– The paper aims to look at some of the problems commonly associated with qualitative methodologies, suggesting that there is a need for a more rigorous application in order to develop theory and aid effective decision making., – The paper examines three qualitative methodologies: grounded theory, ethnography, and phenomenology. It compares and contrasts their approaches to data collection and interpretation and highlights some of the strengths and weaknesses associated with each one., – The paper suggests that, while qualitative methodologies, as opposed to qualitative methods, are now an accepted feature of consumer research, their application in the truest sense is still in its infancy within the broader field of marketing. It proposes a number of possible contexts that may benefit from in‐depth qualitative enquiry., – The paper should be of interest to marketers considering adopting a qualitative perspective, possibly for the first time, as it offers a snap‐shot of three widely‐used methodologies, their associated procedures and potential pitfalls.

Grounded theory, ethnography and phenomenology: A comparative analysis of three qualitative strategies for marketing research

Focused ethnographies can have meaningful and useful application in primary care, community, or hospital healthcare practice, and are often used to determine ways to improve care and care processes. They can be pragmatic and efficient ways to capture data on a specific topic of importance to individual clinicians or clinical specialities. While many examples of focused ethnographies are available in the literature, there is a limited availability of guidance documents for conducting this research. This paper defines focused ethnographies, locates them within the ethnographic genre, justifies their use in healthcare research, and outlines the methodological processes including those related to sampling, data collection and maintaining rigour. It also identifies and provides a summary of some recent focused ethnographies conducted in healthcare research. While the emphasis is placed on healthcare research, focused ethnographies can be applicable to any discipline whenever there is a desire to explore specific cultural perspectives held by sub-groups of people within a context-specific and problem-focused framework. Keywords: Focused Ethnography, Healthcare Research, Qualitative Methodology, Guidance

/pdf/guidance-on-performing-focused-ethnographies-with-an-1ylxj9x6w1.pdf

Guidance on Performing Focused Ethnographies with an Emphasis on Healthcare Research

Background
Scientific findings must withstand critical review if they are to be accepted as valid, and editorial peer review (critique, effort to disprove) is an essential element of the scientific process. We review the evidence of the editorial peer-review process of original research studies submitted for paper or electronic publication in biomedical journals.

Objectives
To estimate the effect of processes in editorial peer review.

Search methods
The following databases were searched to June 2004: CINAHL, Ovid, Cochrane Methodology Register, Dissertation abstracts, EMBASE, Evidence Based Medicine Reviews: ACP Journal Club, MEDLINE, PsycINFO, PubMed.

Selection criteria
We included prospective or retrospective comparative studies with two or more comparison groups, generated by random or other appropriate methods, and reporting original research, regardless of publication status. We hoped to find studies identifying good submissions on the basis of: importance of the topic dealt with, relevance of the topic to the journal, usefulness of the topic, soundness of methods, soundness of ethics, completeness and accuracy of reporting.

Data collection and analysis
Because of the diversity of study questions, viewpoints, methods, and outcomes, we carried out a descriptive review of included studies grouping them by broad study question.

Main results
We included 28 studies. We found no clear-cut evidence of effect of the well-researched practice of reviewer and/or author concealment on the outcome of the quality assessment process (9 studies). Checklists and other standardisation media have some evidence to support their use (2 studies). There is no evidence that referees' training has any effect on the quality of the outcome (1 study). Different methods of communicating with reviewers and means of dissemination do not appear to have an effect on quality (3 studies). On the basis of one study, little can be said about the ability of the peer-review process to detect bias against unconventional drugs. Validity of peer review was tested by only one small study in a specialist area. Editorial peer review appears to make papers more readable and improve the general quality of reporting (2 studies), but the evidence for this has very limited generalisability.

Authors' conclusions
At present, little empirical evidence is available to support the use of editorial peer review as a mechanism to ensure quality of biomedical research. However, the methodological problems in studying peer review are many and complex. At present, the absence of evidence on efficacy and effectiveness cannot be interpreted as evidence of their absence. A large, well-funded programme of research on the effects of editorial peer review should be urgently launched.

Editorial peer review for improving the quality of reports of biomedical studies

Ethnography is a type of qualitative research that gathers observations, interviews and documentary data to produce detailed and comprehensive accounts of different social phenomena. The use of ethnographic research in medical education has produced a number of insightful accounts into its role, functions and difficulties in the preparation of medical students for clinical practice. This AMEE Guide offers an introduction to ethnography - its history, its differing forms, its role in medical education and its practical application. Specifically, the Guide initially outlines the main characteristics of ethnography: describing its origins, outlining its varying forms and discussing its use of theory. It also explores the role, contribution and limitations of ethnographic work undertaken in a medical education context. In addition, the Guide goes on to offer a range of ideas, methods, tools and techniques needed to undertake an ethnographic study. In doing so it discusses its conceptual, methodological, ethical and practice challenges (e.g. demands of recording the complexity of social action, the unpredictability of data collection activities). Finally, the Guide provides a series of final thoughts and ideas for future engagement with ethnography in medical education. This Guide is aimed for those interested in understanding ethnography to develop their evaluative skills when reading such work. It is also aimed at those interested in considering the use of ethnographic methods in their own research work.

https://www.tandfonline.com/doi/pdf/10.3109/0142159X.2013.804977

Ethnography in qualitative educational research : AMEE Guide No. 80

Authors' conclusions Health care organisations share a range of generic characteristics that make them particularly challenging for quality improvement programmes: complex care processes; multiple stakeholders; long-standing interand intraprofessional ‘turf wars’; an emphasis on individual proficiency rather than team-working; a history of challenging relationships between managers and health professionals; varying standards of data and infrastructure support for data collection/analysis; and a long history of successive top-down reorganisations and change programmes. These characteristics need to be borne in mind when considering which approaches to quality improvement will have greatest application in health services. Importing quality improvement techniques from outside health care may have the benefit that the tools and approaches have been tested to some degree, but the complexity of health care and the contingencies of the particular local and organisational circumstances can combine to overwhelm these potential advantages. Nonetheless, the accumulated knowledge from more than two decades of research, evaluation and experience has highlighted that, whatever quality improvement methods or approaches are used, there are core conditions that need to be met. Health care organisations need to: • Apply methods consistently over a sufficiently long timescale with demonstrated sustained organisational commitment and support • Involve doctors and other health professionals in a wide team effort while providing adequate training and development • Seek active involvement of middle and senior managers, the board (including nonexecutive directors) and, most obviously and visibly, the chief executive • Integrate quality improvement into the organisation’s other activities (so that it is part of the organisation’s strategic plans and priorities, targets etc) • Tailor the selected methods to local circumstances • Create robust IT systems that enable the measurement of processes and impacts, iteratively refining the approaches used

A systematic narrative review of quality improvement models in health care

The move towards evidence-based healthcare across the industrialised world has raised questions about the nature of evidence, and how good evidence is determined. In response to a hierarchy of evid...

Ethnographic evidence: The value of applied ethnography in healthcare

This paper describes the second phase of a research study into the introduction of the 'modern matron' role in the National Health Service. It draws on information from a survey of modern matrons in 10 case study trusts and from semistructured interviews with purposively selected matrons and their key contacts. Three models of role implementation are identified, each typical of 'hybrid management' but with different emphases on matrons' professional (clinical) and corporate management responsibilities. There is evidence that matrons are starting to make an impact on different aspects of quality improvement in their trusts, but this is often limited by lack of forethought about where they should be located in the organization. It is suggested that, before making decisions about establishing modern matron posts, trusts need to have a clearer understanding both of the different contributions matrons can make to quality improvement and the challenges posed by this type of role.

Jan Savage

Papers

Ethnographic evidence: The value of applied ethnography in healthcare

The modern matron: a hybrid management role with implications for continuous quality improvement

Evaluating the role of modern matrons.

Peer Review in the Health Sciences Fiona Godlee Peer Review in the Health Sciences and Tom Jefferson (eds) BMJ Books>£30,2700-7279-1181-30727911813

Sexuality and nursing care: setting the scene.