Construction Of Vignettes Research Articles

Use of vignettes in an international comparative social work research

The aim of this article is to reflect on the strengths and challenges in qualitative comparative research on personal social services. The specific methodological approach that these reflections emerge from is the application of case vignettes in focus group interviews with social workers, working in different welfare regimes. We describe the process of vignette construction and implementation in focus group interviews, and relate this to findings in a large international project with researchers and data from Chile, Mexico, Norway, Sweden, Lithuania, Bulgaria, Ireland and the UK. Findings reveal that some globally spread professional norms prevail when they are applied locally, while others are more formed through welfare systems with strong contextual norms and legal and socio-economic barriers. Furthermore, the project showed that to use case vignettes and focus groups, in order to compare ‘social work’ in its totality between countries, is really difficult. It appears more fruitful to use such research methods to compare subsectors and sub-disciplines instead of social work as a whole. The strength of the data retrieved from the study is that it makes it possible to separate information on actual practice from information on principles and system norms, thus providing in-practice and on-practice reflections.

Vignettes as a novel research tool in spiritual care: A methods paper.

To discuss the construction and use of vignettes as a novel approach in spiritual care research and education. Methods paper. In this methods paper, the authors introduce the use of vignettes in spiritual care research and provide insight into the construction of vignettes. The vignette presented was part of a study of neurosurgical nurses' attitudes and responses to the spiritual needs of neuro-oncology patients. The development process, consisting of four steps, is explained in this paper. Using a vignette to explore nurses' attitudes towards spiritual care is an innovative way to understand what behaviours nurses consider appropriate insituations where the patient is seeking meaning and connection. Transparent description of the development process is crucial to ensure reproducibility. The use of theoretically constructed and validated vignettes in spiritual care research is new. Vignettes used in surveys have the potential to elicit nurses' responses to patients' search for meaning and connectedness. In order to investigate nurses' attitudes and behaviours towards patients' spiritual needs, carefully constructed and validated vignettes are valuable research tools. Vignettes have proven to be a valuable research tool in the social and health sciences. So far, their use as a survey instrument in spiritual care research has not been investigated. Therefore, this method paper introduces vignettes as a novel approach to spiritual care research. Our findings contribute to the further development of vignettes in nursing science, as there are similarities with case development and simulation training in nursing education. Reporting guideline is not applicable. No patient or public contribution.

Estimation of Health State Utility Values in Fabry Disease Using Vignette Development and Valuation

Background: Health state utilities are measures of health-related quality of life that reflect the value placed on improvements in patients’ health status and are necessary for estimation of quality-adjusted life-years. Health state utility data on Fabry disease (FD) are limited. In this study we used vignette (scenario) construction and valuation to develop health state utilities. Objectives: The aim of this study was to use vignette construction and valuation to estimate health state utility values suitable for inclusion in economic models of FD treatments. Methods: Health state vignettes were developed from semistructured qualitative telephone interviews with patients with FD and informed by published literature and input from an expert. Each vignette was valued in an online survey by members of the United Kingdom (UK) general population using the composite time trade-off (TTO) method, which aims to determine the time the respondent would trade to live in full health compared with each impaired health state. Results: Eight adults (50% women) with FD from the UK were interviewed. They were recruited via various approaches, including patient organizations and social media. The interviewees’ responses, evidence from published literature, and input from a clinical expert informed the development of 6 health state vignettes (pain, moderate clinically evident FD [CEFD], severe CEFD, end-stage renal disease [ESRD], stroke, and cardiovascular disease [CVD]) and 3 combined health states (severe CEFD + ESRD, severe CEFD + CVD, and severe CEFD + stroke). A vignette valuation survey was administered to 1222 participants from the UK general population who were members of an external surveying organization and agreed to participate in this study; 1175 surveys were successfully completed and included in the analysis. Responses to TTO questions were converted into utility values for each health state. Pain was the highest valued health state (0.465), and severe CEFD + ESRD was the lowest (0.033). Discussion: Overall, mean utility values declined as the severity of the vignettes increased, indicating that respondents were more willing to trade life-years to avoid a severe health state. Conclusions: Health state vignettes reflect the effects of FD on all major health-related quality-of-life domains and may help to support economic modeling for treatment of FD.

Estimation of Health State Utility Values in Fabry Disease Using Vignette Development and Valuation.

Background: Health state utilities are measures of health-related quality of life that reflect the value placed on improvements in patients' health status and are necessary for estimation of quality-adjusted life-years. Health state utility data on Fabry disease (FD) are limited. In this study we used vignette (scenario) construction and valuation to develop health state utilities. Objectives: The aim of this study was to use vignette construction and valuation to estimate health state utility values suitable for inclusion in economic models of FD treatments. Methods: Health state vignettes were developed from semistructured qualitative telephone interviews with patients with FD and informed by published literature and input from an expert. Each vignette was valued in an online survey by members of the United Kingdom (UK) general population using the composite time trade-off (TTO) method, which aims to determine the time the respondent would trade to live in full health compared with each impaired health state. Results: Eight adults (50% women) with FD from the UK were interviewed. They were recruited via various approaches, including patient organizations and social media. The interviewees' responses, evidence from published literature, and input from a clinical expert informed the development of 6 health state vignettes (pain, moderate clinically evident FD [CEFD], severe CEFD, end-stage renal disease [ESRD], stroke, and cardiovascular disease [CVD]) and 3 combined health states (severe CEFD + ESRD, severe CEFD + CVD, and severe CEFD + stroke). A vignette valuation survey was administered to 1222 participants from the UK general population who were members of an external surveying organization and agreed to participate in this study; 1175 surveys were successfully completed and included in the analysis. Responses to TTO questions were converted into utility values for each health state. Pain was the highest valued health state (0.465), and severe CEFD + ESRD was the lowest (0.033). Discussion: Overall, mean utility values declined as the severity of the vignettes increased, indicating that respondents were more willing to trade life-years to avoid a severe health state. Conclusions: Health state vignettes reflect the effects of FD on all major health-related quality-of-life domains and may help to support economic modeling for treatment of FD.

Disrupting phonocentricism for teaching Deaf pupils: prospective physical education teachers’ learning about visual pedagogies and non-verbal communication

ABSTRACT Background: When compared to their hearing peers, Deaf pupils are likely to experience fewer activities and participate less often in physical education (PE), be less physically active, lag in motor skill development, and are more likely to be overweight or obese. While the reasons for these differences are nuanced and complex, established phonocentric pedagogical practices and (mis)communication between Deaf pupils and hearing PE teachers have been identified as key issues of concern. Purpose: The purpose of this research is to explore prospective PE teachers’ attempts to disrupt phonocentricism by learning about visual pedagogies and non-verbal communication through: (1) teaching activities to peers who are wearing noise-cancelling ear defenders; and (2) wearing noise-cancelling ear defenders themselves as they are taught by other prospective PE teachers. Methodology: A total 75 prospective PE teachers (i.e. those who intended to apply to train to become a teacher once their undergraduate studies were complete) participated in the research, all of whom had attended at least some of the eight, two-hour practical activities dedicated to using ear defenders for pedagogical purposes. Data were generated via practical lesson observations and audio-recorded group discussions about teaching peers who were wearing ear defenders. All qualitative data were analysed thematically and informed the construction of vignettes used to represent data. Findings: Prospective PE teachers learned how to disrupt phonocentric practices by using hand gestures and touch as pedagogical tools to gain the attention of learners and for instructional purposes. In this respect, I identify a need to explore the ethics of using these tools when working with Deaf pupils especially because some of the practices witnessed raised questions about power and consent. There was also evidence of pedagogical experimentation relating to the use of both pictures and text-to-speech smart phone applications for communicating non-verbally. Here, concerns were expressed by prospective PE teachers that these forms of communication were often ‘one-way’, preventing opportunities for more dynamic and interactive forms of communication and learning. It was notable that prospective PE teachers found it difficult to provide meaningful feedback, non-verbally, to support learning and development. I end by acknowledging the difficulty in knowing whether what prospective PE teachers learned could and should be transferred to myriad contexts and situations in PE that Deaf pupils find themselves. Moving forward, this is something for members of our academic community to explore.

Vignette element analysis for automated generation of vignettes in pharmacy education

Objectives: The aim of this study is to analyze and describe vignette elements and structure, and resulting difficulty, as a foundation for vignette construction in medical education, and ultimately automated vignette generation. Methods: Sixty-three vignettes representing a variety of disease states were sourced from the Objective Structured Clinical Experiences, published practice literature focused on pharmacy, and other training and assessment environments within the school. Three coders independently coded each vignette to identify underlying elements and structure. A consensus-building process was used by the coders to discuss and reconcile coding differences. Results: The coding process resulted in 36 vignette elements. The most common elements were age (n = 59, 93.6%), gender (n = 57, 90.5%), and medications (n = 54, 85.7%); others included race, medications, and chief complaint. Vignette structures and wording were found to be highly variable, with elements present in different magnitudes (range: 4–18 elements), being used with different descriptors, and given in different sequences. Conclusions: Vignette construction could benefit from further understanding of vignette structures and wording and their influence on the level of difficulty. This undertaking will allow educators to construct better vignettes for teaching and assessment to ensure that student performance accurately represents student knowledge and skills, rather than construct irrelevant variance due to vignette-level inconsistencies in content or structure. The defined elements and structure will also enable a systematic generation of vignettes for further consistency in teaching and assessment.

Using vignettes in educational research: a framework for vignette construction

ABSTRACT In this paper, we investigate using vignettes in educational research, particularly for eliciting value-laden constructs such as teacher beliefs and understandings and how these influence teacher practices. Drawing on research where vignettes have been used as the central instrument for data collection, we argue that methodological consistency is achieved when the research aims, methodologies and vignette methods are aligned, and this helps satisfy internal validity and supports the findings. To assist with achieving methodological consistency we introduce and discuss a vignette framework that identifies three key elements for vignette construction (conception, design, and administration), supplemented by characteristics for each element and descriptions. We then illustrate the framework by using an empirical study from mathematics education where two purposefully formulated vignettes were used to elicit diverse teacher beliefs and practices for promoting student engagement. This illustration shows that using vignettes in educational research can be particularly effective for gaining insights into interpretations and concerns that teachers may have about particular phenomena, such as student engagement in mathematics. We propose that carefully formulated vignettes aligned with the phenomena being investigated can help capture participants’ beliefs leading to a more nuanced understanding of the phenomena.

Content of Vignettes and Ethical Decision Making among Business Education Students at the University of Nairobi, Kenya

Vignette-based methodologies are frequently used to examine judgments, decision-making processes and ethical sensitivity of business education teachers and learners during the learning process in business ethics instruction. In this study, sources of knowledge content in construction of vignettes, was considered as a foundation on which ethical sensitivity can be inculcated through experiential learning. The study was focused at establishing the effect of vignettes derived from various content sources on ethical decision-making among business education students. A sample of 57 students from a target population provided information through filling questionnaires, which was then analyzed using descriptive statistics. The study adopted Moral Foundations theory (MFT), a social psychological model intended to explain the origins of and variation in human moral reasoning. The finding of the study indicated that vignettes derived from case studies (94.1%) influence ethical decision-making; interviews (75.4%) stories (66.7%), textbooks (80.7%) and personal experiences (91.2%). The study recommended that universities and institutions training teachers should consider developing and adopting vignettes particularly from the learners’ personal experiences as an instructional approach in teaching business ethics; business education teachers could adopt vignettes from case studies, textbooks, stories or interviews with business people in business education methods and other subject areas. On practice, the study recommended vignettes as an instructional tool to enhance dialogue, exchange of ideas and critical thinking; and more studies on the extent to which business education teachers have adopted vignettes as an instructional method. https://doi.org/10.26803/ijlter.17.11.2 ISSN: 1694-2116

Designs of trials assessing interventions to improve the peer review process: a vignette-based survey

BackgroundWe aimed to determine the best study designs for assessing interventions to improve the peer review process according to experts’ opinions. Furthermore, for interventions previously evaluated, we determined whether the study designs actually used were rated as the best study designs.MethodsStudy design: A series of six vignette-based surveys exploring the best study designs for six different interventions (training peer reviewers, adding an expert to the peer review process, use of reporting guidelines checklists, blinding peer reviewers to the results (i.e., results-free peer review), giving incentives to peer reviewers, and post-publication peer review).Vignette construction: Vignettes were case scenarios of trials assessing interventions aimed at improving the quality of peer review. For each intervention, the vignette included the study type (e.g., randomized controlled trial [RCT]), setting (e.g., single biomedical journal), and type of manuscript assessed (e.g., actual manuscripts received by the journal); each of these three features varied between vignettes.Participants: Researchers with expertise in peer review or methodology of clinical trials.Outcome: Participants were proposed two vignettes describing two different study designs to assess the same intervention and had to indicate which study design they preferred on a scale, from − 5 (preference for study A) to 5 (preference for study B), 0 indicating no preference between the suggested designs (primary outcome). Secondary outcomes were trust in the results and feasibility of the designs.ResultsA total of 204 experts assessed 1044 paired comparisons. The preferred study type was RCTs with randomization of manuscripts for four interventions (adding an expert, use of reporting guidelines checklist, results-free peer review, post-publication peer review) and RCTs with randomization of peer reviewers for two interventions (training peer reviewers and using incentives). The preferred setting was mainly several biomedical journals from different publishers, and the preferred type of manuscript was actual manuscripts submitted to journals. However, the most feasible designs were often cluster RCTs and interrupted time series analysis set in a single biomedical journal, with the assessment of a fabricated manuscript. Three interventions were previously assessed: none used the design rated first in preference by experts.ConclusionThe vignette-based survey allowed us to identify the best study designs for assessing different interventions to improve peer review according to experts’ opinion. There is gap between the preferred study designs and the designs actually used.

Measuring value sensitivity in medicine

BackgroundValue sensitivity – the ability to recognize value-related issues when they arise in practice – is an indispensable competence for medical practitioners to enter decision-making processes related to ethical questions. However, the psychological competence of value sensitivity is seldom an explicit subject in the training of medical professionals. In this contribution, we outline the traditional concept of moral sensitivity in medicine and its revised form conceptualized as value sensitivity and we propose an instrument that measures value sensitivity.MethodsWe developed an instrument for assessing the sensitivity for three value groups (moral-related values, values related to the principles of biomedical ethics, strategy-related values) in a four step procedure: 1) value identification (n = 317); 2) value representation (n = 317); 3) vignette construction and quality evaluation (n = 37); and 4) instrument validation by comparing nursing professionals with hospital managers (n = 48).ResultsWe find that nursing professionals recognize and ascribe importance to principle-related issues more than professionals from hospital management. The latter are more likely to recognize and ascribe importance to strategy-related issues.ConclusionsThese hypothesis-driven results demonstrate the discriminatory power of our newly developed instrument, which makes it useful not only for health care professionals in practice but for students and people working in the clinical context as well.

Dilemmas, Conspiracies, and Sophie’s Choice: Vignette Themes and Ethical Judgments

Knowledge about ethical judgments has not advanced appreciably after decades of research. Such research, however, has rarely addressed the possible importance of the content of such judgments; that is, the material appearing in the brief vignettes or scenarios on which survey respondents base their evaluations. Indeed, this content has seemed an afterthought in most investigations. This paper closely examined the vast array of vignettes that have appeared in relevant research in an effort to reduce this proliferation to a more concise set of overarching vignette themes. Six generic themes emerged from this process, labeled here as Dilemma, Classic, Conspiracy, Sophie’s Choice, Runaway Trolley, and Whistle Blowing. Each of these themes is characterized by a unique combination of four key factors that include the extent of protagonist personal benefit from relevant vignette activities and victim salience in vignette descriptions. Theme identification enabled inherent ambiguities in vignettes that threaten construct validity to come into sharp focus, provided clues regarding appropriate vignette construction, and may help to make sense of patterns of empirical findings that heretofore have seemed difficult to explain.

The construction and interpretation of vignettes in social research

Vignettes refer to stimuli, including text and images, which research participants are invited to respond. Drawing on a range of social science sources, this paper focuses on two substantive areas concerning the use of vignettes in research. Considered first is the development and construction of vignettes. This section is concerned with internal reliability; research topics; participants; and interest, relevance, realism and timing. Considered second are vignette interpretations and responses, in particular open and closed questioning; vignette perspectives; and difficulties with interpreting and responding to vignettes. Together these explorations contribute to the wider appreciation of vignette methodologies used within the social sciences. The paper concludes by outlining the limitations of using vignettes in social research.

Deskilling and adaptation among primary care physicians using two work innovations

The U.S. health care system has innovated over the past decade in ways aimed at improving quality of care while increasing managerial control over how medicine is practiced. Two key issues in examining innovation implementation is the extent to which physicians may experience deskilling as part of innovation use and to what extent they actively participate in this deskilling through adaptations they make to accommodate and take advantage of the innovations in their everyday work. Interviews with 78 U.S. primary care physicians were conducted. Data were transcribed and computer analyzed through an interactive process of open coding, theoretical sampling, vignette construction, and pattern recognition that proceeded in several stages. The two innovations examined were the use of electronic medical records and clinical guidelines. Primary care physicians perceive and experience the use of electronic medical records and clinical guidelines in ways that indicate deskilling outcomes. The deskilling outcomes identified include decreased clinical knowledge, decreased patient trust, increased stereotyping of patients, and decreased confidence in making clinical decisions. Physicians are actively involved in the deskilling process through the adaptive choices made when incorporating the innovations into their everyday work. The existing primary care business model exacerbates the deskilling effects of the two innovations examined in the study. Primary care physicians perceive and experience deskilling as a tangible outcome of using particular health care innovations. However, such deskilling is, in part, a function of physicians' own actions as well as extant pressures in the surrounding work context. Health care organizations and managers have a productive role to play in attempting to mitigate these pressures and lessen the deskilling outcomes associated with them. This study supports closer examination of the total costs and benefits deriving from using different health care innovations while portraying innovation use as a negotiated set of outcomes.

Story-based scales: Development and validation of questionnaires to measure subjective health status and cultural adherence in British Bangladeshis with diabetes

Questionnaires that measure subjective health status are increasingly used in clinical trials. But scales based on the quantification of subjective traits (“rate your feelings on a scale of 1 to 5”) and initially developed in western population samples may not be valid for use in minority ethnic groups, even if accurately translated. The measurement of cultural adaptation and assimilation in immigrant groups is important for health research but has well documented methodological challenges. The aim of this study was to develop valid and reliable questionnaires to measure subjective health status and cultural adherence in a minority ethnic group, using the story as the unit of inquiry. The design was a multi-phase study involving (a) narrative interview, (b) vignette construction, (c) questionnaire development, and (d) questionnaire validation in relation to two scales (well-being and cultural adherence) in British Bangladeshis with diabetes. Using data from in-depth narrative interviews (i.e., a non-directive research technique in which the participant is invited to “tell me the story about your diabetes, starting with when you first noticed anything wrong”, and the only prompts used are “tell me more about that” or “what happened next?”; Greenhalgh, Helman, & Chowdhury, 1998; Muller, 1999), we constructed culturally congruent vignettes to depict different subjective health states and behaviours. We refined these items in focus group interviews and validated the instruments on 98 Bangladeshi participants, randomly sampled from GP diabetes registers in inner London and interviewed by a Bangladeshi anthropologist. We used factor analysis to explore the underlying structure in the responses to questionnaire items, plus Cronbach alpha tests to measure internal consistency of scales. The questionnaires were acceptable and credible to Bangladeshi participants with diabetes. Ninety of 98 participants were able and willing to complete them with interviewer assistance. Following factor analysis, we produced two definitive instruments. The well-being scale was a single-factor model with four story-based items (measuring depression, anxiety, physical energy, and social activities), with a Cronbach's alpha of .92. The cultural adherence scale was a single-factor model with five items (measuring religious restrictions, ethnic practices, and social ties), with a Cronbach's alpha of .83. In conclusion, this study has produced two important outputs: (a) easy-to-administer, story-based questionnaires that measure well-being and cultural adherence, which are specific to British Bangladeshis with diabetes; (b) a general method for developing story-based instruments to quantify the subjective experience of illness and adherence to cultural norms, which potentially has applications beyond the study population.

The construction and interpretation of vignettes in social research

Vignettes refer to stimuli, including text and images, which research participants are invited to respond. Drawing on a range of social science sources, this paper focuses on two substantive areas concerning the use of vignettes in research. Considered first is the development and construction of vignettes. This section is concerned with internal reliability; research topics; participants; and interest, relevance, realism and timing. Considered second are vignette interpretations and responses, in particular open and closed questioning; vignette perspectives; and difficulties with interpreting and responding to vignettes. Together these explorations contribute to the wider appreciation of vignette methodologies used within the social sciences. The paper concludes by outlining the limitations of using vignettes in social research.

Social Judgments of Responsibility in Elder Self-Neglect Cases

Abstract In this study, 1,038 case judgments made by 26 adult protective service (APS) workers in the United States were examined using hypothetical elder self-neglect vignettes. The independent variables used to construct realistic vignettes were based on the relevant literature, the law in the jurisdiction being studied, and other practical considerations. The factorial survey method was used in the vignette construction phase, and multiple regression was used for analysis. The independent variables of age, household income, disability, family presence and involvement, and the form and consequence of the self-neglect revealed statistically significant findings, but the main effect rested with the social perception of disability in assigning responsibility. Over 25% of the variance was explained in the model, the majority of which could be attributed to the victim's disability. The findings indicate that judgment of responsibility was almost entirely due to the perception of the victim's disability. Resp...

On the construction of vignettes: Short simulation processes for role-playing purposes

Starting from the concept of the psychiatric interview as a multistage interaction process between the therapist and the patient, a computer simulation was constructed to be used for both research and training purposes. The “patient” was stored in a computer program and a trainee assumed the role of the therapist. In this way, certain interviewing techniques, as well as a number of other features of this interaction process, could be examined and analyzed. All that follows is part of the general area of decision making, subject to complexity, uncertainty, and time pressure.