Constructivist Grounded Theory Methodology Research Articles

Simulation psychological safety ecosystem: using constructivist grounded theory to explore nurses’ experiences with prelicensure simulation

Introduction Learning through simulation requires psychological safety where participants feel comfortable engaging to their fullest extent, speaking up or asking questions without fear of embarrassment. While professional simulation organizations provide recommendations on fostering psychological safety, anecdotal stories from newly graduated nurses demonstrated variability in their experiences. The study explored nurses’ experience with psychological safety in their prelicensure curricula. Methods Using constructivist grounded theory methodology, the researchers conducted 17 semi-structured interviews with nurses who had experienced simulation in their prelicensure curriculum. They collected and analysed data iteratively using constant comparison to identify categories and explore their relationships. They used theoretical sampling in later stages until data sufficiency was achieved. Results The constructed theory, Simulation Psychological Safety Ecosystem, expresses the variability of nurses’ experiences. Psychological safety is a dynamic, complex process with a spectrum of outcomes from feeling psychologically safe to suffering psychological harm. Factors that influence this outcome include clarification of Expectations, Facilitation from the instructor during scenarios, experience with Observation, and structure and quality of Debriefing/Feedback. Psychological safety is also influenced by nurses’ existing relationships with faculty and peers, and their desire to achieve meaningful clinical learning. Discussion Implications for nursing education reinforce clarifying expectations for equipment and roles, instructor presence, and observation. The findings suggest the benefits of establishing peer and faculty relationships prior to simulation-based education implementation and providing guidelines for faculty and peer feedback. Potential areas for future research include clarifying the ecosystem model and exploring the impact of faculty and peer relationships on psychological safety.

Role of emotions in change and change management in an emergency department: a qualitative study

BackgroundChanges in emergency departments are frequently implemented to improve efficiency and reduce costs. However, staff acceptance and adoption are crucial for the intended success of changes.ObjectivesThis study explored staff perceptions...

The Taxonomy of Predict-Observe-Explain (POE) as a Teaching Strategy and Thinking Process of Chemistry Stakeholders

Predict-observe-explain (POE) is a strategy being used during scientific investigations and experiments. However, POE-related studies mainly focused on its validity and reliability as a teaching strategy in classrooms. Thus, this paper extends the context of POE discussion not only as a teaching strategy but also as science process skills, and as cognitive thinking skills in performing experiments and answering scientific inquiries among chemistry stakeholders: students, teachers, and chemists. The study sees POE as a way to develop critical thinking and builds the skills needed for further academic and professional endeavors in the different fields of science. Through a constructivist grounded theory methodology using focus group discussions for students and in-depth interviews with the teachers and chemists, the study: described how students, teachers, and chemists exemplified POE strategy in terms of its process, and identified mutual patterns of POE process from the chemistry stakeholders. The study revealed that: student POE taxonomy is focused on basic processes and structures of POE; teacher POE taxonomy is a guide in their lesson planning; and chemist POE taxonomy is based on local and international compliance during experimentation. Therefore, POE is a science process skill for chemistry stakeholders where the POE taxonomy used by the chemistry stakeholders are different based on experiences, needs, and context.

"This whole journey was sacred": Latter-day Saint parents' process in coming to accept a transgender child.

This constructivist grounded theory (CGT) study examines Latter-day Saint (LDS) parents' process in coming to accept a transgender or gender diverse (TGD) child and the factors that impact acceptance. Data come from interviews with 38 LDS parents of TGD children and 130 Facebook posts from the same population. Data were analyzed using CGT methodology in coding and theory construction. A model of LDS parents' process in accepting a TGD child and the factors that impact that process are presented. The results indicate that coming to accept a TGD child tends to engage LDS parents cognitively, emotionally, socially, and spiritually, and is a developmental process. We identified four stages of parents' process: assimilation of new information, deconstruction and disequilibrium, reconstruction and accommodation, and acceptance; as well as typical emotional responses in each stage. We found that factors thatimpacted parents' process included parents' pre-process characteristics and contexts, religiously defined meaning making, social embeddedness, external resources, community building, and spiritual autonomy. Additionally, we found that parents' commitment to their child's wellbeing and connection with their child (i.e., attachment) motivates their process and that their personal spiritual experiences tend to guide it. Parents in the study who reached a state of acceptance expressed that their process had been both deeply challenging and profoundly, personally meaningful. This study strengthens the case for using attachment-based therapies with this population and indicates the value of incorporating spirituality into the therapeutic work.

Being different: what it means to be a person with albinism in Nigeria

Persons with albinism experience visual impairments and have unusually white hair and skin colour. In Nigeria, they face social disadvantages due to misconceptions about albinism, which create barriers to equal participation in education, employment, and society. This study explored the life stories of persons with albinism in Nigeria to understand the meanings they ascribe to their experiences. Using a Constructivist Grounded Theory methodology, forty-two interviews were conducted with eleven persons with albinism. ‘Being Different’ emerged as the main theme representing the life experiences of persons with albinism in Nigeria from childhood to adulthood. Participants expressed ‘Being Different’ through subthemes such as ‘being in a tug of war’, ‘disadvantaging schooling system’, and ‘suffering double tragedy’. The study concludes that strongly enforcing anti-discrimination laws, promoting inclusive education, and regularly educating the public about albinism can significantly reduce the negative effects of ‘Being Different’ in Nigeria.

Afghan immigrants' perceptions of integration policies in Iran

AbstractIn the contemporary global context, the challenge of integrating immigrants into host societies has gained prominence. This paper delves into the perceptions and experiences of Afghan immigrants in Iran regarding immigration policies and laws. Employing a constructivist grounded theory methodology, the study aims to uncover participants' interpretations and the meanings attributed to immigration policies and laws. Grounded theory analysis, involving initial, focused, and theoretical coding, was employed to collect data. The results reveal that current immigration laws and policies in Iran have led to economic disparities, limited educational opportunities, social isolation, and identity challenges for Afghan immigrants. Iran's integration policies lean towards exclusion. Consequently, Afghan immigrants experience a weakened sense of belonging in the country. Therefore, our study suggests the importance of implementing integration theories and policies instead of those promoting disintegration. Such policies not only hinder immigrants' assimilation but also impede the overall progress of the host nation, thus undermining social cohesion.

Embedding Public Involvement in a PhD Research Project With People Affected by Advanced Liver Disease.

Liver disease is an increasing cause of morbidity and mortality in the United Kingdom and can be challenging to live with in the advanced stages. There has been little research exploring the healthcare experiences of UK individuals with decompensated disease when the liver cannot carry out its functions properly. A PhD research project was developed with people who have liver disease to explore care experiences in decompensated advanced liver disease. Public involvement (PI) is an essential aspect of meaningful health research, and this paper reports on the progression of our PI approach in this ongoing study. To embed PI throughout the research project to ensure that the study is meaningful to individuals with liver disease and the people who support them. The research adopts a Constructivist Grounded Theory methodology to develop a theory of care experience. Various PI approaches were considered in developing the PI strategy for this qualitative study. Initially, Embedded consultation was the preferred model, which has evolved to include aspects of collaboration and coproduction. A PI group was set up to oversee the project through the national public engagement website VOICE, and reflections on PI from three members of the group are included in this paper to illuminate the PI process. Six individuals with liver disease and three carers from across the United Kingdom are part of an ongoing PI group. Their role includes commenting on the findings of the systematic literature review for this project and contributing to decisions about recruitment, data collection and data analysis. Additionally, they had a direct impact on changing the focus of the research. The PI group will continue involvement until the completion of the project. Successfully embedding PI into doctoral research, as demonstrated in this project, requires commitment, planning and dedication to reciprocal working for the benefit of PI contributors as well as the research. This approach could be adopted by other postgraduate researchers. This project is overseen by the PI group, whose contribution is described throughout, including reflections from three PI group members.

Quality of life assessment among ethnically diverse Black prostate cancer survivors: a constructivist grounded theory approach.

Prostate cancer (CaP) is the most common cancer in Black men (BM), and the number of Black CaP survivors is rapidly increasing. Although Black immigrants are among the fastest-growing and most heterogeneous ethnic groups in the USA, limited data exist regarding their CaP experiences. Therefore, this study aimed to explore and model the experiences of ethnically diverse Black men with CaP. In-depth interviews were conducted with 34 participants: native-born BM (NBBM) (n = 17), African-born BM (ABBM) (n = 11), and Caribbean-born BM (CBBM) (n = 6) CaP survivors recruited through QR code-embedded flyers posted in Black businesses, clinics, social media platforms, and existing research networks within the USA. Guided by Charmaz's constructivist grounded theory methodology, the interviews were analyzed using constant comparison following key stages of initial, focused, and theoretical coding using Atlas.ti v23. Participants were thirty-four men aged 49-84years (mean ± SD, 66 ± 8). Most were married (77%), likely to be diagnosed at stage I (35%), and treated with radiotherapy (56%). Our study findings explored the complex trajectory of Black prostate cancer (CaP) survivors, unveiling a comprehensive model termed "Journeying through Unfamiliar Terrain." Comprising three phases and 11 sub-phases, this model uniquely captures the pre-diagnosis awareness and post-treatment adaptation among survivors. The resulting theoretical model delineates the entire CaP survivorship process among BM, providing contextual and conceptual understanding for developing interventions and enhancing patient-centered care for ethnically diverse CaP survivors, pivotal in bridging the gaps in survivorship research and healthcare practices. Black CAP survivors experience significant burdens and challenges that impact their overall quality of life.Understanding the factors that impact the complex survivorship journey can inform design and implementation ofinterventions to address the multiple challenges and thus improve quality of life.

P.111 The surgeon experience of flow

Background: Cognitive flow has been linked with enhanced performance, career satisfaction, and decreased burnout. However, while elite sport has long trained athletes to enter flow states, the concept has not been adopted strongly in healthcare. Flow has primarily been explored from a unidimensional (cognitive) perspective. The present study sought to understand the experience of flow among surgeons through a multidimensional lens. Methods: Using a constructivist grounded theory methodology, semi-structured interviews were conducted with 19 staff surgeons at the University of Toronto, purposively sampled. Data were coded and analyzed iteratively by three researchers until theoretical saturation was achieved. Results: Although many surgeons had not previously heard of cognitive flow, the phenomenon deeply resonated with most. Participants described different physical, cognitive, emotional, sociocultural, and environmental components that interacted to shape the subjective experience of flow: “I think that there are many different facets of [flow] that don’t always come together all at the same time, you may feel different parts of it… depending on what the kind of case is, who your help is, if you recently had a complication.” (P4) Conclusions: Understanding flow in clinical practice may lead to new avenues for enhancing career satisfaction and promoting physician wellness.

Striving for Improved Infection Prevention and Control Practice: A Grounded Theory of Healthcare Workers' Struggles in Implementing Infection Prevention and Control Guidance in Uganda.

There is a scarcity of qualitative research focusing on the implementation of infection prevention and control (IPC) guidance in low-income countries. This study aimed to address this gap by exploring the perspectives of healthcare workers (HCWs) regarding the implementation of IPC guidance at the healthcare facility level in Uganda. The study also sought to generate a theoretical understanding of the processes involved in implementing IPC guidance in these settings. This robust qualitative research employed a design based on constructivist grounded theory methodology, conducting individual interviews with 13 frontline health workers such as doctors, nurses, nurse interns, and laboratory staff. The key findings of the study revealed that HCWs undergo a process of 'striving for improved practice' in their efforts to implement IPC guidance. This process involved four phases: recognising the importance of IPC, playing a role, encountering challenges, and overcoming challenges. However, achieving full implementation proved difficult due to various individual and organisational barriers presented by the low-income setting. HCWs employed improvisation as a means to overcome these obstacles. Additionally, the study identified enabling factors that facilitated the implementation of IPC guidance within these settings. This study is significant as it applies robust qualitative research methods to provide valuable evidence of HCWs' perspectives on an important topic in an under-researched context, with findings transferable to similar settings.

Representing the experiences of charity peer leaders facilitating well-being interventions to their peers using a constructivist grounded theory methodology

PurposeThis study aims to generate theory that represented charity peer leader experiences, facilitating well-being interventions to two specific groups of people: new mothers and refugees.Design/methodology/approachPart 1 of this study used in-depth interviews (n = 8) and phone calls with experienced mothers (called “peer leaders”) who had facilitated well-being interventions to new mothers. These interviews were analysed using Constructivist Grounded Theory (CGT) (Charmaz, 2014) generating a theory. Following a systematic literature review using the theory categories as search terms, a training approach was devised: The Modelled Training Approach (MTA). Refugees (n = 16) were trained to facilitate another well-being intervention using the MTA followed by a further set of interviews (n = 6). These interviews were analysed using CGT.FindingsA theory was generated representing the “journey” the peer leaders took: their lived experience triggered empathic feelings towards their peers, which motivated them to build a rapport where they gave hope. As a result, the peer leaders felt rewarded.Originality/valueThe literature search did not find any studies looking at the experiences of peer leaders in the above settings. The theory generated could support mental health peer work offsetting statutory health costs.

Exploring Diversity, Equity, and Inclusion-Related Pedagogy Across Different Professions.

Diversity, equity, and inclusion (DEI) have become an important priority for academic medicine. However, several barriers challenge the effective implementation of DEI-related pedagogy. An exploration of the barriers to and enablers of DEI-related pedagogy-as they relate to professional contexts-can inform how to advance DEI in medical education. Shulman's notion of signature pedagogies offers a foundation for understanding and exploring the influence of such contexts on teaching and learning. Comparisons across professions may help make signature pedagogies more visible and may facilitate change. In this study, the authors aim to explore how the professional contexts of medicine, nursing, and teacher education approach DEI-related pedagogy. The authors conducted a qualitative exploratory study using constructivist grounded theory methodology. Using both purposive and theoretical sampling, 24 participants from across the United States and Canada were interviewed, including physicians, nurses, and K-12 teachers in practice as well as professional educators in each discipline (May-December 2022). Interviews included a case-based elicitation approach, and data were analyzed iteratively across the data collection period using constant comparative analysis. Medicine and nursing tend to prioritize objectivity and seek to avoid or neutralize emotions that are intrinsic to DEI-related learning, view DEI expertise as being outside the purview of their profession, and view time for DEI as limited in a clinical learning environment. In contrast, teaching is built on the assumption that DEI expertise is co-constructed and inclusive of community voices and lived experiences. DEI-related pedagogy in teaching allowed for exploration of deep assumptions and learning about structural inequities. Findings suggest that assumptions and values held in professions, such as medicine and nursing, that valorize objectivity and neutrality, while stigmatizing vulnerability and suppressing emotions, may constrain DEI-related teaching and learning in such contexts.

Role of family medicine physicians in providing nutrition support to older patients admitted to orthopedics departments: a grounded theory approach.

Care of older adults requires comprehensive management and control of systemic diseases, which can be effectively managed by family physicians. Complicated medical conditions in older patients admitted to orthopedic departments (orthopedic patients) necessitate interprofessional collaboration. Nutrition is one of the essential components of management involved in improving the systemic condition of older patients. Nutrition support teams play an important role in nutrition management and can be supported by family physicians. However, the role of family physicians in nutrition support teams is not well documented. This study aimed to investigate the role of family physicians in supporting nutrition management in orthopedic patients. This qualitative study was conducted between January and June 2023 using constructivist grounded theory methodology. Eight family medicine physicians, three orthopedic surgeons, two nurses, two pharmacists, four rehabilitation therapists, four nutritionists, and one laboratory technician working in Japanese rural hospitals participated in the research. Data collection was performed through ethnography and semi-structured interviews. The analysis was performed iteratively during the study. Using a grounded theory approach, four theories were developed regarding family physicians' role in providing nutrition support to orthopedic patients: hierarchical and relational limitation, delay of onset and detection of the need for geriatric care in orthopedic patients, providing effective family medicine in hospitals, and comprehensive management through the nutrition support team. The inclusion of family physicians in nutrition support teams can help with early detection of the rapid deterioration of orthopedic patients' conditions, and comprehensive management can be provided by nutrition support teams. In rural primary care settings, family physicians play a vital role in providing geriatric care in community hospitals in collaboration with specialists. Family medicine in hospitals should be investigated in other settings for better geriatric care and to drive mutual learning among healthcare professionals.

The Jewish religious heritage continuum: Jewish religious communities’ interactions with synagogues and ceremonial objects in Amsterdam

ABSTRACT This article explores how rabbis, directors and members of Amsterdam’s Jewish religious communities view the heritagisation of Jewish religious life by analysing how they interact with Amsterdam’s main synagogues and their collections of ceremonial objects. It focuses on the synagogues of the Jewish Cultural Quarter – the Portuguese Synagogue with its accompanying Sephardi community, and the former Ashkenazi synagogue complex, now the Jewish Museum. From a dynamic heritage perspective, this heterogeneous constellation raises questions about how and why heritage making occurs here. Following a Constructivist Grounded Theory methodology, concurrent data collection and analysis let emerge interrelated conceptual categories that explain how communities interact with these functioning and musealised synagogues and objects: Embodying the transmission of tradition; Instrumentalising the heritage of Jewish religious life; Transforming the beauty of holiness; and Assembling in heritagised synagogues. These categories intersect in the core category of the Jewish religious heritage continuum, which this article presents as a dynamic embodiment of remembering, reconnection, and revival of Jewish tradition. For the interviewees, these performances, and the deployment of functioning and musealised synagogues and collections, form a cultural apparatus that marks their present, diverse and living material culture and grafts a Jewish future onto a Jewish past.

‘She became this liaison’. Perspectives of a preschool community on coaches as brokers of assistive technology access, communication and support for teachers and caregivers of children with disabilities

ABSTRACT While AT has been well-documented as a valuable support for disabled and nondisabled children across developmental domains and settings, several barriers to access and implementation persist. Studies have described heightened barriers for community-based preschools, whose access to AT professional development, AT resources, and practitioners with AT experience may be limited. Researchers in this qualitative inquiry engaged twenty-seven participants (teachers, teacher assistants, caregivers and administrators) to learn about their experiences of an AT intervention programme over a 2-year period. Using Constructivist Grounded Theory Methodology, we analysed data from focus groups and semi-structured interviews, generating five themes. Members of the school community valued the programme’s AT coaches, whose presence, affective style and actions promoted their confidence using AT. While the COVID-19 pandemic impacted both programme delivery and participants’ experiences, the programme and its coaches helped bolster technology and communication access in unanticipated ways. Insights from this inquiry emphasise the important, yet often understated role of building relationships with all participants when delivering community-based preschool interventions, invaluable in meeting the holistic needs of children, as well as the practitioners and families who support them. Notably, AT coaches were perceived as liaisons, building rapport, providing technical assistance, and sustaining connections within a school learning community.

Systemic family therapists and dementia: A constructivist grounded theory study

AbstractThis article presents research that explored the ways that systemic and family therapists might approach the support of families living with dementia. A constructivist grounded theory methodology was used to interpret interviews with four systemic family therapists working in the United Kingdom. All participants had professional and/or lived experience of dementia. Transcript analysis and theoretical sampling led to the development of five categories, each related to different aspects of considering systemic therapy in a dementia context. These categories were further developed into a ‘systemically informed dementia orienteering’ conceptual framework, which is presented in this paper as a learning resource. Findings are related to existing literature, and recommendations for future research are made.

Exploring epistemic aspects of engineering for K–12 science and engineering education

AbstractBackgroundSince the advent of the Next Generation Science Standards (NGSS), there has been an increasing focus on engineering in K–12 education. As educators and researchers have gained a better understanding of the nature of engineering in the decade following the release of the NGSS, there are new opportunities for growth and complexity.PurposeThis study used an epistemological approach to seek insights from experts in the science and engineering communities about the prominent aspects of engineering for K–12 education.Design/MethodThis mixed‐methods study employed a three‐round Delphi study and a focus group meeting to elicit experts' opinions on the epistemic aspects of engineering that could shed light on the nature of engineering knowledge and practices. Constructivist grounded theory methodology was used to identify preliminary themes concerning the epistemic aspects of engineering and then to develop main themes by combining relevant themes together.ResultsThe analysis process yielded 21 preliminary themes that reflect key ideas about the engineering knowledge base, engineering design activities, and values and norms of the engineering community. Additionally, the current study identified eight main themes that captured the broader patterns in the data.ConclusionsThe outcome of this study, including the preliminary themes and main themes concerning the epistemic aspects of engineering, could serve as a conceptual tool for establishing and improving students' conceptions of engineering and as a guide for designing and implementing engineering design activities in K–12 education settings.

Situating data relations in the datafied home: A methodological approach

Studying datafication focusing on the microlevel of everyday life poses epistemological and methodological challenges. Indeed, the black-boxed nature of algorithms makes data inaccessible and unintelligible to the researcher. Therefore, this paper aims to advance a methodological proposal for addressing the situatedness of datafication in everyday life by framing mediatised relations as a proxy for data relations. In particular, this research adopts a “non-media-centric” approach and frames families as communicative figurations. By reporting a qualitative longitudinal study on the datafication of childhood and family life involving 20 families with at least 1 child aged 8 years or younger in Italy and by employing a mixed method constructivist grounded theory methodology that includes network methods, we analyse three families as exemplary of different network articulations. Such an approach, we argue, can help materialise the mediatised relations through, about, and around data that emerge in contemporary family life.

How the commercial virtual care industry gathers, uses and values patient data: a Canadian qualitative study

ObjectivesTo understand and report on the direct-to-consumer virtual care industry in Canada, focusing on how companies collect, use and value patient data.DesignQualitative study using situational analysis methodology.SettingCanadian for-profit virtual care...

More than the sum of its parts-A constructivist grounded-theory study on specialist palliative care during crises like the COVID pandemic.

The COVID pandemic is an example of a crisis challenging healthcare systems worldwide. The impact of the pandemic on providing high-quality palliative care calls for a deeper understanding of specialist services during crises. This is essential in preparation for further crises. To develop a conceptual understanding of the impact of the pandemic on specialist palliative care as an example for arising future crises. Qualitative interview study across Germany, following a constructivist grounded theory methodology. Eleven semi-structured interviews with experts with overarching knowledge of structures and processes in specialist palliative care between 05-07/2020 and between 02-06/2021, 23 semi-structured interviews with healthcare professionals working in a specialist palliative care setting. The complex system of palliative care provision during crises has properties that cannot be understood as separated parts of the care process. The pandemic led to unique structural and processual challenges characterized by interconnectedness, uncertainty, dynamic, underlying dilemmas, and unclear long-term goal. In response to the pandemic, teams experienced different phases, which enhanced adaption, innovation, and progress within complex care situations. Creative strategy approaches and dynamic responsiveness facilitated innovative development and could lead to long-lasting improvement within services. Availability of information, transparent communication, comprehensible instructions, participation in decision-making, and search for solutions contributed to teams' proactive development throughout the pandemic. Addressing the complex problems in specialist palliative care caused by crises requires system thinking and a learning mindset. This can facilitate teams to overcome the crisis and move forward rather than bounce back to normal.