From quantitive to qualitative research: my beginner’s experience

My background is in quantitative healthcare research, which I love. For over a year now, I’ve started doing qualitative research as well (specifically, systematic reviews of patient values and preferences), and my PhD will be (mostly) qualitative. I enjoy it now, but from my experience, there’s a gap in teaching and communicating about qualitative research to a quantitative audience (and, I assume, vice versa). My introduction to qualitative research was a 3-hour lecture and tutorial exercise during my master’s. I don’t remember the readings, but I remember being bored, texting passages to my friend (a fellow quantitive-trained person who ended up in qualitative research), and that we laughed and commiserated. I remember thinking, this is important, but just not my cup of tea.

I started working on qualitative research via clinical practice guidelines. The BMJ RapidRecs are multidisciplinary guideline panels of about 20-25 clinicians, methodologists, and patients/carers. I recruit and train patients/carers in the panels (brief abstract here, and more to come), and also look for empirical evidence of patient values and preferences. I jumped into it by happenstance, and was, as they say, “baptized by fire.” I’m taking an introductory course to qualitative research now, and our prof, Dr. Susan Jack, mentioned that people have different motivations for pursuing qualitative research. Some people, she said, start out with their research question, and after trying to figure out how to answer it, realize that using a quantitative approach isn’t the best approach. Others might turn to it because they don’t like statistics (which is unfortunate!). When I first started, I wasn’t sure if this was something I wanted to do in the long run, but so far it fits well with my interests.

After my master’s, I took a 10-week “Storytelling Workshop” at the University of Toronto. A friend of mine (a mixed-methods researcher with a MA in Narrative Medicine) recommended I apply after someone dropped out last minute. I wrote a short personal essay (re: death, pie) in an effort to show our prof, Ann Silversides, that I have some writing ability. In the course, we discussed things like how to interview, setting the scene, describing characters, essays/memoirs, and graphic medicine(!). I loved it, and it made a lasting impression on what I choose to read and write about. I held on to this positive experience as a good omen when I dove into qualitative research.

Reading the first chapter of the “Introduction to Qualitative Research” textbook, I feel very far from the terminology and way of thinking. One of our required readings is an amusing and helpful article from 1993, phrased as a (fictional) conversation where a director with “an impressive record of quantitative research” is speaking with a recently appointed sociologist. The director asks “Do you have to talk in “isms”? If you could put it in plain English I might be able to understand.” A bit harsh, but, admittedly, I can relate. A follow up article was published in 2009, where they highlighted that there’s been more uptake, but concern that the methods aren’t always used appropriately. Again phrased as a conversation (“socratic dialogue”), this time the director is enthusiastic and the sociologist is critical – but highlights some great applications, particularly the emerging use of qualitative synthesis methods.

There’s plenty of critique of qualitative research by quantitative folks, citing reasons like lack of generalizability. Some of my first thoughts to that were, randomized trials and observational studies aren’t always generalizable either – it’s often that trials (and guideline recommendations based on those trials) can exclude common populations that clinician would see. My quan-to-qual friend suggested a great line to frame one’s mind about the two worlds: “Quantitative research is meant to be generalizable, whereas qualitative research is meant to be transferable.” My personal perspective, with a lens about guidelines, is that there’s not enough guidance about how to incorporate qualitative evidence in decision making, e.g. moving from evidence to recommendations. Not entirely devoid, of course – an example of some guidance here, and evidence of increased use here.

In the qualitative course, we are asked to start keeping a journal and write our reflections (a reflexivity exercise, to make us more aware of our perspectives and roles as researchers), starting now and due at the end of the course. As I learn more about qualitative research, I want to reflect how to better teach and communicate about the value of this field. Regular blog posts about this are a good motivation for me to reflect, in depth and often. As Dr. Jack writes, “the onus must fall on qualitative researchers to conduct studies of relevance to decision makers, educate decision makers about the richness and value of qualitative research, clearly articulate the outcomes of qualitative research to both funding agencies and decision makers, dispel the myth that qualitative findings are not broadly generalizable, and develop contextspecific strategies illustrating how the findings can be used by clinicians and policy makers.

Are you a quantitative-trained person who switched to qualitative? Or the other way around? Leave a comment and share your experience!

PS If you know any publications out there about how to incorporate qualitative evidence into guidelines, please share!

Advertisements

Hello 2018: Starting up and setting goals

I’ve been thinking about ways to encourage myself to write more for some time now (which, you may cleverly notice, doesn’t involve doing any writing). Inspired by my friend Heidi – who blogs about her PhD research on participant recruitment in clinical trials, science communication (#scicomm), phd life (#phdchat), and other things – I finally started a blog. About a year ago. She’d occasionally nudge me to actually write something, but I’d deflect with the promise to do it later. Mac users: you know when you see the “updates available” pop-up, and answer “install later,” but then it asks “when later? like, in an hour? tonight?” and you think, uhh, I don’t know, “later”? Kind of like that.

Nudged by seeing Heidi’s 2018 goals, I figured “later” should be “now.” While I have more goals in mind, professional and personal, I’ll share some main ones here that I’ll write about.

Submit one PhD chapter for publication

My PhD thesis is on patient/carer/public partnership in developing clinical practice guidelines. I’ll write a longer post about it, but it’s about the process of making recommendations for medical decisions (e.g. drugs, surgeries) with the people they apply to. For example, a guideline on diabetes management co-produced with persons who have, and those who care for persons who have, diabetes.

One of my favourite profs, Dr. Lehana Thabane, lectured on practical advice for new PhD students, i.e. how to be productive while preserving your sanity. Something that stuck with me was, instead of seeing your thesis as this behemoth task, focus on publishing one PhD paper each year: 3 years, 3 chapters. In our program, if your thesis chapter is already published in a peer-reviewed journal, it’s not subject to revisions from your committee. Awesome, right? Granted, publishing can take almost as long as writing, hence my (hopefully) achievable goal of just submitting.

Read 365 papers

The #365papers challenge is something I’m eager to take on this year – I have a looong list of papers to read. Other than thesis stuff, I want to read classic papers in epidemiology, such as the clinician-trialist series from the (late, great) Dr. David Sackett. I’m neither a clinician nor a trialist, but the series was highly recommended, especially the 3 papers on “ways to advance your career by saying no,” with Dr. Andy Oxman.

Read 6 fiction and 6 non-fiction books

I usually have one fiction and one non-fiction book on the go, but I can go weeks or  months without touching them. I find that a struggle for many grad students is that it’s hard to read “for pleasure” when there’s so much mandatory reading to do. I know it will help my writing (and thinking) though. Sackett, for example, loved the work of Kurt Vonnegut. And I’m interested in narrative medicine, medical memoirs, and the like, which has some overlap with my thesis work (e.g. qualitative research, patient experience). Time to work on reducing my tsundoku.

Make 12 creative things

As a kid, I always enjoyed arts and crafts, but I haven’t done much in a long time. Sculpting used to be a favourite. Before soft “play-doh” was around, we had plasticine, and to make it more malleable, my sister and I would put it on the radiator heater – often (to my mother’s dismay) we’d forget it there, leaving plastic-smelling, brightly-coloured streaks. Sorry mum! Anyway. I signed up for a 4-week sculpting class in January at the Art Gallery of Ontario, aka AGO.

Each creative thing has no bounds, but must be unlike the others. This blog post is the first of 12.

Looking forward to 2018!

IMG_2668