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Qualitative Research in Medicine

Qualitative Research in Medicine. Deepak Dath CORE program in Surgery. BACKGROUND. Used in the Social Sciences for a long time Felt to be “soft science” by those using quantitative methodology Generally was rare in medicine Gained popularity in the nursing literature

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Qualitative Research in Medicine

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  1. Qualitative Research in Medicine Deepak Dath CORE program in Surgery

  2. BACKGROUND • Used in the Social Sciences for a long time • Felt to be “soft science” by those using quantitative methodology • Generally was rare in medicine • Gained popularity in the nursing literature • Now being embraced slowly in medicine as “real” science

  3. Why the lag? • Push to EBM • Values numerical data • Values typical EBM research designs • Little previous techniques for determining the quality of the qualitative research design • Very time (researcher time) intensive • Inertia and unfamiliarity • Infrastructure for quantitative research

  4. Objectives • What is Qualitative Research • What are the types of Qualitative Research methodologies • Do something to wake up and to ‘feel’ the topic • How do we use qualitative research in medicine

  5. What is it? • Helps to answer questions like • What? • Why? • How? • What does that mean? • Can help generate new theories or hypotheses • Helps to generate a deeper understanding of an issue or topic

  6. What is it? • Inductive vs deductive • Deductive: premise 1 and premise 2 and…. therefore ………. • All men are mortal. (major premise) • Socrates is a man. (minor premise) • Socrates is mortal. (conclusion) • Inductive: fact 1 and fact 2 and … therefore new fact is…. after touching much ice, I can say that all ice is cold

  7. What is it? • Descriptive • Analytical • Selective • Experiential • Begins with broad, exploratory aims that provide a focus for study without pre-empting which aspects of the experience may be deemed important or relevant

  8. What is it? • When there is a gap in knowledge or when little is known about a particular phenomenon, experience, or concept • Researchers study people in natural settings • Attempts to make sense of, or interpret the meanings people attribute to their experiences

  9. Many types of Quantitative Research • Participant observation • Intensive, lengthy • Direct observation • Trained observers • Unstructured Interviewing • Can be very in-depth and focussed • Case studies • Focus groups

  10. Techniques used in Qualitative Research • Interviews • Focus groups • Surveys • Observation

  11. Data Analysis • Data collected is • Variable i.e. not determined apriori • Written (notes/written comments) or spoken, • Large volume • Requires consolidation and summarization according to the researchers’ meaningful interpretation • Multiple iterations of data consolidiation

  12. Data Analysis • Data analysis starts the minute you start collecting data, and affects how and what is collected. • As meaning or interest is generated, the data collection is focused to increase the understanding • Grounded theory • Previous concepts • Thematic analysis • Previous concepts and emergent concepts used to help collate data

  13. Data Analysis • Software used to streamline analysis • Categorizes • Links • Summarizes • Compares • Functions as a textual database • The actual analysis is the meaning that you interpret/generate from the raw data and the discussion that convinces the reader

  14. Data Validation • Member checks • Triangulation • Post-analysis observation • Repeat study or observational validation in a different setting to determine generalizability

  15. Case #1 • Dr. Osteo Blast notices that some patients with arthroscopies do well and others do less well – its just an impression, and he wants to know just what that means and what is involved.

  16. Case # 2 • Dr. Islets Langerhans wants to know whether the patients who come to see him in consultation leave the office satisfied with the consultation. He is a HPB surgeon who spends a great deal of time describing treatment approaches or discussing cases without surgical options.

  17. Case # 3 • Dr. Ed Ucator is keen to understand what makes a good operative teacher.

  18. Dr. Osteone notices that some patients with arthroscopies do well and others do less well – its just an impression, and he wants to know just what that means and what is involved. • Dr. Langerhans wants to know whether the patients who come to see him in consultation leave the office satisfied with the consultation. He is a HPB surgeon who spends a great deal of time describing treatment approaches or discussing cases without surgical options. • Dr. Ed Ucator is keen to understand what makes a good operative teacher.

  19. Questions • How do you need to ask? • What design would you use? • What instruments do you need? • How many will need to participate? • How can you disseminate the data?

  20. In Summary • A technique of research that you need to understand to interpret the results • Useful as a first step in understanding a question/process • A well-validated science • Resources on the web: • http://www.socialresearchmethods.net/kb/index.php • Poor literature on qualitative research methodology in journals • Suggest that if you decide on a qualitative project, you include a qualitative expert in your process at the start.

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