Exploring the Use of Qualitative Methods in Published Health Services and Management Research

Hoff, Timothy; Witt, Lori C.

doi:10.1177/107755870005700201

Cited by 39 publications

(68 citation statements)

References 10 publications

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“…Beyond medical education, qualitative research is relatively popular (Roche 1991;Bergsjø 1999) in general practice (Boulton et al 1996;Hoddinott & Pill 1997) and health services research Shortell 1999;Hoff & Witt 2000;Bradley et al 2007;O'Cathain et al 2007a;Lingard et al 2008;O'Cathain 2009;O'Cathain et al, 2009). Qualitative research still struggles, however, for funding and mainstream medical acceptance (Cribb & Bignold 1999;Morse 2006;Dixon-Woods et al 2007;Goguen et al 2008;Sandelowski 2008;Pope & Mays 2009), undermined in 'evidence' hierarchies (Thorne 2009) and the hidden curriculum (Goguen et al 2008).…”

Section: Practice Pointsmentioning

confidence: 99%

Mixing it but not mixed-up: Mixed methods research in medical education (a critical narrative review)

Maudsley

2011

Medical Teacher

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Background: Some important research questions in medical education and health services research need 'mixed methods research' ( particularly synthesizing quantitative and qualitative findings). The approach is not new, but should be more explicitly reported. Aim: The broad search question here, of a disjointed literature, was thus: What is mixed methods research -how should it relate to medical education research?, focused on explicit acknowledgement of 'mixing'. Methods: Literature searching focused on Web of Knowledge supplemented by other databases across disciplines. Findings: Five main messages emerged:-Thinking quantitative and qualitative, not quantitative versus qualitative -Appreciating that mixed methods research blends different knowledge claims, enquiry strategies, and methods -Using a 'horses for courses' [whatever works] approach to the question, and clarifying the mix -Appreciating how medical education research competes with the 'evidence-based' movement, health services research, and the 'RCT' -Being more explicit about the role of mixed methods in medical education research, and the required expertise Conclusion: Mixed methods research is valuable, yet the literature relevant to medical education is fragmented and poorly indexed. The required time, effort, expertise, and techniques deserve better recognition. More write-ups should explicitly discuss the 'mixing' ( particularly of findings), rather than report separate components.

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Section: Practice Pointsmentioning

confidence: 99%

Mixing it but not mixed-up: Mixed methods research in medical education (a critical narrative review)

Maudsley

2011

Medical Teacher

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“…8 -10 Qualitative approaches are becoming more common in clinical medicine and health services research. 5,[11][12][13][14][15] Federal encouragement of qualitative research is regularly reflected in funding program announcements issued by the National Institutes of Health. 16 For more than a decade, federal agencies and foundations such as the National Science Foundation have demonstrated a commitment to supporting qualitative research through funding scientific conferences, workshops, and monographs on this field of inquiry.…”

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confidence: 99%

Qualitative and Mixed Methods Provide Unique Contributions to Outcomes Research

2009

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O utcomes research examines the effects of medical care interventions and policies on the health outcomes of individuals and society. 1 Investigators conducting outcomes research seek to inform the development of clinical practice guidelines, to evaluate the quality of medical care, and to foster effective interventions to improve the quality of care. 2 Outcomes research has traditionally used quantitative sciences to examine the utilization, cost, and clinical effectiveness of medical care through randomized and nonrandomized experimental designs. Quantitative methods are not as well suited to measure other complex aspects of the healthcare delivery system, such as organizational change, clinical leadership in implementing evidence-based guidelines, and patient perceptions of quality of care, which are also critical issues in outcomes research. [3][4][5][6][7] These more nuanced aspects of healthcare delivery may be most appropriately examined with qualitative research methods. 8 -10 Qualitative approaches are becoming more common in clinical medicine and health services research. 5,[11][12][13][14][15] Federal encouragement of qualitative research is regularly reflected in funding program announcements issued by the National Institutes of Health. 16 For more than a decade, federal agencies and foundations such as the National Science Foundation have demonstrated a commitment to supporting qualitative research through funding scientific conferences, workshops, and monographs on this field of inquiry. [17][18][19][20] Despite this steady growth in qualitative research, outcomes investigators in cardiology have relatively little guidance on when and how best to implement these methods in their investigations.The purpose of the present report is to introduce qualitative methods as providing unique and critical contributions to outcomes research. This report will describe the situations in which qualitative approaches are most helpful; summarize the primary principles and practices in study design, sampling, data collection, and data analysis for qualitative studies; present representative examples of cardiovascular outcomes research that uses qualitative methods; and synthesize current standards for ensuring rigor and enhancing credibility of qualitative research. Defining Qualitative ResearchQualitative research is a form of scientific inquiry that spans different disciplines, fields, and subject matter and comprises many varied approaches. 21 Qualitative methods can be used to understand complex social processes, to capture essential aspects of a phenomenon from the perspective of study participants, 5 and to uncover beliefs, values, and motivations that underlie individual health behaviors. [22][23][24] Such research can also illuminate aspects of organizational context and healthcare delivery that influence organizational performance and quality of care. 10,25 Qualitative studies are often exploratory in nature and seek to generate novel insights 9,23,26,27 using inductive (starting with observations and dev...

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“…Qualitative methods are oriented toward understanding, rather than measuring, phenomena. 20 Because data collection is open-ended, research participants are free to express themselves in their own words. Through detailed in-depth analysis of the resulting data, these methods can uncover what takes place in complex health care environments.…”

Section: Study Design and Samplementioning

confidence: 99%

A Qualitative Study to Identify Barriers to Local Implementation of Prehospital Termination of Resuscitation Protocols

Sasson

Forman

Krass

et al. 2009

Circ: Cardiovascular Quality and Outcomes

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Background— Despite the existence of national American Heart Association guidelines and 2 termination-of-resuscitation (TOR) rules for ceasing efforts in refractory out-of-hospital cardiac arrest, many emergency medical services agencies in the United States have adopted their own local protocols. Public policies and local perceptions may serve as barriers or facilitators to implementing national TOR guidelines at the local level. Methods and Results— Three focus groups, lasting 90 to 120 minutes, were conducted at the National Association of Emergency Medical Services Physicians meeting in January 2008. Snowball sampling was used to recruit participants. Two reviewers analyzed the data in an iterative process to identify recurrent and unifying themes. We identified 3 distinct groups whose current policies or perceptions may impede efforts to adopt national TOR guidelines: payers who incentivize transport; legislators who create state mandates for transport and allow only narrow use of do-not-resuscitate orders; and communities where cultural norms are perceived to impede termination of resuscitation. Our participants suggested that national organizations, such as the American Heart Association and American College of Emergency Physicians, may serve as potential facilitators in addressing these barriers by taking the lead in asking payers to change reimbursement structures; encouraging legislators to revise laws to reflect the best available medical evidence; and educating the public that rapid transport to the hospital cannot substitute for optimal provision of prehospital care. Conclusion— We have identified 3 influential groups who will need to work with national organizations to overcome current policies or prevailing perceptions that may impede implementing national TOR guidelines.

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Exploring the Use of Qualitative Methods in Published Health Services and Management Research

Cited by 39 publications

References 10 publications

Mixing it but not mixed-up: Mixed methods research in medical education (a critical narrative review)

Mixing it but not mixed-up: Mixed methods research in medical education (a critical narrative review)

Qualitative and Mixed Methods Provide Unique Contributions to Outcomes Research

A Qualitative Study to Identify Barriers to Local Implementation of Prehospital Termination of Resuscitation Protocols

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