Grounding Qualitative Medical Research in Coherence, Not Standards

Qualitative research publications have become more prominent in medical journals. However, in medical discourse, those researchers who are adhere to postpositivist (quantitative) paradigm often criticize diverse qualitative inquiry for a perceived lack of rigor. We suggest that qualitative research, just like quantitative research should be guided by methodological coherence rather than prescriptive standards. Coherence is defined as an alignment between epistemology, theoretical perspective, methodology, methods, and research questions. In the medical field, a lack of training in methodological diversity, a long-held post-positivist privileging, and insufficient methodological dialogue, promulgates reliance on quantitative analyses. Neglecting to articulate sufficient methodological detail has caused other researchers to assert that qualitative research lacks rigor. Providing methodological details permits study replication. Qualitative researchers have been discussing the necessity for this scholastic imperative for decades, although it is relatively new in medical discourse. The authors’ interest in this topic stems from an analysis of rigor within qualitative medical educational articles since 2012 (CI), and reviewing grant proposals, doctoral research studies, and publishing in medical journals (LBH, CI). During out work, we observed that while the literature reviews in these submissions are frequently excellent, the method and results sections often lacked the essential linkages that are needed to support methodological coherence. Owing to our interest, we undertook a critical review while using deductive content analysis of forty qualitative articles in a top-tier medical journal. The purpose of this paper is to provide examples of coherence with the qualitative medical article reviewed. Our aim is to provide scholarly guidance to novice medical researchers and practitioners. The authors believe that this information will support increased scholarly integrity and coherence in the qualitative research publications, specifically in medical education and more generally in other discipline-related qualitative studies. We believe that both researchers and readers of qualitative research in academic medicine need to know about these issues so they can capably provide evidence of coherence

Assessing Participant Group Affiliation and Attitudes Towards CTSI Services

Analyzing open-ended survey text responses holds the capacity to yield greater insight about participants’ perceptions of clinical translational science institute (CTSI) initiatives. Few translational research studies have explored their effectiveness. The aim of this mixed methods analysis was to assess participant perspectives of the impact and effectiveness of our CTSI program and services. We selected two open-ended survey question items (how CTSI benefitted research, and the most important impact of the research facilitated by the CTSI) from a larger set and compared responses by participant affiliations (clinical/non-clinical; lab/non-lab). We used a three-step analysis. First, nodes were generated using NVivo word frequency function. Next, with the aid of Python, we used sentiment analysis to classify each node (as positive, negative, or neutral) to indicate participant ratings toward their experiences with the CTSI and computed the average differences between groups. Third, we selected nodes that met pre-established criteria and report the qualitative distinctions. We recommend using precisely worded open-ended questions in future annual surveys or administering a survey using only opened-ended questions every six months

Enhancing Cultural Competence Among Dental Students Through Active Teaching and Experiential Learning

Dental schools are required to utilize teaching practices that increase students’ culture competence and ensure their ability to deliver equitable oral care. This study explored the impact of active teaching, an approach that offered comprehensive engagement and experiential learning. Students participated in small group activities, conducted interviews and developed reflective writings. A QUAN→qual sequential mixed method was used to analyze their reflective writings. Quantitative results indicated that students’ cultural competence was significantly enhanced. Qualitative findings showed that students recognized their unconscious biases and reported an increase of cultural competence. This study demonstrates the effectiveness of experiential learning, particularly the addition of small group discussions, in instruction aimed at enhancing cultural competence among 84 first year pre-doctoral dental students

From Contemplation to Action: Mechanisms of Change in the Mentoring Academy

Mentoring is fundamental to the professional development of research scientists in academic health centers (AHC). Qualified mentors can support the development of competencies considered most significant in training research scientists. Yet AHC faculty may have little preparation in and knowledge of how to mentor. Emerging AHC mentor academies provide educational environments whereby faculty can learn the art and practice of mentoring. However, little is known about their effectiveness. Using the Transtheoretical Change Model (TTM), this study explored how 23 mentors used newly learned information to change their communication styles and develop shared expectations with mentees. Based on an inductive analysis of 46 reflective writing assignments, the results showed that the mentor academy enabled progress through the stages of contemplation and preparation, however, mentors rarely implemented new knowledge to make changes in their approach to mentoring. The authors suggest instructional strategies that will promote actionable change and accountability for implementation

What Open-Ended Comments Reveal: An Analysis of a Clinical Translational Science Institute’s Annual Surveys

Analyzing open-ended responses can provide insight regarding participants’ experiences or illuminate organizational issues. The purpose of this study was to qualitatively analyze 1096 open-ended responses to a longitudinal survey and report patterns observed across participants. Word frequency, text search and matrix coding were used to analyze the data. Thematic differences were noted by the college group denoting the participant’s primary appointment. Although perceived gaps between expectations and service delivery were expected, participants’ statements pointed out informational inaccuracies or an absence of awareness. The inherent richness and insight of the analysis yielded complexities, otherwise not discernable using quantitative analyses. The authors offer suggestions for improving the university clinical translational science institute’s delivery of biomedical research services

Migrant Hispanic Families of Young Children: An Analysis of Parent Needs and Family Support

The population served by early interventionists has changed to include more migrant families. Although there has been much research concerning Caucasian families, less is known about culturally and linguistically diverse families. Forming partnerships with families can be aided by understanding how to identify families\u27 needs and support networks. The purpose of this study was to assess the group differences between Hispanic migrant families of young children with and without disabilities (ages birth - 5) regarding their perceptions of needs and use of support systems. The findings indicate that there is little difference between migrant families of young children with and without disabilities. Implications of the findings and suggestions for further research are discussed

Are All Dentiform Teeth with Simulated Caries the Same? A Six-Year Retrospective Study in Preclinical Operative Dentistry

Dentiform teeth with simulated caries (DTSC), frequently used in preclinical courses, should show no variability in the amount of simulated caries from tooth to tooth. However, the level of caries variability among DTSC is currently unknown. The aim of this study was to assess the variation in simulated caries levels in one group of DTSC and determine whether variation among DTSC impacted the preclinical performance of dental students. In the study, 80 commercially available mandibular first molar DTSC with simulated mesio-occluso-distal caries were sectioned in coronal (n=40) and sagittal (n=40) planes where the caries depth/width was greatest. Section images were analyzed for variation in levels of simulated caries using image-processing software. Three years of practical performance data using DTSC were compared with three years of practical performance data using dentiform teeth without simulated caries, for a total of six years (students' performance on two exams, Practical 1 and Practical 2). The results showed that 70% of the coronally sectioned teeth had manufacturing defects that resulted in caries overextension at the dentino-enamel junctions (DEJs). Overextensions were found at the DEJ in 41.3% of the sagittally sectioned teeth. There was a statistically significant decrease in Practical 1 performance of the students who used DTSC as compared with students who used teeth without simulated caries (p=0.0001); there was no statistically significant difference on Practical 2 performance. Of the DTSC evaluated in this study, 56.6% contained manufacturing defects, and more than 80% were found to have excessive caries variation. Prediction of which DTSC will have caries overextension is not possible. Students preparing DTSC that contain caries overextension are therefore at increased risk of receiving undeserved negative summative assessment on practical examinations