‘Difficult Bedfellows’: Relate Supervisors' Experiences of Synthesising the Functions in Their Roles

Background: Reflexive thematic analysis is widely used in qualitative research published in Palliative Medicine, and in the broader field of health research. However, this approach is often not used well. Common problems in published reflexive thematic analysis in general include assuming thematic analysis is a singular approach, rather than a family of methods, confusing themes and topics, and treating and reporting reflexive thematic analysis as if it is atheoretical. Purpose: We reviewed 20 papers published in Palliative Medicine between 2014 and 2022 that cited Braun and Clarke, identified using the search term ‘thematic analysis’ and the default ‘relevance’ setting on the journal webpage. The aim of the review was to identify common problems and instances of good practice. Problems centred around a lack of methodological coherence, and a lack of reflexive openness, clarity and detail in reporting. We considered contributors to these common problems, including the use of reporting checklists that are not coherent with the values of reflexive thematic analysis. To support qualitative researchers in producing coherent and reflexively open reports of reflexive thematic analysis we have developed the Reflexive Thematic Analysis Reporting Guidelines (the RTARG; in Supplemental Materials) informed by this review, other reviews we have done and our values and experience as qualitative researchers. The RTARG is also intended for use by peer reviewers to encourage methodologically coherent reviewing. Key learning points: Methodological incoherence and a lack of transparency are common problems in reflexive thematic analysis research published in Palliative Medicine. Coherence can be facilitated by researchers and reviewers striving to be knowing – thoughtful, deliberative, reflexive and theoretically aware – practitioners and appraisers of reflexive thematic analysis and developing an understanding of the diversity within the thematic analysis family of methods.

This paper presents a comparative conceptual review of major qualitative data analysis approaches, focusing on reflexive thematic analysis, interpretative phenomenological analysis, and narrative inquiry. Although reflexive thematic analysis is part of the broader tradition of thematic analysis, it is examined here as a distinct approach because of its specific epistemological assumptions, analytical procedures, and strong emphasis on researcher reflexivity (Braun and Clarke, 2006; 2019; 2021). The study explores how these three approaches differ in their engagement with data, construction of meaning, and interpretation of participants’ experiences. It compares their philosophical foundations, the role of the researcher in knowledge production, and their methods of developing analytical claims (Smith et al., 2009; Riessman, 2008). Rather than presenting new empirical findings, the paper synthesises methodological literature to examine how coding, theme development, interpretation, and reflexivity are understood and practised within each tradition. Particular attention is given to the researcher's positionality, analytical transparency, and theoretical engagement in shaping qualitative interpretations. Through systematic comparison, the study identifies key similarities and differences in how qualitative data are organised, interpreted, and evaluated. It shows how different analytical choices influence clarity, depth, and credibility in qualitative research. By bringing these approaches together, the study offers clear guidance to help researchers understand their options and analyse data more effectively in complex social research.

The phenomenon of perinatal distress in terms of depression, anxiety, bipolar, and psychotic disorders is well-explored in the West but barely investigated in South Asia; particularly research evidence highlighting the cultural expression of couples’ mental health with respect to Pakistan is rare. The purpose of this research is to focus on the exploration of psycho-socio-cultural expression of couples’ perinatal distress and coping strategies used in the Pakistani context in relation to maternal and paternal mental health, with implications for the wellbeing of their unborn or born progeny. The research design focused on qualitative interpretative approaches. In data triangulation, reflexive thematic analysis and interpretative phenomenological analyses were applied on the verbatim of the semi-structured interviews conducted with the mental health professionals (n = 9) and the couples (n = 8), screened positive for perinatal distress. Four couples were screened out of 325 perinatal women visiting the gynaecological ward of Aziz Bhatti Shaheed Teaching Hospital, Gujrat. Edinburg Postnatal Depression Scale, Generalized Anxiety Disorder-7 and Washington Early Recognition Center Affectivity and Psychosis Screen are the standardized instruments considered to be used for screening perinatal distress among couples. The Urdu version of WERCAP Screen was developed by a standardized forward-backward translation procedure. The rest of the four couples were purposively selected from the psychiatric ward of the same hospital. The Simplified Negative and Positive Symptoms Interviews were administered to the couples after getting approval for the Urdu version form. All couples were probed with an indigenously developed Structured Clinical Interview Schedule for DSM Disorders based on DSM-5-TR. The triangulation carried out with reflexive thematic analysis and interpretative phenomenological analysis revealed cultural conception of perinatal distress as perceived by the mental health professionals and experienced by the couples during the antenatal and postnatal period of their lives. They were enlightened with a constructive view aimed at promoting transformational change in terms of their mental health care and coping. The implications suggested implementation of a psychotherapeutic intervention for reduction in the level of distress and subsequent enhancement of well-being in couples during the perinatal period.

A transparent analytical process contributes to the methodological rigor of reflexive thematic analysis. To enhance such transparency in reflexive thematic analysis, novice researchers need to document and present the analytical processes of theme development. In this article, we showcase how qualitative comparative analysis can be integrated into reflexive thematic analysis as a strategy for novice researchers. We demonstrate how novice researchers can develop codes and categories, use qualitative comparative analysis to facilitate the exploration of the complex causal relationships between categories, and construct candidate themes based on these analyses. We then show how novice researchers can continue developing these themes by creating relationships between codes and categories on the basis of qualitative data and existing literature. Such integration of methods not only facilitates theme development, but also assists researchers in justifying the decisions made in a reflexive thematic analysis process. The analytical procedures presented in this article may thus help novice researchers engaged in reflexive thematic analysis to enhance the transparency of their analytical process.

BackgroundClinical placements are an essential part of student nurse education, but their effectiveness is influenced by the type and availability of supervision and existing resources. In Sri Lanka, the specific socio-political context in which nursing, and nurse education, operate may also be important. ObjectivesTo examine the impact of socio-political factors on Sri Lankan nurses' supervisory practices and student nurses' experiences of clinical supervision. DesignQualitative descriptive. SettingsFour teaching hospitals and four educational establishments in Colombo district, Sri Lanka. Participants217 student nurses in years 2–4 of their programmes. 205 qualified nurses (clinical and academic) with a minimum of two years' supervisory experience. MethodsWritten responses to three open questions, followed by reflexive thematic analysis with inductive, semantic coding. ResultsTwo themes were identified: 1. Personal and professional development 2. Tensions and conflicts. Sociocultural norms and governance structures, which limited nurses' professional recognition and self-determination, negatively affected clinical supervision. ConclusionsThe sociocultural changes necessary to raise the professional status of Sri Lankan nurses will take time to occur. Approval of a mentorship education programme for supervisors, recognition of their role and greater support for students are important first steps in this process.

Many new athletic trainers (ATs) obtain graduate-assistant (GA) positions to gain more experience and professional development while being mentored by a veteran AT; however, GA ATs' perceptions of the supervisor's role in professional development are unknown. To explore the supervisor's role in the professional development of GAs in the collegiate setting. Qualitative study. Phone interviews. A total of 19 collegiate GAs (15 women, 4 men; average age = 23 ± 0.15 years; National Collegiate Athletic Association Division I = 13, II = 3, III = 2; National Association of Intercollegiate Athletics = 2; postprofessional athletic training program = 5). Data were collected via phone interviews and transcribed verbatim. Interviews were conducted until data saturation occurred. Data were analyzed through phenomenologic reduction. Trustworthiness was established via member checks and peer review. Three themes emerged: (1) GAs' expectations of supervisors, (2) professional development, and (3) mentoring and support. Participants expected their supervisors to provide mentorship, support, and feedback to help them improve their athletic training skills, but they also realized supervisors were busy with patient care responsibilities. Most participants felt their supervisors were available, but others believed their supervisors were too busy to provide support and feedback. Participants felt their supervisors provided professional development by teaching them new skills and socializing them into the profession. Furthermore, they thought their supervisors provided mentorship professionally, personally, and clinically. Supervisors supported the participants by standing behind them in clinical decisions and having open-door policies. The graduate assistantship allows new ATs to gain experience while pursuing professional development, mentorship, and support from a supervisor. The extent of development is highly dependent on the supervisor, but most supervisors mentor GAs. When looking for graduate assistantships, future GAs should seek positions in which supervisors actively provide mentoring and professional development.

There are increasing numbers of international students applying for preregistration nursing courses in the UK. Encouraging overseas students to study nursing in the UK has potential benefits for the profession, but practice assessors and practice supervisors may face challenges when supporting international students during placements. To explore the experiences of practice assessors and practice supervisors in facilitating international preregistration nursing students' learning during placements. A qualitative interpretive research method was used. Data from ten semi-structured interviews undertaken in one hospital in an acute NHS trust were analysed using reflexive thematic analysis and interpretive approaches. Three overarching themes emerged: communication, support and collaboration. Participants identified barriers related to language and culture and expressed a desire for additional information about students' background before the start of placements. Solutions included drawing from the expertise of colleagues with similar backgrounds to those of students, using buddying and creating peer support groups. Effective collaboration between universities and practice placement providers is needed to develop interventions that can support practice assessors and practice supervisors to enhance international students' learning experiences.

Aim/Purpose: In this case study research, we aimed to understand the development of effective doctoral supervision practices in Educational Research by examining supervisors’ experiences as doctoral students and how they learned their evolving supervision and mentoring roles as professors. Background: Doctoral supervision is shaped by institutional systems, program structures, research cultures, and national guidelines. Supervisors impact doctoral students’ research experiences, academic success, and personal growth. Many new professors lack formal training, rely on their own experiences being supervised, and learn how to supervise effectively through trial and error and on the job. Methodology: Our case study research involved interviewing five tenured, mid-career doctoral supervisors who were deemed effective based on doctoral student completions. Using reflexive thematic analysis and evaluative coding of interview transcripts, we identified two key findings and nine themes to describe supervisors’ experiences as doctoral students and their on-the-job development and practices as supervisors. Contribution: This study highlights how experiences being supervised as a doctoral student impact and influence the development of supervision practices in combination with various experiences of learning on-the-job during one’s academic career. We expand understanding of the complexity of supervision practice and uncover differences between contemporary contexts and past experiences being supervised. We demonstrate how several supervisors translated impoverished experiences with their own supervisor into targeted efforts to learn how to effectively supervise their own students, to change history, and to deliberately not supervise the way they were supervised. Findings: Two findings are presented: (1) experiences being supervised influence early supervision practices, and (2) learning to supervise on-the-job happens in a variety of ways. Nine themes describe how supervisors’ experiences being supervised influenced their supervisory practices and the various informal on-the-job development approaches, such as learning from students, colleagues, and prior career experiences. Findings highlight the roles of doctoral supervisors, academic peers, doctoral students, programs, and institutions that contribute to developing effective supervisory practices. In our case study, we demonstrate how supervisors can transform academic and research cultures over time. Recommendations for Practitioners: Institutions, programs, and supervisors play crucial roles in ensuring doctoral student success. Institutions should offer structured professional learning and peer mentoring that supports supervisors in developing effective practices early in their careers. By leveraging study findings, institutions can design professional learning opportunities that increase faculty adoption of effective supervision practices and accelerate their learning. Recommendation for Researchers: Given the vital role played by supervisors in research training and talent development of the next generation of researchers and leaders across society, we argue it is crucial to understand and optimize the ways in which doctoral supervisors develop effective supervisory practice as a matter of ongoing research interest. Future research can investigate the importance of intergenerational learning and knowledge transfer in academia, encouraging a more reflective and informed approach to supervisory development. Impact on Society: Findings can inform how to maximize individual, institutional, and governmental investments in higher education. This research can improve outcomes in doctoral education by expanding effective, research-informed development of supervisory practices. Quality supervision impacts doctoral students’ academic success, mental health, and career progression. Understanding supervisory lineage enables universities to enhance current and future doctoral experiences. Future Research: Four questions are provided to guide and promote supervisory development and ongoing research. There is an ongoing need to examine how supervisors and doctoral students define the impact and outcomes of successful supervision and mentoring practices beyond the completion of the thesis.

Thematic analysis methods, including the reflexive approach we have developed, are widely used in counselling and psychotherapy research, as are other approaches that seek to develop ‘patterns’ (themes, categories) across cases. Without a thorough grounding in the conceptual foundations of a wide variety of across‐case analytic approaches, and qualitative research more broadly—something rarely offered in counselling training—it can be difficult to understand how these differ, where they overlap, and which might be appropriate for a particular research project. Our aim in this paper is to support researchers in counselling and psychotherapy to select an appropriate across‐case approach for their research, and to justify their choice, by discussing conceptual and procedural differences and similarities between reflexive thematic analysis (TA) and four other across‐case approaches. Three of these are also widely used in counselling and psychotherapy research—qualitative content analysis, interpretative phenomenological analysis and grounded theory. The fourth—discourse analysis—is less widely used but importantly exemplifies the critical qualitative research tradition. We contextualise our comparative approach by highlighting the diversity within TA. TA is best thought of as a spectrum of methods—from types that prioritise coding accuracy and reliability to reflexive approaches like ours that emphasise the inescapable subjectivity of data interpretation. Although reflexive TA provides the point of comparison for our discussion of other across‐case approaches, our aim is not to promote reflexive TA as ‘best’. Rather, we encourage the knowing selection and use of analytic methods and methodologies in counselling and psychotherapy research.

Supervision of staff in the helping professions is valued and considered important for effective service delivery, with expert consensus that the delivery of high-quality supervision strengthens the social service workforce. The demands of publicly funded settings provide compelling rationale for supervision to protect marginalized clients, while ensuring staff are supported in delivering quality services. As conceptual frameworks, models of supervision are one way to strengthen supervision through intentionally incorporating theory, best practices, and research. Theoretically grounded and integrative, the Stop Now and Plan (SNAP) clinical supervision model incorporates best practices, guidelines, and techniques informed by explanatory and practice theories, and research. This article presents a qualitative study exploring the experiences of supervisors and supervisees in children's mental health settings implementing this model of supervision for an evidence-based intervention. Reflexive thematic analysis was conducted using qualitative data collected from participant interviews (N = 20) directly following the completion of a 6-month implementation of the SNAP model of clinical supervision. Identified themes demonstrate the value of a structured model of supervision in supporting practitioner confidence, accountability, and professional development, while allowing supervisors to meet their responsibilities to their team and their organizations. The challenges associated with implementing a supervision model within publicly funded settings are highlighted, with suggestions for over coming these challenges provided. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Several Indian states have banned the sale of loose cigarettes, and India is considering a national ban. This study examines the perceptions of policymakers, implementers, and law enforcement officials regarding the implementation and enforcement of this ban. Between May-October 2022, we conducted in-depth interviews with 26 key stakeholders involved in tobacco control in two Indian cities, Delhi (where the ban was not implemented) and Mumbai (where the ban was in effect). Participants included representatives from various government departments such as police, municipal corporations, FDA, health, and civil society organizations / NGOs such as Vital Strategies, World Health Organization, International Union against Tuberculosis and Lung Disease, and local NGOs. Interviews explored policy awareness, implementation and enforcement status, and factors influencing implementation and enforcement of the ban. Interview transcripts were organized in NVivo, and reflexive thematic analysis was conducted. In Mumbai, awareness of the ban was poor among implementers and law enforcers, including FDA, municipal, and police officials, while it was higher among health department officials and NGOs directly involved in tobacco control. Participants from Mumbai expressed that the implementation and enforcement of the ban was poor and loose cigarettes were still widely available. Main barriers to policy implementation included unclear implementation guidelines, poor awareness among tobacco vendors, limited resources, and lack of stakeholder commitment for tobacco control. Participants from both the cities emphasized the need for a vendor licensing system, imposing hefty penalties, imparting health education, and a multi-sectoral approach for effective policy implementation and enforcement. Limited awareness of the ban and continued sale of loose cigarettes highlight gaps in policy implementation and enforcement. Effective policy implementation and enforcement requires raising awareness regarding the policy, adopting a tobacco vendor licensing system, and establishing clear implementation guidelines involving a multi-sectoral approach.

There are increasing demands for including interprofessional education (IPE) within medical curricula. Primary care is a relatively new medium for IPE. Traditionally in medical programs, most primary care placements are in general medical practice. However, primary care may provide a sustainable solution for practice-based interprofessional learning; ultimately, improving interprofessional collaborative practice. An innovative program at Sydney Medical Program (Australia) incorporates medical student placements with various primary care interprofessional supervisors. Uniprofessional supervisor experiences are well documented. In this qualitative study, we aimed to gain an in-depth understanding of interprofessional supervisor experiences and motivating factors affecting their recruitment and ongoing engagement. Semi-structured interviews were conducted with 21 supervisors from various health professions. Themes were developed through reflexive thematic analysis and further explored using self-determination theory (SDT) as a theoretical lens. Key themes impacting motivation were identified: (a) Affordances and challenges in providing placements (b) Developing competencies and enhancing skills (c) Bridging gaps in primary care. Using SDT as a framework enabled a better understanding of supervisor perceptions and motivation for participating in student placements. Encouraging supervisor autonomy, engaging supervisors in faculty development, and strengthening their relatedness to universities are key to forming sustainable partnerships and enriching student learning in uni- and interprofessional settings.

Reflexive thematic analysis (reflexive TA) originated within psychology and the social sciences and has become an increasingly popular qualitative analytic method across a range of disciplines. In this article, we offer a brief methodological guide for researchers hoping to use the method, suitable for beginners through to those experienced in qualitative research. Reflexive TA can be used to analyze data generated via a range of methods. Reflexive TA is highly flexible, and we outline the choices that researchers need to address when conducting their research. These choices relate to the theoretical approach (realist through to relativist/experiential to critical), their orientation to analyzing the data (inductive to deductive), and the depth in which they analyze their dataset (semantic to latent). We offer an accessible but comprehensive discussion of the six phases of reflexive thematic analysis and how best to produce a rigorous analysis. Starting with familiarization of the dataset as a foundation for analysis, data are then coded, before using these codes to generate initial themes. These early themes are then reviewed and developed, before the researcher moves to defining and naming them. The final phase of analysis is the writing up of the research, at which point final changes may still be made to the results. Written from the basis of our experience of using, teaching, and training reflexive thematic analysis within psychology and the social sciences, we see it as useful for those working across a range of disciplines.

Thematic analysis is a widely cited method for analyzing qualitative data. As a team of graduate students, we sought to explore methods of data analysis that were grounded in qualitative philosophies and aligned with our orientation as applied health researchers. We identified reflexive thematic analysis, developed by Braun and Clarke, as an interpretive method firmly situated within a qualitative paradigm that would also have broad applicability within a range of qualitative health research designs. In this approach to analysis, the subjectivity of the researcher is recognized and viewed not as problematic but instead valued as integral to the analysis process. We therefore elected to explore reflexive thematic analysis, advance and apply our analytic skills in applied qualitative health research, and provide direction and technique for researchers interested in this method of analysis. In this paper, we describe how a multidisciplinary graduate student group of applied health researchers utilized Braun and Clarke’s approach to reflexive thematic analysis. Specifically, we explore and describe our team’s process of data analysis used to analyze focus group data from a study exploring postnatal care referral behavior by traditional birth attendants in Nigeria. This paper illustrates our experience in applying the six phases of reflexive thematic analysis as described by Braun and Clarke: (1) familiarizing oneself with the data, (2) generating codes, (3) constructing themes, (4) reviewing potential themes, (5) defining and naming themes, and (6) producing the report. We highlight our experiences through each phase, outline strategies to support analytic quality, and share practical activities to guide the use of reflexive thematic analysis within an applied health research context and when working within research teams.

Aim(s): The present study explored perspectives of school staff, who shared their experiences of facilitators and barriers to mainstream school ‘emotional based school avoidance’ (EBSA) initiatives and practices, and school-aged pupils presenting with EBSA, who described what supported or hindered their school experiences. Method: Semi-structured interviews were conducted with six mainstream school staff and seven school-aged pupils who have engaged in EBSA. Staff interviews were analysed using reflexive thematic analysis (RTA), and pupil interviews were analysed using Interpretative Phenomenological Analysis (IPA). Findings: Six main themes emerged across the two samples, two of which are presented in the present study: for school staff, ‘Systemic and Unanticipated Barriers’; and for pupils, ‘Pupil’s Sense of Inclusivity’. Findings from school staff suggest that EBSA initiatives and practices are hindered by financial constraints, less cooperative families, and misalignment with external partners, who may function according to different working models. For pupils, the findings suggest their experience is facilitated when they feel included, accepted, have a sense of school belonging, and where there is attention towards their interests, strengths, and achievements. Limitations: This research did not capture parent voices, even though their involvement is a crucial aspect in supporting their children. Conclusions: This study highlights some of the long-standing (systemic) challenges as well as those associated with multi-agency working and working with families, which threaten to impede effective EBSA initiatives and practices. It also highlights the power of inclusivity and positive relationships for pupils, which may function as a protective factor to their school attendance.