Conducting the interviews

The use of intensive interviewing methods (which is an in-depth investigation of a topic) is a good way of collecting data using the grounded theory method (Charmaz, 2009), as both methods rely upon the use of open-ended questioning which allows the emergence of data. It also allows the researcher to take control over the direction of the data collection and analysis.

The method adopted for interviews was to devise an interview schedule that was informed by experts in the field. Interview questions focused on important issues, and a few broad open-ended questions were included to enable and facilitate the

participants’ stories to emerge. In this way by inviting and gently encouraging

participants I was helping them to share their experiences with me. Participants were asked for clarification, and to add details to help them reflect upon their experiences. An advantage of using interviews is that the interviewer is allowed to lead the

conversation and follow up on areas they think are pertinent. This is unlike an

ordinary conversation where this may be interpreted as being rude. This allowed me to follow up on and ask participants to expand on relevant issues.

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Interviews were semi-structured in nature drawing on issues identified in the scoping exercise (Phase One) and the literature review (Phase Two) but also allowing

interviewees to introduce new issues of pertinence to them.

Interviews were conducted via the telephone rather than face-to-face. This was largely for feasibility reasons; participants were dispersed geographically across a large region and were professionals with busy work schedules involving shifts, on call rotas. By using telephone interviews, some flexibility in times can be obtained. In addition, asking sensitive questions by telephone may be preferable as evidence shows that respondents may find it easier to discuss issues which may be sensitive over the phone(Illing, 2007). There is also research to say that there is little

difference in responses when interviews are conducted via the telephone compared to face-to-face (Sturges and Hanran, 2004).

5.5.6.1 Potential Risks and Hazards

An important consideration when conducting research is the potential risks and hazards for both the researcher and the participants. Potential risks were identified for trainee participants, as topics could be sensitive and upsetting for the participants. Important considerations prior to the research were taken into account to try to

minimise the risks. I read around the topic of conducting research in sensitive areas to help prepare myself for conducting the interviews. When entering the lives of others, the researcher needs to be mindful and respectful of the participants’ privacy and how much they intend to disclose of their life. I was very aware of this during the interviews with trainees when they were disclosing often very sensitive events, which held great meaning to them.

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“you need to demonstrate a certain degree of discretion, of respect, of

appreciation for what they are doing…it is more than just words, it’s more than just what you are going to analyse, it’s their life, their experience and you need to make sure you are aware of that” (Dickson-Swift et al., 2007p328).

The researcher must remain objective throughout the research. Again, I was very aware during the interviews not to be drawn into the ‘stories’ that the participants were telling me and to remain impartial but remain respectful of what they were sharing.

Considerations that the researcher can apply to mitigate some of these risks and hazards are to consider and pre-empt scenarios and responses in advance of the interview, discuss with colleagues, and seek expert advice if necessary.

Another important ethical consideration is to gather information on support available for both the researcher and the participant prior to the interview, and have these readily available during and following the interview. Another consideration to be aware of your limits and expertise and do not give advice, but signpost to information and support. Following several interviews with trainees, I was thankful of family and friends for support.

Prior to the interview participants were aware of what the interview was about, potential question areas and why they had been chosen to take part. This was to provide participants with as much understanding as possible about the interview and to help prepare them as much as possible.

On the information sheets (see appendix 4) participants were given information about support organisations and occupational health. During the interview, the researcher

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had these in front of them in case they needed to pass the information on to the participant.

It was decided prior to the interview that any issues of disclosure, such as patient safety issues, during interviews would be discussed with my PhD supervisors (retaining confidentiality) and then if necessary passed on to the relevant party (e.g. HEE regional office). It was stated in the information sheet that confidentiality would be broken if the participant disclosed certain information, such as any serious patient safety issues, abuse or criminal activity.

I was also mindful that if a participant became distressed during an interview I would ask if the participant wanted to terminate or reschedule the interview. If a participant wanted advice, I would ask them to speak with the Specialty Training Manager in the first instance. I would also direct them to Health Education England North East (HEE regional office) Managing Concerns webpage and the British Medical Association (BMA) webpage, which both have helpful information and will signpost them to the most appropriate channel.

Developing rapport with study participants is an important stage for any qualitative researcher, especially during one-off interviews where you do not have the luxury of time and several meetings to build a rapport. The development of rapport can

facilitate an honest in depth interview (Willing and Stainton-Rogers, 2008). A good way to help establish rapport, facilitate disclosure, and establish a non-hierarchical relationship is to disclose something of yourself as a researcher. However, this is very personal and needs to be thought about prior to the interviews taking place. The researcher must think about their boundaries in advance and how or what they wish to disclose about themselves.

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Prior to the interview, I talked to the participants about what I was going to ask them, about my background as a researcher and some asked if I was a clinician. The fact that I was not seemed to put them at ease, as I was an outsider. I gave them the opportunity to ask me any questions. In this way, I was building up a rapport with my participants and offering something about myself. During the interview some

participants would discuss children, maternity leave and childcare and would ask me outright whether I had children (I had already decided prior to the interview that I would be happy to disclose that I had a child) and this helped to build up a rapport and empathy with participants.

Completion of the interview was also a consideration. I was conscious not to leave participants feeling deflated after their interview, especially as they were talking about often sensitive and upsetting times in their lives. Therefore, following the interview, I had an informal chat with the participant to wind down the conversation, end on a chatty informal note, and make sure participants were okay. It would have seemed too abrupt to end the interview and say goodbye straight away and

sometimes I talked about other research that reflected some of the things participants were saying, for example about overseas doctors and research on preparedness for practice. On several occasions, I offered to send participants articles from those projects for information as a way of giving them something back.