Qualitative research - PCW19, AMEE2010

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1. Questions

1.1. Why has it become more popular?

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

1.3. What is it particularly good at?

1.3.1. In depth accounts

1.3.1.1. Groups

1.3.1.2. Individual

1.3.1.2.1. Why people make choices

1.3.1.2.2. How people make choices

1.3.1.3. Methods

1.3.1.3.1. Watching

1.3.1.3.2. Listening

1.3.2. Assessment

1.3.2.1. psychometrics

1.3.2.1.1. Reliability

1.3.2.1.2. Validity

1.3.2.1.3. Testing psychological constructs

1.3.2.1.4. Does not particularly work well for social constructs

1.3.2.2. People interactions

1.3.2.2.1. Context

1.3.2.2.2. Individuals

1.3.2.2.3. Effective collaborations

1.4. Why Qualitative methods?

2. Methods

2.1. Focus groups

2.1.1. Sample transcript focus group

2.2. interviews

2.3. Text analysis

2.3.1. Handouts 1

2.3.1.1. Hand Out - A basic guide to textual analysis: some guiding questions

2.3.1.1.1. analyze retorical context

2.3.1.1.2. Analyze the textual features?

2.3.1.1.3. Place the text in a new or larger context

2.3.2. NVivo

2.3.2.1. Coding software

2.4. Observation

2.4.1. Field notes

2.4.2. Hand out transcript page 1

2.4.3. Hand out transcript 2

3. Assignment

3.1. Develop a research question

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

3.1.1.1. New node

3.1.2. Write it down

3.1.3. Are you passionate about this problem or issue?

3.1.4. Explain the problem and why it interests you to your neighbour

3.2. My personal thoughts on this assignment in context of education

3.2.1. Learning objective of healthcare studies is quite often: learn to work in a team

3.2.1.1. What level of competence is being meant?

3.2.1.1.1. What are the competencies involved in teamwork?

3.2.1.2. Are we actually achieving this goal in our studies?

3.2.1.2.1. I suspect we are not

3.2.1.3. How can your measure it?

3.2.1.3.1. The whole "Social sciences"

3.2.1.4. Are some students better equipped than others?

3.2.1.4.1. I suspect that students with NGO voluntary work experience / teamwork experience are performing better

3.2.1.4.2. I think that students whom have had structured coaching/reflection are even better at this.

3.2.2. I'm passionate about this because

3.2.2.1. We need teamwork for

3.2.2.1.1. Quality of care

3.2.2.1.2. Solving Medical Emergencies

3.2.2.1.3. Innovation of healthcare

3.2.2.1.4. Delivery of extraordinary research

3.3. Assignment 2: problem definition

3.3.1. What if any investigation of this problem have you done?

3.3.1.1. reading about it

3.3.1.2. talking with an expert

3.3.2. Has anyone researched this problem before?

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

3.3.4. Share your ideas with your neighbour

3.4. My personal thoughts on question 2

3.4.1. What if any investigation of this problem have you done?

3.4.1.1. reading about it

3.4.1.2. talking with an expert

3.4.2. Has anyone researched this problem before?

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

3.4.4. Share your ideas with your neighbour

3.5. Assignment 3: Can your question be studied?

3.5.1. Too vague?

3.5.1.1. What's the meaning of life?

3.5.2. Too ambitious

3.5.2.1. What is the best curriculum to train a professional physician for the 21st century?

3.6. Where do ideas come from

3.6.1. it is known that...

3.6.1.1. General knowledge

3.6.2. everyone agrees that...

3.6.2.1. Why does everyone agree?

3.6.2.2. Interrogate general assumptions

3.6.3. many studies have shown that...

3.6.4. I believe that...

3.7. Assignment 4: Unearth your hypotheses, perspectives and assumptions

3.7.1. 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)

3.7.2. Share with your colleague

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

4. New node

5. Group 1

5.1. Observation

5.2. Role: observer of an interview

5.3. Clinicians observe at an additional level

5.3.1. keep fieldnotes

5.3.2. Things that are different / similar to a clinical interview

5.3.2.1. Assignment observation notes

5.3.2.1.1. Similar

5.3.2.1.2. Different

5.3.2.1.3. Questions

5.4. Debriefing

5.4.1. Open ended questions

5.4.1.1. Start with a yes/no

5.4.1.1.1. captured: why

5.4.1.2. probing questions

5.4.1.3. structuring questions

5.4.1.4. Checking

5.4.1.4.1. Verifying your understanding

5.4.2. Dynamic

5.4.2.1. Interviewee felt a bit threatened by first question

5.4.2.1.1. defensive behavior

5.4.2.1.2. Sometimes it's helpfull to send questions in advance

5.4.2.1.3. Be mindfull it's semi-structured

5.4.2.2. Conclusion:

5.4.2.2.1. start with icebreaking

5.4.2.2.2. build trust

5.4.2.3. Interview

5.4.2.3.1. Introduction is essential

5.4.2.4. Body language

5.4.2.4.1. Eye contact

5.4.2.4.2. Some say: don't take notes

5.4.2.4.3. Others:

5.4.3. Co-construction

5.4.3.1. giving something of yourself

5.4.4. Different roles for researcher

5.4.4.1. power relationships

5.4.4.1.1. equal

5.4.4.1.2. expert-no expert

5.4.5. Training of interviewers

5.4.5.1. Take care of trust

5.4.5.2. Take care of feeling of exposure

5.4.5.2.1. colleague

5.4.5.2.2. publication

5.4.5.2.3. power relationships

5.5. Topic

5.5.1. What is professionalism?

5.5.1.1. Many different contexts possible

5.5.1.1.1. In Canada

5.5.1.1.2. In Taiwan

5.5.1.1.3. As a medical student

5.5.1.1.4. As a internist

5.5.1.1.5. In a teacher

5.5.1.2. How is it experienced?

5.5.2. Rephrase: what is professionalism for a medical educator in Canada

5.5.2.1. 10 minutes

5.5.2.1.1. 3 questions

5.5.2.1.2. What are the questions you wish to ask?

5.5.2.2. four an hour 14 questions

5.5.2.2.1. to define structure of interview

5.5.2.2.2. you may not use all questions

5.5.2.3. Questions

5.5.2.3.1. Deep

5.5.2.3.2. Open

6. Group 2

6.1. Text analysis

6.2. Assignment

6.2.1. read 2 articles on professionalism

6.2.1.1. personal notes

6.2.1.1.1. article 2

6.2.1.1.2. article 1

6.2.2. What's considered good?

6.2.2.1. Altruism is expected from doctors

6.2.3. What's bad?

6.2.4. What do they mean?

6.3. Text analysis

6.3.1. how is this diferent from literature?

6.3.2. what has been said

6.3.3. by whom it's said

6.3.4. in what context it is said?

6.4. See hand out

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

7.1. Surgical team checklists

7.1.1. missed

7.2. "Kind of theory"

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

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

7.2.3. Theories can be divided into:

7.2.3.1. 'macro'(or 'grand') theories,

7.2.3.2. mid-range theories,

7.2.3.3. 'micro' (or practice) theories

7.3. Where to start?

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

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

7.3.3. Search creatively for relevant models

7.3.4. search for advice and allies

7.4. databases

7.4.1. sociological abstracts

7.4.2. google scholar

7.4.3. scopus

7.4.4. webofscience

7.5. How do we know we do a good job?

7.5.1. Four questions to ask yourself

7.5.1.1. Is this research question best answered using qualitative methods?

7.5.1.1.1. in-depth understanding of experience, meaning perception, culture, value, etc.

7.5.1.1.2. are there counter examples?

7.5.1.2. Which qualitative method is best for answering this question?

7.5.1.2.1. interviews

7.5.1.2.2. focus groups

7.5.1.2.3. observation

7.5.1.2.4. text analysis

7.5.1.2.5. mixed methods

7.5.1.3. What is the best sample to answer the question?

7.5.1.3.1. for interviews and focus group: who and how many?

7.5.1.3.2. For text analysis: which texts, how many, what time span, etc.

7.5.1.3.3. for observations: which sites, how many, what duration, at what frequency, etc.

7.5.1.4. What steps should be taken to increase the trustworthiness of the results

7.5.1.4.1. Why should people believe your story?

7.5.1.4.2. multiple coding

7.5.1.4.3. triangulation,

7.5.1.4.4. member checking,

7.5.1.4.5. peer debriefing

7.5.1.4.6. audit trail

7.5.1.4.7. etc.

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

7.6.1. No

7.6.1.1. It's not because you have your method right that you're doing "good" research

7.6.1.2. Good research is not only about complying with a set of rules, but first and foremost about creativity, imagination, intuition, knowing how -- be creative

7.6.1.2.1. Tips to be creative

8. Assignment: coding and analysis of qualitative text

8.1. Hand out A4 transcript of interview on professionalism

8.1.1. page1

8.1.2. page2

8.2. Analysis by facilitator:

8.2.1. What we saw

8.2.1.1. Defining professionalism

8.2.1.1.1. making a living vs fulfilling a calling

8.2.1.1.2. related to altruism

8.2.1.1.3. physician a s healer vs doctor as a clinician (scientist)

8.2.1.2. Inculcating professionalism

8.2.1.2.1. role-modeling

8.2.1.2.2. importance of advocates

8.2.1.2.3. teaching and overt curriculum

8.2.1.2.4. disciplining mechanisms

8.2.1.3. Barriers to professionalism

8.2.1.3.1. hidden curriculum

8.2.1.3.2. "residents as sponges"

8.2.2. Deductive coding

8.2.3. Use this framework

8.2.4. Grounding

8.2.4.1. Your knowledge of literature

8.3. Coding

8.3.1. Deductive coding

8.3.1.1. Top down

8.3.2. Inductive coding

8.3.2.1. Bottom up