1. Qualitative Research Methods: An Introduction Elizabeth Boyd, Ph.D. EPI 240 May 30, 2006

2. Course Outline Introduction and Overview Doing Qualitative Research: study design, sampling, data collection Interviews and Focus Groups Doing Fieldwork I: Basics of ethnographic research Doing Fieldwork II: Analyzing ethnographic data Using audio- and video-recorded data

3. Course description Introductory lectures Discussion of assigned reading Collective data analysis Assignments: practical applications of concepts

4. Outline What is qualitative research? Historical roots and theoretical assumptions Qualitative vs. quantitative research Types of qualitative methodologies Implications for health services and clinical research

5. What is qualitative data? Verbal Interviews Focus groups Speeches Interactions -- examining room; ED; M&M; telephone Written Diaries Letters Case notes/charts Text -- any written documents, including email; chat rooms; blogs

6. What is qualitative research? Collection and analysis of non-numerical information via formal research methods Qualitative research involves an interpretive, naturalistic approach to the world, … studying things in their natural settings, attempting to make sense of, or interpret, phenomena in terms of the meanings people bring to them. (Denzin and Lincoln, 2000)

7. What is qualitative analysis? Systematic extraction, coding, and definition of conceptual themes and categories Description of relationships, range of factors, norms and extreme or deviant cases/behaviors Theory-building and elaboration

8. Why use qualitative methods? Complex situations Experiences Members’ meanings

9. The importance of meaning “Consider 2 boys rapidly contracting the eyelids of their right eyes. In one, this is an involuntary twitch; in the other, a conspiratorial wink. The two movements, as movements, are identical; … from observation alone, one could not tell which was twitch and which was wink, or indeed whether both or either was twitch or wink. Yet the difference, however unphotographable, between a twitch and a wink is vast; as anyone unfortunate enough to have had the first taken for the second knows.” Clifford Geertz, 1973, The Interpretation of Cultures.

10. What to ask? “The thing to ask about a burlesqued wink or a mock sheep raid is not what their ontological status is. It is the same as that of rocks on the one hand and dreams on the other -- they are things of this world. The thing to ask is what their import is: what it is, ridicule or challenge, irony or anger, snobbery or pride, that, in their occurrence and through their agency, is getting said.” Clifford Geertz, 1973, The Interpretation of Cultures.

11. Historical roots Cultural and social anthropology Malinowski (1916); Geertz (1970s); Clifford and Marcus (1980s) Sociology Chicago School (1930s); Goffman (1960s); Garfinkel (1960s); Strauss and Glaser (1970s)

12. Theoretical assumptions I Symbolic interactionism (Blumer 1938) Humans act toward things on the basis of the meanings that things have for them; this meaning is derived from, or arises out of, social interactions; meanings are handled in, and modified through, an interpretive process. The meanings that people invest in objects, events, experiences, actions is the starting point for research.

13. Theoretical assumptions II Ethnomethodology (Garfinkel 1968) Members’ methods for producing social realities; commensense knowledge; practical sociological reasoning; taken-for-grantedness of social life. Social interaction is produced through structures of social action; context is produced in and through interaction; no detail is a priori disorderly, accidental, or irrelevant. Research focus on routine activities of everyday life -- production of social realities

14. Theoretical assumptions III Structuralism and poststructuralism (Derrida 1976) Cultural systems of meaning frame perceptions and the making of social reality Texts are not objective representations of the world but result from the interests and perceptions of the producers of the text and those who read it. Social reality is not fixed but constructed thorough cultural, historical, personal lenses Research focuses on reflexive relationships

15. Theoretical assumptions IV Central role of the researcher in qualitative approaches: Interpreter Participant-observer Reflexive involvement

16. Epistemologies Positivistic Objective reality Measurable Testable (hypothesis testing) Predictive Interpretative Reality socially constructed Access through shared understandings Descriptive

17. Qualitative vs. Quantitative? Different research questions require different approaches and methodologies Choose the methods that will give you the types of results needed to answer the research question Methods as tools:

18. When are qualitative methods most useful? When the research topic is: Concerned with interaction or process Complex Not quantifiable Sensitive

19. When are qualitative methods most useful? When the research objective is: To interpret, illuminate, illustrate To understand how or why To describe previously unstudied processes or situations To learn about subjects who are few or hard to reach To brainstorm ideas

20. Qualitative vs. Quantitative questions Qualitative questions: Why? How? When? Who? Quantitative questions: What? How many? How often or how frequently?

21. Strengths of each approach Qualitative strengths: Depth and detail Openness and flexibilty Subjects’ views central Takes into account deviant cases, extreme cases, range of experiences Small N Quantitative strengths: Breadth Predictive Protocol fixed, reproducible Instrument is explicit Categories, variables pre-specified Large N

22. Qualitative AND Quantitative! Different foci Complementary Compatible Exploratory study to develop hypotheses, then test using quantitative methods Qualitative study with simple (descriptive) statistical evidence

23. Types of qualitative methods Individual interviews Group interviews Focus groups Case studies Ethnographic observation Participant-observation Archival or documentary research Audio/video analysis

24. Implications for health services and clinical research Qualitative studies not the norm but increasingly visible in generalist and specialty journals Key to quality is rigor of methods, as in any research design Questions and methodologies must be appropriate Time consuming; write-up a challenge

25. Research design What are your goals or objectives? What are your research questions? Specific or general Rarely have luxury of purely unmotivated looking How will you answer your questions? Data, methods, analysis