 1 of medical school? Observation of small groups pre & post Interviews with small group leaders (retrospective comparison) In-depth interviews with students Focus group with students Written evaluations of group process by students and faculty

Other topics / questions Recording (audio, video) Transcription Software for qualitative analysis

Convincing a Colleague “You are about to present the results of a survey evaluating your program to colleagues in your department. The results include both quantitative results (descriptive statistics for responses to structured questions) and an analysis of responses to open-ended questions. One of your colleagues says: “Let’s just look at the numbers, the hard data, not the anecdotes.” You would say (or do) . . .

Teaching Material References Lofland & Lofland. Analyzing social settings. Rubin, H.J. & Rubin, I.S. (1995). Qualitative interviewing: The art of hearing data. Thousand Oaks, CA: Sage Publications Strauss, A. & Corbin, J. (1990). Basics of qualitative research: Grounded theory procedures and techniques. Newbury Park: Sage Publications Cote, L., & Turgeon, J. (2005). Appraising qualitative research articles in medicine and medical education. Medical Teacher, 27(1), 71-75. Green J, Thorogood N. Qualitative methods for health research. London: Sage; 2005. Thomas D. A general inductive approach for analyzing qualitative evaluation data. Am J of Eval. 2006; 27: 237-246. Expanded bibliography distributed via handout

Exercise 1: Manuscript Discussion Why was this study done? What questions or problems does the study examine? Do you have a clear sense of the context of the study and the role of the researcher(s)? How well do you feel the methodology used in this study captured the research question? Explain some of the strengths and/or limitations. What other methods could have been used to study this topic?