Qualitative Research, Part 3

The objectives of sampling in qualitative research differ from those in quantitative research. The reason for that difference is that with qualitative research we are not concerned with our ability to generalize the information we collect to a larger population, which is the entire point of the sampling methods used in most quantitative studies. The sampling in qualitative research is called “purposive.” This means that it is intended to describe the processes of a phenomenon, and not its distribution. Our goal is to obtain information-rich cases that allow us to look in-depth into the phenomenon our study is examining. Again, the entire idea is to look at interpretation and lived experience.

Liamputtong and Ezzy (1) list a number of different sampling methods that may be used in qualitative research. They include the following:

▪ Extreme or deviant case sampling: where we select cases that are unusual or distinctive in order to illustrate the processes under examination.
▪ Maximum variation sampling: where we try to select cases that provide for wide ranges in the experience or process under examination.
▪ Homogenous group sampling: here we select a sample to minimize variation and to maximize homogeneity to getter better depth in the process under examination.
▪ Typical case sampling: where we select a case because it is not in any way unusual or atypical.
▪ Critical case sampling: where cases are selected to illustrate processes where the processes would be thought least likely.
▪ Criterion sampling: all cases meet some set of pre-specified criteria. This allows in-depth study of a phenomena, providing rich information.
▪ Stratified purposive sampling: where we select cases from some previously identified subgroups.
▪ Snowball or chain sampling: where after identifying an initial group of respondents, we ask them to suggest other possible participants.
▪ Opportunistic sampling: where as a project develops and as new information is discovered, opportunities to go in new directions arise that are taken advantage of.
▪ Convenience sampling: where we invite whomever we can easily locate and involve. It is often confused with purposive sampling, but Liamputtong and Ezzy (1, p. 49) note that this is a mistake because it does not theorize the sample.
▪ Volunteer sampling: where we obtain participants by advertising for them.
▪ Triangulated sampling: we can combine any of the above as strategies for creating our project develop.

As always, the best method to use is the one that best helps you answer the questions you are asking. It is the best tool for the situation, and the decision to use sample method as opposed to another will be driven by the needs of your project.

REFERNECES
1. Liamputtong P, Ezzy D. Qualitative research methods, 2nd edition. South Melbourne, Australia; Oxford University Press, 2006

Qualitative Research, Part 2

Qualitative research places interpretation at the center of activity. What we are looking at is how people interpret and give meaning to their experiences and actions. There is a quote by David Karp that provides insight into this process. In his work, he was looking at depression and had this to say: “I’m not primarily interested in explaining what causes depression or how to cure it because I don’t think anyone can answer those questions. Instead, I’m interested in how depressed individuals make sense of an inherently ambiguous life situation. I’m interested in how a depression consciousness unfolds over time, how people think about psychiatry and medications, and how they deal with family and friends.” (1) He as not gathering quantitative data via, for example, a survey that asked specific questions, but instead was interested in how people interpret what it means to suffer from depression. Quantitative methods simply cannot address that question.

Rossman and Rallis (2) summarize the common features of qualitative research: that it occurs in the natural world, that it has a focus on content, that it may use multiple methods, that it is emergent and that it is interpretive. It is also worth noting that qualitative studies may often lead to quantitative studies as the basis for human belief emerges from the study of how they experience their world. What does it mean to the patient when he or she checks off a score of 6 on a Visual Analogue Scale? If I check a 6 and you check a 6, does it mean the same thing to both of us? This is not a question you can answer using quantitative statistical means.

Liamputtong and Ezzy (3) state that there are three questions which much be answered at the outset of any qualitative study. The first is, what is the theoretical framework within which the study is being conducted. The second is, what is the substantive issue being researched. The final question is, what are the desired outcomes of the study? These are all inter-related questions, and no single one of them has priority over the other two. However, the manner in which the research is conducted relates very much to the framework, and a future entry will look at some of the theoretical frameworks for conducting this interesting form of research.

REFERENCES
1. Karp D. Speaking of sadness: depression, disconnection and the meanings of illness. New York, NY; Oxford University Press, 1996
2. Rossman GB, Rallis SF. Learning in the field: an introduction to qualitative research, 2nd edition. Thousand Oaks, CA; Sage Publications, 2003
3. Liamputtong P, Ezzy D. Qualitative research methods, 2nd edition. South Melbourne, Australia; Oxford University Press, 2006

Qualitative Research: An Introduction

If you look at the rubrics which comprise part of the process of applying for promotion to associate or full professor, you will see that there are separate entries for the publication of research papers, divided into quantitative and qualitative research. While most of us are more than familiar with standard quantitative research, we may be less so with regard to qualitative studies. Yet certain information can only be gleaned using qualitative methods, and so I hope here to spend a short amount of time describing a bit about this form of research.

In quantitative studies, we gather information that is converted into numbers, so that the data can be statistically analyzed. A simple example would be to conduct a study where we look at changes in pain scores before and after a chiropractic adjustment. Using statistical methods, we would derive a mean pre-adjustment score, and then a mean adjustment score, and perhaps we would then compare these pre and post scores to a second group of individuals who received a different intervention. The appropriate statistical methods would allow us to test the strength of our hypotheses and determine whether our results reached statistical significance. This is the kind of research we are familiar with. But embedded in this research are other questions. For example: what does it mean to the patient that his or her pain score improved by 2.4 points? We learn nothing about the lived experience of the patient in this study.

What qualitative research does is “elicit the contextualized nature of experience and action, and attempts to generate analyses that are detailed, ‘thick,’ and integrative (in the sense of relating individual events and interpretations to larger meaning systems and patterns).” (1) We are focused, in qualitative research, on meaning and interpretation. It is a method to help us understand what meaning people ascribe to their behaviors and actions. This is not something that can be addressed using statistical methods. Instead, we need to use different methods, equally rigorous in comparison to quantitative research, but appropriate to the kinds of questions we ask in qualitative research. As Liamputtong notes, “ Metaphors, meanings and interpretations require the more fluid, but no less rigorous, methods employed by qualitative research.” (1)

We can conduct a study that shows that people with back pain are more depressed than people without back pain’ statistics can clearly show a link between back pain and depression. But why are people with back pain depressed? Can a survey be sufficient to answer that question? Or, can we drill deeper? Qualitative methods can provide us the means to do so.

I will follow this entry with more information on qualitative methods. Hang tight until then.


REFERENCES
1. Liamputtong P, Ezzy D. Qualitative research methods, 2nd edition. South Melbourne, Australia; Oxford, 2006:2

Learning Styles

The tendencies and characteristics that students use in their learning are known as learning styles. These styles may influence how students learn, as well as how instructors teach. Understanding something about learning styles may help instructors create the most effective learning environment and impact their instructional design. I think we are already aware, from our learning objective development process, that learning styles are combinations of cognitive, affective and physical factors, which are then used to use to help the student navigate through the learning process. As defined by Sadler-Smith a learning style is “a distinctive and habitual manner of acquiring knowledge, skills and attitudes through study or experience.” (1)

There have been a number of attempts to classify learning styles. As early as 1966, Hudson (2) made a distinction between convergers and divergers. Convergers generally followed linear thinking, using a step-by-step approach to arrive at the “right” answer. The diverger was more fluid and flexible, approaching a problem from a number of different directions, some of which might be quite novel. He felt that convergers would learn best from convergent teachers, and divergers from divergent teachers. Pask (3) used this model to develop his own, breaking learning styles into holists and serialists. The holist used an overarching conceptual framework to help contextualize learning, while the serialist learns in a piece-by-piece fashion, creating knowledge out of smaller pieces of information. Holist learning is mainly associated with art training, while serialist learning would more characterize the average medical or chiropractic setting. Kolb (4) took these 2 approaches and used them to devise his own, which involves divergers and convergers, as well as assimilators and accommodators. In his model, the divergers uses creative ideas and diverse views, the converger is good at problem-solving and implementation, the assimilators uses inductive reasoning to generate theory and integrate ideas, and the accommodator actively applies knowledge but adapts to changing circumstances. These were used to develop Kolb’s Learning Styles Inventory, which was later used to develop The Learning Styles Questionnaire of Honey and Mumford (5). This tool is still used today.

When we begin to ask how we can best develop deep learning in our students, one of the components we need to look at is the styles of learning students use. It is a challenging environment to do so. Certain technologies that younger students use today did not exist when many of us had our undergraduate, graduate or teacher training. This includes the presence of the web, and of instructional platforms such as BlackBoard and WebCT. We have to adapt to these technologies and we can do so most effectively when we understand how our students learn.

REFERENCES
1. Sadler-Smith E. Learning style and instructional design. Innovations Educ Training Internat 1996;33:185-193
2. Hudson L. Contrary imaginations. New York, NY; Penguin, 1966
3. Pask G. Styles and strategies of learning. Br J Educ Psych 1976;46:128-148
4. Kolb DA. Experimental learning experience as a source of learning and development. London; Prentice Hall, 1984
5. Honey P, Mumford A. Using your learning styles. London; Maidenhead, 1986

Diffusion of Innovations

One of the books I have been reading lately is Everett Rogers text Diffusion of Innovations (1). What Rogers has done is demonstrate how an innovation spreads through a social system; his work is what has led to the slightly more recent concept of a “tipping point.” This is the idea that change occurs in a system through what amounts to a domino effect (2)

When we are confronted with an innovation from within a social system (consider, for example, such new technologies as myspace, facebook, pda’s, etc.) we have to consider whether or not to use or participate in that innovation. Rogers notes that there are typically 5 steps in how we do this. First, we become aware that the innovation exists, and we gather knowledge about it. Second, we form an opinion about the innovation. This step, persuasion, may lead to use considering the innovation positively or negatively. For example, my personal initial opinion regarding myspace was negative. Third, we decide whether or not we wish to adopt the innovation or not. Then, we implement it, and put it into use. Finally, we evaluate our use of the innovation, and confirm that we did the right thing.

But this is at the personal level. There are also influences that come from our social system. Rogers notes that we can divide a social system into 5 groups: innovators, early adopters, early majority, late majority and laggards. Within medical education, for example, Howard Barrows was the innovator who began the initial talks about the use of problem-based learning methodologies. Once his work had been published, a small number of early adopters began to use that methodology. Their colleagues, noticing the success of that method, began to explore use in their own classrooms; these were the early majority. Some people were late to the game, and for whatever reason put off the adoption until its use had been fairly well established. Finally, there were some who, given the choice, refused to consider the use of this method at all. Innovators are those creative types who are in the forefront of technological developments. Early adopters are often seen as opinion leaders and change agents, people whom others see as trustworthy. When we see these people adopt an innovation, that is when we feel comfortable doing the same. This is when the majority begins to use that innovation. Some come to this early, others late. Finally, the laggards are often isolated or traditional in their work environment, and often suspicious of change.

This is but a framework for this theory, which has implications across disciplines, in media, marketing, education and many other areas of life. But as noted, it may also have implications for how innovations in education can be successfully initiated.

REFERENCES
1. Rogers EM. Diffusion of innovations, 5th edition. New Rok, NY; Simon and Schuster, 2003
2. Orr G. Review of Diffusion of Innovations, by Everett Rogers. http://www.stanford.edu/class/symbsys205/Diffusion%20%of%20Innovations.htm, accessed August 15, 2008

Scientific Papers: The Introduction

The Introduction to a scientific paper- whether that paper is an original data report, literature review or case report- has a very specific function. Its primary purpose is to let the reader know why your paper was written. It therefore provides context for the work you present. Typically, the introduction will provide a short overview of the topic area for your paper. For example, if you are presenting a case report on the successful management of an unusual condition, the Introduction will usually give the reader information about the condition in question, as well as some information about the intervention that was so successfully used. This information will be broad and general in nature; the Discussion section is where you can delve into the details about the condition in question.

An Introduction need not be lengthy. In fact, it is likely that a lengthy Introduction contains information that more appropriately belongs in the Discussion section. And often the Introduction is written to demonstrate where a gap in the literature exists. That is, a certain measure of literature is cited, and the author then points out areas of confusion, disagreement or question and notes where his or her paper fits into that confusion, and how it will provide information that may help to resolve some or all of that confusion.

Let me offer an example. Say we were writing a case report discussing the chiropractic management of Condition AB. My Introduction might proceed along these lines: “Condition AB is a disease affecting X% of the population at any given time, with a lifetime incidence of Y%. The condition occurs when something goes wrong in your organ system, affecting the function of this organ [AUTHOR”S NOTE: I am making this all up so am keeping comments purposely vague]. As a result, this lack of function leads to problems in the musculoskeletal system. Medical treatment for Condition X includes this, that and the other thing. However, there is no information in the literature regarding chiropractic management for Condition AB. This paper presents a case which was successfully managed using high-velocity low-amplitude adjustment.” Now, each sentence here would normally be expanded (and each factual statement referenced correctly) upon so that this entry would run to approximately 3 paragraphs, but you can see all the necessary elements in place.

I highly recommend that to get a good sense of the elements I note above, simply read over a few papers from the Journal of Manipulative and Physiological Therapeutics or other chiropractic journal. This will give you a template from which you can begin to develop not only the Introduction to your paper, but the rest of the paper as well.

Writing an Abstract

Not all that long, the abstract for a scientific paper was a prose paragraph that attempted to provide the 5 W’s of a piece of scientific research: who, where, why, when and what. That is, it attempted to give the reader a general sense of what question was being asked, how the researchers attempted to answer it, what they found and what they felt it meant. But studies done in the late 1980s and early 1990s indicated that the abstract was failing in is goal. Squires (1) found that 56% of abstracts did not report the technical design of a study, 79% gave no information on how subjects were selected, 86% made no mention of limitations and 93% made no recommendations for further study. To resolve this failure, the Ad Hoc Working Group for the Critical Appraisal of the Literature (2) proposed the structured abstract, and that is now the professional norm.

A structured abstract is simply that; an abstract that has a specific structure. In the case of an original data report, the structure can be as simple as: Objective; Methods; Results; Conclusion. It may be slightly expanded, so that instead of a Methods section, there are sections on Subject Selection; Site, Main Outcome Measures, etc. Some journals ask that the author prepare a Background section as well, to precede the Objective section. It is important to keep mindful that there is usually a limit of 250 words to the abstract, so brevity is important. The Background section provides context; Objective provides the intent of the paper; Methods tells what was done and how; Results provide aggregate important findings; and Conclusion briefly tells what was discovered.

Abstracts for literature reviews and case reports differ. For a literature review, the main headings should include: Objective; Study Selection; Data Extraction; Data Synthesis; Results; Conclusion. In this form of abstract, the key is in describing what search terms and databases were used, what information was taken from the yield of papers, and how that information was analyzed. In a case report, the main headings include: Objective; Clinical Features; Intervention and Outcome; Conclusion. Here, clinical features refers to important findings leading to diagnosis; intervention and outcome refers to what was done and how the patient responded.

I should also note that different journals may deviate slightly from these models and as always it is important to read Instructions to Authors. And keep mindful that your abstract is the single most important key to whether people decide to read your paper, so spending a little time to get it right serves you very well indeed.


REFERENCES
1. Squires BP. Abstracts: the need for improvement. Can Med Assoc J 1991;144:421
2. Ad Hoc Working Group for Critical Appraisal of the Medical Literature. A proposal for more informative abstracts of clinical articles. Ann Intern Med 1987;106:598-604