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Qualitative Research in Family Medicine Education

Sarah Stumbar, MD, MPH; David Brown, MD Florida International University Herbert Wertheim College of Medicine

What is qualitative research? Qualitative research seeks to uncover the meanings people ascribe to phenomena they experience—to elucidate the underlying structures (why?) and textures (how?) of the social world. This kind of knowledge is contextual and requires interpretation. It is understood that qualitative researchers also bring their own experiences, which influence the meanings uncovered through the research process. Qualitative research contrasts with quantitative research, which is numerically grounded in the presentation and investigation of context-free cause and effect relationships.

Why do qualitative research? Qualitative research allows for a more exploratory and flexible approach than quantitative methods. In family medicine education, narrative essays and assignments may particularly lend themselves to qualitative analysis. For example, thematic analysis is a qualitative method in which data is evaluated for recurring thematic patterns. These identified themes then become the framework used to answer the initial research question. We recently conducted a thematic analysis study—we analyzed student reflective essays about our household visit curriculum to further elucidate the actual experiences that our students are having in the field. The themes we identified allowed us to determine what our students report learning and the emotional and professional development that they describe going through. This provided us with a description of an important part of our household visit program—the student experience—that has further allowed us to evaluate this curriculum. Finally, while qualitative research can certainly stand alone, it can also lay the groundwork for hypothesis-generation for quantitative or mix-methods projects.

How do you do qualitative research? Qualitative research may be more theoretical in nature than quantitative projects; nonetheless, high-quality qualitative research uses well-defined methods. The first step is to define the problem you want to address or the question you want to answer. Next, consider your pool of potential data. Data that lends itself to qualitative research comes in many forms, including interviews, focus groups, observations, art, narratives, and other documents. A variety of potential methods exist for sampling and analyzing data, emerging from different research traditions. The kind of question, and the type of available data, can guide the choice of method. To frame your study, find a mentor and read a qualitative methods text.

To conduct research, you will need to apply for institutional review board (IRB) approval or exemption. After IRB review, it is time to collect (sample) and analyze your data. While the details of sampling and analyzing qualitative data are beyond the scope of this article, it is important to have a clear rationale for your sampling strategy and reproducible methodology for your analysis.

A common strategy includes having two or more independent researchers review the data and then meet to discuss and agree upon the identified themes (codes) and outcomes through consensus. Alternatively, software may be used to facilitate analysis. Sampling, coding, and analysis often occur in iterative cycles of proposing and checking. Once this analysis is complete, it is time to interpret the meaning of the themes and codes that have been presented. This ties your outcomes back to your research question. The literature review for a qualitative study should lay the theoretical premise and framework for your study and results. Once the data has been analyzed and interpreted and the literature review has been completed, the findings of your study are reported as they relate to your initial research question and previous research.

In conclusion. Qualitative research is used to investigate, explain, and describe. Family medicine education provides many possible research questions that are best investigated using qualitative methods. While qualitative research is a more flexible approach, step-wise, rigorous, and reproducible methods are still followed.

Reference Material

  1. Creswell JW. Research design: qualitative, quantitative, and mixed methods approaches, fourth edition. Los Angeles, CA: Sage Publications, 2014.
  2. Fereday J, Muir-Cochrane E. Demonstrating rigor using thematic analysis: a hybrid approach of inductive and deductive coding and theme development. International Journal of Qualitative Methods 2006;(5)1:80-92.
  3. Strauss AL, Corbin JM. Grounded theory procedures and techniques. Newbury Park, CA: Sage Publications, 1990.

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