Sampling in Qualitative Research: Insights from an Overview of the Methods Literature

The methods literature regarding sampling in qualitative research is characterized by important inconsistencies and ambiguities, which can be problematic for students and researchers seeking a clear and coherent understanding. In this article we present insights about sampling in qualitative research derived from a systematic methods overview we conducted of the literature from three research traditions: grounded theory, phenomenology, and case study. We identified and selected influential methods literature from each tradition using a purposeful and transparent procedure, abstracted textual data using structured abstraction forms, and used a multistep approach for deriving conclusions from the data. We organize the findings from this review into eight topic sections corresponding to the major domains of sampling identified in the review process: definitions of sampling, usage of the term sampling strategy, purposeful sampling, theoretical sampling, sampling units, saturation, sample size, and the timing of sampling decisions. Within each section we summarize how the topic is characterized in the corresponding literature, present our comparative analysis of important differences among research traditions, and offer analytic comments on the findings for that topic. We identify several specific issues with the available guidance on certain topics, representing opportunities for future methods authors to improve our collective understanding

Critical Approach to Reflexivity in Grounded Theory

A problem with the popular desire to legitimate one’s research through the inclusion of reflexivity is its increasingly uncritical adoption and practice, with most researchers failing to define their understandings, specific positions, and approaches. Considering the relative recentness with which reflexivity has been explicitly described in the context of grounded theory, guidance for incorporating it within this research approach is currently in the early stages. In this article, we illustrate a three-stage approach used in a grounded theory study of how parents of children with autism navigate intervention. Within this approach, different understandings of reflexivity are first explored and mapped, a methodologically consistent position that includes the aspects of reflexivity one will address is specified, and reflexivity-related observations are generated and ultimately reported. According to the position specified, we reflexively account for multiple researcher influences, including on methodological decisions, participant interactions and data collection, analysis, writing, and influence of the research on the researcher. We hope this illustrated approach may serve both as a potential model for how researchers can critically design and implement their own context-specific approach to reflexivity, and as a stimulus for further methodological discussion of how to incorporate reflexivity into grounded theory research

The Adoption and Implementation of Evidence-Based Practice (EBP) Among Allied Health Professions.

Background and aims: Evidence-based practice (EBP) is widely accepted within patient care as it ensures health care professionals remain informed of recent evidence and research relating to their clinical practice. However, the particular characteristics detrimental to the successful implementation of EBP within Allied Health Professionals' (AHP) clinical practice are unknown. The purpose of this study was to assess and characterise adoption of EBP within AHP's clinical practice. Methods: Questionnaires comprising the Evidence-Based Practice Questionnaire (EBPQ; Upton and Upton, 2006a) were administered to 154 (response rate=27.3%) newly qualified practitioners (NQPs) from NHSScotland. Data were analysed to determine attitudes, knowledge and skill of EBP; K-means cluster and chi-square analyses were conducted in order to differentiate profiles of NPQs within high-, medium- and low- categories on the EBPQ practice and knowledge/skills sub-sections. Findings: Moderate scores were recorded for NQP's implementation, knowledge, and attitudes toward EBP. Chi-square analysis performed on the high-, moderate- and low- practice and skills' profiles revealed no significant results for NQP's year qualified, age, or year of clinical practice. Conclusions: The findings illustrate that the majority of NQPs have a good understanding of the application and importance of EPB, and suggests the improvement in NQPs training with regards to EBP enables them to successfully transfer acquired knowledge within their clinical practice

Filtering Medline for a clinical discipline: diagnostic test assessment framework

Objective To develop and test a Medline filter that allows clinicians to search for articles within a clinical discipline, rather than searching the entire Medline database

AIMD - A validated, simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies

Background: Proliferation of terms describing the science of effectively promoting and supporting the use of research evidence in healthcare policy and practice has hampered understanding and development of the field. To address this, an international Terminology Working Group developed and published a simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies. This paper presents results of validation work and a second international workgroup meeting, culminating in the updated AIMD framework [Aims, Ingredients, Mechanism, Delivery]. Methods: Framework validity was evaluated against terminology schemas (n = 51); primary studies (n = 37); and reporting guidelines (n = 10). Framework components were independently categorized as fully represented, partly represented, or absent by two researchers. Opportunities to refine the framework were systematically recorded. A meeting of the expanded international Terminology Working Group updated the framework by reviewing and deliberating upon validation findings and refinement proposals. Results: There was variation in representativeness of the components across the three types of literature, in particular for the component 'causal mechanisms'. Analysis of primary studies revealed that representativeness of this concept lowered from 92 to 68% if only explicit, rather than explicit and non-explicit references to causal mechanisms were included. All components were very well represented in reporting guidelines, however the level of description of these was lower than in other types of literature. Twelve opportunities were identified to improve the framework, 9 of which were operationalized at the meeting. The updated AIMD framework comprises four components: (1) Aims: what do you want your intervention to achieve and for whom? (2) Ingredients: what comprises the intervention? (3) Mechanisms: how do you propose the intervention will work? and (4) Delivery: how will you deliver the intervention? Conclusions: The draft simplified framework was validated with reference to a wide range of relevant literature and improvements have enhanced useability. The AIMD framework could aid in the promotion of evidence into practice, remove barriers to understanding how interventions work, enhance communication of interventions and support knowledge synthesis. Future work needs to focus on developing and testing resources and educational initiatives to optimize use of the AIMD framework in collaboration with relevant end-user groups

Description and evaluation of an EBM curriculum using a block rotation

BACKGROUND: While previous authors have emphasized the importance of integrating and reinforcing evidence-based medicine (EBM) skills in residency, there are few published examples of such curricula. We designed an EBM curriculum to train family practice interns in essential EBM skills for information mastery using clinical questions generated by the family practice inpatient service. We sought to evaluate the impact of this curriculum on interns, residents, and faculty. METHODS: Interns (n = 13) were asked to self-assess their level of confidence in basic EBM skills before and after their 2-week EBM rotation. Residents (n = 21) and faculty (n = 12) were asked to assess how often the answers provided by the EBM intern to the inpatient service changed medical care. In addition, residents were asked to report how often they used their EBM skills and how often EBM concepts and tools were used in teaching by senior residents and faculty. Faculty were asked if the EBM curriculum had increased their use of EBM in practice and in teaching. RESULTS: Interns significantly increased their confidence over the course of the rotation. Residents and faculty felt that the answers provided by the EBM intern provided useful information and led to changes in patient care. Faculty reported incorporating EBM into their teaching (92%) and practice (75%). Residents reported applying the EBM skills they learned to patient care (86%) and that these skills were reinforced in the teaching they received outside of the rotation (81%). All residents and 11 of 12 faculty felt that the EBM curriculum had improved patient care. CONCLUSIONS: To our knowledge, this is the first published EBM curriculum using an individual block rotation format. As such, it may provide an alternative model for teaching and incorporating EBM into a residency program

Core competencies in the science and practice of knowledge translation: description of a Canadian strategic training initiative

<p>Abstract</p> <p>Background</p> <p>Globally, healthcare systems are attempting to optimize quality of care. This challenge has resulted in the development of implementation science or knowledge translation (KT) and the resulting need to build capacity in both the science and practice of KT.</p> <p>Findings</p> <p>We are attempting to meet these challenges through the creation of a national training initiative in KT. We have identified core competencies in this field and have developed a series of educational courses and materials for three training streams. We report the outline for this approach and the progress to date.</p> <p>Conclusions</p> <p>We have prepared a strategy to develop, implement, and evaluate a national training initiative to build capacity in the science and practice of KT. Ultimately through this initiative, we hope to meet the capacity demand for KT researchers and practitioners in Canada that will lead to improved care and a strengthened healthcare system.</p

Ovulation, In Vivo Emotion Regulation Problems, and Sexual Risk Recognition Deficits

Objective: To examine associations between menstrual cycle phase, negative mood, sexual risk recog-nition deficits (assessed via an analogue risk vignette), and in vivo emotion dysregulation. Partici-pants: Participants were 714 college women recruited between February 2007 and December 2009. Methods: Participants were randomly assigned to a negative or neutral mood induction and in-structed to identify sexual risk during an audiotaped sexual coercion vignette. Participants reported menstrual cycle information, in vivo emotional nonacceptance, and attention during the vignette. Results: In the negative mood condition, ovulation was associated with longer risk recognition laten-cies relative to the luteal and follicular phases of the menstrual cycle. Increased in vivo emotional nonacceptance and decreased attention to the vignette mediated associations between ovulation and risk recognition deficits in the negative mood condition. Conclusions: Sexual assault risk reduction programs could provide psychoeducation regarding negative mood during ovulation and empha-size emotional acceptance and attention to external stimuli when distressed

A web-based library consult service for evidence-based medicine: Technical development

BACKGROUND: Incorporating evidence based medicine (EBM) into clinical practice requires clinicians to learn to efficiently gain access to clinical evidence and effectively appraise its validity. Even using current electronic systems, selecting literature-based data to solve a single patient-related problem can require more time than practicing physicians or residents can spare. Clinical librarians, as informationists, are uniquely suited to assist physicians in this endeavor. RESULTS: To improve support for evidence-based practice, we have developed a web-based EBM library consult service application (LCS). Librarians use the LCS system to provide full text evidence-based literature with critical appraisal in response to a clinical question asked by a remote physician. LCS uses an entirely Free/Open Source Software platform and will be released under a Free Software license. In the first year of the LCS project, the software was successfully developed and a reference implementation put into active use. Two years of evaluation of the clinical, educational, and attitudinal impact on physician-users and librarian staff are underway, and expected to lead to refinement and wide dissemination of the system. CONCLUSION: A web-based EBM library consult model may provide a useful way for informationists to assist clinicians, and is feasible to implement