Abstract
Background In a recent editorial,1 discuss the use of ethnography and the ‘ethnographic label’ in health services research. Commenting on Vindrola-Padros & Vindrola-Padros’2 review of ‘rapid ethnographies’, the authors encourage further debate around the use of the ethnographic label in this scholarly field. Aim and objectives We wish to contribute to this debate by discussing our experience of carrying out ethnographic observations informed by anthropological and Actor-Network Theory (ANT) sensibilities. To illustrate the methodological challenges and possibilities of ethnographic work in health care we use examples from our recent study of the collection and impact of patient experience data.3 Methods This paper draws upon a study which comprised two main phases: 1) a one-year long ANT-informed ethnographic study of five participating NHS Trusts in England, and 2) a series of workshops (one cross-site and five local workshops) in the format of Joint Interpretive Forums (JIFs). Results We focus here in particular on how the researchers in our team – mainly trained anthropologists - worked through ANT ‘sensibilities’ throughout the duration of ethnographic observation and the further analytical work following data generation. We also discuss how interacting with NHS staff and patients in the context of the JIFs required adaptation and re-calibration of these sensibilities. We explore how these sensibilities are refined and challenged through engagement with the field in different ways to develop a particular „amalgam of anthropological, ‘ANTy’ and health services approaches. Conclusions We suggest that the use of the ‘ethnographic label’ should be reserved for studies which provide,4 words, ‘thick description coupled with theoretical interrogation’. We suspect this process is unlikely to be ‘rapid’ but also that –as our experience demonstrates - it can still lead to applicable, generalisable and timely evidence for health policy and practice. References Cupit C, Mackintosh N, Armstrong N. Using ethnography to study improving healthcare: Reflections on the ‘ethnographic’ label. BMJ Quality and Safety, 2018;27:258–260. Vindrola-Padros C, Vindrola-Padros B. Quick and dirty? A systematic review of the use of rapid ethnographies in healthcare organisation and delivery. BMJ Quality and Safety, 2018;27:321–330. Donetto S, Desai A, Zoccatelli G, Robert G, Allen D, Brearley S, Rafferty A.M. (in press). Exploring the impact of patient experience data in acute NHS hospital trusts in England: using Actor-Network Theory to optimise organisational strategies and practices for improving patients’ experiences of care. London: National Institute for Health Research. Jowsey T. Watering down ethnography. BMJ Qualityand Safety, 2016;25:554–555.
Highlights
Psychostimulant use has increased over the past two decades, notably in North America, referring to pharmaceuticals such as Adderall, Ritalin, and Vyvanse
About half of the children who fall ill with cancer must migrate to another city
This gives rise to different forms of territorial mobility
Summary
Psychostimulant use has increased over the past two decades, notably in North America, referring to pharmaceuticals such as Adderall, Ritalin, and Vyvanse. While these medications are prescribed for Attention Deficit/Hyperactivity Disorder, an accrued non-medical use is reported. We discuss how interacting with NHS staff and patients in the context of the JIFs required adaptation and re-calibration of these sensibilities. We explore how these sensibilities are refined and challenged through engagement with the field in different ways to develop a particular amalgam of anthropological, ‘ANTy’ and health services approaches
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