why is it important to use qualitative research

The purpose of qualitative research

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why is it important to use qualitative research

Janice M. Morse 3 &
Peggy Anne Field 4

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Research fills a vital and important role in society: it is the means by which discoveries are made, ideas are confirmed or refuted, events controlled or predicted and theory developed or refined. All of these functions contribute to the development of knowledge. However, no single research approach fulfills all of these functions, and the contribution of qualitative research is both vital and unique to the goals of research in general. Qualitative research enables us to make sense of reality, to describe and explain the social world and to develop explanatory models and theories. It is the primary means by which the theoretical foundations of social sciences may be constructed or re-examined.

Research is to see what everybody has seen and to think what nobody has thought. (Albert Szent-Gyorgy)

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Morse, J.M., Field, P.A. (1996). The purpose of qualitative research. In: Nursing Research. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-4471-9_1

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Article Contents

Introduction, when to use qualitative research, how to judge qualitative research, conclusions, authors' roles, conflict of interest.

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Qualitative research methods: when to use them and how to judge them

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K. Hammarberg, M. Kirkman, S. de Lacey, Qualitative research methods: when to use them and how to judge them, Human Reproduction , Volume 31, Issue 3, March 2016, Pages 498–501, https://doi.org/10.1093/humrep/dev334

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In March 2015, an impressive set of guidelines for best practice on how to incorporate psychosocial care in routine infertility care was published by the ESHRE Psychology and Counselling Guideline Development Group ( ESHRE Psychology and Counselling Guideline Development Group, 2015 ). The authors report that the guidelines are based on a comprehensive review of the literature and we congratulate them on their meticulous compilation of evidence into a clinically useful document. However, when we read the methodology section, we were baffled and disappointed to find that evidence from research using qualitative methods was not included in the formulation of the guidelines. Despite stating that ‘qualitative research has significant value to assess the lived experience of infertility and fertility treatment’, the group excluded this body of evidence because qualitative research is ‘not generally hypothesis-driven and not objective/neutral, as the researcher puts him/herself in the position of the participant to understand how the world is from the person's perspective’.

Qualitative and quantitative research methods are often juxtaposed as representing two different world views. In quantitative circles, qualitative research is commonly viewed with suspicion and considered lightweight because it involves small samples which may not be representative of the broader population, it is seen as not objective, and the results are assessed as biased by the researchers' own experiences or opinions. In qualitative circles, quantitative research can be dismissed as over-simplifying individual experience in the cause of generalisation, failing to acknowledge researcher biases and expectations in research design, and requiring guesswork to understand the human meaning of aggregate data.

As social scientists who investigate psychosocial aspects of human reproduction, we use qualitative and quantitative methods, separately or together, depending on the research question. The crucial part is to know when to use what method.

The peer-review process is a pillar of scientific publishing. One of the important roles of reviewers is to assess the scientific rigour of the studies from which authors draw their conclusions. If rigour is lacking, the paper should not be published. As with research using quantitative methods, research using qualitative methods is home to the good, the bad and the ugly. It is essential that reviewers know the difference. Rejection letters are hard to take but more often than not they are based on legitimate critique. However, from time to time it is obvious that the reviewer has little grasp of what constitutes rigour or quality in qualitative research. The first author (K.H.) recently submitted a paper that reported findings from a qualitative study about fertility-related knowledge and information-seeking behaviour among people of reproductive age. In the rejection letter one of the reviewers (not from Human Reproduction ) lamented, ‘Even for a qualitative study, I would expect that some form of confidence interval and paired t-tables analysis, etc. be used to analyse the significance of results'. This comment reveals the reviewer's inappropriate application to qualitative research of criteria relevant only to quantitative research.

In this commentary, we give illustrative examples of questions most appropriately answered using qualitative methods and provide general advice about how to appraise the scientific rigour of qualitative studies. We hope this will help the journal's reviewers and readers appreciate the legitimate place of qualitative research and ensure we do not throw the baby out with the bath water by excluding or rejecting papers simply because they report the results of qualitative studies.

In psychosocial research, ‘quantitative’ research methods are appropriate when ‘factual’ data are required to answer the research question; when general or probability information is sought on opinions, attitudes, views, beliefs or preferences; when variables can be isolated and defined; when variables can be linked to form hypotheses before data collection; and when the question or problem is known, clear and unambiguous. Quantitative methods can reveal, for example, what percentage of the population supports assisted conception, their distribution by age, marital status, residential area and so on, as well as changes from one survey to the next ( Kovacs et al. , 2012 ); the number of donors and donor siblings located by parents of donor-conceived children ( Freeman et al. , 2009 ); and the relationship between the attitude of donor-conceived people to learning of their donor insemination conception and their family ‘type’ (one or two parents, lesbian or heterosexual parents; Beeson et al. , 2011 ).

In contrast, ‘qualitative’ methods are used to answer questions about experience, meaning and perspective, most often from the standpoint of the participant. These data are usually not amenable to counting or measuring. Qualitative research techniques include ‘small-group discussions’ for investigating beliefs, attitudes and concepts of normative behaviour; ‘semi-structured interviews’, to seek views on a focused topic or, with key informants, for background information or an institutional perspective; ‘in-depth interviews’ to understand a condition, experience, or event from a personal perspective; and ‘analysis of texts and documents’, such as government reports, media articles, websites or diaries, to learn about distributed or private knowledge.

Qualitative methods have been used to reveal, for example, potential problems in implementing a proposed trial of elective single embryo transfer, where small-group discussions enabled staff to explain their own resistance, leading to an amended approach ( Porter and Bhattacharya, 2005 ). Small-group discussions among assisted reproductive technology (ART) counsellors were used to investigate how the welfare principle is interpreted and practised by health professionals who must apply it in ART ( de Lacey et al. , 2015 ). When legislative change meant that gamete donors could seek identifying details of people conceived from their gametes, parents needed advice on how best to tell their children. Small-group discussions were convened to ask adolescents (not known to be donor-conceived) to reflect on how they would prefer to be told ( Kirkman et al. , 2007 ).

When a population cannot be identified, such as anonymous sperm donors from the 1980s, a qualitative approach with wide publicity can reach people who do not usually volunteer for research and reveal (for example) their attitudes to proposed legislation to remove anonymity with retrospective effect ( Hammarberg et al. , 2014 ). When researchers invite people to talk about their reflections on experience, they can sometimes learn more than they set out to discover. In describing their responses to proposed legislative change, participants also talked about people conceived as a result of their donations, demonstrating various constructions and expectations of relationships ( Kirkman et al. , 2014 ).

Interviews with parents in lesbian-parented families generated insight into the diverse meanings of the sperm donor in the creation and life of the family ( Wyverkens et al. , 2014 ). Oral and written interviews also revealed the embarrassment and ambivalence surrounding sperm donors evident in participants in donor-assisted conception ( Kirkman, 2004 ). The way in which parents conceptualise unused embryos and why they discard rather than donate was explored and understood via in-depth interviews, showing how and why the meaning of those embryos changed with parenthood ( de Lacey, 2005 ). In-depth interviews were also used to establish the intricate understanding by embryo donors and recipients of the meaning of embryo donation and the families built as a result ( Goedeke et al. , 2015 ).

It is possible to combine quantitative and qualitative methods, although great care should be taken to ensure that the theory behind each method is compatible and that the methods are being used for appropriate reasons. The two methods can be used sequentially (first a quantitative then a qualitative study or vice versa), where the first approach is used to facilitate the design of the second; they can be used in parallel as different approaches to the same question; or a dominant method may be enriched with a small component of an alternative method (such as qualitative interviews ‘nested’ in a large survey). It is important to note that free text in surveys represents qualitative data but does not constitute qualitative research. Qualitative and quantitative methods may be used together for corroboration (hoping for similar outcomes from both methods), elaboration (using qualitative data to explain or interpret quantitative data, or to demonstrate how the quantitative findings apply in particular cases), complementarity (where the qualitative and quantitative results differ but generate complementary insights) or contradiction (where qualitative and quantitative data lead to different conclusions). Each has its advantages and challenges ( Brannen, 2005 ).

Qualitative research is gaining increased momentum in the clinical setting and carries different criteria for evaluating its rigour or quality. Quantitative studies generally involve the systematic collection of data about a phenomenon, using standardized measures and statistical analysis. In contrast, qualitative studies involve the systematic collection, organization, description and interpretation of textual, verbal or visual data. The particular approach taken determines to a certain extent the criteria used for judging the quality of the report. However, research using qualitative methods can be evaluated ( Dixon-Woods et al. , 2006 ; Young et al. , 2014 ) and there are some generic guidelines for assessing qualitative research ( Kitto et al. , 2008 ).

Although the terms ‘reliability’ and ‘validity’ are contentious among qualitative researchers ( Lincoln and Guba, 1985 ) with some preferring ‘verification’, research integrity and robustness are as important in qualitative studies as they are in other forms of research. It is widely accepted that qualitative research should be ethical, important, intelligibly described, and use appropriate and rigorous methods ( Cohen and Crabtree, 2008 ). In research investigating data that can be counted or measured, replicability is essential. When other kinds of data are gathered in order to answer questions of personal or social meaning, we need to be able to capture real-life experiences, which cannot be identical from one person to the next. Furthermore, meaning is culturally determined and subject to evolutionary change. The way of explaining a phenomenon—such as what it means to use donated gametes—will vary, for example, according to the cultural significance of ‘blood’ or genes, interpretations of marital infidelity and religious constructs of sexual relationships and families. Culture may apply to a country, a community, or other actual or virtual group, and a person may be engaged at various levels of culture. In identifying meaning for members of a particular group, consistency may indeed be found from one research project to another. However, individuals within a cultural group may present different experiences and perceptions or transgress cultural expectations. That does not make them ‘wrong’ or invalidate the research. Rather, it offers insight into diversity and adds a piece to the puzzle to which other researchers also contribute.

In qualitative research the objective stance is obsolete, the researcher is the instrument, and ‘subjects’ become ‘participants’ who may contribute to data interpretation and analysis ( Denzin and Lincoln, 1998 ). Qualitative researchers defend the integrity of their work by different means: trustworthiness, credibility, applicability and consistency are the evaluative criteria ( Leininger, 1994 ).

Trustworthiness

A report of a qualitative study should contain the same robust procedural description as any other study. The purpose of the research, how it was conducted, procedural decisions, and details of data generation and management should be transparent and explicit. A reviewer should be able to follow the progression of events and decisions and understand their logic because there is adequate description, explanation and justification of the methodology and methods ( Kitto et al. , 2008 )

Credibility

Credibility is the criterion for evaluating the truth value or internal validity of qualitative research. A qualitative study is credible when its results, presented with adequate descriptions of context, are recognizable to people who share the experience and those who care for or treat them. As the instrument in qualitative research, the researcher defends its credibility through practices such as reflexivity (reflection on the influence of the researcher on the research), triangulation (where appropriate, answering the research question in several ways, such as through interviews, observation and documentary analysis) and substantial description of the interpretation process; verbatim quotations from the data are supplied to illustrate and support their interpretations ( Sandelowski, 1986 ). Where excerpts of data and interpretations are incongruent, the credibility of the study is in doubt.

Applicability

Applicability, or transferability of the research findings, is the criterion for evaluating external validity. A study is considered to meet the criterion of applicability when its findings can fit into contexts outside the study situation and when clinicians and researchers view the findings as meaningful and applicable in their own experiences.

Larger sample sizes do not produce greater applicability. Depth may be sacrificed to breadth or there may be too much data for adequate analysis. Sample sizes in qualitative research are typically small. The term ‘saturation’ is often used in reference to decisions about sample size in research using qualitative methods. Emerging from grounded theory, where filling theoretical categories is considered essential to the robustness of the developing theory, data saturation has been expanded to describe a situation where data tend towards repetition or where data cease to offer new directions and raise new questions ( Charmaz, 2005 ). However, the legitimacy of saturation as a generic marker of sampling adequacy has been questioned ( O'Reilly and Parker, 2013 ). Caution must be exercised to ensure that a commitment to saturation does not assume an ‘essence’ of an experience in which limited diversity is anticipated; each account is likely to be subtly different and each ‘sample’ will contribute to knowledge without telling the whole story. Increasingly, it is expected that researchers will report the kind of saturation they have applied and their criteria for recognising its achievement; an assessor will need to judge whether the choice is appropriate and consistent with the theoretical context within which the research has been conducted.

Sampling strategies are usually purposive, convenient, theoretical or snowballed. Maximum variation sampling may be used to seek representation of diverse perspectives on the topic. Homogeneous sampling may be used to recruit a group of participants with specified criteria. The threat of bias is irrelevant; participants are recruited and selected specifically because they can illuminate the phenomenon being studied. Rather than being predetermined by statistical power analysis, qualitative study samples are dependent on the nature of the data, the availability of participants and where those data take the investigator. Multiple data collections may also take place to obtain maximum insight into sensitive topics. For instance, the question of how decisions are made for embryo disposition may involve sampling within the patient group as well as from scientists, clinicians, counsellors and clinic administrators.

Consistency

Consistency, or dependability of the results, is the criterion for assessing reliability. This does not mean that the same result would necessarily be found in other contexts but that, given the same data, other researchers would find similar patterns. Researchers often seek maximum variation in the experience of a phenomenon, not only to illuminate it but also to discourage fulfilment of limited researcher expectations (for example, negative cases or instances that do not fit the emerging interpretation or theory should be actively sought and explored). Qualitative researchers sometimes describe the processes by which verification of the theoretical findings by another team member takes place ( Morse and Richards, 2002 ).

Research that uses qualitative methods is not, as it seems sometimes to be represented, the easy option, nor is it a collation of anecdotes. It usually involves a complex theoretical or philosophical framework. Rigorous analysis is conducted without the aid of straightforward mathematical rules. Researchers must demonstrate the validity of their analysis and conclusions, resulting in longer papers and occasional frustration with the word limits of appropriate journals. Nevertheless, we need the different kinds of evidence that is generated by qualitative methods. The experience of health, illness and medical intervention cannot always be counted and measured; researchers need to understand what they mean to individuals and groups. Knowledge gained from qualitative research methods can inform clinical practice, indicate how to support people living with chronic conditions and contribute to community education and awareness about people who are (for example) experiencing infertility or using assisted conception.

Each author drafted a section of the manuscript and the manuscript as a whole was reviewed and revised by all authors in consultation.

No external funding was either sought or obtained for this study.

The authors have no conflicts of interest to declare.

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Qualitative research: What is it and why should you use it?

What is qualitative research.

For those more familiar with quantitative research techniques, the methods used in qualitative research may, at first look, seem ineffective. However, it is important to realise that qualitative research is not trying to answer the same questions that are asked in quantitative research.

In short, in comparison to quantitative, qualitative research methods focus on words rather than numbers, depth rather than breadth. Its methods are exploratory; they seek to unearth the opinions, thoughts and feelings of respondents. It is most commonly used to help inform new concepts, theories and products. First developed within the social sciences, qualitative research is now widely used to inform market research, by gaining unique consumer insight from a wealth of data.

One particular difference between qualitative and quantitative research is that the former requires much more in-depth involvement from the qualitative researchers. It is their interpretation which shapes the outcome.

Why choose online qualitative research?

Now you know the basics of qualitative research, why should you use it to conduct your project? Here are some of the main benefits:

Qualitative studies give you a unique depth of understanding which is difficult to gain from a closed question survey. Respondents are able to freely disclose their experiences, thoughts and feelings without constraint. Qualitative methods offer a dynamic approach to research, where the researcher has an opportunity to follow up on answers given by respondents in real time, generating valuable conversation around a subject – something which isn’t possible with a structured survey. Whilst the facts and figures generated by quantitative research are undoubtedly useful, you can often be left looking for the ‘why’ behind the stats. This is where qualitative research is key, as respondents have the opportunity to freely elaborate on their answers.

“Not everything that can be counted counts, and not everything that counts can be counted“ (Albert Einstein)

Online qualitative research methods are a relatively new approach within the field but come with their own unique benefits. Online methods make qualitative research more accessible by taking away the constraints of traditional techniques. For example, collecting data via a traditional focus group can be time-consuming and costly, whereas conducting an online focus group removes the cost of participant travel, venues and transcriptions, as well as logistically being easier to manage.

Furthermore, by not being face-to-face with the moderator, respondents are likely to feel anonymous and therefore are more likely to give the most honest answers. This also helps alleviate moderator bias; body language, expressions, tone of language are all possible sources of bias in a face-to-face environment, something which is eradicated by online methods. There are many ways in which online qualitative techniques can specifically be useful for conducting market and consumer research. For example, if a brand needs to clarify or test new marketing messages, focus groups can be the perfect way to gain honest feedback. Qualitative methods can also be used to help construct new ideas for how to improve or fine tune a product, as well as learning how a brand matches its target audience. Overall, for any in-depth insight into how a brand/product is viewed by the general consumer, qualitative research has the perfect tools.

Whilst these methods aren’t going to give you statistics from large sample sizes which you can extrapolate across a population, it will give you the perfect tools to explore a new concept, or gain feedback on a new idea. It is also a great starting point to develop ideas which will later inform your quantitative research.

Online qualitative methods

There are a wealth of online qualitative methods you can use to gain product and customer insight. Here are a few common techniques:

Focus Groups: This is a useful way to generate guided discussion around the topics of your choice. The moderator of the group would begin the discussion using text or video, allowing respondents to construct a conversation, generating data in real time. The moderator’s role would be to ensure conversation is on track and relevant, whilst also probing for deeper insight where appropriate.

Discussion boards: Similar to focus groups, discussion boards are useful when wanting to collect dynamic data over a longer period of time. Much like an online forum, the researcher can prompt a topic for discussion, allowing respondents to contribute and build on each other’s thoughts and ideas. This is an interactive way to produce qualitative data, and allows the researcher to have as much or little input as needed, through the use of prompts and probing. A discussion board could be active for several days to weeks.

These methods would be a great choice for generating feedback on a new product or marketing message; creating conversation between a diverse group of people, will help you understand different views of the product from various perspectives, and ensure you really get to know your customer.

Diaries and Journals: The use of diary or journal entries are a great way of generating qualitative data over a longer period of time. Respondents have the opportunity to upload entries at requested time intervals e.g. every day or once a week, recording their experiences and commenting on any changes of opinion.

This method would be of particular use within consumer research when wanting to understand the experience of a product over a period of time. For example, if you were looking to track the usage and experience of an app or website over a number of weeks, this would help gain insight into how it would be used by a consumer in the real world.

Pictures and Video: Other interactive qualitative techniques include the use of pictures and videos. Respondents are able to upload photos or short video clips to help illustrate their experiences. For example, if providing a feedback on a product, respondents could provide video footage to complement their written word.

So now you have generated your qualitative data, what happens next? With such rich, detailed data, in-depth analysis is necessary to generate the key themes and insight from the research. Once these key themes are formulated, the results can help inform the next stages in the development of a product or marketing message or help to narrow down your target audience.

In addition, your research may have prompted some new thoughts and concepts which you wish to explore, generating the basis for a quantitative survey to understand if these opinions are typical of a larger population.

In summary, qualitative research methods sit perfectly alongside quantitative methods to offer a unique opportunity to gain in-depth insight from consumers. What quantitative research lacks in depth of meaning, qualitative makes up for. Having access to both methods of research allows the ability for all research needs to be fulfilled.

What is qualitative research? For those more familiar with quantitative research techniques, the methods used in qualitative research may, at […]

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Published: 05 October 2018

Interviews and focus groups in qualitative research: an update for the digital age

P. Gill 1 &
J. Baillie 2

British Dental Journal volume 225 , pages 668–672 ( 2018 ) Cite this article

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Highlights that qualitative research is used increasingly in dentistry. Interviews and focus groups remain the most common qualitative methods of data collection.

Suggests the advent of digital technologies has transformed how qualitative research can now be undertaken.

Suggests interviews and focus groups can offer significant, meaningful insight into participants' experiences, beliefs and perspectives, which can help to inform developments in dental practice.

Qualitative research is used increasingly in dentistry, due to its potential to provide meaningful, in-depth insights into participants' experiences, perspectives, beliefs and behaviours. These insights can subsequently help to inform developments in dental practice and further related research. The most common methods of data collection used in qualitative research are interviews and focus groups. While these are primarily conducted face-to-face, the ongoing evolution of digital technologies, such as video chat and online forums, has further transformed these methods of data collection. This paper therefore discusses interviews and focus groups in detail, outlines how they can be used in practice, how digital technologies can further inform the data collection process, and what these methods can offer dentistry.

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Interviews in the social sciences

Professionalism in dentistry: deconstructing common terminology

A review of technical and quality assessment considerations of audio-visual and web-conferencing focus groups in qualitative health research, introduction.

Traditionally, research in dentistry has primarily been quantitative in nature. 1 However, in recent years, there has been a growing interest in qualitative research within the profession, due to its potential to further inform developments in practice, policy, education and training. Consequently, in 2008, the British Dental Journal (BDJ) published a four paper qualitative research series, 2 , 3 , 4 , 5 to help increase awareness and understanding of this particular methodological approach.

Since the papers were originally published, two scoping reviews have demonstrated the ongoing proliferation in the use of qualitative research within the field of oral healthcare. 1 , 6 To date, the original four paper series continue to be well cited and two of the main papers remain widely accessed among the BDJ readership. 2 , 3 The potential value of well-conducted qualitative research to evidence-based practice is now also widely recognised by service providers, policy makers, funding bodies and those who commission, support and use healthcare research.

Besides increasing standalone use, qualitative methods are now also routinely incorporated into larger mixed method study designs, such as clinical trials, as they can offer additional, meaningful insights into complex problems that simply could not be provided by quantitative methods alone. Qualitative methods can also be used to further facilitate in-depth understanding of important aspects of clinical trial processes, such as recruitment. For example, Ellis et al . investigated why edentulous older patients, dissatisfied with conventional dentures, decline implant treatment, despite its established efficacy, and frequently refuse to participate in related randomised clinical trials, even when financial constraints are removed. 7 Through the use of focus groups in Canada and the UK, the authors found that fears of pain and potential complications, along with perceived embarrassment, exacerbated by age, are common reasons why older patients typically refuse dental implants. 7

The last decade has also seen further developments in qualitative research, due to the ongoing evolution of digital technologies. These developments have transformed how researchers can access and share information, communicate and collaborate, recruit and engage participants, collect and analyse data and disseminate and translate research findings. 8 Where appropriate, such technologies are therefore capable of extending and enhancing how qualitative research is undertaken. 9 For example, it is now possible to collect qualitative data via instant messaging, email or online/video chat, using appropriate online platforms.

These innovative approaches to research are therefore cost-effective, convenient, reduce geographical constraints and are often useful for accessing 'hard to reach' participants (for example, those who are immobile or socially isolated). 8 , 9 However, digital technologies are still relatively new and constantly evolving and therefore present a variety of pragmatic and methodological challenges. Furthermore, given their very nature, their use in many qualitative studies and/or with certain participant groups may be inappropriate and should therefore always be carefully considered. While it is beyond the scope of this paper to provide a detailed explication regarding the use of digital technologies in qualitative research, insight is provided into how such technologies can be used to facilitate the data collection process in interviews and focus groups.

In light of such developments, it is perhaps therefore timely to update the main paper 3 of the original BDJ series. As with the previous publications, this paper has been purposely written in an accessible style, to enhance readability, particularly for those who are new to qualitative research. While the focus remains on the most common qualitative methods of data collection – interviews and focus groups – appropriate revisions have been made to provide a novel perspective, and should therefore be helpful to those who would like to know more about qualitative research. This paper specifically focuses on undertaking qualitative research with adult participants only.

Overview of qualitative research

Qualitative research is an approach that focuses on people and their experiences, behaviours and opinions. 10 , 11 The qualitative researcher seeks to answer questions of 'how' and 'why', providing detailed insight and understanding, 11 which quantitative methods cannot reach. 12 Within qualitative research, there are distinct methodologies influencing how the researcher approaches the research question, data collection and data analysis. 13 For example, phenomenological studies focus on the lived experience of individuals, explored through their description of the phenomenon. Ethnographic studies explore the culture of a group and typically involve the use of multiple methods to uncover the issues. 14

While methodology is the 'thinking tool', the methods are the 'doing tools'; 13 the ways in which data are collected and analysed. There are multiple qualitative data collection methods, including interviews, focus groups, observations, documentary analysis, participant diaries, photography and videography. Two of the most commonly used qualitative methods are interviews and focus groups, which are explored in this article. The data generated through these methods can be analysed in one of many ways, according to the methodological approach chosen. A common approach is thematic data analysis, involving the identification of themes and subthemes across the data set. Further information on approaches to qualitative data analysis has been discussed elsewhere. 1

Qualitative research is an evolving and adaptable approach, used by different disciplines for different purposes. Traditionally, qualitative data, specifically interviews, focus groups and observations, have been collected face-to-face with participants. In more recent years, digital technologies have contributed to the ongoing evolution of qualitative research. Digital technologies offer researchers different ways of recruiting participants and collecting data, and offer participants opportunities to be involved in research that is not necessarily face-to-face.

Research interviews are a fundamental qualitative research method 15 and are utilised across methodological approaches. Interviews enable the researcher to learn in depth about the perspectives, experiences, beliefs and motivations of the participant. 3 , 16 Examples include, exploring patients' perspectives of fear/anxiety triggers in dental treatment, 17 patients' experiences of oral health and diabetes, 18 and dental students' motivations for their choice of career. 19

Interviews may be structured, semi-structured or unstructured, 3 according to the purpose of the study, with less structured interviews facilitating a more in depth and flexible interviewing approach. 20 Structured interviews are similar to verbal questionnaires and are used if the researcher requires clarification on a topic; however they produce less in-depth data about a participant's experience. 3 Unstructured interviews may be used when little is known about a topic and involves the researcher asking an opening question; 3 the participant then leads the discussion. 20 Semi-structured interviews are commonly used in healthcare research, enabling the researcher to ask predetermined questions, 20 while ensuring the participant discusses issues they feel are important.

Interviews can be undertaken face-to-face or using digital methods when the researcher and participant are in different locations. Audio-recording the interview, with the consent of the participant, is essential for all interviews regardless of the medium as it enables accurate transcription; the process of turning the audio file into a word-for-word transcript. This transcript is the data, which the researcher then analyses according to the chosen approach.

Types of interview

Qualitative studies often utilise one-to-one, face-to-face interviews with research participants. This involves arranging a mutually convenient time and place to meet the participant, signing a consent form and audio-recording the interview. However, digital technologies have expanded the potential for interviews in research, enabling individuals to participate in qualitative research regardless of location.

Telephone interviews can be a useful alternative to face-to-face interviews and are commonly used in qualitative research. They enable participants from different geographical areas to participate and may be less onerous for participants than meeting a researcher in person. 15 A qualitative study explored patients' perspectives of dental implants and utilised telephone interviews due to the quality of the data that could be yielded. 21 The researcher needs to consider how they will audio record the interview, which can be facilitated by purchasing a recorder that connects directly to the telephone. One potential disadvantage of telephone interviews is the inability of the interviewer and researcher to see each other. This is resolved using software for audio and video calls online – such as Skype – to conduct interviews with participants in qualitative studies. Advantages of this approach include being able to see the participant if video calls are used, enabling observation of non-verbal communication, and the software can be free to use. However, participants are required to have a device and internet connection, as well as being computer literate, potentially limiting who can participate in the study. One qualitative study explored the role of dental hygienists in reducing oral health disparities in Canada. 22 The researcher conducted interviews using Skype, which enabled dental hygienists from across Canada to be interviewed within the research budget, accommodating the participants' schedules. 22

A less commonly used approach to qualitative interviews is the use of social virtual worlds. A qualitative study accessed a social virtual world – Second Life – to explore the health literacy skills of individuals who use social virtual worlds to access health information. 23 The researcher created an avatar and interview room, and undertook interviews with participants using voice and text methods. 23 This approach to recruitment and data collection enables individuals from diverse geographical locations to participate, while remaining anonymous if they wish. Furthermore, for interviews conducted using text methods, transcription of the interview is not required as the researcher can save the written conversation with the participant, with the participant's consent. However, the researcher and participant need to be familiar with how the social virtual world works to engage in an interview this way.

Conducting an interview

Ensuring informed consent before any interview is a fundamental aspect of the research process. Participants in research must be afforded autonomy and respect; consent should be informed and voluntary. 24 Individuals should have the opportunity to read an information sheet about the study, ask questions, understand how their data will be stored and used, and know that they are free to withdraw at any point without reprisal. The qualitative researcher should take written consent before undertaking the interview. In a face-to-face interview, this is straightforward: the researcher and participant both sign copies of the consent form, keeping one each. However, this approach is less straightforward when the researcher and participant do not meet in person. A recent protocol paper outlined an approach for taking consent for telephone interviews, which involved: audio recording the participant agreeing to each point on the consent form; the researcher signing the consent form and keeping a copy; and posting a copy to the participant. 25 This process could be replicated in other interview studies using digital methods.

There are advantages and disadvantages of using face-to-face and digital methods for research interviews. Ultimately, for both approaches, the quality of the interview is determined by the researcher. 16 Appropriate training and preparation are thus required. Healthcare professionals can use their interpersonal communication skills when undertaking a research interview, particularly questioning, listening and conversing. 3 However, the purpose of an interview is to gain information about the study topic, 26 rather than offering help and advice. 3 The researcher therefore needs to listen attentively to participants, enabling them to describe their experience without interruption. 3 The use of active listening skills also help to facilitate the interview. 14 Spradley outlined elements and strategies for research interviews, 27 which are a useful guide for qualitative researchers:

Greeting and explaining the project/interview

Asking descriptive (broad), structural (explore response to descriptive) and contrast (difference between) questions

Asymmetry between the researcher and participant talking

Expressing interest and cultural ignorance

Repeating, restating and incorporating the participant's words when asking questions

Creating hypothetical situations

Asking friendly questions

Knowing when to leave.

For semi-structured interviews, a topic guide (also called an interview schedule) is used to guide the content of the interview – an example of a topic guide is outlined in Box 1 . The topic guide, usually based on the research questions, existing literature and, for healthcare professionals, their clinical experience, is developed by the research team. The topic guide should include open ended questions that elicit in-depth information, and offer participants the opportunity to talk about issues important to them. This is vital in qualitative research where the researcher is interested in exploring the experiences and perspectives of participants. It can be useful for qualitative researchers to pilot the topic guide with the first participants, 10 to ensure the questions are relevant and understandable, and amending the questions if required.

Regardless of the medium of interview, the researcher must consider the setting of the interview. For face-to-face interviews, this could be in the participant's home, in an office or another mutually convenient location. A quiet location is preferable to promote confidentiality, enable the researcher and participant to concentrate on the conversation, and to facilitate accurate audio-recording of the interview. For interviews using digital methods the same principles apply: a quiet, private space where the researcher and participant feel comfortable and confident to participate in an interview.

Box 1: Example of a topic guide

Study focus: Parents' experiences of brushing their child's (aged 0–5) teeth

1. Can you tell me about your experience of cleaning your child's teeth?

How old was your child when you started cleaning their teeth?

Why did you start cleaning their teeth at that point?

How often do you brush their teeth?

What do you use to brush their teeth and why?

2. Could you explain how you find cleaning your child's teeth?

Do you find anything difficult?

What makes cleaning their teeth easier for you?

3. How has your experience of cleaning your child's teeth changed over time?

Has it become easier or harder?

Have you changed how often and how you clean their teeth? If so, why?

4. Could you describe how your child finds having their teeth cleaned?

What do they enjoy about having their teeth cleaned?

Is there anything they find upsetting about having their teeth cleaned?

5. Where do you look for information/advice about cleaning your child's teeth?

What did your health visitor tell you about cleaning your child's teeth? (If anything)

What has the dentist told you about caring for your child's teeth? (If visited)

Have any family members given you advice about how to clean your child's teeth? If so, what did they tell you? Did you follow their advice?

6. Is there anything else you would like to discuss about this?

Focus groups

A focus group is a moderated group discussion on a pre-defined topic, for research purposes. 28 , 29 While not aligned to a particular qualitative methodology (for example, grounded theory or phenomenology) as such, focus groups are used increasingly in healthcare research, as they are useful for exploring collective perspectives, attitudes, behaviours and experiences. Consequently, they can yield rich, in-depth data and illuminate agreement and inconsistencies 28 within and, where appropriate, between groups. Examples include public perceptions of dental implants and subsequent impact on help-seeking and decision making, 30 and general dental practitioners' views on patient safety in dentistry. 31

Focus groups can be used alone or in conjunction with other methods, such as interviews or observations, and can therefore help to confirm, extend or enrich understanding and provide alternative insights. 28 The social interaction between participants often results in lively discussion and can therefore facilitate the collection of rich, meaningful data. However, they are complex to organise and manage, due to the number of participants, and may also be inappropriate for exploring particularly sensitive issues that many participants may feel uncomfortable about discussing in a group environment.

Focus groups are primarily undertaken face-to-face but can now also be undertaken online, using appropriate technologies such as email, bulletin boards, online research communities, chat rooms, discussion forums, social media and video conferencing. 32 Using such technologies, data collection can also be synchronous (for example, online discussions in 'real time') or, unlike traditional face-to-face focus groups, asynchronous (for example, online/email discussions in 'non-real time'). While many of the fundamental principles of focus group research are the same, regardless of how they are conducted, a number of subtle nuances are associated with the online medium. 32 Some of which are discussed further in the following sections.

Focus group considerations

Some key considerations associated with face-to-face focus groups are: how many participants are required; should participants within each group know each other (or not) and how many focus groups are needed within a single study? These issues are much debated and there is no definitive answer. However, the number of focus groups required will largely depend on the topic area, the depth and breadth of data needed, the desired level of participation required 29 and the necessity (or not) for data saturation.

The optimum group size is around six to eight participants (excluding researchers) but can work effectively with between three and 14 participants. 3 If the group is too small, it may limit discussion, but if it is too large, it may become disorganised and difficult to manage. It is, however, prudent to over-recruit for a focus group by approximately two to three participants, to allow for potential non-attenders. For many researchers, particularly novice researchers, group size may also be informed by pragmatic considerations, such as the type of study, resources available and moderator experience. 28 Similar size and mix considerations exist for online focus groups. Typically, synchronous online focus groups will have around three to eight participants but, as the discussion does not happen simultaneously, asynchronous groups may have as many as 10–30 participants. 33

The topic area and potential group interaction should guide group composition considerations. Pre-existing groups, where participants know each other (for example, work colleagues) may be easier to recruit, have shared experiences and may enjoy a familiarity, which facilitates discussion and/or the ability to challenge each other courteously. 3 However, if there is a potential power imbalance within the group or if existing group norms and hierarchies may adversely affect the ability of participants to speak freely, then 'stranger groups' (that is, where participants do not already know each other) may be more appropriate. 34 , 35

Focus group management

Face-to-face focus groups should normally be conducted by two researchers; a moderator and an observer. 28 The moderator facilitates group discussion, while the observer typically monitors group dynamics, behaviours, non-verbal cues, seating arrangements and speaking order, which is essential for transcription and analysis. The same principles of informed consent, as discussed in the interview section, also apply to focus groups, regardless of medium. However, the consent process for online discussions will probably be managed somewhat differently. For example, while an appropriate participant information leaflet (and consent form) would still be required, the process is likely to be managed electronically (for example, via email) and would need to specifically address issues relating to technology (for example, anonymity and use, storage and access to online data). 32

The venue in which a face to face focus group is conducted should be of a suitable size, private, quiet, free from distractions and in a collectively convenient location. It should also be conducted at a time appropriate for participants, 28 as this is likely to promote attendance. As with interviews, the same ethical considerations apply (as discussed earlier). However, online focus groups may present additional ethical challenges associated with issues such as informed consent, appropriate access and secure data storage. Further guidance can be found elsewhere. 8 , 32

Before the focus group commences, the researchers should establish rapport with participants, as this will help to put them at ease and result in a more meaningful discussion. Consequently, researchers should introduce themselves, provide further clarity about the study and how the process will work in practice and outline the 'ground rules'. Ground rules are designed to assist, not hinder, group discussion and typically include: 3 , 28 , 29

Discussions within the group are confidential to the group

Only one person can speak at a time

All participants should have sufficient opportunity to contribute

There should be no unnecessary interruptions while someone is speaking

Everyone can be expected to be listened to and their views respected

Challenging contrary opinions is appropriate, but ridiculing is not.

Moderating a focus group requires considered management and good interpersonal skills to help guide the discussion and, where appropriate, keep it sufficiently focused. Avoid, therefore, participating, leading, expressing personal opinions or correcting participants' knowledge 3 , 28 as this may bias the process. A relaxed, interested demeanour will also help participants to feel comfortable and promote candid discourse. Moderators should also prevent the discussion being dominated by any one person, ensure differences of opinions are discussed fairly and, if required, encourage reticent participants to contribute. 3 Asking open questions, reflecting on significant issues, inviting further debate, probing responses accordingly, and seeking further clarification, as and where appropriate, will help to obtain sufficient depth and insight into the topic area.

Moderating online focus groups requires comparable skills, particularly if the discussion is synchronous, as the discussion may be dominated by those who can type proficiently. 36 It is therefore important that sufficient time and respect is accorded to those who may not be able to type as quickly. Asynchronous discussions are usually less problematic in this respect, as interactions are less instant. However, moderating an asynchronous discussion presents additional challenges, particularly if participants are geographically dispersed, as they may be online at different times. Consequently, the moderator will not always be present and the discussion may therefore need to occur over several days, which can be difficult to manage and facilitate and invariably requires considerable flexibility. 32 It is also worth recognising that establishing rapport with participants via online medium is often more challenging than via face-to-face and may therefore require additional time, skills, effort and consideration.

As with research interviews, focus groups should be guided by an appropriate interview schedule, as discussed earlier in the paper. For example, the schedule will usually be informed by the review of the literature and study aims, and will merely provide a topic guide to help inform subsequent discussions. To provide a verbatim account of the discussion, focus groups must be recorded, using an audio-recorder with a good quality multi-directional microphone. While videotaping is possible, some participants may find it obtrusive, 3 which may adversely affect group dynamics. The use (or not) of a video recorder, should therefore be carefully considered.

At the end of the focus group, a few minutes should be spent rounding up and reflecting on the discussion. 28 Depending on the topic area, it is possible that some participants may have revealed deeply personal issues and may therefore require further help and support, such as a constructive debrief or possibly even referral on to a relevant third party. It is also possible that some participants may feel that the discussion did not adequately reflect their views and, consequently, may no longer wish to be associated with the study. 28 Such occurrences are likely to be uncommon, but should they arise, it is important to further discuss any concerns and, if appropriate, offer them the opportunity to withdraw (including any data relating to them) from the study. Immediately after the discussion, researchers should compile notes regarding thoughts and ideas about the focus group, which can assist with data analysis and, if appropriate, any further data collection.

Qualitative research is increasingly being utilised within dental research to explore the experiences, perspectives, motivations and beliefs of participants. The contributions of qualitative research to evidence-based practice are increasingly being recognised, both as standalone research and as part of larger mixed-method studies, including clinical trials. Interviews and focus groups remain commonly used data collection methods in qualitative research, and with the advent of digital technologies, their utilisation continues to evolve. However, digital methods of qualitative data collection present additional methodological, ethical and practical considerations, but also potentially offer considerable flexibility to participants and researchers. Consequently, regardless of format, qualitative methods have significant potential to inform important areas of dental practice, policy and further related research.

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Gill, P., Baillie, J. Interviews and focus groups in qualitative research: an update for the digital age. Br Dent J 225 , 668–672 (2018). https://doi.org/10.1038/sj.bdj.2018.815

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Accepted : 02 July 2018

Published : 05 October 2018

Issue Date : 12 October 2018

DOI : https://doi.org/10.1038/sj.bdj.2018.815

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Why use theories in qualitative research?

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Peer review
Scott Reeves , associate professor 1 ,
Mathieu Albert , assistant professor 2 ,
Ayelet Kuper , assistant professor 3 ,
Brian David Hodges , associate professor and vice-chair (education) 2
1 Department of Psychiatry, Li Ka Shing Knowledge Institute, Centre for Faculty Development, and Wilson Centre for Research in Education, University of Toronto, 200 Elizabeth Street, Eaton South 1-565, Toronto, Ontario, Canada M5G 2C4
2 Department of Psychiatry and Wilson Centre for Research in Education
3 Department of Medicine, Sunnybrook Health Sciences Centre, and Wilson Centre for Research in Education
Correspondence to: S Reeves scott.reeves{at}utoronto.ca

Theories such as interactionism, phenomenology, and critical theory can be used to help design a research question, guide the selection of relevant data, interpret the data, and propose explanations of causes or influences

Previous articles in this series have addressed several methodologies used in qualitative research. Qualitative researchers also rely heavily on theories drawn from the social sciences and humanities to guide their research process and illuminate their findings. This article discusses the role and use of three theoretical approaches commonly used by qualitative researchers in health domains: interactionism, phenomenology, and critical theory. It also explains why such theories are important for clinicians, for health policy, and for patient care.

Why is theory useful?

Theories provide complex and comprehensive conceptual understandings of things that cannot be pinned down: how societies work, how organisations operate, why people interact in certain ways. Theories give researchers different “lenses” through which to look at complicated problems and social issues, focusing their attention on different aspects of the data and providing a framework within which to conduct their analysis.

Just as there is no one way to understand why, for instance, a culture has formed in a certain way, many lenses can be applied to a problem, each focusing on a different aspect of it. For example, to study doctor-nurse interactions on medical wards, various theories can provide insights into different aspects of hospital and ward cultures. Box 1 indicates how each of the theories discussed in this paper could be used to highlight different facets of this research problem.

Box 1 How different theories help illuminate the culture of doctor-nurse interactions on a medical ward

Phenomenology.

A researcher using phenomenology would approach the study of doctor-nurse interprofessional interactions by exploring how individual doctors and nurses made sense of their ward-based interprofessional experiences. Such a study would aim to elicit, through interviews, the meanings each individual attached to their interactions and the classifications they employed to make sense of their working lives within this context. Data would be analysed inductively, focusing on allowing meanings to emerge from the interviews. Specifically, this process would entail examining statements from the interviews and clustering them to form common themes linked to understanding the meanings that doctors and nurses each individually attached to their interactions.

Interactionism

Interactionist theory would be used to explore how the interprofessional relations within a medical ward context were created and modified during the daily interactions of doctors and nurses. Researchers in such a study would observe how doctors and nurses interacted (both verbally and non-verbally) in their shared clinical work; they would also interview both groups to understand the meanings they attached to their differing interprofessional interactions. Data would be analysed inductively by examining observational field notes and interviews to identify and explore the different elements which contributed to the nature of doctor-nurse interactions within a particular context. For example, researchers might examine differences between formal interactions (in front of patients) and informal interactions (in more private hospital settings).

Critical theory

A researcher employing critical theory would approach a study of doctor-nurse interactions by asking how power is related to characteristics of individuals or groups (for example, gender, race, culture). For example, critical scholars such as Anne Witz have shown that professions form hierarchies in which the dominant ones are predominately male (doctors), the first subordinate profession is largely female (nurses) and the most subordinate are often members of ethic minorities (nursing assistants). 14 Data analysis would be informed by the specific critical theoretical lens selected by the researcher. For example, data could be filtered through a feminist lens to help understand how patriarchy operates through doctor-nurse interactions within medical ward settings.

What are examples of theories used by qualitative researchers?

This theory was originally developed by Edmund Husserl to explain how individuals give meanings to social phenomena in their everyday lives. The role of phenomenology was therefore to explore “the essence of consciousness as experienced from the first-person point of view.” 1 Studies that draw upon this theoretical perspective concentrate on exploring how individuals make sense of the world in terms of the meanings and classifications they employ. As such, phenomenology aims to provide accounts that offer an insight into the subjective “lived” experience of individuals. 2 Given the emphasis, phenomenological studies do not attempt to generate wider explanations; rather their focus is on providing research accounts for individuals in a specific setting.

In general, studies that draw upon a phenomenological approach gather data in the form of in-depth semistructured or unstructured interviews and personal documents such as diaries. For example, Porter and colleagues used in-depth individual interviews to understand the meanings people living in residential homes held about their caregivers, 3 whereas Mitchell gathered the meanings of being a senior from narrative stories written by older people about their personal experiences in later life. 4 Theories that privilege understanding of human experience in terms of individual consciousness, such as phenomenology, share links to the work of the German philosopher Georg Wilhelm Friedrich Hegel and French existentialists such as Jean-Paul Sartre. However, phenomenology, as a result of its specific, empirical focus on the individual experience, is an example of a micro level theory within this philosophical orientation.

In contrast to the phenomenological focus on understanding individual perceptions, interactionism concentrates on exploring collective (group or team) behaviours and perceptions. Originally developed by George Mead, this approach aimed to provide an understanding of individuals’ interactions by examining the symbols, especially the language, they use in their daily encounters. In particular, interactionism is an approach that aims to elicit an understanding of how meaning is created and modified by individuals through their social actions, interactions, and reactions. Herbert Blumer outlined interactionism’s three guiding assumptions: that human beings act towards things on the basis of the meanings that these things have for them; that the meaning of such things is derived from, and arises out of, social interaction with one’s fellows; that these meanings are handled in, and modified through, an interpretative process used by the person in dealing with the things he or she encounters. 5

Given the emphasis on understanding the processes of social interactions, interactionist research studies often draw on methods of data collection such as participant observation and interviews to capture these elements of social action. For example, Goffman found that individuals’ interactions are largely dependent on whether they are interacting in a “front stage” (a hospital ward, for example) or a “backstage” (private office, for example) setting. 6 More recent research on the socialisation of medical students has indicated the significance of front and backstage performances in their socialisation. 7

Several theories conceptualise reality as a social or collective construction, and these have roots in the work of European writers such as Émile Durkheim and Lev Vygotsky and of Americans Peter Berger and Thomas Luckman. Interactionism attempts to generalise beyond the individual experience but retains a mid-range focus on local systems and contexts within this broader social constructivist school.

Critical theory is oriented towards critiquing and changing society as a whole. 8 With roots in the work of Marx on production and capitalism, it was further developed at the Institute for Social Research of the University of Frankfurt in the 1930s. More recently, this tradition has been carried on by social scientists such as Pierre Bourdieu and Michel Foucault.

Critical theorists study how the construction of knowledge and the organisation of power in society generally, and in institutions such as schools, hospitals, and governments specifically, can lead to the subjugation or oppression of particular individuals, groups, or perspectives. Critical theorists are concerned with equity and justice in relation to issues such as race, socioeconomic status, religion, and sexuality. 9 For example, Battiste studied how Euro-American dominated health care, pharmaceutical research, and educational institutions marginalise indigenous knowledge, and how both endangered certain populations and marginalised important knowledge about health and the environment. 10 Muzzin used critical theory in her study of how education of health professionals has come to reflect corporate interests, thereby reproducing gender and class inequity, as universities developed “academic capitalism.” 11

Critical theory is not tied to one specific methodology and can be applied at the micro (individual), macro (local systems and contexts), or macro (societal) level.

Aren’t there a lot more theories?

The three theories we have discussed so far in this paper are examples of the possible theories a qualitative researcher might use. Box 2 provides some further examples of other theories that have been used in qualitative research studies in domains related to medicine.

Box 2 More examples of theories used in qualitative research

Professionalisation theory.

Elliot Freidson developed his theory of professionalisation in response to previous explanations that had considered only the range of positive traits of professional groups. 15 Freidson argued that occupational groups, such as medicine, had previously engaged in a process of professionalisation to secure exclusive ownership of specific areas of knowledge and expertise. In obtaining exclusivity, occupational groups secure autonomy of practice, which leads to economic rewards and enhanced status. To protect the gains obtained from professionalisation, occupations guard their areas of knowledge and expertise through strict regulation of entry and the maintenance of professional standards. More recently, this theory has been questioned because of the increasing influence of clinical management on medicine, which Haug argued had resulted in a “deprofessionalisation” process, whereby some of the professional gains described by Freidson have been undermined. 16

Labelling theory

Originating in the sociology of deviance, labelling theory focuses on how society can negatively label a group whose behaviour is deemed as deviating from the norm. The theory was applied in a healthcare context by Scheff to help understand the nature of mental illness. 17 Scheff argued that mental illness is essentially generated as a result of societal influence. To understand deviant actions, individuals often place the label “mental illness” on those who show such actions. Certain expectations are then placed on these individuals and, over time, they unconsciously change their behaviour to fulfil them (a notion termed self fulfilling prophesy). Empirical work by Link et al has shown how influential labelling can be for mentally ill patients: once they are labelled as having this type of illness, people may withdraw from society. 18

Negotiated order theory

This theory was developed by Strauss et al to advance thinking about the way social order is maintained in organisations. 19 Previous explanations of social order within organisations tended to emphasise formal structures and rules and to neglect the influence of negotiations at the micro level. For Strauss and his colleagues, negotiation between individuals (through bargaining, compromising, and mediating) creates and shapes organisational rules and structures. Consequently, micro level negotiation contributes to the development and maintenance of the social order that exists within an organisation. This theory has been used in various organisational settings, including health care, where it indicated that informal negotiation was key in nurse-doctor decisions on patient care. 20

Following work by Merton, such theories can usefully be grouped into a taxonomy to guide novice researchers as to which theories are likely to be helpful in dealing with a particular research problem (table ⇓ ). 12 As shown in the table, grand or “macro” theories are non-specific and constructed from relatively abstract concepts. As a result of their wide ranging nature, these types of theories are difficult to operationalise and verify on an empirical basis. Mid-range theories consider specific phenomena and involve a small number of concepts relating to a restricted range of contexts. “Micro” or practice theories have the narrowest range of interest and are focused on specific phenomena and contexts. Box 3 addresses further frequently asked questions about theories in qualitative research.

Types of theory, with examples from related domains

View inline

Box 3 Frequently asked questions

How is the term “theory” defined.

A theory is an organised, coherent, and systematic articulation of a set of issues that are communicated as a meaningful whole.

How are theories generated?

Theories are usually generated deductively, from an empirically informed act of creativity, then empirically verified. In this sense, theories result from an ongoing process of deduction and induction.

How can theories be used?

Theories are usually used to help design a research question, guide the selection of relevant data, interpret the data, and propose explanations of the underlying causes or influences of observed phenomena.

Can theories be used to predict research findings and generate hypotheses?

In general, theories in the natural sciences are used to generate predictions about the relation between two or more different variables in order to generate universal laws. In contrast, social scientists assume that social reality is too complex to consider variables in isolation in order to test their causal relationship. In addition, social scientists view universal laws as being unable to explain the complex interrelated functions of societies, thus making it impossible to draw on evidence for prediction. So, for social scientists, a theory is first and foremost a conceptual tool useful in making sense of a complex social reality.

How are theories and methodologies related?

Some theories and methodologies are historically related—that is, they both derive from the same discipline or school, and although they are sometimes used separately they are often taught and used together. The classic example of this is the link between interactionism (theory) and ethnography. Other theories (or families of theories) link well with multiple methodologies. For example, critical theories have been used to varying effect with almost every available methodology (both qualitative and quantitative).

Are these all the possible theories?

No—we have just scratched the surface. Theories have been developed and modified over several hundred years and have dialectically informed each other’s changes over time. The theories we have mentioned in this paper are those that readers are likely to encounter in the health domain. Other important theories used often in the social sciences and humanities, but only occasionally in health related research, include (but are not limited to) marxism and its descendants, feminism, hermeneutics, and the post-modernist family of theories.

Box 4 Further reading

Crotty M. Foundations of social research: meaning and perspective in the research process . London: Sage, 1998.

Denzin NK, Lincoln YS, eds. Handbook of qualitative research . 2nd ed. Thousand Oaks, CA: Sage, 2000.

Layder D. Understanding social theory . London: Sage, 1994.

Ritzer G, Smart B, eds. Handbook of social theory . London: Sage, 2003.

Roberts B. Micro social theory . Basingstoke: Palgrave, 2006.

Scamber G, ed. Sociological theory and medical sociology . London: Tavistock, 1987.

Stones R, ed. Key sociological thinkers . Basingstoke: Macmillan, 1998.

Why is theory important to health policy and patient care?

Theories such as those described above are important to health policy and the delivery of patient care, as the insights they provoke enable research that provides practitioners with a broader understanding of the situations they face in their daily working lives. The use of theory makes it possible for researchers to understand, and to translate for policy makers and healthcare providers, the processes that occur beneath the visible surface and so to develop knowledge of underlying (generating) principles. Importantly, theory can help people move beyond individual insights gained from their professional lives to a situation where they can understand the wider significance and applicability of these phenomena. Good theory based research is immediate, insightful, and applicable in practice; in the words of Kurt Lewin, “there’s nothing so practical as a good theory.” 13

Summary points

Different theories provide different lenses through which to analyse research problems

Various theories are currently used within health related research

Theories can be divided into macro (or grand) theories, mid-range theories, and micro (or practice) theories.

Theories can arise from, or be used within, different research domains (for example, biomedical domain, psychological domain, social domain)

The insights derived from theories are important for guiding health policy and informing the delivery of patient care

Cite this as: BMJ 2008;337:a949

Related to doi: , 10.1136/bmj.a288
doi: , 10.1136/bmj.39602.690162.47
doi: , 10.1136/bmj.a1020
doi: , 10.1136/bmj.a879
doi: 10.1136/bmj.a1035

This is the fifth in a series of six articles that aim to help readers to critically appraise the increasing number of qualitative research articles in clinical journals. The series editors are Ayelet Kuper and Scott Reeves.

For a definition of general terms relating to qualitative research, see the first article in this series.

Funding: None.

Competing interests: None declared.

Provenance and peer review: Commissioned; externally peer reviewed.

↵ Smith D. Husserl . London: Routledge, 2007 .
↵ Schutz A. The phenomenology of the social world . New York: Northwestern University Press, 1967 .
↵ Porter E, Ganong H, Drew N, Lanes T. A new typology of home-care helpers. Gerontologist 2004 ; 44 : 750 -9. OpenUrl Abstract / FREE Full Text
↵ Mitchell G. The meaning of being a senior. Nurs Sci Q 1994 ; 7 : 70 -9. OpenUrl Abstract / FREE Full Text
↵ Blumer H. Symbolic interactionism: perspective and method . Englewood Cliffs, NJ: Prentice-Hall, 1969 .
↵ Goffman E. The presentation of self in everyday life . London: Penguin, 1963 .
↵ Sinclair S. Making doctors: an institutional apprenticeship . Oxford: Berg, 1997 .
↵ Calhoun C. Critical social theory: culture, history and the challenge of difference . Oxford: Blackwell, 1995 .
↵ Kinchloe JL, McLaren P. Rethinking critical theory and qualitative research. In: Denzin NK, Lincoln YS, eds. Handbook of qualitative research . 2nd ed. Thousand Oaks, CA: Sage, 2000 .
↵ Battiste M. You can’t be the global doctor if you’re the colonial disease. In: Tripp P, Muzzin L, eds. Teaching as activism: equity meets environmentalism . Montreal and Kingston: McGill-Queen’s University Press, 2005 :121-133
↵ Muzzin L. The brave new world of professional education. In: Tripp P, Muzzin L, eds. Teaching as activism: equity meets environmentalism . Montreal and Kingston: McGill-Queen’s University Press, 2005 :149-166
↵ Merton R. Social theory and social structure . New York: Free Press, 1968 .
↵ Lewin K. Field theory in social science: selected theoretical papers . New York: Harper & Row, 1951 .
↵ Witz A. Professions and patriarchy . London: Macmillan, 1992 .
↵ Freidson E. Profession of medicine: a study of the sociology of applied knowledge. New York: Harper & Row, 1970 .
↵ Haug M. De-professionalisation: an alternative hypothesis for the future. Sociol Rev Monograph 1993 ; 20 : 195 -211. OpenUrl
↵ Scheff T. Being mentally ill: a sociological theory . 3rd ed. New York: Transaction, 1999 .
↵ Link B, Phelan J. The labelling theory of mental disorder: The consequences of labelling. In: Horwitz A, Scheid T, eds. A handbook for the study of mental health . New York: Cambridge University Press, 1999 :361-76.
↵ Strauss A, Schatzman D, Ehrlich R, Bucher M, Sabshin C. The hospital and its negotiated order. In: Freidson E, ed. The hospital in modern society . New York: Free Press, 1963 :147-69.
↵ Svensson R. The interplay between doctors and nurses—a negotiated order perspective. Sociol Health Illness 1996 ; 18 : 379 -98. OpenUrl CrossRef Web of Science

Qualitative methods: what are they and why use them?

Affiliation.

1 Robert P. Luciano Professor of Health Care Policy, School of Public Affairs, Baruch College, New York, New York 10010, USA.
PMID: 10591275
PMCID: PMC1089055

Objective: To provide an overview of reasons why qualitative methods have been used and can be used in health services and health policy research, to describe a range of specific methods, and to give examples of their application.

Data sources: Classic and contemporary descriptions of the underpinnings and applications of qualitative research methods and studies that have used such methods to examine important health services and health policy issues.

Principal findings: Qualitative research methods are valuable in providing rich descriptions of complex phenomena; tracking unique or unexpected events; illuminating the experience and interpretation of events by actors with widely differing stakes and roles; giving voice to those whose views are rarely heard; conducting initial explorations to develop theories and to generate and even test hypotheses; and moving toward explanations. Qualitative and quantitative methods can be complementary, used in sequence or in tandem. The best qualitative research is systematic and rigorous, and it seeks to reduce bias and error and to identify evidence that disconfirms initial or emergent hypotheses.

Conclusions: Qualitative methods have much to contribute to health services and health policy research, especially as such research deals with rapid change and develops a more fully integrated theory base and research agenda. However, the field must build on the best traditions and techniques of qualitative methods and must recognize that special training and experience are essential to the application of these methods.

Publication types

Focus Groups / methods
Health Services Research / methods*
Health Services Research / statistics & numerical data
Interviews as Topic / methods
Observation / methods
Organizational Case Studies / statistics & numerical data
Policy Making*
Quality Assurance, Health Care / methods
Research Design*

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CRO Guide > Chapter 3.1

Qualitative Research: Definition, Methodology, Limitation & Examples

Qualitative research is a method focused on understanding human behavior and experiences through non-numerical data. Examples of qualitative research include:

One-on-one interviews,
Focus groups, Ethnographic research,
Case studies,
Record keeping,
Qualitative observations

In this article, we’ll provide tips and tricks on how to use qualitative research to better understand your audience through real world examples and improve your ROI. We’ll also learn the difference between qualitative and quantitative data.

Marketers often seek to understand their customers deeply. Qualitative research methods such as face-to-face interviews, focus groups, and qualitative observations can provide valuable insights into your products, your market, and your customers’ opinions and motivations. Understanding these nuances can significantly enhance marketing strategies and overall customer satisfaction.

What is Qualitative Research

Qualitative research is a market research method that focuses on obtaining data through open-ended and conversational communication. This method focuses on the “why” rather than the “what” people think about you. Thus, qualitative research seeks to uncover the underlying motivations, attitudes, and beliefs that drive people’s actions.

Let’s say you have an online shop catering to a general audience. You do a demographic analysis and you find out that most of your customers are male. Naturally, you will want to find out why women are not buying from you. And that’s what qualitative research will help you find out.

In the case of your online shop, qualitative research would involve reaching out to female non-customers through methods such as in-depth interviews or focus groups. These interactions provide a platform for women to express their thoughts, feelings, and concerns regarding your products or brand. Through qualitative analysis, you can uncover valuable insights into factors such as product preferences, user experience, brand perception, and barriers to purchase.

Types of Qualitative Research Methods

Qualitative research methods are designed in a manner that helps reveal the behavior and perception of a target audience regarding a particular topic.

The most frequently used qualitative analysis methods are one-on-one interviews, focus groups, ethnographic research, case study research, record keeping, and qualitative observation.

1. One-on-one interviews

Conducting one-on-one interviews is one of the most common qualitative research methods. One of the advantages of this method is that it provides a great opportunity to gather precise data about what people think and their motivations.

Spending time talking to customers not only helps marketers understand who their clients are, but also helps with customer care: clients love hearing from brands. This strengthens the relationship between a brand and its clients and paves the way for customer testimonials.

A company might conduct interviews to understand why a product failed to meet sales expectations.
A researcher might use interviews to gather personal stories about experiences with healthcare.

These interviews can be performed face-to-face or on the phone and usually last between half an hour to over two hours.

When a one-on-one interview is conducted face-to-face, it also gives the marketer the opportunity to read the body language of the respondent and match the responses.

2. Focus groups

Focus groups gather a small number of people to discuss and provide feedback on a particular subject. The ideal size of a focus group is usually between five and eight participants. The size of focus groups should reflect the participants’ familiarity with the topic. For less important topics or when participants have little experience, a group of 10 can be effective. For more critical topics or when participants are more knowledgeable, a smaller group of five to six is preferable for deeper discussions.

The main goal of a focus group is to find answers to the “why”, “what”, and “how” questions. This method is highly effective in exploring people’s feelings and ideas in a social setting, where group dynamics can bring out insights that might not emerge in one-on-one situations.

A focus group could be used to test reactions to a new product concept.
Marketers might use focus groups to see how different demographic groups react to an advertising campaign.

One advantage that focus groups have is that the marketer doesn’t necessarily have to interact with the group in person. Nowadays focus groups can be sent as online qualitative surveys on various devices.

Focus groups are an expensive option compared to the other qualitative research methods, which is why they are typically used to explain complex processes.

3. Ethnographic research

Ethnographic research is the most in-depth observational method that studies individuals in their naturally occurring environment.

This method aims at understanding the cultures, challenges, motivations, and settings that occur.

A study of workplace culture within a tech startup.
Observational research in a remote village to understand local traditions.

Ethnographic research requires the marketer to adapt to the target audiences’ environments (a different organization, a different city, or even a remote location), which is why geographical constraints can be an issue while collecting data.

This type of research can last from a few days to a few years. It’s challenging and time-consuming and solely depends on the expertise of the marketer to be able to analyze, observe, and infer the data.

4. Case study research

The case study method has grown into a valuable qualitative research method. This type of research method is usually used in education or social sciences. It involves a comprehensive examination of a single instance or event, providing detailed insights into complex issues in real-life contexts.

Analyzing a single school’s innovative teaching method.
A detailed study of a patient’s medical treatment over several years.

Case study research may seem difficult to operate, but it’s actually one of the simplest ways of conducting research as it involves a deep dive and thorough understanding of the data collection methods and inferring the data.

5. Record keeping

Record keeping is similar to going to the library: you go over books or any other reference material to collect relevant data. This method uses already existing reliable documents and similar sources of information as a data source.

Historical research using old newspapers and letters.
A study on policy changes over the years by examining government records.

This method is useful for constructing a historical context around a research topic or verifying other findings with documented evidence.

6. Qualitative observation

Qualitative observation is a method that uses subjective methodologies to gather systematic information or data. This method deals with the five major sensory organs and their functioning, sight, smell, touch, taste, and hearing.

Sight : Observing the way customers visually interact with product displays in a store to understand their browsing behaviors and preferences.
Smell : Noting reactions of consumers to different scents in a fragrance shop to study the impact of olfactory elements on product preference.
Touch : Watching how individuals interact with different materials in a clothing store to assess the importance of texture in fabric selection.
Taste : Evaluating reactions of participants in a taste test to identify flavor profiles that appeal to different demographic groups.
Hearing : Documenting responses to changes in background music within a retail environment to determine its effect on shopping behavior and mood.

Below we are also providing real-life examples of qualitative research that demonstrate practical applications across various contexts:

Qualitative Research Real World Examples

Let’s explore some examples of how qualitative research can be applied in different contexts.

1. Online grocery shop with a predominantly male audience

Method used: one-on-one interviews.

Let’s go back to one of the previous examples. You have an online grocery shop. By nature, it addresses a general audience, but after you do a demographic analysis you find out that most of your customers are male.

One good method to determine why women are not buying from you is to hold one-on-one interviews with potential customers in the category.

Interviewing a sample of potential female customers should reveal why they don’t find your store appealing. The reasons could range from not stocking enough products for women to perhaps the store’s emphasis on heavy-duty tools and automotive products, for example. These insights can guide adjustments in inventory and marketing strategies.

2. Software company launching a new product

Method used: focus groups.

Focus groups are great for establishing product-market fit.

Let’s assume you are a software company that wants to launch a new product and you hold a focus group with 12 people. Although getting their feedback regarding users’ experience with the product is a good thing, this sample is too small to define how the entire market will react to your product.

So what you can do instead is holding multiple focus groups in 20 different geographic regions. Each region should be hosting a group of 12 for each market segment; you can even segment your audience based on age. This would be a better way to establish credibility in the feedback you receive.

3. Alan Pushkin’s “God’s Choice: The Total World of a Fundamentalist Christian School”

Method used: ethnographic research.

Moving from a fictional example to a real-life one, let’s analyze Alan Peshkin’s 1986 book “God’s Choice: The Total World of a Fundamentalist Christian School”.

Peshkin studied the culture of Bethany Baptist Academy by interviewing the students, parents, teachers, and members of the community alike, and spending eighteen months observing them to provide a comprehensive and in-depth analysis of Christian schooling as an alternative to public education.

The study highlights the school’s unified purpose, rigorous academic environment, and strong community support while also pointing out its lack of cultural diversity and openness to differing viewpoints. These insights are crucial for understanding how such educational settings operate and what they offer to students.

Even after discovering all this, Peshkin still presented the school in a positive light and stated that public schools have much to learn from such schools.

Peshkin’s in-depth research represents a qualitative study that uses observations and unstructured interviews, without any assumptions or hypotheses. He utilizes descriptive or non-quantifiable data on Bethany Baptist Academy specifically, without attempting to generalize the findings to other Christian schools.

4. Understanding buyers’ trends

Method used: record keeping.

Another way marketers can use quality research is to understand buyers’ trends. To do this, marketers need to look at historical data for both their company and their industry and identify where buyers are purchasing items in higher volumes.

For example, electronics distributors know that the holiday season is a peak market for sales while life insurance agents find that spring and summer wedding months are good seasons for targeting new clients.

5. Determining products/services missing from the market

Conducting your own research isn’t always necessary. If there are significant breakthroughs in your industry, you can use industry data and adapt it to your marketing needs.

The influx of hacking and hijacking of cloud-based information has made Internet security a topic of many industry reports lately. A software company could use these reports to better understand the problems its clients are facing.

As a result, the company can provide solutions prospects already know they need.

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Qualitative Research Approaches

Once the marketer has decided that their research questions will provide data that is qualitative in nature, the next step is to choose the appropriate qualitative approach.

The approach chosen will take into account the purpose of the research, the role of the researcher, the data collected, the method of data analysis , and how the results will be presented. The most common approaches include:

Narrative : This method focuses on individual life stories to understand personal experiences and journeys. It examines how people structure their stories and the themes within them to explore human existence. For example, a narrative study might look at cancer survivors to understand their resilience and coping strategies.
Phenomenology : attempts to understand or explain life experiences or phenomena; It aims to reveal the depth of human consciousness and perception, such as by studying the daily lives of those with chronic illnesses.
Grounded theory : investigates the process, action, or interaction with the goal of developing a theory “grounded” in observations and empirical data.
Ethnography : describes and interprets an ethnic, cultural, or social group;
Case study : examines episodic events in a definable framework, develops in-depth analyses of single or multiple cases, and generally explains “how”. An example might be studying a community health program to evaluate its success and impact.

How to Analyze Qualitative Data

Analyzing qualitative data involves interpreting non-numerical data to uncover patterns, themes, and deeper insights. This process is typically more subjective and requires a systematic approach to ensure reliability and validity.

1. Data Collection

Ensure that your data collection methods (e.g., interviews, focus groups, observations) are well-documented and comprehensive. This step is crucial because the quality and depth of the data collected will significantly influence the analysis.

2. Data Preparation

Once collected, the data needs to be organized. Transcribe audio and video recordings, and gather all notes and documents. Ensure that all data is anonymized to protect participant confidentiality where necessary.

3. Familiarization

Immerse yourself in the data by reading through the materials multiple times. This helps you get a general sense of the information and begin identifying patterns or recurring themes.

Develop a coding system to tag data with labels that summarize and account for each piece of information. Codes can be words, phrases, or acronyms that represent how these segments relate to your research questions.

Descriptive Coding : Summarize the primary topic of the data.
In Vivo Coding : Use language and terms used by the participants themselves.
Process Coding : Use gerunds (“-ing” words) to label the processes at play.
Emotion Coding : Identify and record the emotions conveyed or experienced.

5. Thematic Development

Group codes into themes that represent larger patterns in the data. These themes should relate directly to the research questions and form a coherent narrative about the findings.

6. Interpreting the Data

Interpret the data by constructing a logical narrative. This involves piecing together the themes to explain larger insights about the data. Link the results back to your research objectives and existing literature to bolster your interpretations.

7. Validation

Check the reliability and validity of your findings by reviewing if the interpretations are supported by the data. This may involve revisiting the data multiple times or discussing the findings with colleagues or participants for validation.

8. Reporting

Finally, present the findings in a clear and organized manner. Use direct quotes and detailed descriptions to illustrate the themes and insights. The report should communicate the narrative you’ve built from your data, clearly linking your findings to your research questions.

Limitations of qualitative research

The disadvantages of qualitative research are quite unique. The techniques of the data collector and their own unique observations can alter the information in subtle ways. That being said, these are the qualitative research’s limitations:

1. It’s a time-consuming process

The main drawback of qualitative study is that the process is time-consuming. Another problem is that the interpretations are limited. Personal experience and knowledge influence observations and conclusions.

Thus, qualitative research might take several weeks or months. Also, since this process delves into personal interaction for data collection, discussions often tend to deviate from the main issue to be studied.

2. You can’t verify the results of qualitative research

Because qualitative research is open-ended, participants have more control over the content of the data collected. So the marketer is not able to verify the results objectively against the scenarios stated by the respondents. For example, in a focus group discussing a new product, participants might express their feelings about the design and functionality. However, these opinions are influenced by individual tastes and experiences, making it difficult to ascertain a universally applicable conclusion from these discussions.

3. It’s a labor-intensive approach

Qualitative research requires a labor-intensive analysis process such as categorization, recording, etc. Similarly, qualitative research requires well-experienced marketers to obtain the needed data from a group of respondents.

4. It’s difficult to investigate causality

Qualitative research requires thoughtful planning to ensure the obtained results are accurate. There is no way to analyze qualitative data mathematically. This type of research is based more on opinion and judgment rather than results. Because all qualitative studies are unique they are difficult to replicate.

5. Qualitative research is not statistically representative

Because qualitative research is a perspective-based method of research, the responses given are not measured.

Comparisons can be made and this can lead toward duplication, but for the most part, quantitative data is required for circumstances that need statistical representation and that is not part of the qualitative research process.

While doing a qualitative study, it’s important to cross-reference the data obtained with the quantitative data. By continuously surveying prospects and customers marketers can build a stronger database of useful information.

Quantitative vs. Qualitative Research

Qualitative and quantitative research side by side in a table

Image source

Quantitative and qualitative research are two distinct methodologies used in the field of market research, each offering unique insights and approaches to understanding consumer behavior and preferences.

As we already defined, qualitative analysis seeks to explore the deeper meanings, perceptions, and motivations behind human behavior through non-numerical data. On the other hand, quantitative research focuses on collecting and analyzing numerical data to identify patterns, trends, and statistical relationships.

Let’s explore their key differences:

Nature of Data:

Quantitative research : Involves numerical data that can be measured and analyzed statistically.
Qualitative research : Focuses on non-numerical data, such as words, images, and observations, to capture subjective experiences and meanings.

Research Questions:

Quantitative research : Typically addresses questions related to “how many,” “how much,” or “to what extent,” aiming to quantify relationships and patterns.
Qualitative research: Explores questions related to “why” and “how,” aiming to understand the underlying motivations, beliefs, and perceptions of individuals.

Data Collection Methods:

Quantitative research : Relies on structured surveys, experiments, or observations with predefined variables and measures.
Qualitative research : Utilizes open-ended interviews, focus groups, participant observations, and textual analysis to gather rich, contextually nuanced data.

Analysis Techniques:

Quantitative research: Involves statistical analysis to identify correlations, associations, or differences between variables.
Qualitative research: Employs thematic analysis, coding, and interpretation to uncover patterns, themes, and insights within qualitative data.

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Korean J Med Educ
v.29(2); 2017 Jun

The qualitative orientation in medical education research

Qualitative research is very important in educational research as it addresses the “how” and “why” research questions and enables deeper understanding of experiences, phenomena and context. Qualitative research allows you to ask questions that cannot be easily put into numbers to understand human experience. Getting at the everyday realities of some social phenomenon and studying important questions as they are really practiced helps extend knowledge and understanding. To do so, you need to understand the philosophical stance of qualitative research and work from this to develop the research question, study design, data collection methods and data analysis. In this article, I provide an overview of the assumptions underlying qualitative research and the role of the researcher in the qualitative process. I then go on to discuss the type of research objectives which are common in qualitative research, then introduce the main qualitative designs, data collection tools, and finally the basics of qualitative analysis. I introduce the criteria by which you can judge the quality of qualitative research. Many classic references are cited in this article, and I urge you to seek out some of these further reading to inform your qualitative research program.

Introduction

When we speak of “quantitative” or “qualitative” methodologies, we are in the final analysis speaking about an interrelated set of assumptions about the social world which are philosophical, ideological, and epistemological. They encompass more than just data collection methodologies [ 1 ].

It is easy to assume that the differences between quantitative and qualitative research are solely about how data is collected—the randomized controlled trial versus ethnographic fieldwork, the cohort study versus the semi-structured interview. However, quantitative and qualitative approaches make different assumptions about the world [ 2 ], about how science should be conducted, and about what constitutes legitimate problems, solutions and criteria of “proof” [ 3 ].

Why is it important to understand differences in assumptions, or philosophies, of research? Why not just go ahead and do a survey or carry out some interviews? First, the assumptions behind the research tools you choose provide guidance for conducting your research. They indicate whether you should be an objective observer or whether you have a contributory role in the research process. They guide whether or not you must slavishly ask each person in a study the same questions or whether your questions can evolve as the study progresses. Second, you may wish to submit your work as a dissertation or as a research paper to be considered for publication in a journal. If so, the chances are that examiners, editors, and reviewers might have knowledge of different research philosophies from yours and may be unwilling to accept the legitimacy of your approach unless you can make its assumptions clear. Third, each research paradigm has its own norms and standards, its accepted ways of doing things. You need to “do things right”. Finally, understanding the theoretical assumptions of the research approach helps you recognize what the data collection and analysis methods you are working with do well and what they do less well, and lets you design your research to take full advantage of their strengths and compensate for their weaknesses.

In this short article, I will introduce the assumptions of qualitative research and their implications for research questions, study design, methods and tools, and analysis and interpretation. Readers who wish a comparison between qualitative and quantitative approaches may find Cleland [ 4 ] useful.

Ontology and epistemology

We start with a consideration of the ontology (assumptions about the nature of reality) and epistemology (assumptions about the nature of knowledge) of qualitative research.

Qualitative research approaches are used to understand everyday human experience in all its complexity and in all its natural settings [ 5 ]. To do this, qualitative research conforms to notions that reality is socially constructed and that inquiry is unavoidably value-laden [ 6 ]. The first of these, reality is socially constructed, means reality cannot be measured directly—it exists as perceived by people and by the observer. In other words, reality is relative and multiple, perceived through socially constructed and subjective interpretations [ 7 ]. For example, what I see as an exciting event may be seen as a threat by other people. What is considered a cultural ritual in my country may be thought of as quite bizarre elsewhere. Qualitative research is concerned with how the social world is interpreted, understood, experienced, or constructed. Mann and MacLeod [ 8 ] provide a very good overview of social constructivism which is a excellent starting point for understanding this.

The idea of people seeing things in diverse ways also holds true in research process, hence inquiry being valued-laden. Different people have different views of the same thing depending on their upbringing and other experiences, their training, and professional background. Someone who has been trained as a social scientist may “see” things differently from someone who has been medically trained. A woman may see things differently to a man. A more experienced researcher will see things differently from a novice. A qualitative researcher will have very different views of the nature of “evidence” than a quantitative researcher. All these viewpoints are valid. Moreover, different researchers can study the same topic and try to find solutions to the same challenges using different study designs—and hence come up with different interpretations and different recommendations. For example, if your position is that learning is about individual, cognitive, and acquisitive processes, then you are likely to research the use of simulation training in surgery in terms of the effectiveness and efficacy of training related to mastery of technical skills [ 9 , 10 ]. However, if your stance is that learning is inherently a social activity, one which involves interactions between people or groups of people, then you will look to see how the relationships between faculty members, participants and activities during a simulation, and the wider social and cultural context, influence learning [ 11 , 12 ].

Whether researchers are explicit about it or not, ontological and epistemological assumptions will underpin how they study aspects of teaching and learning. Differences in these assumptions shape not only study design, but also what emerges as data, how this data can be analysed and even the conclusions that can be drawn and recommendations that can be made from the study. This is referred to as worldview, defined by Creswell [ 13 ] as “a general orientation about the world and the nature of research that a researcher holds.” McMillan [ 14 ] gives a very good explanation of the importance of this phenomenon in relation to medical education research. There is increasing expectation that researchers make their worldview explicit in research papers.

The research objective

Given the underlying premise that reality is socially constructed, qualitative research focuses on answering “how” and “why” questions, of understanding a phenomena or a context. For example, “Our study aimed to answer the research question: why do assessors fail to report underperformance in medical students? [ 15 ]”, “The aim of this work was to investigate how widening participation policy is translated and interpreted for implementation at the level of the individual medical school [ 4 ].”

Common verbs in qualitative research questions are identify, explore, describe, understand, and explain. If your research question includes words like test or measure or compare in your objectives, these are more appropriate for quantitative methods, as they are better suited to these types of aims. Bezuidenhout and van Schalkwyk [ 16 ] provide a good guide to developing and refining your research question. Lingard [ 17 ]’s notion of joining the conversation and the problem-gap-hook heuristic are also very useful in terms of thinking about your question and setting it out in the introduction to a paper in such a way as to interest journal editors and readers.

Do not think formulating a research question is easy. Maxwell [ 18 ] gives a good overview of some of the potential issues including being too general, making assumptions about the nature of the issue/problem and using questions which focus the study on difference rather than process. Developing relevant, focused, answerable research questions takes time and generating good questions requires that you pay attention not just to the questions themselves but to their connections with all the other components of the study (the conceptual lens/theory, the methods) [ 18 ].

Theory can be applied to qualitative studies at different times during the research process, from the selection of the research phenomenon to the write-up of the results. The application of theory at different points can be described as follows [ 19 , 20 , 21 ]: (1) Theory frames the study questions, develops the philosophical underpinnings of the study, and makes assumptions to justify or rationalize the methodological approach. (2) Qualitative investigations relate the target phenomenon to the theory. (3) Theory provides a comparative context or framework for data analysis and interpretation. (4) Theory provides triangulation of study findings.

Schwartz-Barcott et al. [ 20 ] characterized those processes as theoretical selectivity (the linking of selected concepts with existing theories), theoretical integration (the incorporation and testing of selected concepts within a particular theoretical perspective), and theory creation (the generation of relational statements and the development of a new theory). Thus, theory can be the outcome of the research project as well as the starting point [ 22 ].

However, the emerging qualitative researcher may wish a little more direction on how to use theory in practice. I direct you to two papers: Reeves et al. [ 23 ] and Bordage [ 24 ]. These authors clearly explain the utility of theory, or conceptual frameworks, in qualitative research, how theory can give researchers different “lenses” through which to look at complicated problems and social issues, focusing their attention on different aspects of the data and providing a framework within which to conduct their analysis. Bordage [ 24 ] states that “conceptual frameworks represent ways of thinking about a problem or a study, or ways of representing how complex things work the way they do. Different frameworks will emphasise different variables and outcomes.” He presents an example in his paper and illustrates how different lens highlight or emphasise different aspects of the data. Other authors suggest that two theories are potentially better than one in exploring complex social issues [ 25 ]. There is an example of this in one of my papers, where we used the theories of Bourdieu [ 26 ] and Engestrom [ 27 , 28 ] nested within an overarching framework of complexity theory [ 29 ] to help us understand learning at a surgical bootcamp. However, I suggest that for focused studies and emerging educational researchers, one theoretical framework or lens is probably sufficient.

So how to identify an appropriate theory, and when to use it? It is crucially important to read widely, to explore lots of theories, from disciplines such as (but not only) education, psychology, sociology, and economics, to see what theory is available and what may be suitable for your study. Carefully consider any theory, check its assumptions [ 30 ] are congruent with your approach, question, and context before final selection [ 31 ] before deciding which theory to use. The time you spend exploring theory will be time well spent in terms not just of interpreting a specific data set but also to broadening your knowledge. The second question, when to use it, depends on the nature of the study, but generally the use of theory in qualitative research tends to be inductive; that is, building explanations from the ground up, based on what is discovered. This typically means that theory is brought in at the analysis stage, as a lens to interpret data.

In the qualitative approach, the activities of collecting and analyzing data, developing and modifying theory, and elaborating or refocusing the research questions, are usually going on more or less simultaneously, each influencing all of the others for a useful model of qualitative research design [ 18 ]. The researcher may need to reconsider or modify any design decision during the study in response to new developments. In this way, qualitative research design is less linear than quantitative research, which is much more step-wise and fixed.

This is not the same as no structure or plan. Most qualitative projects are pre-structured at least in terms of the equivalent of a research protocol, setting out what you are doing (aims and objectives), why (why is this important), and how (theoretical underpinning, design, methods, and analysis). I have provided a brief overview of common approaches to qualitative research design below and direct you to the numerous excellent textbooks which go into this in more detail [ 32 , 33 , 34 , 35 ].

There are five basic categories of qualitative research design: ethnography, narrative, phenomenological, grounded theory, and case study [ 13 , 32 ].

2. Ethnography

In ethnography, you immerse yourself in the target participants’ environment to understand the goals, cultures, challenges, motivations, and themes that emerge. Ethnography has its roots in cultural anthropology where researchers immerse themselves within a culture, often for years. Through multiple data collection approaches—observations, interviews and documentary data, ethnographic research offers a qualitative approach with the potential to yield detailed and comprehensive accounts of different social phenomenon (actions, behavior, interactions, and beliefs). Rather than relying on interviews or surveys, you experience the environment first hand, and sometimes as a “participant observer” which gives opportunity to gather empirical insights into social practices which are normally “hidden” from the public gaze. Reeves et al. [ 36 ] give an excellent guide to ethnography in medical education which is essential reading if you are interested in using this approach.

3. Narrative

The narrative approach weaves together a sequence of events, usually from just one or two individuals to form a cohesive story. You conduct in-depth interviews, read documents, and look for themes; in other words, how does an individual story illustrate the larger life influences that created it. Often interviews are conducted over weeks, months, or even years, but the final narrative does not need to be in chronological order. Rather it can be presented as a story (or narrative) with themes, and can reconcile conflicting stories and highlight tensions and challenges which can be opportunities for innovation.

4. Phenomenology

Phenomenology is concerned with the study of experience from the perspective of the individual, “bracketing” taken-for-granted assumptions and usual ways of perceiving. Phenomenological approaches emphasise the importance of personal perspective and interpretation. As such they are powerful for understanding subjective experience, gaining insights into people’s motivations and actions, and cutting through the clutter of taken-for-granted assumptions and conventional wisdom.

Phenomenological approaches can be applied to single cases or to selected samples. A variety of methods can be used in phenomenologically-based research, including interviews, conversations, participant observation, action research, focus meetings, and analysis of personal texts. Beware though—phenomenological research generates a large quantity data for analysis.

The phenomenological approach is used in medical education research and there are some good articles which will familiarise you with this approach [ 37 , 38 ].

5. Grounded theory

Whereas a phenomenological study looks to describe the essence of an activity or event, grounded theory looks to provide an explanation or theory behind the events. Its main thrust is to generate theories regarding social phenomena: that is, to develop higher level understanding that is “grounded” in, or derived from, a systematic analysis of data [ 39 ]. Grounded theory is appropriate when the study of social interactions or experiences aims to explain a process, not to test or verify an existing theory. Rather, the theory emerges through a close and careful analysis of the data.

The key features of grounded theory are its iterative study design, theoretical (purposive) sampling, and cycles of simultaneous data collection and analysis, where analysis informs the next cycle of data collection. In keeping with this iterative design, the sample is not set at the outset but is selected purposefully as the analysis progresses; participants are chosen for their ability to confirm or challenge an emerging theory. As issues of interest are noted in the data, they are compared with other examples for similarities and differences.

Grounded theory was first proposed by Glaser and Strauss [ 40 ] in 1967 but since then there have been many interpretations of this approach, each with their own processes and norms [ 41 , 42 , 43 ].

Beware—grounded theory is often done very badly, and numerous studies are rejected by journals because they claim to use grounded theory but do not actually do so, or do so badly.

6. Case study

Researcher Yin [ 44 ] defines the case study research method as an empirical inquiry that investigates a contemporary phenomenon within its real-life context; when the boundaries between phenomenon and context are not clearly evident; and in which multiple sources of evidence are used. The case study method enables a researcher to closely examine the data within a specific context—for example, in a small geographical area or a very limited number of individuals as the subjects of study. Case studies explore and investigate contemporary real-life phenomenon through detailed contextual analysis of a limited number of events or conditions, and their relationships. A case study involves a deep understanding through multiple types of data sources. For example, we used case study methodology recently to explore the nature of the clinical learning environment in a general surgical unit, and used both documents and interviews as data sources. Case studies can be explanatory, exploratory, or describing an event [ 44 ] and case study design can be very open or more structured [ 45 ]. Case studies are a useful approach where the focus is to explain the complexities of real life situations.

While the five methods generally use similar data collection techniques (observation, interviews, and reviewing text—see below), the purpose of the study differentiates them.

Data collection methods

The qualitative methods most commonly used for research purposes can be classified in three broad categories: (1) interviews (individual or group), (2) observation methods, and (3) document review.

The qualitative research interview seeks to describe and gain understanding of certain themes in the life world of the subjects. Interviews can be organised one-to-one or group (focus groups) depending on the topic under study, the cultural context, and the aims of the project. Observational data collection in qualitative research involves the detailed observation of people and events to learn about behaviors and interactions in natural settings [ 46 ]. Such study designs are useful when the study goal is to understand cultural aspects of a setting or phenomenon [ 47 ], when the situation of interest is hidden, (tacit), or when subjects in the setting appear to have notably different views to other groups. Written materials or documents such as institutional records, personal diaries, and historical public documents may also serve as a valuable source of secondary data, providing insight into the lives and experiences of the group under study. For example, in one of my recent studies we used document analysis to uncover the thinking behind the design of a new medical school, then carried out interviews with “users” of the new building to explore how the intentions of the planners played out in reality. However, this is only one way of incorporating document analysis into a study: see Bowen [ 48 ] for an excellent introduction to the purpose and practicalities of document review within qualitative research.

See Dicicco-Bloom and Crabtree [ 49 ] for a useful summary of the content and process of the qualitative research interview, Creswell [ 50 ] for further discussion of the many different approaches in qualitative research and their common characteristics.

1. Data management

Qualitative research may use some form of quantification, but statistical forms of analysis are not central [ 51 ]. Instead, qualitative data analysis aims to uncover emerging themes, patterns, concepts, insights, and understandings [ 52 ]. The data are allowed to “speak for themselves” by the emergence of conceptual categories and descriptive themes. Trying to squeeze narratives into boxes (like “0” and “1”) would result in the loss of contextualisation and narrative layering. The researcher must immerse themselves in the data in order to be able to see meaningful patterns and themes, making notes as they go through the processes of data collection and analysis, and then using these notes to guide the analysis strategy.

Qualitative data has to be managed before it can be analysed—you can generate a lot of data from just a few interviews or observations! You may want to use a specialist qualitative database to facilitate data management and analysis. NVivo is a well-known qualitative data analysis software package (note that qualitative software packages enable you to make and store notes, and explanations of your codes, so you do not need to juggle bits of paper and electronic data files). These and similar databases are available commercially (i.e., at a cost) and are used widely by universities. The choice of database may be dictated by the resources of your institution, your personal preference, and/or what technical support is available locally. However, if you do not have access to qualitative data management software, then use paper and pencil: read and re-read transcripts, take notes on specifics and the bigger patterns, and label different themes with different coloured pen. You do all this in a software package anyway, as data management software does not describe or analyse your data for you. See Cleland et al. [ 53 ] for comprehensive guidance on how to use qualitative databases in education research.

Data analysis

While bearing in mind that qualitative data collection and analysis are iterative rather than linear (see earlier), Miles and Huberman [ 54 ] explain the process of qualitative data analysis as (1) data reduction (extracting the essence), (2) data display (organizing for meaning), and (3) drawing conclusions (explaining the findings).

Data analysis usually follows an inductive approach where the data are allowed to “speak for themselves” by the emergence of conceptual categories and descriptive themes. The researcher must be open to multiple possibilities or ways to think about a problem, engaging in “mental excursions” using multiple stimuli, “side-tracking” or “zigzagging,” changing patterns of thinking, making linkages between the “seemingly unconnected,” and “playing at it,” all with the intention of “opening the world to us in some way” [ 52 ]. The researcher must immerse themselves in the data in order to be able to see meaningful patterns and themes, making notes as they go through the processes of data collection and analysis, and then using these notes to guide the analysis strategy and the development of a coding framework.

In this way, good qualitative research has a logical chain of reasoning, multiple sources of converging evidence to support an explanation, and rules out rival hypotheses with convincing arguments and solid data. The wider literature and theory are used to derive analytical frameworks as the process of analysis develops and different interpretations of the data are likely to be considered before the final argument is built. For example, one of our own studies aimed to explore how widening access policy is translated and implemented at the level of individual medical schools [ 4 ]. Data was collected via individual interviews with key personnel. We initially conducted a primary level thematic analysis to determine themes. After the themes emerged, and following further team discussion, we explored the literature, identified and considered various theories, in some depth, before identifying the most appropriate theory or conceptual lens for a secondary, theory-driven analysis.

There are some excellent text books which discuss qualitative data analysis in detail [ 35 , 55 ].

Judging the quality of research

There are various criteria by which you can judge the quality of qualitative research. These link to efforts by the research team to consider their findings. The most common ways of doing so are triangulation, respondent validation, reflexivity, detail and process, and fair dealing [ 56 ] (but see also Varpio et al. [ 57 ] for a detailed discussion of the limitations of some of these methods).

Triangulation compares the results from either two or more different methods of data collection (for example, interviews and observation) or, more simply, two or more data sources (for example, interviews with different people). The researcher looks for patterns of convergence to develop or corroborate an overall interpretation. This is as a way of ensuring comprehensiveness. Respondent validation, or “member checking,” includes techniques in which the investigator’s account is compared with those of the research subjects to establish the level of correspondence between the two sets. Study participants’ reactions to the analyses are then incorporated into the study findings. Providing a clear account of the process of data collection and analysis is important. By the end of the study, it should be possible to provide a clear account of how early, simple coding evolved into more sophisticated coding structures and thence into clearly defined concepts and explanations for the data collected. Reflexivity is discussed earlier but in terms of analysis reflexivity means sensitivity to the ways in which the researcher and the research process have shaped the collected data, including the role of prior assumptions and experience. These two points address credibility, whether the study has been conducted well and the findings seem reasonable. It is important to pay attention to “negative cases,” data that contradict, or seem to contradict, the emerging explanation of the phenomena under study. These can be a very useful source of information in terms of refining the analysis and thinking beyond the obvious. The final technique is to ensure that the research design explicitly incorporates a wide range of different perspectives. In practice this can mean presenting data from a wide range of diverse participants. A very practical point is worth mentioning here—any reviewer will want to see quotes labelled in some way; for example, P11FFG2 would be participant 11, female, focus group 2). This helps the reader see that your data does not just represent the view of one or two people, but that there is indeed some sort of pattern or commonality to report.

Guba and Lincoln [ 58 ] provide the following criteria for judging qualitative research: credibility, transferability, dependability, and confirmability. I direct you to the original resource and to a very good explanation of these criteria in Mann and MacLeod [ 8 ].

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Understanding Qualitative Research: An In-Depth Study Guide
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Qualitative Research
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COMMENTS

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Significance of Qualitative Research. The qualitative method of inquiry examines the 'how' and 'why' of decision making, rather than the 'when,' 'what,' and 'where.'[] Unlike quantitative methods, the objective of qualitative inquiry is to explore, narrate, and explain the phenomena and make sense of the complex reality.Health interventions, explanatory health models, and medical-social ...
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What Is Qualitative Research?
Qualitative research involves collecting and analyzing non-numerical data (e.g., text, video, or audio) to understand concepts, opinions, or experiences. It can be used to gather in-depth insights into a problem or generate new ideas for research. Qualitative research is the opposite of quantitative research, which involves collecting and ...
Criteria for Good Qualitative Research: A Comprehensive Review
This review aims to synthesize a published set of evaluative criteria for good qualitative research. The aim is to shed light on existing standards for assessing the rigor of qualitative research encompassing a range of epistemological and ontological standpoints. Using a systematic search strategy, published journal articles that deliberate criteria for rigorous research were identified. Then ...
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In qualitative research, the researcher is the main data collection instrument. The researcher examines why events occur, what happens, and what those events mean to the participants studied. 1, 2. Qualitative research starts from a fundamentally different set of beliefs—or paradigms—than those that underpin quantitative research.
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Qualitative research uses open -ended questions and probing, which gives participants the opportunity to respond in their own words, rather than forcing them to choose from fixed responses, as quantitative ... However, it requires a thorough understanding of the important questions to ask, the best way to ask them, and the range of possible ...
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research is conceived, synthesized, and presented have a myriad of implications in demonstrating and enhancing the utilization of its findings and the ways and skills required in transforming knowledge gained from it. The purpose of this article is to define qualitative research and discuss its significance in research, the questions it addresses, its characteristics, methods and criteria for ...
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Qualitative research enables us to make sense of reality, to describe and explain the social world and to develop explanatory models and theories. It is the primary means by which the theoretical foundations of social sciences may be constructed or re-examined.
Planning Qualitative Research: Design and Decision Making for New
Qualitative research, conducted thoughtfully, is internally consistent, rigorous, and helps us answer important questions about people and their lives (Lincoln & Guba, 1985). These fundamental epistemological foundations are key for developing the right research mindset before designing and conducting qualitative research. ... It is important ...
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However, research using qualitative methods can be evaluated (Dixon-Woods et al., 2006; Young et al., 2014) ... It is widely accepted that qualitative research should be ethical, important, intelligibly described, and use appropriate and rigorous methods (Cohen and Crabtree, 2008). In research investigating data that can be counted or measured ...
The Central Role of Theory in Qualitative Research
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Qualitative methods have much to contribute to health services and health policy research, especially as such research deals with rapid change and develops a more fully integrated theory base and research agenda. However, the field must build on the best traditions and techniques of qualitative meth …
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The qualitative research interview is an important data collection tool for a variety of methods used within the broad spectrum of medical education research. However, many medical teachers and life science researchers undergo a steep learning curve when they first encounter qualitative interviews, both in terms of new theory but also regarding ...
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• What was the goal of the research • Why it was thought important • Its relevance: 2. Is a qualitative methodology appropriate? • If the research seeks to interpret or illuminate the actions and/or subjective experiences of research participants • Is qualitative research the right methodology for addressing the research goal: 3.
The qualitative orientation in medical education research
Abstract. Qualitative research is very important in educational research as it addresses the "how" and "why" research questions and enables deeper understanding of experiences, phenomena and context. Qualitative research allows you to ask questions that cannot be easily put into numbers to understand human experience.

The purpose of qualitative research

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Qualitative research methods: when to use them and how to judge them

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Qualitative research: What is it and why should you use it?

Why choose online qualitative research?

Online qualitative methods

What is qualitative research? For those more familiar with quantitative research techniques, the methods used in qualitative research may, at […]

Interviews and focus groups in qualitative research: an update for the digital age

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Interviews in the social sciences

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Overview of qualitative research

Types of interview

Conducting an interview

Box 1: Example of a topic guide

Focus groups

Focus group considerations

Focus group management

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Why use theories in qualitative research?

Why is theory useful?

Box 1 How different theories help illuminate the culture of doctor-nurse interactions on a medical ward

Interactionism

Critical theory

What are examples of theories used by qualitative researchers?

Aren’t there a lot more theories?

Box 2 More examples of theories used in qualitative research

Labelling theory

Negotiated order theory

Box 3 Frequently asked questions

How are theories generated?

How can theories be used?

Can theories be used to predict research findings and generate hypotheses?

How are theories and methodologies related?

Are these all the possible theories?

Box 4 Further reading

Why is theory important to health policy and patient care?

Summary points

Qualitative methods: what are they and why use them?

Publication types

Qualitative Research: Definition, Methodology, Limitation & Examples

Table of Contents

What is Qualitative Research

Types of Qualitative Research Methods

1. One-on-one interviews

2. Focus groups

3. Ethnographic research

4. Case study research

5. Record keeping

6. Qualitative observation

Qualitative Research Real World Examples

1. Online grocery shop with a predominantly male audience

2. Software company launching a new product

3. Alan Pushkin’s “God’s Choice: The Total World of a Fundamentalist Christian School”