Qualitative methods: an alternative view
BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d424 (Published 09 February 2011) Cite this as: BMJ 2011;342:d424
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As Paley and Lilford (1) indicate, attitudes to quantitative and
qualitative techniques often seem irreconcilable. This note considers
psychophysics - the discipline entailing human judgements of sensory
stimuli - for which the current mode of investigation is overwhelmingly
quantitative in nature. Typical phenomena that are investigated include
illusions of visual motion: motion aftereffect, induced motion and
autokinetic motion. The approach is underpinned by an interpretational
model that has been hugely successful for over fifty years -
neuroreductionism - whereby human psychophysical data are linked directly
to non-human physiological data concerning those parts of the brain -
including the sensory organs - which are identified with sensory
processing (2,3).
Yet these linkages are often found to be incomplete. All illusions of
motion have been explained in neuroreductionist terms - but all require
more, including reference to untoward and difficulate-to-define components
of the viewer's attention and experience (2,4). A striking example
concerns autokinetic motion, the illusory and haphazard motion of a
fixated static spot of light in otherwise entirely dark conditions; the
phenomenon is generally taken to reflect the individual viewer's
involuntary and unpredictable eye movements (drifts and saccades) that can
never be suppressed during fixation, no matter how hard the viewer may
try. Yet if a viewer makes his/her judgments within a group of other
viewers, responses tend to become much the same across the group: a social
effect seems to operate whereby a phenomenon whose sequence is normally
idiosyncratic to the individual now attains uniformity across the group of
viewers (5).
Should these untoward effects be subjected to qualitative research
for further understanding? Perhaps, although this would represent a
remarkable paradigm-shift and might yield little of definitive value. The
more realistic outcome in this area of research is that informal
qualititative research might be the impetus for further formal
quantitative research.
However the issues are dealt with, it must always be important to
explore the scope and limitations entailed with any research orthodoxy,
whether quantitative or qualitative.
REFERENCES
(1) Paley J, Lilford R. Qualitative methods: an alternative view. BMJ
2011;324:d424.
(2) Reinhardt-Rutland A H. Induced movement in the visual modality,
Psychol Bull 1988;102:57-72.
(3) Lynn C, Curran W. A comparison of monkey and human motion
processing mechanisms, Vision Res 2010;50:2137-2141.
(4) Uttal W R. A taxonomy of visual processes. 1981: New Jersey:
Erlbaum.
(5) Sherif M. The psychology of social norms. 1937: Oxford UK:Harper.
Competing interests: No competing interests
Paley and Lilford are correct that many disciplines have adopted the
either postivisim, or constructivism, approach. As a GP, training in
Integrative Psychotherapy for the last four years, I have been subject to
this insistence that I must choose my paradigm (and it had better be
constructivism...)
I was encouraged to find other thinkers, including psychotherapists and
philosophers, who accept that both ways of thinking and doing research are
valid. Indeed Denzin and Lincoln (2003) themselves, whilst acknowledging
that one cannot easily move between paradigms, do develop a powerful case
for the researcher as "bricoleur" who does work between competing
paradigms. The term "bricoleur" was first used by the anthropologist Levi-Strauss in 1966 (Denzin and Lincoln, 2003) to mean "jack-of-all-trades" -
someone who used whatever tools were at his disposal, which may include
numbers, graphs or statistics to produce the most fulsome picture of the
subject of study. It seems to me that the BMJ's approach of including a
patient perspective is something similar.
Mary Midgley wrote about the myth of the Enlightenment view that
positivism can provide all the answers; that all that we need to know can
be explained by objective studies. She asks us to accept that different
ways of looking at the world are helpful and indeed, can co-operate. She
paints a picture of the world as a giant aquarium, with observers peering
into its dimly lit recesses through a number of small windows: "we can
eventually make quite a lot of sense of this habitat if we patiently put
together the data from different angles. But if we insist that our own
window is the only one worth looking through, we shall not get very far"
(Midgley, 2001 p 27).
Denzin, N.K. & Lincoln Y.S. (2003) Strategies of Qualitative
Inquiry, second edition. Thousand Oaks: Sage
Midgley, M (2003) The Myths We Live By. London: Routledge
Competing interests: No competing interests
Sir,
All of science is based on a series of assumptions about how the
world is constituted (ontology) and how we can come to know about it
(epistemology) and unless these are revisited critically methods can be
misunderstood and mis-applied.
Paley and Lilford's analysis 1 raises an outmoded choice for
researchers between positivist and constructivist ontologies. A post-
positivist methodology that accommodates some of the assumptions behind
both of these diametrically opposite positions already exists - realism 2.
In brief, realism takes the position that an objective reality does exist,
but that this reality can only be interpreted subjectively as it has to be
'filtered' through our senses (e.g. sight, touch). So to take Paley and
Lilford's example of light (to illustrate key general concepts), a realist
would accept that light has objective properties. However, we are unable
to fully discern the 'truth' of what these properties are as we are not
able to directly observe its behaviour through the senses that we possess.
Instead we have to rely on using instruments that we have constructed
(which are in turn based on our assumptions and interpretation of how both
light, and the instruments, work). It is these additional 'layers' that
interfere with our ability to fully know the objective 'truth'. To assist
we have modified Paley and Lilford's table (Table 1) to incorporate
realism.
Our suggestion is that realism provides a more complete ontological
perspective on how the world works and in particular a more useful
understanding of causation (see table). It has already been developed as a
method for primary 3 and secondary 4 research. Health services research
would be richer for embracing it.
Reference List
(1) Paley J, Lilford R. Qualitative methods: an alternative view.
BMJ 2011; 342:d424.
(2) Sayer A. Realism and Social Science. London: Sage Publications
Ltd.; 2000.
(3) Pawson R, Tilley N. Realistic evaluation. London: Sage; 1997.
(4) Pawson R. Evidence-based policy: A realist perspective. London:
Sage; 2006.
Reference List
(1) Paley J, Lilford R. Qualitative methods: an alternative view. BMJ 2011; 342:d424.
(2) Pawson R, Tilley N. Realistic evaluation. London: Sage; 1997.
(3) Pawson R. Evidence-based policy: A realist perspective. London: Sage; 2006.
Competing interests: No competing interests
If this paper was published to stimulate controversy then we applaud
the BMJ for publishing this article. However, we have serious concerns
over the one sided presentation of qualitative methods, particularly the
over privileging of constructivism. Constructivism comes under the broad
umbrella of constructionism. Often use these terms are used
interchangeably hence; there is considerable confusion around this
terminology. The authors fail to highlight these subtleties. They also
fail to refer to other research that has greatly informed the
constructionist / constructivism debate e.g. grounded theory, Charmaz,
Glaser & Strauss and Glaser's work.
Within constructionism differentiations are made between 'strong'
versus 'weak' constructionism. These two perspectives are quite different.
A 'weak' form of constructionism, we would argue, is compatible with
critical realism as it contains some material base for reality. This
philosophical standpoint does not inevitably lead to the conclusion that
there is no external reality or that it is not possible to share
experiences and understanding. However the authors make no reference to
this body of knowledge, focusing instead on the more extreme form of
'strong' constructionism where ultimately qualitative research is destined
for a black hole, which is clearly not the case. This presentation of
constructionism as suggesting that any interpretation is as good as
another, has caused the most controversy yet there is little debate in
Paley and Lilford's article. It is too convenient to cite lack of space.
These issues warrant a full discussion.
We suggest that most qualitative researchers in health start from a
critical realist standpoint. We are realist in the sense that we
acknowledge that 'what we know' is not confined to the mind, yet we
believe that the influence of culture and social milieu is important in
shaping how we understand or 'know' this reality . Hence, we acknowledge
that all we can aspire to do is produce representations of this social
world rather than reproduce this world. We also do not treat qualitative
data as unproblematic or hold the view that people tell their stories
consistently. Work on narrative (Riessman) guides us as to the complexity
of our human experiences and storytelling. We may tell our story (of
illness) in very different ways depending on who the audience is and which
narrative is most appropriate. However, it is important to acknowledge
that adherence to a particular view of the way the world works is not
peculiar to qualitative research, all researchers hold certain
epistemological beliefs which will inevitably inform their work. Therefore
the authors' suggestion that the research process should be divorced from
any consideration of this, and should merely be seen as a choice between
"alternative tools" is not a realistic goal.
We do acknowledge that some voices are heard more than others. We
would like ours to be heard. A final point in relation to this: we note
that, the authors claim there has been a 'surge' in the number of
qualitative papers articles published in the BMJ, yet since 2006 only 2%-
7% of qualitative papers have been published, with 5% published in 2010
This is hardly representative of a surge.
Competing interests: No competing interests
To criticise one way of thinking about qualitative research is not to
condemn qualitative research in general, and this was certainly not our
aim (we are in favour of qualitative research, subject to certain
provisos). So we have no idea why Fiona Poland and her colleagues refer to
our "sweeping comments on qualitative research"; or why Professor Gabbay
insists, more than once, that our critique, by "false implication",
applies to all qualitative researchers.
Given this indictment, it is surprising to find that Gabbay is
himself rather sweeping about "students of qualitative methods". Yes, some
students will be exposed to authors like David Silverman and Martyn
Hammersley, and be obliged to ask themselves difficult questions. But
others will not be so fortunate, and will be informed that objectivity is
a "chimera", that there are multiple constructed "realities", and that
validity and reliability are not concepts which can be applied to
qualitative research. The obsession with rigour, to which Gabbay refers,
is an obsession with finding alternatives to validity and reliability. It
is not any sort of commitment to them.
Professors Gabbay and May underestimate the influence of Lincoln
& Guba, on two counts. First, the methodological ideas of Lincoln
& Guba - credibility and transferability, for example, their
substitutes for validity and reliability - are widely used, even among
those who have never heard of "Naturalistic Inquiry". Second, and even
more importantly, the concept "paradigm", as standardly employed by
writers on qualitative methods, was invented by L&G, whose understanding
of the term is vastly different from that of Kuhn. Their concept, unlike
Kuhn's, is in our view demonstrably broken. (We are unsure why Poland et
al. feel entitled to assume that we wrote without "attending to" the
relevant philosophies. We have attended to Lincoln & Guba's
philosophy. We disagree with it.)
Gabbay says that the philosophy of science has disabused "most of us"
of the naive idea that one can simply postulate hypotheses and falsify
them by experiment. This sounds like a reference to Popper's early
falsificationism. If it is, what Gabbay says is true but irrelevant. We
would refer him to the more recent writings of the so-called "new
experimentalists", who seek to identify the conditions under which
hypotheses are experimentally accepted or rejected, and do so by drawing
heavily on the history of experimental practice [1,2]. Mayo's work, for
example, suggesting that a core achievement of science is the formulation
of canonical procedures for minimising the risk of error, poses an
important question for qualitative methods: what comparable procedures
should qualitative researchers use to achieve the same goal? No amount of
philosophical bluster will make this question go away. A start was made on
answering it by Glaser & Strauss [3], but the debate got swamped by
paradigm-chatter, constructivism, phenomenology, hermeneutics and
postmodernism.
Professors May and Pearce point out that "words and numbers are
plainly not the same thing". Indeed. Bicycles and aircraft are plainly not
the same thing, either, but that doesn't mean that they are not both forms
of transport. Similarly, the difference between words and numbers does not
entail that they are not both forms of measurement. There is nothing in
measurement theory that requires measurement to be numerical. It requires
only that there be a homomorphism between a representing domain, Y, and
the represented domain, X, such that every member of X can be assigned to
a member of Y [4]. Domain Y does not have to be the domain of real
numbers. Maps are one example of a non-numerical form of measurement; and
the sentences of a language are another, at least when the represented
domain is states of mind [5]. Both language and the domain of real numbers
define a logical space into which items from the represented domain can be
plotted as the consequence of a stimulus-response exchange between the
item concerned and an instrument, whether it be a ruler, a thermometer, or
an interview question.
Resistance to the idea that linguistic attributions of psychological
states - characteristic of qualitative research - are measurement
predicates is curious. What is so unappealing about it? There is nothing
inside anybody's head that even looks like a sentence (nothing that looks
like a number, either), so the sentences we use to talk about what others
believe are not just snapshots of "interior" states. Could it be that it
isn't us who are "fearful of... debate about what research in general and
qualitative research specifically are" (Poland et al.), but some of our
critics?
References
[1] Ackermann R. The new experimentalism. British Journal for the
Philosophy of Science 2010; 40(2): 185-190.
[2] Mayo DG, Spanos A, editors. Error and Inference: Recent Exchanges on
Experimental Reasoning, Reliability, and the Objectivity and Rationality
of Science. Cambridge, UK, Cambridge University Press, 2010.
[3] Glaser B, Strauss A. The Discovery of Grounded Theory: Strategies for
Qualitative Research. Chicago, Aldine, 1967.
[4] Suppes P, Krantz D, Luce R, Tversky A. Foundations of Measurement,
Vol II. New York, Academic Press, 1989.
[5] Matthews RJ. The Measure of Mind: Propositional Attitudes and Their
Attribution. Oxford, Oxford University Press, 2007.
Competing interests: No competing interests
I completely agree with Paley and Lilford's conclusion that "it is
neither necessary nor desirable that qualitative research should align
itself with a particular philosophy." That's probably why it doesn't. I
also agree with them that both qualitative and quantitative methods are
needed and must work alongside each other. But if they genuinely believe
that, then it is a pity they have they written an article that is likely
to be cited (if not properly read) by many who wish to question the
validity of qualitative research per se. It may therefore be worth
pointing out just a few of the fundamental flaws in such an argument. I
apologise that my response is so long, but that's because there are so
many flaws. I shall restrict myself to just six.
First, beware the classic logical error (or is it the classic
rhetorical trick?) of negating one subcategory of something and then
concluding that your critique invalidates the whole group. To criticise
constructivism on the grounds that Guba and Lincoln's views are
problematic would be like dismissing all of English football because
someone shows that Wayne Rooney is not as good as he's cracked up to be.
And to criticise qualitative research on those grounds would be even
worse: akin to dismissing the entire range of ball games because of
Rooney's faults. Qualitative research has a multitude of paradigms within
it, which leads to the second major pitfall for anyone using this article
to damn qualitative research or even constructivism. Don't assume that
constructivists, and hence by (false) implication qualitative researchers,
share a particular philosophical view. They don't. I'd lay large odds that
very few qualitative researchers have a clue what Lincoln and Guba's
philosophy is and nor should they, because most qualitative research
methods have nothing to do with that philosophy, let alone rely on it. And
as for qualitative researchers who do take an interest in philosophical
matters, especially longstanding social constructivists like myself, they
will probably disagree profoundly with the (allegedly) accepted position.
That's what philosophers do.
Third, don't fall for Paley and Lilford's suggestion that
constructivists (and again by false implication, qualitative researchers)
all believe in a "holistic" inquiry that derides simplifications of
complex reality. This not only completely misrepresents the self evident
fact that even qualitative social scientists must simplify things in order
to understand them (which is why they so often use models too), but also
leads inevitably to an own goal since, as part of this argument, it
highlights just why it is that quantitative scientists need to simplify
reality in ways that may be wide open to selective interpretation and
error. While positivists may argue that "if you can't measure it it's not
worth studying"; their own problem is that if you can measure it, it's
inevitably simplified and is therefore probably not "it". Take for example
the research question, the means to carry out the research , the methods
and measures chosen, the statistical inferences, the way the findings are
written up, published and read. None of these can be divorced from the
social and organisational context of the investigators involved - be they
quantitative or qualitative scientists.
Fourth, by claiming that the only real test of a research study is
the extent to which it confirms or disconfirms a theory, (which
qualitative research rarely pretends to do) Paley and Lilford display
startling naivety about the way scientists actually work. A huge
literature on the philosophy of science has long since disabused most of
us of the naive idea that one can simply postulate hypotheses and falsify
them by experiment.
Fifth, Paley and Lilford are unfairly selective in
their interpretation of psychological theories about the way people
misattribute meaning to their own observations and behaviours. If our
"mental states - motives, desires, and beliefs" make it impossible to rely
on what we think we know, then surely that applies to what we think we
know about quantitative findings too. Or at the very least the onus is on
Paley and Lilford to demonstrate why the meanings that we attribute to
measurable variables are somehow beyond that human weakness. Yet they do
not even attempt to do that.
Finally, the notion that "concepts such as validity, reliability and
the nature of truth and objectivity are not applicable to qualitative
methods" will come as a shock to students of qualitative methods. "If
only...", they might sigh as they struggle to get their heads round their
teachers' invariable obsession with the rigour and quality of research
methodology. Let us hope that those who might try to use Paley and
Lilford's article as a stick with which to bash qualitative research also
pay due attention to those concepts, and to logic, when formulating their
arguments.
Competing interests: No competing interests
From my experience as a qualitative researcher, the crucial
theoretical mark of qualitative methodology is not its constructivist
stance but its aim to understand individual or shared meanings (e.g. of
medicine taking). For example, if evidence from systematic reviews points
towards aspirin reducing the risk of heart disease, qualitative research
explores the individual and cultural meanings of medication taking, heart
disease or risk reduction. These form the context within which the
evidence is understood and acted upon. Understanding both the
effectiveness of a medicine and the possible impact, say, of daily
medicine taking on the patient is important for those developing
interventions or guidelines.
Understanding the experience of others (i.e. hermeneutics) is
imperfect compared to verifiable measurements, but captures data that
cannot currently be captured in any other way. If, as this article seems
to suggest, any attempt to understand our own experience (let alone that
of others) is not just imperfect but fatally flawed, this would invalidate
not only qualitative research but a whole body of quantitative research
based on self report through questionnaire scales.
Competing interests: No competing interests
I can see that this article is a little bit of deliberate straw man
mischief making on the part of the BMJ. So it's all good fun. Even so,
I've struggled to think why readers of the BMJ should accept the
unconvincing assertion that words and numbers are equivalent forms of
measurement. Words and numbers are plainly not the same thing. In fact,
much qualitative research published in medical journals is descriptive and
has no theoretical or philosophical content. That earlier authors in the
BMJ have pressed the case for philosophy (what does it mean to know
something) rather than theory (how can we explain something) doesn't
necessarily mean that the majority of medical researchers using these
techniques are constructivists. Some are, some aren't. We don't know how
many because no-one has ever counted them. As for citations of Guba and
Lincoln, other methods books offering different recipes also have
thousands of citations. So do methods books pressing the case for
statistical tests, the investigation of geological strata, and the means
by which the Higgs Boson might be found. It's in the nature of methods
books that they get cited a lot.
The authors labour the point there are
different conceptions of reality at work in the world, but this should not
be too complex a question to grasp for anyone who has ever watched a
clinician trying to get an NHS manager to see sense. People understand the
world differently, this informs their beliefs, attitudes, intentions and
actions. Understanding these differences is sometimes a matter of
listening rather than counting. Which is why history-taking is still
important.
Competing interests: No competing interests
Paley and Lilford's sweeping comments on both qualitative research
and what research is, precisely demonstrate the problems in asserting
ideas about knowledge without attending to the philosophies embodied by
those ideas. Qualitative researchers explicitly recognise and work with
different types of worldview, including what counts as knowledge. This is
not saying there is no reality, just diverse ways of thinking about and
working with that reality. Identifying philosophical differences is not a
waste of time but a means to define components of thinking (ontology,
epistemology, metaphysics) and what consequences for knowledge emerge from
the philosophical positions taken, acknowledged or not. Anthropologist
Birdwhistell (Varenne & McDermott, 1998), illustrates how
philosophical differences underpin differences in knowledge. Individuals,
viewed as threads of a rope, are discrete, discontinuous objects, which
also contribute to the twisted continuity of the rope, so that statements
about individual threads (attitudes, experiences, expectations), can also
be viewed as statements which demonstrate how threads and rope are linked
(social structure, power, connectivity of language).
Without understanding our philosophical differences we cannot know
what to do with knowledge we produce. For instance, taught only methods to
extract DNA, we will know how to extract DNA. Without also knowing
genetics, a field of shared concepts and knowledge-building conventions,
we cannot use this knowledge to advance genetic understandings. Paley and
Lilford seem fearful of open, systematic investigation of and debate about
what research in general and qualitative research specifically are, and
how they contribute to knowledge. Qualitative research may help them do
this.
Reference: Varenne, H., & McDermott, R. (1998). Successful
failure. Retrieved October 27, 2009, from
http://varenne.tc.columbia.edu/hv/sf/p_11_13.html
Competing interests: No competing interests
Re: Qualitative methods: an alternative view
When I read Paley & Lilford’s 1 article I felt delighted and displeased in almost equal measure. Delighted because there was an informed and heated debate (having read the responses to date) about qualitative methods in the BMJ! Displeased because so many things were said which did a disservice to contemporary qualitative research. If I was to give an overview of my response, it would be that Paley & Lilford open up a long overdue discussion of the perception of qualitative research in medical science. As other responders have said, qualitative researchers do not all pigeon hole themselves as constructivists; in fact there is huge variety and often epistemological gulfs between different qualitative methods.
I’ve looked at the issues presented by Paley & Lilford in turn:
Fragmentation/holism: I would agree that holism in the strictest sense is impossible and that models are of course useful precisely because they leave things out. It’s the method of generating the model that needs to be holistic, and driven by openness. 2 Sometimes when confined to an experimental method the messiness of people’s lives are excluded as confounding variables but when using qualitative methods we’re able to look at these complexities in a rigorous and systematic way. Indeed, at the end of this holistic process, just the same as with other research designs, we end up summarizing so as to make sense of our findings in a way that can be understood and used by others.
Knower/known: This issue reminds me of a question asked of me recently at a research seminar covering phenomenological research: what is the difference between the ‘natural attitude’ Husserl talked about and objectivity? Husserl’s 3 transcendental (or descriptive) phenomenology aimed to describe a phenomenon in such a way that we are able to identify its constituent features, i.e. if we took away a feature it would no longer be that phenomenon. To do this we have to adopt a ‘natural attitude’ in order to enter into a process of reduction, or the epoché. What this means is we strip ourselves of our ‘scientific attitude’, i.e. all our theoretical constructs and preconceptions about the phenomenon, in order to go ‘back to the things themselves’ instead of making assumptions based on pre-existing theory. Heidegger 4 would argue that knower cannot be separated from known but that we are able to train ourselves to engage in systematic interpretation (learning from hermeneutics) which ensures we approach new data on their own merit and revise our fore-understandings accordingly rather than being blindly led by our preconceptions (biases). This reflexivity 5 is the same sort of ‘corrective strategy’ as objectivity in the experimental method. The difference is that qualitative researchers are more upfront about their role in data construction and analysis because it often involves interactions with participants which are essentially social events.
Cause/meaning: Meaning is not taken-for-granted. The whole enterprise of research using qualitative methods is to unpack meanings we take for granted, to observe their fluidity, their multiplicity, and how different people attribute different meanings to the same event. Phenomenology would guide us to look at what is shared and unshared about a phenomenon for us to understand what makes happiness what it is and not something else. This allows for individual differences but also enables a useful description which may be transferable or generalizable to other similar populations. Qualitative research of high quality does not take participants’ data at face value – we treat them as the expert of their experience but acknowledge they might not have the ability to fully comprehend their meaning-making processes without reflection and guidance (incidentally, the same is true of researchers). Meanings often are created through telling so research interviews can be revelatory. So we don’t take at face value, we examine, interrogate, compare with others, contextualize, problematize. How a participant talks about their experience is as informative as what happened. Their concerns about their experience show us what they prioritize in life and therefore what they need, for example to be satisfied with their health care.
Philosophical basis of research: ‘Paradigm’ is troublesome! Qualitative research is a disparate field; discourse analysis is very different from interpretative phenomenological analysis is very different from framework analysis. There is no philosophical basis for shoehorning methods into paradigms – I agree. This was a long lesson to learn though. I used to wholeheartedly believe that one had to work within a particular worldview (or paradigm) and that quantitative and qualitative methods should not meet. Lucy Yardley and Felicity Bishop’s 6 work on the Pragmatist definition of knowledge as functional and David Hiles’ 7 work on the logics of inquiry (induction-deduction-abduction) has made me realize that defining research as qualitative or quantitative is somewhat arbitrary. Whatever is the most appropriate method for answering the question is what should guide us. This is the toolkit approach to which Paley & Lilford refer, something which has been propagated in the mixed-methods arena for some time.
Qualitative method: I wanted to offer another interpretation of reduction. I have vehemently argued against reduction to numbers in the past 8 and would stand my ground if the research required in-depth experiential accounts to answer its question. Nevertheless, as I’ve described above, qualitative methods also engage in some form of reduction: discourse analysis works with interpretive repertoires and discursive functions; phenomenological analysis culminates in the identification of essential features of a phenomenon. We have to do this otherwise we’d be dealing with raw data all the time and that would be completely unmanageable. I think as researchers we need to drop these labels of qualitative and quantitative because they are unhelpful and highlight differences when in fact there are many similarities both in the objectives of the questions we want to answer but also in the day-to-day business of doing research in health care settings. We’re in the business of knowledge creation with the aim of bettering health care and improving patients’ and health care professionals’ quality of life. To do this effectively, we need all the methods at our disposal. As Rom Harré 9 said, in science it’s not an either/or but a both/and: we need the idiographic and the nomothetic to understand human behaviour and experience.
1. Paley J, Lilford R. Qualitative methods: an alternative view. BMJ 2011;342:d424.
2. Dahlberg K, Dahlberg H, Nystrom M. Reflective lifeworld research (2nd Ed.). Studentlitteratur, 2008.
3. Langdridge D. Phenomenological psychology: theory, method and research. Pearson Prentice Hall, 2007.
4. Heidegger M. Being and time. Blackwell, 1962/1927.
5. Shaw RL. Embedding reflexivity within experiential qualitative psychology. Qual Res Psych 2010;7:233-243.
6. Yardley L, Bishop F. Mixing qualitative and quantitative methods: a Pragmatic approach. In: C. Willig, W. Stainton-Rogers (Eds.) The SAGE Handbook of Qualitative Research in Psychology. Sage, 2008.
7. Hiles DR. Mixed methods and the problem of the logic of inquiry. Paper presented at the British Psychological Society Qualitative Methods in Psychology Section Conference, London, April, 2012.
8. Shaw, RL. Vicarious violence and its context: an inquiry into the psychology of violence. Unpublished PhD thesis, available at: http://ethos.bl.uk/SearchResults.do (accessed 08/03/13).
9. Harré R. Personal being. Harvard University Press, 1984.
Competing interests: No competing interests