Making sense of qualitative research: a new series

Abstract

In the last 10 years, qualitative research methods have become increasingly well accepted within medical journals. In earlier times, qualitative researchers were used to having their manuscripts rejected on the grounds that their work was ‘unscientific’ and ‘anecdotal’. Now several mainstream medical journals regularly publish qualitative research and have guidelines for the evaluation of qualitative papers. It is hard to find medical audiences that do not have at least some awareness of qualitative methods and their potential contribution to knowledge. Medically qualified researchers are increasingly using these methods themselves. However, wider acceptance does not necessarily mean that qualitative methods are well understood. Some clinicians may regard them as matters of common sense, or as straightforward and easy, especially those who spend much of their time talking to patients. Studying qualitative methods often brings home to clinicians the fact that qualitative research can be labour-intensive and time-consuming, as well as intellectually challenging. As a teacher of qualitative methods, I feel I have succeeded if I have changed a student's perception that qualitative research is a soft option into one that considers that it would be much easier and quicker to carry out a questionnaire survey. There is an overwhelming choice of textbooks on qualitative research, aimed at a wide variety of audiences. What are missing are succinct and accessible explanations of the major methods in qualitative research, and their potential application to the kinds of research questions that practitioners would like to investigate. In particular, the application of qualitative methods to medical education research has not been explored in the pages of this journal. Such methods have been developed in disciplines such as anthropology, education, psychology, sociolinguistics and sociology, and represent a rich resource for medical education researchers wishing to broaden the scope of their investigations. There is a long tradition of qualitative sociological research on medical education, beginning with the work of Becker and colleagues in the 1960s1 and continuing through Atkinson's research in the 1980s2 to that of Sinclair in the 1990s.3 The issues these studies sought to address include the ways in which medical students are taught to ‘see’ what is in front of them and the ways in which students' educational activities in medical school may be regarded as theatrical performance. The more widespread acceptance of qualitative methods has not been without its own problems. There is an over-emphasis on the use of interviews and focus groups as methods of data collection, and a comparative neglect of observational and other methods more concerned with actions than perceptions. The codification of qualitative methods which has accompanied their acceptance into the medical canon has led to heated debates about the appropriateness of using checklists for evaluating research quality, and the inappropriate use of terms such as ‘grounded theory’. As a result, medical audiences may not realise that the range of methods extends well beyond interviews and focus groups, or that qualitative methods can tell us about much more than respondents' perceptions. They may believe there is more homogeneity in qualitative research than is the case, or that the only respectable kind of qualitative research is something that calls itself grounded theory. This journal has an educational mission in relation to research methods as well as to medical education itself, as demonstrated by the recent series on the metric of medical education research. As its name suggests, this series focused on quantitative methods. The journal has now decided to run a comparable series about qualitative research to increase readers' awareness of the range of methods available and their relevance to educational research. The specific aims of the series are: to make readers aware of the range of qualitative research performed outwith the field of medical education; to bring to readers' attention some contemporary issues in qualitative research; to give readers a broader understanding of qualitative research methods so that they will be better able to understand and interpret this type of research; to encourage readers to think how they might possibly apply such methods to their own areas of interest; to increase readers' awareness of how methods and approaches to qualitative research have been used in health and education research and to use this awareness in their own work settings, and to give readers suggestions for further reading. We anticipate recruiting between 12 and 15 authors, all of whom will be well known in their respective fields, with a view to publishing a series of papers on different aspects of qualitative research. Our plans are well advanced but we would welcome suggestions for further contributions. The papers will be practical in their focus, well written, and will draw from relevant theories. They will include examples relevant to medical education in order to inspire our readers and begin to equip them to pursue new lines of enquiry themselves. The point is not to produce a cookbook, but to help educationalists to frame their own research questions and to see new possibilities for researching the questions they are interested in.