2. PART 2 Generating Data Observational methods

3. Introduction • Observational methods provide data on phenomena (such as behaviour), as well as on people’s accounts of those phenomena. • Can be purely observational or actively involve the researcher.

4. Observational Methods • Observational methods are presumed to be the ‘Gold Standard’ in qualitative research methods, because they minimise disruption. • However, pure observation is simply not possible in some instances. • Furthermore, the assumption that it is ‘the Gold Standard’ may be incorrect.

5. Participatory Research • Participation requires deep integration within a group, increasing the researcher’s level of understanding. • This is criticised by proponents of ‘observation’ as changing the outcome of research.

6. Gold’s Ideal type of Research Role

7. Etic vs. Emic • An ‘etic’ perspective is that of ‘impartial’ observers (the analyst perspective). • An ‘emic’ perspective relies upon the understanding and explanation of those practising in the culture that you are investigating (the insider perspective).

8. ‘Emic’ Research • Advantages of Emic: • allows for greater understanding of a group’s cultural practises by contextualising them. e.g. understanding the ‘cosmology’ of a tribe • Disadvantages of Emic: • Forming such an emotional connection with a group might undermine the researchers objective perspective.

9. Ethnography in Healthcare • These ethnographic methods are also applicable to healthcare studies in developed countries. e.g. Interviews and observational data

10. Examples of ‘ethnography close to home’ • Helman (1978) - Studies of ‘lay’ health beliefs: Examined folk beliefs on the causes of colds in a North London suburb. • Fineman (1991) – Studies of health service organization and delivery: Looked at how clinicians, social workers and alcohol counsellors in a clinic constructed ‘non-compliance’ in clients

11. Importance of Insider Knowledge • Medicine is a highly specialised discipline. This means that researchers using ethnography must either be experts themselves in the field that the are investigating or they should rely on ‘emics’. • Being an outsider is advantageous to the objectivity of the researcher, but it places limitations on understanding. • The importance of understanding what you are studying, and more importantly, what you are looking for, means that one of the best research methods is interviews.

12. Importance of Insider Knowledge • One approach which can be useful is the ‘auto-ethnographic’ approach, where the researcher records and analyses their own experience of care. • However, analysing one’s own experiences with a degree of emotional disinvestment is difficult.

13. Covert and Overt Research • Overt roles are when the researcher is open about his intentions and role. • Covert roles require a researcher to not declare their intentions. • Covert studies can be very insightful, but are rarely used because of ethical considerations.

14. Covert and Overt Research • One way of conducting covert research is pseudo-patient study, where a researcher pretends to be a patient in order to have direct experience of treatment. • This also comes with significant ethical considerations.

15. Research Sites • As with all studies, identifying an appropriate research site is a real challenge. • This is made even more challenging by the fact that there is so much specialisation within medicine. • Someone wishing to research cardiology for example, may only have a few locations to choose from, and may be granted permission by even fewer.

16. Methodological implications of participant observation studies • Identifying a site • ethnography often involves a field of interlocking networks spread across organizations and geographies, particularly in policy issues • Gaining access – ‘Cold’ calling or prior contact • Refining observational skills • Recording observations and writing field notes

17. Rapid Ethnographic Methods • Advantages: Relatively quick and cheap data collection and data that are addressed to designing practical interventions rather than academic findings • Disadvantages: Controversial, as they are likely to collect superficial or even misleading information.

18. Non-participant observational methods • Ethnomethodology (‘folk’ methods’): the rules and processes by which people give meaning to behaviour and interpret social interaction. • ‘Topicalization’ of common sense • Transcripts • Analysing videos to look at story-telling

19. KEY POINTS • The major strength of observational methods is that they provide data on what people do, as well as what they say they do. • In ethnography, long-term participation in the field enables the researcher to capitalize on both distance and familiarity to analyse social behaviour. • Doing ethnography in familiar sites has benefits in terms of access and familiarity, but poses challenges for the researcher in achieving analytic distance.

20. Key Points • Rapid ethnographic techniques have been widely used in public health research, with some success. There has been debate about the validity of data generated using this method. • Non-participant observational methods provide access to social interaction with minimal intervention in the field and are one way of producing empirical and reliable data for analysis.