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Qualitative research - PCW19, AMEE2010 by Mind Map: Qualitative research - PCW19,
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Qualitative research - PCW19, AMEE2010

Good journal: Social Science and medicine


Why has it become more popular?

What has it given us, what we didn't have before?

What is it particularly good at?

In depth accounts, Groups, Individual, Why people make choices, How people make choices, Methods, Watching, Interactions, Individual responses, Within groups, Between groups, Particular contexts, Listening, Interactions, Between groups, Within groups, Particular contexts, Individual responses

Assessment, psychometrics, Reliability, Validity, Testing psychological constructs, Can they do this?, do they know this?, Does not particularly work well for social constructs, Interactions of people, People interactions, Context, culture, professional role, Individuals, Effective collaborations, Notion of what is "effective" changes

Why Qualitative methods?


Focus groups

Sample transcript focus group


Text analysis

Handouts 1, Hand Out - A basic guide to textual analysis: some guiding questions, analyze retorical context, who is the writer?, what is her/his role or position?, who is intended audience?, what is the apparent purpose of the text?, what discipline or discourse community does this text seem to be a part of?, Analyze the textual features?, what issue is being addressed?, what is the author's major claim or thesis (if any)?, is the claim qualified (does the author hedge)? if so, how?, What evidence or reasons does the author supply to support the claim?, Do you trust or distrust the author? why?, What assumptions are made about the issues?, What assumptions are made about the audience?, What underlying values are apparent in the text?, Place the text in a new or larger context, how does this text relate to other texts you have been reading?, what are the likely consequences of this text?, How might another writer (or you) use this text?, how might another writer (or you) use this text?, who is able to use this text, and who is unable to use it?, Who is able to write this text, and who is unable to write it?, what perspectives are absent from this text?

NVivo, Coding software


Field notes

Hand out transcript page 1

Hand out transcript 2


Develop a research question

Think of an idea, problem or issue in education that has been on your mind, New node

Write it down

Are you passionate about this problem or issue?

Explain the problem and why it interests you to your neighbour

My personal thoughts on this assignment in context of education

Learning objective of healthcare studies is quite often: learn to work in a team, What level of competence is being meant?, What are the competencies involved in teamwork?, How are each of these studied?, How are each of those measured?, How are each of those being taught?, What's the best way to teach them?, Are we actually achieving this goal in our studies?, I suspect we are not, How can your measure it?, The whole "Social sciences", Are some students better equipped than others?, I suspect that students with NGO voluntary work experience / teamwork experience are performing better, I think that students whom have had structured coaching/reflection are even better at this.

I'm passionate about this because, We need teamwork for, Quality of care, Solving Medical Emergencies, Innovation of healthcare, Delivery of extraordinary research

Assignment 2: problem definition

What if any investigation of this problem have you done?, reading about it, talking with an expert

Has anyone researched this problem before?

If you are to persue a study about this problem, what will you need to know more about it?

Share your ideas with your neighbour

My personal thoughts on question 2

What if any investigation of this problem have you done?, reading about it, talking with an expert

Has anyone researched this problem before?

If you are to persue a study about this problem, what will you need to know more about it?

Share your ideas with your neighbour

Assignment 3: Can your question be studied?

Too vague?, What's the meaning of life?

Too ambitious, What is the best curriculum to train a professional physician for the 21st century?

Where do ideas come from

it is known that..., General knowledge

everyone agrees that..., Why does everyone agree?, Interrogate general assumptions

many studies have shown that...

I believe that...

Assignment 4: Unearth your hypotheses, perspectives and assumptions

Write down a set of answers to your question (even if you are not sure or even if you just "suspect" them to be true)

Share with your colleague

How many sub questions can you make out of your main question?

New node

Group 1


Role: observer of an interview

Clinicians observe at an additional level

keep fieldnotes

Things that are different / similar to a clinical interview, Assignment observation notes, Similar, Introduction, purpose, explanation of method, Verifying understanding, Asking more on the same line of talking., Open atmosphere, Paraphrases, Summaries, Breaking the ice, Different, Many different perspectives, Patient-doctor = not about other patients, This conversation is about self andabout others, nature of questions, Questions, Why do you say of course?, What do you mean with professional?, Is there a difference?, being a professional, being professional


Open ended questions, Start with a yes/no, captured: why, unfreezes interview, probing questions, structuring questions, Checking, Verifying your understanding, part of rigour

Dynamic, Interviewee felt a bit threatened by first question, defensive behavior, Sometimes it's helpfull to send questions in advance, Be mindfull it's semi-structured, Conclusion:, start with icebreaking, build trust, Interview, Introduction is essential, Assume interviewee has not read any of the paperwork, Body language, Eye contact, Some say: don't take notes, "do you mind if I take notes", Showing the page to interviewee, draw diagram "is this what you mean?", Others:

Co-construction, giving something of yourself

Different roles for researcher, power relationships, equal, expert-no expert, more in control, less sharing, less co-construction

Training of interviewers, Take care of trust, Take care of feeling of exposure, colleague, publication, power relationships


What is professionalism?, Many different contexts possible, In Canada, In Taiwan, As a medical student, As a internist, In a teacher, How is it experienced?

Rephrase: what is professionalism for a medical educator in Canada, 10 minutes, 3 questions, What are the questions you wish to ask?, Do you feel that you are a professional medical educator? (probing question related to identity), Do you consider yourself a professional, Do you feel some people think of you as a professional, Do you think you are recognised as a professional differently in different contexts?, Could you share an example from your setting which you consider good professionalism? (probing question about reference frame/context/perspective, This may in other research be put under demographics, Personal meaning of professionalism, attitudes, Do you consider professionalism to be an important issue? (attitudes, perception), Values, four an hour 14 questions, to define structure of interview, you may not use all questions, Questions, Deep, not to be obtained in any other way than a personal conversation, Open

Group 2

Text analysis


read 2 articles on professionalism, personal notes, article 2, Professionalism: a contract between medicine and society, S. R. Cruess, 2000, Ethical philosophical viewpoint on professionalism., Analysis / discussion, both talk about society, core values, team: not in conflict, more inviting compared to article 1, Becoming part of society, bridging to society / other professions, Background article, written after socialisation of medicine in Canada, Much different political context, article 1, Maintaining professionalism in a material age, Macleod, 1982, Conservative liberal viewpoint on professionalism, dichotomy between liberal conservative viewpoints and contents/ethics of the profession, call to "fight" to preserve traditions, Analsysis / discussion, knowledge, "martyr", Fence profession of from others, feels threatened, strong emotions, I feel he was not involving students, Could have been written in USA right now, yet not in North-western Europe or Canada, background, head of medical society, political negotiator, fighting on money and on who is in charge, ended in Dr. strike in Ontario, Socialisation of medicine in Canada, Call to action, agression, derogatory, very political, liberal, Stepping away of society

What's considered good?, Altruism is expected from doctors

What's bad?

What do they mean?

Text analysis

how is this diferent from literature?

what has been said

by whom it's said

in what context it is said?

See hand out

PPT presentation continued14:47 - missed 30 mins session, started early.

Surgical team checklists


"Kind of theory"

theories can arise from or be used within, different research domains (e.g., biomedical, psychological, social)

Find manageable framework - you don't have to know them all

Theories can be divided into:, 'macro'(or 'grand') theories,, mid-range theories,, 'micro' (or practice) theories

Where to start?

you already have theoretical assumptions: start by interrogating them and making them explicit

read resources which address both theory and methods in qualitative research\

Search creatively for relevant models

search for advice and allies


sociological abstracts

google scholar



How do we know we do a good job?

Four questions to ask yourself, Is this research question best answered using qualitative methods?, in-depth understanding of experience, meaning perception, culture, value, etc., are there counter examples?, Which qualitative method is best for answering this question?, interviews, focus groups, observation, text analysis, mixed methods, What is the best sample to answer the question?, for interviews and focus group: who and how many?, For text analysis: which texts, how many, what time span, etc., for observations: which sites, how many, what duration, at what frequency, etc., What steps should be taken to increase the trustworthiness of the results, Why should people believe your story?, objective?, valid?, multiple coding, Why multiple coding, epistemology, philosophy of science, not used in social science, used in medical education, different school of thinking Medical Doctors, gives feeling of objectivity, triangulation,, member checking,, peer debriefing, audit trail, etc.

Does the use of sound and adequate method guarantee "good" research

No, It's not because you have your method right that you're doing "good" research, Good research is not only about complying with a set of rules, but first and foremost about creativity, imagination, intuition, knowing how -- be creative, Tips to be creative, Read, read and read, Read within and outside your research domain (become more literate), challenge the taken-for-granted ideas within scientific community, Think outside the box, be cautious, the scientific community is a conervative community

Assignment: coding and analysis of qualitative text

Hand out A4 transcript of interview on professionalism



Analysis by facilitator:

What we saw, Defining professionalism, making a living vs fulfilling a calling, related to altruism, physician a s healer vs doctor as a clinician (scientist), Inculcating professionalism, role-modeling, importance of advocates, teaching and overt curriculum, disciplining mechanisms, Barriers to professionalism, hidden curriculum, "residents as sponges"

Deductive coding

Use this framework

Grounding, Your knowledge of literature


Deductive coding, Top down

Inductive coding, Bottom up