Education and debate

Ethnography and health care

BMJ 2000; 321 doi: 10.1136/bmj.321.7273.1400 (Published 2 December 2000)
Cite this as: BMJ 2000;321:1400

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  1. Jan Savage (jan.savage@rcn.org.uk), senior research fellow
  1. Royal College of Nursing, London W1M OAB
  1. Correspondence to:
  • Accepted 20 September 2000

Development of a culture of evidence based medicine depends on a body of research that draws from both qualitative and quantitative approaches.1 Recent BMJ articles have usefully questioned a stark polarity between qualitative and quantitative research and helped to demystify qualitative approaches. 2 3 4 There has been little mention of ethnography, however, and little argument for its use in health research.

I have examined some of these omissions, giving a broad indication of the nature of ethnography and arguing for its greater use within health care. I have given examples of ethnographic studies to suggest some of the issues that ethnography can help to explore, together with a brief outline of limitations of the approach.

Summary points

Ethnography has been overlooked as a qualitative methodology for the in depth study of healthcare issues in the context in which they occur

An ethnographic study can utilise a range of qualitative and quantitative methods

The methods of ethnographic research raise ethical and other issues, which means that skilled supervision is essential

Ethnographers do not usually aim to produce findings that can be generalised

Ethnography can be useful in a predesign stage of research and can generate questions for research that can be followed up by other methodologies

What is ethnography?

Perhaps one of the reasons for the neglect of ethnography is that there is no standard interpretation of what it is. Ethnography is, confusingly, both a process and a product: the term can apply both to a methodology and to the written account of a particular ethnographic project. It is not, as is often implied, a pseudonym for qualitative research in general or a way of describing studies premised solely on semistructured interviews. On the contrary, an ethnographic approach usually incorporates a range of methods and can combine qualitative and quantitative data. For many, the …

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