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Navigating research methods: qualitative methods 

Navigating research methods: qualitative methods
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Navigating research methods: qualitative methods
DOI:
10.1093/med/9780199608478.003.0004
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Objectives

  • To outline qualitative research methods using the example of educational research

  • To demystify and position educational research within an accessible social research framework

  • To explore and evaluate suitable methodological approaches

  • To consider how to handle the products of the research

  • To provide an overall insight of the value of educational research, in particular a mixed-methods approach, within the healthcare setting

What constitutes educational research?

Educational research is social research and the training of the majority of healthcare personnel is grounded in ‘conventional scientific standards’. It is this juxtaposition that Gergen and Gergen suggest is a major detractor from the pursuit of social research after ‘purer’ scientific research.7

Nevertheless, social research does incorporate elements of the scientific approach that should put the healthcare researcher (referred to as ‘the researcher’ from this point on) within a research framework that is partially familiar to him or her.

The research process, regardless of the paradigm adopted, is multi-phased and Table 4.1 outlines these according to Bryman.3

Table 4.1 The phases of the research process (after Bryman)3

The research process

Formulating the research objectives

Choosing the research

Securing research participants

Collecting and analysing data

Interpreting data

Disseminating findings

Broom and Willis describe paradigms as the overarching philosophical, ideological stance, or world view that will form the assumptive platform from which new knowledge will be explored.2 Thus, the researcher needs to start from his or her own standpoint and determine how this relates to the research philosophy. This requires consideration and exploration, particularly with regard to how these are grounded in the educational research paradigm. Epistemological considerations pertain to what should be regarded as acceptable knowledge (positivism vs ‘interpretivism’). Johnson argues that ‘critical theory’ is the third research paradigm.9

Ontological considerations take into account whether the social entities ‘have a reality external to social actors, or whether they can and should be considered social constructions built up from perceptions and actions of social actors’. The two ontological positions are objectivism and constructionism.2

Johnson raises the methodological question (‘how can the researcher go about finding out whatever he or she believes can be known?’) as the third critical consideration when embarking on research.9 The methodology, or research strategy, refers to the kind of theoretical framework that will be used to shape the research. This framework will be important in defining the interpretation of data. This is not to say that theory should be used to define the data, but as a theoretical framework the methodology is useful in helping the researcher make sense of the data in context with the social world. The methodology should be used as a guideline, allowing the researcher to be creative in interpreting the data.

Underpinning any research is the acquisition of data to deconstruct ‘the situation’ in order to address, change, and improve that situation. What approaches should the researcher adopt? Johnson suggests considering two critical questions when embarking on a research project:9

  • How does one address the challenges/dilemmas (the situations) associated with research in one paradigm or in mixed paradigms?

  • How does knowledge of the researcher’s philosophical stance help the researcher in researching?

In order to deconstruct the range of representations of paradigms, methods, approaches, and methodologies for the researchers new to healthcare education, these will be presented in tabulated and diagrammatic forms in an overview of these complex relationships in Figure 4.1, and detailed in the next section.


Figure 4.1 An overview of the relationship between the research paradigms, research approaches, and research methodologies.

Figure 4.1 An overview of the relationship between the research paradigms, research approaches, and research methodologies.

Bryman explains ‘interpretivism’ as subsuming the views of others who have been influenced by different intellectual traditions.3

Evaluating the research paradigms, approaches, and methodologies

In this section, a number of research approaches will be compared and contrasted in order to justify the use to a mixed-method multidisciplinary approach to social educational research.

Table 4.2 combines a summary of Newby’s approach to methods and research design.15

Table 4.2 Comparing the traditional research approaches

Quantitative research

Qualitative research

Underpins rationale with theoretical perspectives/scientific method

  • Inductive (observations and/or findings to theory); evident in grounded theory OR

  • Deductive (theory to observations and/or findings)

Objectivist paradigm

Interpretivist/Constructivist paradigm

Positivist view of social reality

Post-/anti-positivist view of social reality

The ‘standard view’

Evidence imperfect and fallible

Realism

Idealism

Derivation of a hypothesis and sometimes a null hypothesis as well

Inductive: observations; analysis + assessment; conjecture + hypothesis; generalization of the theory

Deductive: starts with an idea or theory; hypothesis; evidence; conclusion; feedback into the research

Generalizable as data are reliable and unbiased so findings can be extrapolated to the rest of the population

Validity because the new knowledge draws on understandings of research subjects

Not generalizable as analysis relies on the interpretation of researcher

Validity, reliability and objectivity of the research

Credibility, dependability, confirmability of the research

Deterministic as phenomena can be predicted by acknowledging scientific laws

Naturalistic as data are collected in the setting of everyday life

Subjectivity because research practice and knowledge production are neither neutral nor objective, but partial

Complexity as analysis explores depth as opposed to inferences

What is the relationship between x and y?

How does x relate to y?

Enables deeper exploration of the situation and subsequent

Requires reflection on the data in relation to the situation

RCT (randomized controlled trials) commonly recognized method

Interviews, observation, focus groups, secondary discourse analysis, questionnaires

Social surveys’ epidemiology, structured interviews, systematic meta-analysis reviews, secondary document analysis (e.g. content analysis)

In unfolding these perspectives on social reality, Greenfield (1975) defined the realism of the positivist/objectivist school (quantitative) as being external from the individual as ‘the world exists and is knowable as it really is. Organizations are real entities with a life of their own’. As individuals are mere players within society, the researcher treats the individual and society as separate entities. By comparison, she described the idealistic and subjectivist (qualitative) thus: ‘the world exists but different people construe it in very different ways. Organizations are invented social reality’. Individuals are the basis of the social structure and cannot be treated as separate entities, so personal accounts are a key tool in gaining a better understanding of a given situation.

The disciplinary backgrounds may differ in approach and perspective, but the search for an explanation and/or solution remains the central point of departure.

Robson’s work16 informs the researcher as to the worldview that underpins the selection of the adopted research paradigm; that is, quantitative or qualitative. Healthcare researchers seek to explore the underlying causes of a situation that are part of the real world ‘where the social dimension is important and approaches which take serious note of this aspect have a clear attraction’. His point of departure infers a scientific attitude implying that the research is carried out within a systematic, sceptical, and ethical manner that permeates the research.

Healthcare is carried out in the real world and is inseparable from social which is why the ‘qualitivist’ paradigm,16 with its social constructivist research approach, is most likely to facilitate the exploration of the root causes of the topic at the core of the research.

Essentially, the divide is between purist (scientific method/qualitative) and pragmatic researchers. Robson grounds this assumption by purporting the view that a pragmatic approach would blend the quantitative and qualitative traditions. He labels this approach a ‘multi-strategy research design’,16 reflecting Tritter17 who called it ‘mixed methods and multi-disciplinary research’.

Tritter17 emphasizes the importance of the ability to triangulate evidence using the mixed-methods research method that enables a more holistic approach to research in healthcare settings. Cook5 supports this view because only through consulting multiple sources of evidence can understanding of a given situation deepen. He further supports the value of a mixed-methods research approach by stating that ‘we need carefully planned, theory building, programmatic research reflecting a variety of paradigms and approaches’, because they will ‘clarify why, when and how something works’. Researchers turn to qualitative methods, according to Gergen and Gergen, ‘in the hope of generating richer and more finely nuanced accounts of human interaction’.7 The authors continue by saying that supporters of the qualitative approach highlight the absence of ‘the critical ingredient of human understanding’ when empirical research is selected over a qualitative one. It remains difficult to convince purist empirical quantitative researchers of the intrinsic value of qualitative and mixed methods research findings. The inclusion of a critical and action-orientated research approach in mixed methods offers a conduit for adding academic rigour to the adoption of a mixed-methods research approach.

Figure 4.2 illustrates how this third methodological movement blends different research approaches.


Figure 4.2. A blending of the three research paradigms through a mixed-methods approach.

Figure 4.2. A blending of the three research paradigms through a mixed-methods approach.

The logic of the design affects the credibility of the research and its findings, again adding weight to the value of this ‘third methodological movement’15 in ensuring that the design is appropriate to the situation under investigation. The elephant in the room remains the fact that RCT is seen in medical spheres as the best and most powerful form for gathering research evidence. Tritter’s proposed resolution is through reflection: ‘The credibility afforded different kinds of data is a reflection of different kinds of disciplinary cultures’.17 This reflection can be on practice (by the researcher and the research subjects) and in practice (the research subjects), thus affording the evidence some triangulation (Oversby, p. [link])14 as depicted in Figure 4.2. This figure does not position the role of reflection in the process. Figure 4.3 presents the characteristics which the researcher needs to be aware of when using a mixed-methods research approach.


Figure 4.3 A summary of the mixed-methods research approach and its characteristics.

Figure 4.3 A summary of the mixed-methods research approach and its characteristics.

From Haynes, based on Newby.15

Robson16 highlighted the fact that the scientific attitude incorporates scepticism, while Tritter’s17 comment pertaining to the need for careful and detailed planning underpins this view that the qualitative researcher must be able to address in defence of his chosen methodological approach. The criteria underpinning the value of qualitative evidence are, according to Tritter, ‘antithetical to qualitative methods and interpretative data analysis’.17 It is worth noting that in healthcare many of the decisions are made by managerial or polite elite who may not be clinically trained and thus fail to comprehend fully and appreciate the findings from a qualitative or mixed-methods research project.

The use of a mixed-methods approach helps research into attitudes, values, beliefs and performance that are not criterion-referenced. This field of research can be intriguing but more difficult to design for the collection of appropriate data. Miller and Brewer13 outline the historical perspective of this complicated genre of social research, dating back to Thurstone in 1928 with his attitude-measurement scale and Likert’s five-point scale of measuring any qualitative commodity. Fishbein and Ajzen6 explored belief, attitude, intention, and behaviour in their seminal study. A number of healthcare topics, such as depression and ME, would benefit from an exploration of these frames of reference (attitude, belief, values, self-esteem) by examining the evidence in order to expose their root causes.

Selecting the methodological approach

The social researcher should embark on designing the research with an open mind. Newby’s approach might be the most logical for any novice education researcher to take as it provides a platform from which to structure the project.15 He looks at ‘dissecting the research question’, something that is not done often enough, and whose absence often results in the adoption of a flawed research and strategic approach (see Figure 4.4).


Figure 4.4 Newby’s steps in dissecting the research question.15

Figure 4.4 Newby’s steps in dissecting the research question.15

Once the situation has been clearly identified and a research question posed, then the research questioning can lead the researcher to selecting the research method and its concomitant methodological data-gathering tools and analytical strategies.

Research methods

The methods are the tools that will be used in collecting the data. It is important to be aware of the kind of data needed to answer the research question(s), and collect accordingly. Table 4.3 outlines some opposing approaches to consider when choosing a method.

Table 4.3 Opposing approaches to gathering data

Quantitative

Qualitative

Numbering

Wording

Predetermined or controlled

Open-ended or responsive

Measuring

Capturing uniqueness

Short-term

Long-term

Comparing

Capturing particularity

Describing

Interpreting

Description

Explanation

Objective

Subjective

Regularities

Uniqueness

Looking in from the outside

Looking from the inside

(Adapted from Cohen et al. 2011, p. 414)4.

Essentially, it is the sampling procedure selected to gather the data that will vary depending on the research perspective of the project. Quantitative sampling needs to consider the types of probability sampling and non-probability sampling methods that will yield data to address the research issue that the sample size will affect greatly. Table 4.4 provides a summary of these sampling procedures.

Table 4.4 A summary of research methodologies to gathering data for quantitative–qualitative–critical theory and mixed-methods sampling

Methodology

Focus

Information assembly

Case studies

Can learn from the particular situation

Interview to explain, explore and describe

Evaluation

Question focus

Any in order to understand, test compliance, improve and inform

Ethnography

Researcher focus

Observation and conversation (unstructured interviews) to understand and explain

Action research

Change focus

Reflection to change, build, improve, and develop

Ideology critique

Explore the ‘too self-evident’

Elicit ‘critical’ or ‘emancipatory’ knowledge

Biography/ narrative

Discourse analysis

Interpretive + ethnographic account of participant’s perspective to understand the symbolism of an issue/the situation

It has been fairly well established in this chapter that the recommended research approach would blend quantitative and qualitative methodologies with critical theory in order to harvest data to get to ‘those root causes of the situation’ in healthcare and medical education research. Mixed-methods methodological approaches to sampling are presented in Table 4.4 with data from Newby15 and Johnson.9

The reality of using these methodologies

What do these methodologies look like and comprise in terms of research? A brief overview of each tool is presented. The cited references will provide in-depth protocols once the research approach and methodology that best complements researching the situation has been selected.

Case studies

The case study is both a research method and methodology. As a data collection tool, the case study provides a rich platform for obtaining qualitative data because it is ‘the study of an instance in action’.1 A key feature of the case study is that it approaches a research situation ‘holistically’ (Verschuren)18. Yin20 describes five key components of case study research design:

  • Study question

  • The study propositions (if any)

  • The unit(s) of analysis

  • The logic linking the data to the propositions

  • The criteria for interpreting the findings

Ethnographic and qualitative research

Ethnographic research lies within qualitative research and is the study of cultures and people within cultures. Every group or society has a culture in which they function. It is from that culture that meaning is given to everyday actions and objects. The researcher must acknowledge that the questions that are asked will be influenced by the individual’s experiences and values. For example, tacit and implicit knowledge about a social group cannot be ignored and may be invaluable when interpreting a situation.

Interviews are a way to gather this implicit knowledge and opinions, providing valuable narrative data from human subjects. Kvale12 suggests that human subjects are treated as knowledge generators instead of factors or variables, with the interviewer being the research tool. If the researcher can gain trust and establish a rapport with the interviewee(s), he or she can potentially elicit good information unavailable through other forms of research.

There are several types of interview formats. Adopting a suitable style depends on the type of questions the investigation seeks to answer. Cohen and colleagues4 offer four different interview formats:

  • Informal/unstructured conversational interview

  • Interview guide approach loosely adhered to scripted questions

  • Standardized, open-ended interview based on scripted questions

  • Closed, quantitative interview with preset questions and answers from which the respondents have to choose. This format is good for quantifying the data, but it forces the interviewee to fit his or her experiences with the selection of answers and this may distort reality.

Observations are another fundamental tool in qualitative and critical-theory research, such as ethnography and action research. Observations can help to identify and establish the conditions of a given situation or topic. They can provide evidence of quantitative facts and/or behaviours. Interpretations by the researcher should be noted immediately or soon after an observation if any are to be made. It is important that interpretations are not confused with fact in the noting process. Self-awareness and reflection are important throughout the data collection process.

Observations allow for greater flexibility, interest, and creativity than other tools of data collection, such as tests or questionnaires. Anything can happen in a real-world context. For example, one may witness an event only once and yet it should still be included in the analysis. Unlike in physical sciences research, where one is looking for reproducibility, social research allows for a more dynamic approach to understanding the world.

There are four types of observer as described by Gold8 and cited by Cohen and colleagues:4 the complete participant; the participant as observer; the observer as participant; complete observer. Observing should not be a random process but instead one undertaken with predetermined foci and direction.

Role play by the researcher requires insight, behavioural change, and to some extent, empathy. As a data collection tool it is not as well-known but it is a useful technique for gaining insight into how people react to certain social environments, for example, useful in an ethnographic study. It can also be used to encourage individuals to change their behaviour, values, perceptions, and attitudes in a certain way21.

Evaluation

Evaluation, according to Johnson,9 focuses on the appraisal of the programme or process, and reflection on practice and in practice are central in the analytical stage. The focus of an evaluation (Table 4.4) can be elicited through direct talk, interviews, and questionnaires. The latter are one of the most important tools in a researcher’s toolkit, and not only for this methodology. A questionnaire allows the researcher to collect information without being present and can be distributed widely to generate large quantities of data. A good questionnaire format can be tricky to develop and will take time to construct.

It is critical that a questionnaire is piloted before being administered. A simple mistake in a question’s wording, such as omitting to state ‘select the best answer’ when there is more than one correct answer. This oversight can result in respondents ticking more than one box in a check-box answer format, resulting in difficult data interpretation and poor reliability in data analysis.

Cohen and colleagues4 have adapted Sellitz and colleagues’ 19-point guide list when constructing a research questionnaire:

  • Question content

  • Question wording

  • Responding to the question

  • Question order and sequence

  • Action research

Action research

Action research is a good methodology for individuals directly involved with their environment of study. It is a practical tool that can be used to improve local conditions and situations. Action research is a collaborative effort and requires an understanding of both the researcher’s own practice as well as the practice of others. Continuous, constructive self-reflection is critical.

Case studies are another method often employed within action research. Some methods of data collection within a case study include documentation, interview, observation, and analysis of artefacts. Figure 4.5 represents the relationship between a situation or problem and using reflection to seek and apply solutions.


Figure 4.5 The cyclic actions of action research.11

Figure 4.5 The cyclic actions of action research.11

Jordan J, Perry E, Bevins S. Is anyone listening? Action Research and Science Teacher Voice. Education in Science April 2011, pp. 12–13, with kind permission of Julie Jordan.

Ideology critique

Johnson9 depicts this methodology as asking ‘questions that may be considered too self-evident to be put into question, encouraging critical engagement with ideological claims. It attempts to look beneath the obvious and self-evident in order to examine contradictions and counter arguments and claims.’ Handled effectively, this methodology could underpin such research with the academic rigour necessary to substantiate the research findings.

Biographical narrative

Personal accounts, current or past, provide the researcher with insight into the situation and may reveal some root causes of a problem because this anecdotal but nonetheless qualitative evidence documents the participant’s perspective. Narrative is a flexible methodology that can provide evidence missed by any other data-harvesting approach. Discourse analysis should be undertaken bearing in mind the effect of the participant bias of the data.

What to do with the data gathered

As this stage of the research process is as yet some way in the future, only a brief overview of a few strategies and tools to interrogate and interpret the data gathered is offered. Knowing what can be done with and to the data while selecting the methodologies to be used helps to focus the preparation of tools such as interview and questionnaire questions so that they will be compatible with the analytical tools.

Quantitative data can be ‘crunched’ and subjected to numerous statistical tests mentioned earlier in the chapter with which a healthcare worker from a traditional science background will be both familiar and comfortable. These test outcomes will be used to provide the evidence to reject the null hypothesis and present the hypothesis as a fact underpinned by the research itself.

Qualitative data comprises a range of evidence, much of which is subjective and anecdotal. These data can be quantified using NVIVO and SPSS software. Both these programmes use a system of coding, which can again lead to further subjectivity, depending on the nature of the methodology utilized. The programmes present the data in tabulated, graphic, and nodal formats that will facilitate interrogation and interpretation. These graphic representations of the findings will be more accessible to the novice social researcher and the audience to whom these will be presented.

Other forms of data representation include concept (mind) mapping and Ishikawa or fish-bone diagrams to identify cause and effect10 as presented in Figure 4.6. Ishikawa diagrams can be used to represent data and help the researcher drill down into data to identify root causes of the situation (taken from Navigating research methods: qualitative methods www.project-management-skills.com/fishbone-diagram.html).

Regardless of the original answers the researcher derived for the ontological, epistemological, and methodological questions, or the research paradigm followed, the data will present the researcher with a conclusion. Whether that conclusion is what was hoped for, expected or an antithesis thereof, the researcher needs to present these data to the audience to explain what has been ascertained.

This penultimate stage of the research process requires that all decisions pertaining to the methodological approach and criteria (reliability, replicability, and validity of the method and data) need to be succinctly presented and justified in a systematic review. The rigour of the written work is crucial, particularly if the findings will be presented as a grounded theory in induction mode, true to the interpretivist research paradigm. Wallace and Poulson19 provide an insightful introduction to writing in the genre of social and educational research

The paper written and/or presented will need to defend every stage of the process succinctly and rigorously to convince sceptics of the validity of the research findings and their value as a socially constructed instrument to address and/or understand the situation/problem.

Ultimately, the social researcher, novice or experienced, exists within a socially constructed world wherein he or she is continually confronted by situations that can best be addressed by social research, usually most effectively through a mixed-methods approach.

References

1. Adelman C, Kemmis S, Jenkins D. Rethinking case study: notes from the Second Cambridge Conference, in H Simons (ed.), Towards a Science of the Singular. Centre for Applied Research in Education, University of East Anglia, Norwich, 45–61, in Cohen L, Manion L, and Morrison K Research Methods in Education 7th edn. London: Routledge, 2011.Find this resource:

    2. Broom A, Willis E. Competing paradigms and health care research, in M Saks and J Allsop (eds) Researching Health: Qualitative, Quantitative and Mixed Methods. London: Sage, 2007, 16–31.Find this resource:

      3. Bryman A. Social Research Methods, 4th edn. Oxford: Oxford University Press, 2012.Find this resource:

        4. Cohen L, Manion L, Morrison K. Research Methods in Education, 7th edn. London: Routledge, 2011.Find this resource:

          5. Cook DA. Randomised controlled trials and meta-analysis in medical education: What role do they play? Medical Teacher: Early Online 2012;1-6 doi: 10.3109/0142159X.2012.671978.Find this resource:

            6. Fishbein M, Ajzen I. Belief, attitude, intention and behaviour: an introduction to theory and research. Reading, MA: Addison-Welsey, 1975.Find this resource:

              7. Gergen K, Gergen M. Social Construction and Research Methodology, in W Outhwaite and SP Turner (eds), The SAGE Handbook of Social Science Methodology. London: Sage Publications, 461–78.Find this resource:

                8. Gold RL. Roles in sociological field observations. Social Forces 1958; 36(3):217–23.Find this resource:

                9. Johnson J. Deciding paradigms and methodologies, in J Oversby (ed.). ASE Guide to Research in Science Education. Hatfield: Association for Science Education, 2012a, 189–99.Find this resource:

                  10. Johnson J. Analysing data, in J Oversby (ed.), ASE Guide to Research in Science Education Hatfield: Association for Science Education, 2012b,189–99.Find this resource:

                    11. Jordan J, Perry E, Bevins S. Is anyone listening? Action Research and Science Teacher Voice. Education in Science April 2011, pp.12–13.Find this resource:

                      12. Kvale S. Interviews. London: Sage Publications, 1996.Find this resource:

                        13. Miller RL, Brewer JD (eds). The A–Z of Social Research. London: Sage Publications, 2003.Find this resource:

                        14. Oversby J (ed.). ASE Guide to Research in Science Education. Hatfield: Association for Science Education, 2012.Find this resource:

                          15. Newby P. Research Methods for Education. London: Pearson-Longman, 2010.Find this resource:

                            16. Robson C. Real World Research: A Resource for Users of Social Research Methods in Applied Settings, 3rd edn. Chichester: John Wiley & Sons, 2011.Find this resource:

                              17. Tritter J. Mixed methods and multidisciplinary research in health care in M Saks, J Allsop (eds). Researching Health: Qualitative, Quantitative and Mixed Methods. London: Sage Publications, 2007, 301–18.Find this resource:

                                18. Verschuren PJM. Case study as a research strategy: Some ambiguities and opportunities. International Journal of Research Methodology 2003; 6 (2):121–39.Find this resource:

                                19. Wallace M, Poulson L. Critical reading for self-critical writing, in M Wallace and L Poulson (eds). Learning to read critically in Educational Leadership and Management. London: Sage Publications, 2003.Find this resource:

                                  20. Yin RK. Case Study Research: Design and Methods, 3rd edn. Applied Social Research Methods Series, Volume 5. London: Sage Publications, 2003.Find this resource:

                                    21. Bolton GM, Heathcote D. So You Want to Use Role-Play? A New Approach in How to Plan. Stoke on Trent, UK: Trentham Books, 1999.Find this resource:

                                      Further reading

                                      Cooper HM. Research Synthesis and Meta-evaluation: A Step-by-Step Approach. Thousand Oaks, CA: Sage, 2010.Find this resource:

                                        Mackie JL. Causes and conditions. In E Sosa and M Tooley (eds), Causation. Oxford: Oxford University Press, 1993, 33–55.Find this resource:

                                          Marshall C, Rossman GB. Designing Qualitative Research. Newbury Park, CA: Sage, 1995.Find this resource: