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Fundamentals of Qualitative Research Methods: What is Qualitative Research (Module 1) — Transcript

by Yale University · 2,064 words · 339 segments · language en · Watch on YouTube

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0:12Welcome to Fundamentals of Qualitative
0:14Research Methods. My name is Leslie
0:16Curry. I'm a senior research scientist
0:18at the Yale School of Public Health, a
0:20co-director at the Robert Wood Johnson
0:22Clinical Scholars Program at the Yale
0:23School of Medicine, and a lecturer at
0:25Yale College. And in all these various
0:28roles, I have the opportunity to teach
0:30and mentor students in using qualitative
0:33research methods as well as collaborate
0:35across uh a number of multiddisciplinary
0:37teams across the university.
0:40I'd like to give you an overview of the
0:42modules in this series. And to start
0:45with, the goal of the series is to
0:47enhance our capacity to conceptualize,
0:50design, and conduct qualitative research
0:52in the health sciences. And by health
0:54sciences I mean clinical and health
0:56services research implementation science
0:59across a host uh of disciplines and
1:01specialties.
1:03There's six modules in this series. The
1:05first is what is qualitative research.
1:08The second moves us to developing a
1:10qualitative research question which is
1:12actually not as easy uh as it might
1:15sound.
1:16The third module addresses one of the
1:18major qualitative study designs the use
1:20of in-depth interviews.
1:23The fourth module uh uh reviews a second
1:26major qualitative study design, the use
1:28of focus groups.
1:31The fifth module provides an overview of
1:33qualitative data analysis, the
1:35principles and practices of analyzing
1:38qualitative data.
1:40And the last module reviews the
1:42principles of scientific rigor in
1:44qualitative research.
1:46And so to begin with the first module,
1:49what is qualitative research?
1:52I want to invite you to take a moment to
1:55reflect on this fundamental premise.
1:58Really appreciating uh this assumption
2:01is necessary in order to uh maximize the
2:05use of qualitative methods in the health
2:07sciences. And so this is a quote
2:09attributed to Albert Einstein who
2:11reflected that not everything that can
2:13be counted counts and not everything
2:16that counts can be counted.
2:19So if you pause and you think uh of a
2:21circumstance or an issue or a phenomenon
2:23in your own uh clinical practice or area
2:26of research, uh I invite you to
2:29contemplate um uh a phenomenon that
2:33perhaps can't have a number assigned to
2:35it. If we're interested, for instance,
2:37in uh end of life care for terminally
2:40ill patients, you might think um uh
2:44about preferences for um services at the
2:47end of life. This may be something that
2:49was very difficult to put a number on.
2:52And so this assumption helps us
2:54appreciate the potential power of
2:56qualitative methods.
2:58So here's an example. We might be
3:00interested in the care of patients with
3:02epilepsy. This first question is a
3:05quantitative question. What proportion
3:07of people with epilepsy stop taking
3:09their medications for three consecutive
3:11days in a six-month period. This is
3:13something that we can uh quantify, put a
3:16number on and can be very important um
3:18in an overall question in looking at
3:20adherence for med to medication regimes
3:22in this patient group.
3:25A different question related to the same
3:28uh phenomenon might be how does
3:31medication shape the lives of people
3:33with epilepsy. And so looking in a very
3:35uh different perspective for the patient
3:38experience uh whether or not they feel
3:40mastery or self-efficacy in trying to
3:43adhere to complex medication regimes.
3:48So let's move to a definition. Uh what
3:51is qualitative research? There are many
3:53definitions. This is one uh that we feel
3:56uh represents the critical elements of a
3:59qualitative research approach. And so
4:01we'll work through this um through this
4:03definition together for a minute. Uh uh
4:06qualitative research is a strategy for
4:08the systematic collection, organization,
4:11and interpretation of textual
4:13information. So let's break this down
4:15into parts. We use the word strategy uh
4:18to connote the fact that a qualitative
4:21research question is thoughtful,
4:24deliberate, um conceived of with a
4:28broader attention to context and to the
4:30relative strengths and limitations of a
4:32qualitative method. So it's strategic in
4:34its nature.
4:36It's systematic. It's not something
4:38that's loose, loosely formed, ad hoc. um
4:41it rather relies on a set of established
4:45well-defined articulated uh
4:47methodologies for the collecting,
4:49organizing uh and analyzing of of
4:52qualitative data.
4:54Qualitative research broadly uses
4:57inductive approaches. So working from
5:00the ground up to generate novel insights
5:03into phenomena that are difficult to
5:05measure quantitatively such as
5:07preferences for end of life care or uh
5:10issues of self uh efficacy and mastery
5:13uh in self-care management.
5:17So qualitative methods can do a couple
5:19of things two broad buckets. The first
5:22being uh uh generating a comprehensive
5:24description of processes, mechanisms or
5:28settings.
5:29So thinking about processes of
5:31implementing clinical care, mechanisms,
5:35how one intervention may achieve a
5:38particular outcome or settings. What is
5:41it like to care for patients and their
5:42families uh in a particular environment?
5:47These methods can also characterize
5:49participant perspectives and their
5:51experiences in great depth. Uh here we
5:54might think about individual health
5:56behaviors, individual experiences of
5:59care uh in a particular clinic setting.
6:04So I want to spend a few minutes on this
6:06figure. Uh here in this ven diagram we
6:09see on one uh in one circle qualitative
6:12uh in the other circle quantitative. we
6:15have arrows pointing to the center uh of
6:18the intersection of these circles uh in
6:21order to convey the really I think very
6:23critical uh notion that quantitative and
6:26qualitative methods really exist along a
6:29continuum of measurement that each has
6:31its respective strengths and limitations
6:34uh and that when we uh draw upon those
6:36to in order to minimize uh the the
6:39limitations in a particular method and
6:41maximize its assets we use mix we can
6:44use mixed methods which is the combining
6:46of qualitative and quantitative methods.
6:49So let's just populate one of these
6:51circles um the qualitative methods
6:53circle. So I mentioned qualitative
6:55methods in terms of approach is
6:57inductive in nature. So we're not coming
6:59to uh a research question with any a
7:02priority hypothesis that we're testing.
7:04We're rather working from the ground up.
7:08Qualitative research in terms of its
7:09goal is to achieve depth of
7:11understanding. So we're looking in a
7:14very deep way to unpack uh critical
7:17facets of a given phenomenon. We may be
7:19interested in generating a hypothesis
7:21that can then go on and be tested in a
7:23quantitative study.
7:25Qualitative work occurs in a natural
7:27setting. It's not experimental. It's not
7:29controlled. It doesn't happen in a lab.
7:31Rather, we're often interested in
7:33features of the natural environment that
7:35may help us understand um uh the
7:38question of interest.
7:40sampling approaches in qualitative
7:42methods are purposeful in nature. We'll
7:44just take a moment here um uh to think
7:47together about what purposeful means.
7:49This is in contrast to random sampling.
7:52So rather than for instance uh we're in
7:55an emergency department setting and we
7:58are uh rather than um recruit every
8:01fifth uh patient who comes through the
8:03doors of the emergency department, a
8:05purposeful sampling design would choose
8:08individual um patients who come through
8:11the door that share a given
8:13characteristic. So for instance, if
8:15we're interested in uh the care of uh
8:18patients who are homeless in the
8:20emergency department setting, we'd want
8:21to be very purposeful in that design and
8:24choosing only those who have the
8:26experience that we're interested in
8:27studying.
8:28Data collection in qualitative methods
8:31is done through interview guides uh and
8:33various kinds of observation tools.
8:35These are much more uh open-ended than
8:38structured surveys or instrumentation we
8:40use in our quantitative studies. And
8:43lastly, data analysis is iterative. It's
8:45a a process of interpreting data uh
8:48going out to the field, collecting data,
8:50interpreting that, going back out to the
8:52field, collecting data, and interpreting
8:53that. This is in contrast uh to our
8:56approaches in for instance a structured
8:58survey on quantitative methods where we
9:01collect all of the data and then um
9:03begin our analysis only at that point.
9:06And so uh you can see uh how the qual
9:09principles of qualitative methods uh
9:11line up with the quantitative methods.
9:13And I think very important to consider
9:14that these are simply a range of tools
9:17uh all designed uh uh to measure
9:20different aspects of uh phenomena of
9:23interest.
9:25So what are the products of qualitative
9:27research? What can we make of of this?
9:29Well, there are four at least four ways
9:31to think about what we generate through
9:32qualitative methods. The first product
9:34is recurrent themes or hypotheses. We're
9:37going to look at an example of that in a
9:38moment.
9:40The second kind of product might be a
9:42survey instrument measure. So using a
9:44qualitative exploratory uh phase in
9:47order to design a survey to measure
9:49something um uh that hasn't uh been
9:52measured previously.
9:55Taxonomies. These are classification
9:57systems uh in order to identify
9:59essential properties of a particular
10:01construct
10:03and conceptual models or theories. These
10:05are frameworks for helping us understand
10:08um uh a particular phenomenon. Um these
10:12are four major products of qualitative
10:14research. The most common we see in the
10:15health sciences are recurrent themes or
10:18hypotheses.
10:19So themes are unifying concepts or
10:22statements and they can do a couple of
10:23things. Um the first is to help us
10:26identify and characterize
10:28a number of uh of aspects of uh
10:31healthcare and health. The first can be
10:33patterns of behaviors. We might look at
10:36uh how patterns recur in a certain uh
10:39patient population or in a certain
10:40environment. They can help us understand
10:43group interactions and individual
10:45perceptions.
10:48Themes also can help us develop testable
10:51hypotheses. They can do this by helping
10:53identify the salient factors what
10:55matters uh in a given um to a given
10:58question. What matters say from a
11:00patient's perspective and they can help
11:02inform predictions about relationships
11:04how two uh aspects or dimensions of a of
11:07a given question might relate to one
11:09another.
11:11So let's get let's look at an example.
11:14Uh this is a a paper um uh written by a
11:18former clinical scholar at the
11:20Robertwood Johnson uh program, Lisa
11:21Diamond. And Lisa was very interested in
11:25uh the use of interpreters by resident
11:27physic physicians um in caring for
11:30patients who have limited English
11:32proficiency. And so Lisa conducted a
11:35qualitative study. She interviewed
11:37residents at two uh academic medical
11:39centers with excellent uh interpreter
11:41services on site. and she talked with
11:43the residents to understand their
11:46experience in using interpreters in
11:48these environments in order to care uh
11:50for these for these patients. This uh is
11:53an excerpt from the published paper
11:55which is in the journal of general
11:56internal medicine and this is to give
11:58you an example of what a thematic output
12:00looks like. This theme uh is in the is
12:03in bold. This is one of the five
12:06recurrent themes in the paper and the
12:08primary uh theme here. The emphasis is
12:11to indicate that residents physicians
12:14recognize that they underuse
12:16professional interpreters and described
12:19this uh phenomenon as quote getting by.
12:22Sometimes we use the language of
12:24participants in order to represent the
12:26key element, the most um uh pertinent uh
12:29essence of a given theme. And then what
12:32follows is several sentences that
12:34describe that theme in greater depth and
12:37then uh followed by an illustrative
12:39quote. So using the words of
12:41participants in order to um support and
12:44and illustrate the higher level theme.
12:47Uh and just to read this together uh
12:50this theme uh this quote uh from a
12:52resident said that I know that when
12:54people are very pushed for time they may
12:56or may not call an interpreter. They may
12:58just get by on the few words they know
13:00in different languages for like pain and
13:02take a deep breath and just fumble
13:04through. You probably get a pretty bad
13:07history and not maybe a great uh and
13:09maybe not a great physical exam either.
13:12It's an example of thematic output. So
13:15let's conclude with a few thoughts.
13:18First, qualitative methods can provide
13:20unique contributions to health services
13:22and clinical research. We've talked
13:24through briefly some examples in this
13:26introductory segment.
13:29Second, there are rigorous and widely
13:31accepted procedures for study design,
13:34sampling, data collection, and data
13:37analysis in qualitative research. And in
13:39the remaining uh five modules in this
13:41series, we'll talk more about um primary
13:44methodologies, interviews, and focus
13:46groups and data analysis in that
13:49context.
13:50Thank you.

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