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!