Research

last authored:
last reviewed:

 

 

Introduction

"not everything that can be counted, counts; not everything that counts, can be counted" - Einstein

Effective health care research depends on knowledge of the literature, thoughtful planning, and quality implementation. Research is a means to a greater end, and must be applicable to real-life decisions derived from this research.

 

research is the antidote to learned helplessness

we need people who are revolutionary, with fire in their bellies

research FOR patients

 

research agenda fundamentally depends on epistemology what are the ordering principles of the discipline?

 

Funding is an important part of research, but also is a very difficult concern.

 

 

Research Questions

Research questions can proceed from a number of sources: clinical observations, self-reflections, discussions, and formal or informal literature surveys.

 

There are many approaches to designing a good research question:

  • FINER
  • Tab 2

FINER (Hulley et al, 2007)

Feasible

  • are there sufficient participants or events to study?
  • is the available time and money enough?
  • does the researcher, and the research time, have the required expertise?

Interesting

  • interesting to the researcher, and to the potential audience

Novel

  • adding to the body of knowledge

Ethical

  • assisted by research ethics boards

Relevant

  • so what? - how can proposed research question make a difference?

 

Deciding on a Research Question

Too broad a research question and the research project may soon collapse.

Through a thorough literature search, find the information gaps and set out to meet them!

Pick a topic about which you are passionate.

 

Data quality and trustworthiness are absolutely key.

Travel with folks with whom you can discuss ideas and findings.

 

You want to make sure the data is reliable and trustworthy by using different people to do the same job. If people disagree, it is important to come to consensus.

 

Saturation: evaluating and repeating data until no new themes emerge

Authenticity and trustworthiness of data

 

 

 

A research question will normally begin quite broadly. For meaningful research to be carried out, however, it needs to be distilled.

 

 

 

Rural Research

There is often a disconnect

If resources that can be quickly accessed aren't present

Support

Local hubs can be very helpful

Face-to-face

 

Deliveries

syncrhonous and asynchronous learning

audio/video modules

effective means to deliver key, short, easily accessible resources

prompts for online modules

having exemplars

infrastructure

 

engagement

 

 

 

 

Qualitative research

main article:

Quantitative research is designed to be objective, and to test a hypothesis.

Sampling is large enough to be representative.

Data collection is standardized, in order to ensure it's value, and is normally episodic.

Analysis is designed in a way to keep it be generalizable.

 

 

Qualitative research

main article:

The role of qualitative research is to understand. It contains bias, as the researcher is interpreting the data.

Sampling tends to be small and purposeful, with participants selected as those who have a given experience.

Data collection can be flexible and normally over a time period. Interviews and focus groups are the norm.

Analysis is usually accomplished over the course of the study. Results are designed to resonate with the reader of the study.

 

 

Research creates image.

Integrated research is more relevant, financially successful.

 

 

Keep asking, what is this research all about

 

Make good use of field notes

 

Grounded Theory -

use rigorous data analyis to gen hyp and generate theoiries around a core concept to explain most ;action around it

'awareness of dying' glasser and stauss (sp)

true interdisciplinary field

return to top

 

  • quantitative research
  • qualitative research
  • participatory research
  • educational research

Quantitative Research

Qualitative Research

 

 

 

What is Qualitative Research?

Quantitative research

Positivist - proving things definitively. We've since moved past this to postpositivist, a more uncertain stance. Emperical or scientific views currently preside, in which we observe and make deductions as best we can.

 

Constructivist - more around relationships, creates understanding

 

 

Is it rigorous research or

 

Can qualitative research be called evidence-based?

 

 

 

How to Do Qualitative Research

"We should be on our guard not to overestimate science and scientific methods when it is a question of human problems; and we should not assume that experts are the only ones who have a right to express themselves on questions affecting the organization of society." -Albert Einstein.

 

Gather preliminary data first before implementing.

 

Deciding on a Research Question

Too broad a research question and the research project may soon collapse.

Through a thorough literature search, find the information gaps and set out to meet them!

Pick a topic about which you are passionate.

 

Data quality and trustworthiness are absolutely key.

Travel with folks with whom you can discuss ideas and findings.

 

You want to make sure the data is reliable and trustworthy by using different people to do the same job. If people disagree, it is important to come to consensus.

 

Saturation: evaluating and repeating data until no new themes emerge

Authenticity and trustworthiness of data

 

Theoretical Framework

 

Grounded theory - build upwards, from the data towards theory.

Phenomenology

Ethnography

Feminist theory

Critical theory

Narratives

Case Study

 

Gathering Data

Talk with people in their natural settings.

Explore situations, perspectives, and experiences.

The purpose is to increase understanding.

 

Use inductive approaches and interpretation.

 

 

Recruiting People

newspaper, radio, mailouts, bingo halls, churches

how do you contact people in such a way as to protect their privacy?

stories

focus groups

 

 

Triangulation in qualitative research

get data from different groups of people, and hopefully their thoughts converge (tringulate) at a certain spot.

 

Make sure you have well-described and appropriate methods and analysis!

 

Results

Results need to be clearly derived and flow naturally from the analysis.

Use sufficient quotations to support quality of evidence.

Make sure you identifiy limitations.

 

 

 

Researcher and the Research

 

Should marginalized people be researched? There are some ethical concerns around this - is it ethical to attempt to represent others without really knowing their stories?

 

Values and bias are to be reported and indeed embraced.

The researcher's world view comes strongly into play.

 

The researchers should explicitly locate herself in the story:

  • "I am researching this because I am concerned that/passionate about..."

They talk about locatedness or situatedness

 

 

 

 

Benefits of Qualitative Research

 

Rich, rich analysis of a certain thing.

 

 

 

Difficulties of Qualitative Research

 

Multiple perspectives and multiple realities

 

cost

 

Long!

 

 

 

 

 

 

Evaluating Qualitative Research

 

Is the literature review current and relevant?

Are the purpose and research questions clearly stated and relevant?

Does the introduction build a logical case and context for study?

Does the study use theoretical framework?

 

What is the study design?

Are methods clearly described and appropriate?

Are sampling methods and size appropriate?

Is analysis appropriate and clearly described?

 

 

 

 

Qualitative Research Outcomes

 

 

self-management outcomes:

  • QoL
  • functional status
  • empowerment
  • self-efficacy
  • pain
  • disability
  • BP HgB
  • ED visits
  • length of stay
  • GP visits

 

 

 

 

Participatory Research

 

 

 

Introduction

Particpatory research is the process of producing new knowledge by "systematic inquiry, with the collaboration of those affected by the issue being studied, for the purposes of education and taking action or effecting social change" (Green et al, 1994)

It is designed to help improve social and economic conditions, to effect change, and to reduce distrust in people involved in research.

Key elements of participatry research are collaboration, education, and action.

It stresses the relationship between researcher and community, the direct benefit to community, and the community's involvement itself as beneficial.

return to top

 

 

 

Research subjects should 'own' the research process and use its results to improve their quality of life.

It builts self empowerment by removing barriers and promoting environments in which communities can increase their capacity to identify and solve their own problems. This is especially true in disadvantaged communities.

 

Various degrees of participation are possible - even RCTs can be done in a participatory way (Diabetes Prevention Program Research Group, 1999)

 

Positive attributes include:

  • ability to build respect and trust
  • self awareness of biases and perspectives
  • tolerance for complexity, unpredictability, and conflict
  • seasoned group process skills
  • commitment to equality of relationships
  • conflict resolution

Participatory research is strengthened by local, jointly negotiated, ethical codes or aggreements that ensuring shar.ing of leaderhsip, power, and decision making, from design to dissemination. Local codes help identify issues; reflect local culture, needs, and interests, and increase close collaboration.

Ethically sound research builds capacity by collaborators, increases researcher receptivity to collaboration, builds community voice in policy, and strengths mutual trust.

Roles and responsibilities, desired research outcomes, measures of validity, and control of use of data and funding, should all be agreed upon.

Joint interpretation of data increases culteral and internal validity, minimizes harms, and maximizes benefits.

 

Expect problems and conflict, and build means to address changes in research design, of personnel, and of mind .

 

 

 

Resources and References

Green LW, George MA, Daniel M, Frankish CJ, Herbert CJ, Bowie WR, et al. Study of participatory research in health promotion. Ottawa: Royal Society of Canada, 1994

 

Macaulay AC, Commanda LE, Freeman WL, others, BMJ, 1999
- excellent introdiction on participatory research

 

Diabetes Prevention Program Research Group. The Diabetes Prevention Program: design and methods for a clinical trial in the prevention of type 2 diabetes. Diabetes Care 1999;22(4):623­34

return to top

Educational Research

 

Kirkpatrick levels are frequently used to appraise levels of quality of educational interventions, though the validity in regards to medical education is increasingly questioned (Yardley and Dornan, 2012).

 

Instead, realist methods are being proposed as effective methods of moving the field forward (Wong, Greenalgh, Westhorp, and Pawson, 2012).

 

 

Resources and References

CES4Health - peer-reviewed mechanism for publishing community-driven resources

Rapid Surveys -

Hulley SB et al. 2007. Designing Clinical Research.

Wong G, Greenalgh T, Westhorp G, Pawson R. 2012. Realist methods in medical education research: what are they and what can they contribute? Medical Education. 46(1):89-96.

Yardley S, Dornan T. 2012. Kirkpatrick’s levels and education ‘evidence’. Medical Education. 46(1): 97–106.

return to top