QUALITATIVE RIP OUT SERIES

Choosing a Qualitative Research Approach

The Challenge Choosing a Qualitative Approach

Educators often pose questions about qualitative re- Before engaging in any qualitative study, consider how
search. For example, a program director might say: ‘‘I your views about what is possible to study will affect your
collect data from my residents about their learning approach. Then select an appropriate approach within
experiences in a new longitudinal clinical rotation. If I which to work. Alignment between the belief system
want to know about their learning experiences, should I underpinning the research approach, the research ques-
use qualitative methods? I have been told that there are tion, and the research approach itself is a prerequisite for
many approaches from which to choose. Someone rigorous qualitative research. To enhance the understand-
suggested that I use grounded theory, but how do I know ing of how different approaches frame qualitative
research, we use this introductory challenge as an
this is the best approach? Are there others?’’
illustrative example.
What Is Known The clinic rotation in a program director’s training
program was recently redesigned as a longitudinal clinical
Qualitative research is the systematic inquiry into social experience. Resident satisfaction with this rotation
phenomena in natural settings. These phenomena can improved significantly following implementation of the
include, but are not limited to, how people experience new longitudinal experience. The program director wants
aspects of their lives, how individuals and/or groups to understand how the changes made in the clinic rotation
behave, how organizations function, and how interac- translated into changes in learning experiences for the
tions shape relationships. In qualitative research, the residents.
researcher is the main data collection instrument. The Qualitative research can support this program direc-
researcher examines why events occur, what happens, and tor’s efforts. Qualitative research focuses on the events
what those events mean to the participants studied.1,2 that transpire and on outcomes of those events from the
Qualitative research starts from a fundamentally perspectives of those involved. In this case, the program
different set of beliefs—or paradigms—than those that director can use qualitative research to understand the
underpin quantitative research. Quantitative research is impact of the new clinic rotation on the learning
experiences of residents. The next step is to decide which
based on positivist beliefs that there is a singular reality
approach to use as a frame for the study.
that can be discovered with the appropriate experimental
The TABLE lists the purpose of 3 commonly used
methods. Post-positivist researchers agree with the
approaches to frame qualitative research. For each frame,
positivist paradigm, but believe that environmental and
we provide an example of a research question that could
individual differences, such as the learning culture or the
direct the study and delineate what outcomes might be
learners’ capacity to learn, influence this reality, and that
gained by using that particular approach.
these differences are important. Constructivist research-
ers believe that there is no single reality, but that the How You Can Start TODAY
researcher elicits participants’ views of reality.3 Qualita-
tive research generally draws on post-positivist or 1. Examine the foundations of the existing literature:
constructivist beliefs. As part of the literature review, make note of what is
Qualitative scholars develop their work from these known about the topic and which approaches have
beliefs—usually post-positivist or constructivist—using been used in prior studies. A decision should be
different approaches to conduct their research. In this Rip made to determine the extent to which the new
Out, we describe 3 different qualitative research ap- study is exploratory and the extent to which findings
proaches commonly used in medical education: grounded will advance what is already known about the topic.
theory, ethnography, and phenomenology. Each acts as a 2. Find a qualitatively skilled collaborator: If you are
pivotal frame that shapes the research question(s), the interested in doing qualitative research, you should
method(s) of data collection, and how data are ana- consult with a qualitative expert. Be prepared to
lyzed.4,5 talk to the qualitative scholar about what you would
like to study and why. Furthermore, be ready to
DOI: http://dx.doi.org/10.4300/JGME-D-15-00414.1 describe the literature to date on the topic (remem-
Editor’s Note: The online version of this article contains a list of further ber, you are asking for this person’s expertise
reading resources and the authors’ professional information. regarding qualitative approaches—he or she won’t

Journal of Graduate Medical Education, December 2015 669

TABLE
Methodology Overview
Approach Purpose Illustrative Question Illustrative Outcome
Grounded To develop theories grounded in the What factors impact Results would build a theoretical model
theory study data. residents’ preferences for describing how individual-, contextual- and
learning on the clinic teacher-related factors impacted residents’
rotation? preference for learning.
Ethnography To develop an in-depth How do residents Results would contribute to our understanding
understanding of the culture of a experience learning in of the learning culture of the clinic over the
context from the point of view of the context of the course of a year as the residents engage in
the study subjects through learning culture in the the clinic rotation, learn from rotation
immersion in that setting over an clinic rotation? activities, and interact with members of the
extended period of time. care team in their day-to-day activities.
Phenomenology To describe the essence of a How do residents Results would contribute to our understanding
phenomenon by exploring it from experience learning in of the phenomenon of learning in this
the perspective of those who the longitudinal clinic particular context. Interviews would be used
experienced it so as to understand rotation structure? to understand how residents experienced
the meaning participants ascribe their learning, including what they learned
to that phenomenon. and how they learned it.

necessarily have content expertise). Qualitative expertise in qualitative research is to try it in a small
research must be designed and conducted with rigor scale pilot study with the support of a qualitative
(rigor will be discussed in Rip Out No. 8 of this expert. Such application provides an appreciation
series). Input from a qualitative expert will ensure for the thought processes that go into designing a
that rigor is employed from the study’s inception. study, analyzing the data, and reporting on the
3. Consider the approach: With a literature review findings. Alternatively, if you have the opportunity
completed and a qualitatively skilled collaborator to work on a study led by a qualitative expert, take
secured, it is time to decide which approach would it! The experience will provide invaluable opportu-
be best suited to answering the research question. nities for learning how to engage in qualitative
Questions to consider when weighing approaches research.
might include the following:
&
Will my findings contribute to the creation of a
References and Resources for Further Reading
theoretical model to better understand the area of
study? (grounded theory) 1. Bogdan R, Biklen SK. Qualitative Research for Education:
An Introduction to Theories and Methods. 5th ed. London,
&
Will I need to spend an extended amount of time UK: Pearson; 2006.
trying to understand the culture and process of a 2. Corbin J, Strauss A, eds. Basics of Qualitative Research:
particular group of learners in their natural Techniques and Procedures for Developing Grounded
context? (ethnography) Theory. 3rd ed. Thousand Oaks, CA: SAGE Publications;
&
Is there a particular phenomenon I want to better 2008.
understand/describe? (phenomenology) 3. Bergman E, de Feijter J, Frambach J, Godefrooij M,
Slootweg I, Stalmeijer R, et al. AM last page: a guide to
research paradigms relevant to medical education. Acad
What You Can Do LONG TERM Med. 2012;87(4):545.
4. Howell KE. An Introduction to the Philosophy of Method-
1. Develop your qualitative research knowledge and ology. Thousand Oaks, CA: SAGE Publications; 2013.
5. Denzin NK, Lincoln YS, eds. The SAGE Handbook of
skills: A basic qualitative research textbook is a
Qualitative Research. 4th ed. Thousand Oaks, CA: SAGE
valuable investment to learn about qualitative
Publications; 2011.
research (further reading is provided as online
supplemental material). A novice qualitative re-
searcher will also benefit from participating in a
massive online open course or a mini-course (often The views expressed in this article are those of the authors and do
offered by professional organizations or conferenc- not necessarily reflect the official policy or position of the Uniformed
es) that provides an introduction to qualitative Services University of the Health Sciences, the Department of the
Navy, the Department of Defense, or the US government.
research. Most of all, collaborating with a qualita-
tive researcher can provide the support necessary to Corresponding author: Arianne Teherani, PhD, University of
design, execute, and report on the study. California, San Francisco, School of Medicine, Office of Research
and Development in Medical Education, Box 3202, 1855 Folsom
2. Undertake a pilot study: After learning about Avenue, Suite 200, San Francisco, CA 94143-3202, 415.509.4988,
qualitative methodology, the next best way to gain [email protected]

670 Journal of Graduate Medical Education, December 2015