Data collection settings

The research took place at two different premises, MTI for the pilot study and the school of nursing Cairo University. Both places welcomed the research and guaranteed access to students to conduct the focus groups.

Required characteristics of qualitative research include flexibility, ongoing analysis and involvement of the researcher in every step of the study (Polit and Beck 2012, Hancock et al 2009, Creswell 2014, Daniel and Turner 2010). These characteristics were manifested at different occasions during the study. Flexibility was required to change the place of research at the beginning of the study. Access to educational organizations to meet the students and start the study was challenging at the beginning. The study site had to be changed from the British University in Egypt (BUE) to other places such as the faculty of nursing at the MTI and the school of nursing. Negotiation for access and explanation about the research aims and time frame required meetings with the Dean of both places (MTI & school of nursing) to gain initial approval from both places. Studying at Queen Margaret University, Scotland was one of the factors that facilitated access to educational organisations in Cairo since it is well-recognised name for cooperation with the BUE.

Only one pilot focus group took place at the MTI due to the very low number of students who were less than 20 in the fourth year and only three of them agreed to participate in the study. Therefore, a second site was required to continue the study. Hence, the school of nursing was the second choice since it includes five years of study and around 800 student nurses. During conduct of the study at the school of nursing, at Cairo University, the researcher had to negotiate the time and place for each focus group with the year coordinator at the school of nursing prior to the interview. This was due to the busy schedule of the students and the limited availability of classrooms. Therefore, the time plan for conducting the interviews was developed during the study and not predetermined. Another issue that required flexibility was the sequence of questions during the focus group. Although there was a predetermined focus group question guide (Appendix 1), the sequence of the questions varied each time based on the interaction between the group and the flow of conversation. Also the focus group guide was edited several times based on data obtained from each interview. This flexibility helped to obtain detailed and comprehensive views from participants without adherence to a specific sequence of questions.

Nagle & Williams (2011) identified two stages of preparation that have to be considered after the study purpose is determined and prior to starting focus group interviews. Those two stages were defined as conceptualisation and logistics. During the conceptualisation stage, planning details of the research process took place, details such as sample identification, sample size, determining the group participants and obtaining approvals, and developing the discussion guide. During the study, some complexities interfered with the predetermined conceptualisation, such as in the sample size. The size of the sample, was planned to be from 6 -10 as recommended by Krueger and Casey (2000). Yet, this was one of the challenges, as the focus groups ranged between 3 to 5 participants only. This was due to the availability of students and the numbers agreeing to participate. Some literature suggests that the number in a focus group should range from 6 to 12 (Blackshaw and Crawford 2009, Silverman 2009). Ritchie et al (2014) explain that a small number in a focus group can be accepted when seeking in-depth understanding of group members’ point of view about the research topic. The other factor that led to a small number in the focus groups related to the researcher herself who preferred to divide groups consisting of 8 or 9 into two groups. The researcher felt more in control of the discussions with groups up to 5 and recognized how challenging it is to keep the power balance among group opinions during the discussions. It is the facilitator’s responsibility to keep rules for the group discussion and maintain a safe atmosphere for participants to voice their opinions (Morgan 2013). These facilitation skills developed and varied with the different focus groups.

In the current study, the researcher conducted only one or two focus groups per day with students who agreed to participate in the study. This decision was due to the amount of effort and time required to transcribe each interview tape, and the need to start this transcription immediately after the focus group and starts at the same day of focus group and extend to a week for each two focus group transcription. Therefore, it was possible to run only one or two focus group at each weekly visit to the school of nursing. In summary therefore: In the pilot study, the participants were three students from the MTI faculty of nursing. In the main study, the participants were 4th and 5th year undergraduate nursing students who had completed the programme of study

and were waiting for graduation. All students were female. Eight focus groups were conducted with a total of 32 participants at the school of nursing premises at Cairo University.