Nicholls (2009a, p. 589), suggested that “methodologies provide a particular lens through which we may approach the questions posed by our desire to understand the nature of reality”, with them being “a set of principles and ideas that inform the design of the research study” (Birks and Mills 2011, p. 4). The significance of this is that they require strategic decisions to be made by the researcher to determine the most
54
appropriate approaches to obtain pertinent information about the social world under investigation (Walsh and Wigens 2003, Denscombe 2008, Denzin and Lincoln 2005).
Creswell (2007) and Birks and Mills (2011) reinforce that in doing so, any research is guided by a researcher’s ontological and epistemological
assumptions; with their beliefs, paradigms and feelings about the social world and how knowledge is attained influencing the choice of
methodology and methods (Crotty 2005, Mills, Bonner and Francis 2006b, Polit and Beck 2010).
The impact of this is that two researchers will approach the same
phenomenon from their own individual perspectives and preferences. For the purposes of investigating the social worlds of the participants in relation to interprofessional collaboration, the assumptions within this study are conducive with a relativist ontology, that reality is subjective, socially created by individuals and contextually specific to each team, individual or event they encounter.
In determining this there was recognition that the individual perspectives of the participants would comprise several versions of reality, equally relevant in terms of representing the “truth” about particular phenomena (Andrews 2012, p, 2).
Considering the available methodologies, historically there has long been the suggestion that qualitative research lacks “scientific rigour and
credibility” (Horbsurgh 2003, p. 308). Despite this, a qualitative
methodology was determined to be the most appropriate for the purposes of this study. This decision was made based on the awareness that
qualitative methodology involves the interpretation of the “constituent properties of an entity” (Smith 2008, p. 1), hence its relevance in obtaining data to explore the meanings that individuals apply to their experiences within intermediate care settings.
55
This contrasts with how quantitative analyses emphasise measurement to ascertain “how much of the entity there was” (Smith 2008, p. 1).
Whilst this is indicative of many previous empirical studies of intermediate care services relating to the performance indicators and outcomes of intervention, such an approach was disregarded, within this study, as methodologically limiting and insufficient to meet the research aims. A qualitative approach, therefore, enabled the exploration and analysis of the in depth personal information required to generate understanding of individual experiences as people disclosed their unique versions of reality. Utilising this approach, exploration of the topic takes place and insight is gained through interpretation of the events, as perceived by the
participants, in order to generate understanding (Gray 2014). This was relevant within this study as interpretation and generation of meaning occurred during the course of semi-structured interviews, subsequent analysis and comparison of data and continued up to and including the writing up stage.
In summary the methodology for this study was chosen based on a relativist ontology; the personal belief that society comprises multiple realities that are socially constructed on an individual basis. The following section will demonstrate why the Constructivist paradigm is most
appropriate for use within this study due to its relevance in exploring phenomenon relating to personal accounts and interpretation of meaning.
3.1.1 A Constructivist paradigm
When reviewing the literature it was noted that the labels “Constructivist” and “Interpretivist” were used interchangeably (Robson 2002), dependent on the author, with both labels emphasising individuals making sense of meanings. For the purposes of this thesis the term Constructivist is the preferred one for continuity purposes.
56
As Constructivism is an ontological perspective and also an
epistemological position that recognises that two people’s personal
accounts of the same event will differ, this approach enabled insight to be gained of the individual participant’s perceptions of their experiences. The reality explored during data collection was subjective, and constructed on an individual basis by each person, including myself, immersed in the process (Robson 2002, Darlaston-Jones 2007, Charmaz 2014). In doing so this requires the researcher to be aware of their own presuppositions to avoid these affecting the constructions and a reflective diary was kept to review these, within the context of this study.
From the perspective of a researcher the methodological framework affects the position taken in relation to positioning oneself with the
participants, whether to remain at a distance or to be inclusive (Birks and Mills 2011). Following the principles of co-construction within a
Constructivist Grounded Theory approach, and recognising that “total detachment on the part of the researcher is unattainable” (Horsburgh 2003, p. 308), a stance of active inclusion was undertaken, with the
outcome of the study co-constructed between the participants and myself, enabled by the interaction that took place during the interview process. This positioned the researcher as not “neutral” within the study,
acknowledging my input and taking into account the prior knowledge and experience and also the role I played in undertaking the research (Mills, Bonner and Francis 2006a). Due to the phenomenon under investigation, this approach was therefore deemed particularly pertinent for an
exploration of interpersonal relationships.
Unlike a positivist approach which is characterised by the testing of
hypothesis through objective measurement of the social world external to the individuals involved in it (Darlaston-Jones 2007), within a
57
consideration that meaning is socially constructed and moulded by previous experiences, norms, values and beliefs (Charmaz 2014). Given that a positivist approach emphasises an independent, objective reality, has an alignment to the natural sciences, deductive reasoning and the testing of variables to establish relationships between them, this
approach would not have fully represented the dynamic nature of interpersonal interactions between the participants within this study.
Neither would it have fully explored the social processes pertaining to how the experiences and diversity of perspectives of the participants were socially created.
Instead, from an alternative perspective to inquiry, the Constructivist approach places emphasis on understanding as opposed to explanation (Charmaz 2011), discovering patterns rather than linear reasoning and recognising the individualised nature of these processes, that they are a product of social construction (Robson 2002) unique to that time, place and person. The application of this led to the identification of a “reality” that was a co-constructed interpretation in contrast to definitive “facts”. To summarise the processes undertaken for reasoning the methodology, the following diagram is adapted from Carter and Little (2007, p. 1317). It reflects the ontological and epistemological assumptions utilised within this study, offering a pathway for how decisions taken in relation to the study design ultimately led to the development of knowledge.
58 Multiple and socially constructed meanings Constructivist Grounded Theory Knowledge Qualitative methodology Constant comparison leading to category formation
Justify and evaluates Determines
Forms the basis of
Produces data for analysis
Guides the method
Subjective realities
Lead to
Figure 1 Methodological decision making within this study
The following sections will explain in more detail how these assumptions were rationalised and subsequently operationalised to undertake the study.