Intended for healthcare professionals

Practice Qualitative Research

Grounded theory, mixed methods, and action research

BMJ 2008; 337 doi: (Published 07 August 2008) Cite this as: BMJ 2008;337:a567
  1. Lorelei Lingard, associate professor and BMO Financial Group professor in health professions education research1,
  2. Mathieu Albert, assistant professor2,
  3. Wendy Levinson, Sir John and Lady Eaton professor and chair and physician in chief, Sunnybrook Health Sciences Centre3
  1. 1SickKids Learning Institute and Department of Paediatrics and Wilson Centre for Research in Education, University of Toronto, 200 Elizabeth Street, Eaton South 1-565, Toronto, ON, Canada M5G 2C4
  2. 2Department of Psychiatry and Wilson Centre for Research in Education, University of Toronto
  3. 3Department of Medicine, University of Toronto
  1. Correspondence to: L Lingard lorelei.lingard{at}

    These commonly used methods are appropriate for particular research questions and contexts

    Qualitative research includes a variety of methodological approaches with different disciplinary origins and tools. This article discusses three commonly used approaches: grounded theory, mixed methods, and action research. It provides background for those who will encounter these methodologies in their reading rather than instructions for carrying out such research. We describe the appropriate uses, key characteristics, and features of rigour of each approach.

    Grounded theory: what is it and when is it used?

    Grounded theory was developed by Glaser and Strauss.[1] 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. 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. Researchers approach the question with disciplinary interests, background assumptions (sometimes called “sensitising concepts”[2]) and an acquaintance with the literature in the domain, but they neither develop nor test hypotheses. Rather, the theory emerges through a close and careful analysis of the data.

    What are the key features of grounded theory?

    Key features of grounded theory are its iterative study design, theoretical (purposive) sampling, and system of analysis.[3] An iterative study design entails cycles of simultaneous data collection and analysis, where analysis informs the next cycle of data collection. In a study of the experience of caring for a dying family member, for instance, preliminary analysis of interviews with family care providers may suggesta theme of “care burdens,” and this theme could be refined by interviewing participants who are at variouspoints in the care trajectory, who might offer different perspectives. Analysis of the subsequent phase of data collection will lead to further adaptations of the data collection process to refine and complicate the emerging theory of care burdens. In keeping with this …

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