Intended for healthcare professionals


Qualitative methods: an alternative view

BMJ 2011; 342 doi: (Published 09 February 2011) Cite this as: BMJ 2011;342:d424
  1. John Paley, senior lecturer1,
  2. Richard Lilford, professor of clinical epidemiology2
  1. 1School of Nursing, Midwifery and Health, University of Stirling, Stirling, UK
  2. 2Public Health, Epidemiology and Biostatistics, University of Birmingham, Edgbaston, Birmingham, West Midlands B15 2TT, UK
  1. Correspondence to: R Lilford r.j.lilford{at}
  • Accepted 20 December 2010

Are qualitative and quantitative research really based on different philosophies? John Paley and Richard Lilford argue that the idea that qualitative research is constructivist should not be allowed to diffuse into medical literature unopposed

Qualitative research is undergoing a surge in popularity in the medical literature, as shown by the growth in the proportion of qualitative studies in the BMJ over the past two decades (fig 1). Though many qualitative studies are not obviously philosophical—for example, the authors might simply want to determine what doctors think of clinical targets—one school of thought claims that qualitative methods are derived from a constructivist philosophy. This view is widely accepted in several disciplines, including nursing.1 2 3 A recent series of papers published in the BMJ,4 5 6 7 8 9 designed to help readers to critically appraise qualitative research, devotes the whole of the first article to explaining the philosophical differences between qualitative and quantitative approaches.4 Kuper and colleagues state that the differences between qualitative and quantitative methods “run deeper than the presence and absence of numbers,” and that “most qualitative researchers today share a different belief about knowledge, called ‘constructivism,’” which is at odds with the “theoretical underpinnings” of quantitative methods.4 So what is constructivism, exactly?

Fig 1 Percentage of research in BMJ that is qualitative, 1994 to 3 September 2010. Data from No of qualitative papers found using the search term “qualitative,” analysing each result to determine if it was a qualitative paper; expressed as percentage of total number of papers (all articles classified by the BMJ as “Research,” excluding editorials, commentaries, corrections, etc)


The various descriptions of the constructivist philosophical framework share the view that “individuals create, negotiate, and interpret meanings for their actions and for the social situations in which they …

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