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Qualitative Research
What is it and what does it offer dental researchers?
Dr Jason Rutter - http://jasonrutter.co.uk/Imag...
Objectives
• Understand differences between qualitative and quantitative data
• Be aware of different assumptions in qual ...
What do you think
qualitative research is?
What is qualitative research?
Image: ‘what’ by Scott Schiller - https://goo.gl/UbBGqq
Used under CC BY NC
Not just because
It uses qualitative data!
So do literary studies, history, political sciences, religious studies,
philoso...
General elements
• Explores the meanings people give to things (Emic)
• Situated – specific to a particular time and place...
What does qualitative research offer?
• Offers an integrated perspective
• Understand group interactions as well as indivi...
• Data driven
• Focused on a site
• Inductive
• Reflexive
• Iterative
• Produces theory
Image: ‘i kept telling Geoff the S...
Image: ‘Evidence’ by Scott Lowe - https://goo.gl/GiwWTZ
Used under CC BY-NC 2.0
The Gold Standard of RCTs
• The rise of ‘evidence-based’ practice in the 1980s
• Systematic reviews
• Determining ‘what wo...
Limitations of RCTs
• Difference is averaged out
• Decision about what is important made prior to research
• Units of anal...
Why use qualitative research?
Image: ‘Why’ by Katie Sayer - https://goo.gl/iv3X5n
Used under CC BY-SA 2.0
When might qualitative
research be useful?
Evidence-based practice
• Amalgam fillings:
• Proven technology
• Strong
• Long-lasting
• Inexpensive
• Fitted in single v...
• Why is ‘X’ an important clinical problem?
• How are dentists different from doctors?
• How are decisions to prescribe an...
You already do
qualitative research.
You just don’t call it that.
Image: ‘Secret’ by Nathan Rupert -
https://goo.gl/L4TPG2...
The First Five Seconds
• PhD research
• Opening of phone calls
• Corpus of 500 calls to & from a
USA police station
• 499 ...
Kashbour, W.A. et al., 2016.
Patients’ perceptions of implant placement surgery,
the post-surgical healing and the transit...
From the abstract alone,
what can we learn about
this paper?
What types of qualitative
research are there?
Image: ‘Choose a Door’ by Adrian Berg -
https://goo.gl/mfpPdg. Used under CC...
Action Research, Advocacy Research, Aesthetics, Applied Research, Appreciative Inquiry, Artifact
Analysis, A/r/tography, A...
What is Qualitative Data?
‘All is Data’*
Glaser, Barney G. (2001). The Grounded Theory Perspective: Conceptualization
Contrasted with Description. M...
Making or finding data
• Interviews
• Unstructured (passive/nondirective) interviews
• Semi-structured (forced) interviews...
What about sampling?
• If you’re not doing statistics is a
statistical sample necessary?
• Theoretical sampling
• Focus on...
Gelman, A. and Stern, H. (2006)
"The difference between ‘significant’
and ‘not significant’ is not itself
statistically si...
The distribution rule is no less a
‘special case’ for having many
occurrences, nor the latter more
so for having only one....
COREQ: Consolidated criteria for reporting qualitative research
• Specifically for ‘in-depth’ interviews & focus groups
• ...
Are items 9-23 of COREQ
reported in the methods
section?
What about Objectivity?
This discomfort with
subjectivity clearly makes
sense from a psychological
science standpoint that...
Onwuegbuzie, A.J. & Leech, N.L., 2007. Validity and Qualitative Research:
An Oxymoron? Quality & Quantity, 41(2), pp.233–2...
Image: ‘Trying to repair the Camaro’ by clement127
https://goo.gl/jYDoHi. Used under CC BY NC ND
Where’s the Hypothesis?
• Not locked in to original concept
• Hypotheses are developed through analysis
• Testing and refi...
Are the findings generalizable?
• Replication is not the same as generalisability
• You can’t step into the same river twi...
•What are Kashour et al.’s findings?
•Are they generalizable? How? How not?
•What might a study based on their
findings lo...
How do
I recognize
poor quality
qualitative research?
Image: ‘Quality suits’ by Peter Reed - https://goo.gl/0T8fLO. Used u...
•It remains descriptive – Can you ask, ‘so
what?’
•What they did is not clear (COREQ)
•Why they did things is not clear
•I...
•It classifies or quotes without theory
•It employs quantitative categories without
reflexivity
•It reduces data too soon
...
Clues to questionable quality
• It is not firmly situated within a
range of literature
• ‘We used grounded theory’
• ‘We r...
The Textbook Method
• Corbin, J. & Strauss, A. 1990. Basics of Qualitative Research:
Techniques and Procedures for Develop...
Dr Jason Rutter
School of Dentistry,
University of Dundee
http://jasonrutter.co.uk/
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Qualitative Research for Dentists

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What is qualitative research? How is it different from quantitative research? What can qualitative research offer dentistry researchers? Can it make up for some of the limitations of randomized controlled trials (RCTs)? How can we read a qualitative research paper?

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Qualitative Research for Dentists

  1. 1. Qualitative Research What is it and what does it offer dental researchers? Dr Jason Rutter - http://jasonrutter.co.uk/Image: ‘confused’ by TobiGaulke https://goo.gl/fUvQm1 used under CC BY NC ND
  2. 2. Objectives • Understand differences between qualitative and quantitative data • Be aware of different assumptions in qual and quant approaches • Be aware of different types of qualitative data • Recognise the value of qualitative research for dentistry • Begin to critically assess qualitative research papers
  3. 3. What do you think qualitative research is?
  4. 4. What is qualitative research? Image: ‘what’ by Scott Schiller - https://goo.gl/UbBGqq Used under CC BY NC
  5. 5. Not just because It uses qualitative data! So do literary studies, history, political sciences, religious studies, philosophy, archaeology, legal studies, linguistics, etc.
  6. 6. General elements • Explores the meanings people give to things (Emic) • Situated – specific to a particular time and place • Data gathered within context and on context • Aims to understand how people manage, experience and understand their world • Explores people’s activities, processes, perspectives, categories…
  7. 7. What does qualitative research offer? • Offers an integrated perspective • Understand group interactions as well as individuals • Generate ideas and hypotheses • Illustrates how macro-level concepts are experienced and produced at micro level • It can engage with both the rule and exceptions • Sensitive to contradictions – possible to hold conflicting opinions • Can detail unexpected or unique occurrences
  8. 8. • Data driven • Focused on a site • Inductive • Reflexive • Iterative • Produces theory Image: ‘i kept telling Geoff the Stormtrooper, but he wouldn't listen.’ by daren – https://goo.gl/5ne7aR. Used under CC
  9. 9. Image: ‘Evidence’ by Scott Lowe - https://goo.gl/GiwWTZ Used under CC BY-NC 2.0
  10. 10. The Gold Standard of RCTs • The rise of ‘evidence-based’ practice in the 1980s • Systematic reviews • Determining ‘what works’ • Public management and accountability in the 1990s See: Hammersley, M. (2015). Against ‘gold standards’ in research: On the problem of assessment criteria. https://goo.gl/UqwYg7
  11. 11. Limitations of RCTs • Difference is averaged out • Decision about what is important made prior to research • Units of analysis fixed prior to research • Context is ignored • Focus on intervention • Poor at looking at implementation • Lack tools for understanding drop-outs • RCTs designed to complement a body of lab work - Not always the case in dentistry. • RCTs illustrate patterns not causality
  12. 12. Why use qualitative research? Image: ‘Why’ by Katie Sayer - https://goo.gl/iv3X5n Used under CC BY-SA 2.0
  13. 13. When might qualitative research be useful?
  14. 14. Evidence-based practice • Amalgam fillings: • Proven technology • Strong • Long-lasting • Inexpensive • Fitted in single visit • Minimal lose of healthy tooth • Not overly technique sensitive • So why use gold, composite, ceramic materials?
  15. 15. • Why is ‘X’ an important clinical problem? • How are dentists different from doctors? • How are decisions to prescribe antibiotics made? • What do patients mean when the say their tooth hurts? • What might change if dentists were paid only on their results?
  16. 16. You already do qualitative research. You just don’t call it that. Image: ‘Secret’ by Nathan Rupert - https://goo.gl/L4TPG2. Used under CC BY
  17. 17. The First Five Seconds • PhD research • Opening of phone calls • Corpus of 500 calls to & from a USA police station • 499 started the same way… Emanuel Schegloff Distinguished Professorof Sociology University of California at Los Angeles
  18. 18. Kashbour, W.A. et al., 2016. Patients’ perceptions of implant placement surgery, the post-surgical healing and the transitional implant prostheses: A qualitative study. Clinical Oral Implants Research, pp.1–8.
  19. 19. From the abstract alone, what can we learn about this paper?
  20. 20. What types of qualitative research are there? Image: ‘Choose a Door’ by Adrian Berg - https://goo.gl/mfpPdg. Used under CC BY NC
  21. 21. Action Research, Advocacy Research, Aesthetics, Applied Research, Appreciative Inquiry, Artifact Analysis, A/r/tography, Arts-Based Research, Arts-Informed Research, Autobiography, Autoethnography, Basic Research, Biography, Case Study, Clinical Research, Collaborative Research, Community-Based Research, Comparative Research, Content Analysis, Conversation Analysis, Covert Research, Critical Action Research, Critical Arts-Based Inquiry, Critical Discourse Analysis, Critical Ethnography, Critical Hermeneutics, Critical Research, Cross-Cultural Research, Discourse Analysis, Document Analysis, Duoethnography, Ecological Research, Emergent Design, Empirical Research, Empowerment Evaluation, Ethnodrama, Ethnography, Ethnomethodology, Evaluation Research, Evidence-Based Practice, Explanatory Research, Exploratory Data Analysis, Feminist Research, Field Research, Foucauldian Discourse Analysis, Genealogical Approach, Grounded Theory, Hermeneutics, Heuristic Inquiry, Historical Discourse Analysis, Historical Research, Historiography, Indigenous Research, Institutional Ethnography, Institutional Research, Interdisciplinary Research, Internet in Qualitative Research, Interpretive Inquiry, Interpretive Phenomenology, Interpretive Research, Market Research, Meta-Analysis, Meta-Ethnography, Meta-Synthesis, Methodological Holism Versus, Individualism, Methodology, Methods, Mixed Methods Research, Multicultural Research, Narrative Analysis, Narrative Genre Analysis, Narrative Inquiry, Naturalistic Inquiry, Observational Research, Oral History, Orientational Perspective, Para-Ethnography, Participatory Action Research, Performance Ethnography, Phenomenography, Phenomenology, Place/Space in Qualitative, Research, Playbuilding, Portraiture, Program Evaluation, Q Methodology, Readers Theatre, Social Justice, Social Network Analysis, Survey Research, Symbolic Interactionism, Systemic Inquiry, Theatre of the Oppressed, Transformational Methods, Unobtrusive Research, Value-Free Inquiry, Virtual Ethnography, Virtual Research, Visual Ethnography, Visual Narrative Inquiry… Given, L.M. (Ed.) 2008. The SAGE Encyclopediaof Qualitative Research Methods
  22. 22. What is Qualitative Data?
  23. 23. ‘All is Data’* Glaser, Barney G. (2001). The Grounded Theory Perspective: Conceptualization Contrasted with Description. Mill Valley, Ca.: Sociology Press. *Except numbers, number are bad. *Except when they aren’t, and then numbers are data. Image:‘DataShieldsupforthesummer,becauseyoujustneverknow...’ byMarkAhlness-https://goo.gl/xqhQbu.UsedunderCCBYNCND
  24. 24. Making or finding data • Interviews • Unstructured (passive/nondirective) interviews • Semi-structured (forced) interviews • Structured interviews • Focus Groups • Observational & Participational methods • Non-reactive methods/Unobtrusive research • Meeting minutes • Treatment notes • Recordings • Social media
  25. 25. What about sampling? • If you’re not doing statistics is a statistical sample necessary? • Theoretical sampling • Focus on relevance and expertise • Orientate towards depth not breadth • Sampling for particular case/s
  26. 26. Gelman, A. and Stern, H. (2006) "The difference between ‘significant’ and ‘not significant’ is not itself statistically significant." The American Statistician 60(4), pp.328-331. Image: ‘Statistics’ by Monika Hoinkis - https://goo.gl/vReOAL. Used under CC BY NC ND 2.0
  27. 27. The distribution rule is no less a ‘special case’ for having many occurrences, nor the latter more so for having only one. Not number of occurrences, but common subsumption under a more general formulation is what matters. Schegloff, E.A., 1968. Sequencing in Conversational Openings. American Anthropologist, 70(6), pp.1075–1095. Image: ‘Suitcase’ by Rie H- https://goo.gl/rZ61MF. Used under CC Image flipped and cropped ” “
  28. 28. COREQ: Consolidated criteria for reporting qualitative research • Specifically for ‘in-depth’ interviews & focus groups • 32 item checklist • A checklist built on other checklists • Only relevant to health research literature • Does not engage with methodological literature • Not designed as an evaluation tool Tong, A., Sainsbury, P. & Craig, J., 2007. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), pp.349–357.
  29. 29. Are items 9-23 of COREQ reported in the methods section?
  30. 30. What about Objectivity? This discomfort with subjectivity clearly makes sense from a psychological science standpoint that emphasizes theoretically driven research and replicability of research procedures and design. Gough, B., & Madill, A. (2012). Subjectivity in psychological science: From problem to prospect. Psychological Methods, 17(3), 374–384. “ ”Image: ‘’nit’ by pshab - https://goo.gl/F0e0jh. Used under CC BY NC
  31. 31. Onwuegbuzie, A.J. & Leech, N.L., 2007. Validity and Qualitative Research: An Oxymoron? Quality & Quantity, 41(2), pp.233–249 Researcher bias is a very common threat to legitimation in constructivist research because the researcher usually serves as the person (i.e., instrument) collecting the data. “ ” Image: ‘Smile for the Camera’ by Matt Reinbold https://goo.gl/B5wz6A. Used under CC BY SA
  32. 32. Image: ‘Trying to repair the Camaro’ by clement127 https://goo.gl/jYDoHi. Used under CC BY NC ND
  33. 33. Where’s the Hypothesis? • Not locked in to original concept • Hypotheses are developed through analysis • Testing and refining are part of the analytical process • Analysis often parallel with data collection • Responsive to findings - can shape direction of data collection • New data can be added even at later stages of analysis
  34. 34. Are the findings generalizable? • Replication is not the same as generalisability • You can’t step into the same river twice • Data is specific, but theory aims to generalise an understanding • Qualitative work can build on theory making in new sites • Iterative process • Engagement with ‘outliers’/‘deviant cases’
  35. 35. •What are Kashour et al.’s findings? •Are they generalizable? How? How not? •What might a study based on their findings look like?
  36. 36. How do I recognize poor quality qualitative research? Image: ‘Quality suits’ by Peter Reed - https://goo.gl/0T8fLO. Used under CC BY-NC 2.0
  37. 37. •It remains descriptive – Can you ask, ‘so what?’ •What they did is not clear (COREQ) •Why they did things is not clear •It’s position within the literature is unclear •It is essentially quant with qual data Clues to questionable quality
  38. 38. •It classifies or quotes without theory •It employs quantitative categories without reflexivity •It reduces data too soon •Fears ambiguity and lack of control •A theory is used as deus ex machina - introduced at the end to save the day Clues to questionable quality
  39. 39. Clues to questionable quality • It is not firmly situated within a range of literature • ‘We used grounded theory’ • ‘We reached theoretical saturation’ • ‘We analysed the data using nVivo’ • ‘We did an ethnography’ • ‘We use inter-analyst triangulation to ensure consensus’
  40. 40. The Textbook Method • Corbin, J. & Strauss, A. 1990. Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory, London: Sage. • Gubrium, J.F. & Holstein, J.A., 2001. Handbook of Interview Research: Context and Method, London: Sage. • Miles, M.B. & Huberman, A.M. (Saldana, J.), 1983, Qualitative Data Analysis: A Methods Sourcebook, London: Sage. • Silverman, David, (1997/2016) Qualitative Research, London: Sage.
  41. 41. Dr Jason Rutter School of Dentistry, University of Dundee http://jasonrutter.co.uk/

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