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As a research project involving human participants under the auspices of an academic institution, the original case study, from which examples are based, was subject to an institutional ethics review before fieldwork of any sort could commence (Government of Canada, 2010). With a healthcare focus, additional safeguards were put in place. In all, five ethical reviews were conducted: one by the University of Alberta Human Research Ethics Review Process (HERO) where I was a visiting scholar working on my doctoral dissertation, and a delegated review in each of the four organizations where field research was conducted.
The focus of the reviews across these venues was consistent, which was to ensure that the research made a contribution to knowledge, that participation was
harm (See Bell and Bryman (2007) for an overview of ethical principles included in major codes of conduct). To achieve this, the ethics committees required detailed information on: (1) Study objectives and contribution: An overview of purpose
(research questions), design of study (methodology and procedures, including proposed locations), time commitments and time frame of study (for participants and researchers), proposed contributions to theory and practice, and the identification of any conflicts of interest (e.g. relationships, financial incentives); (2) Informed
consent: Participant information as it pertained to recruitment (inclusion and
exclusion criteria, sampling method, and determination of sample size), proposed risks and benefits of the research for participants (including mitigation strategies), details regarding how informed consent will be obtained (including what will happen in the event of a participant withdrawing); and (3) Confidentiality, anonymity, and
privacy: Details regarding how confidentiality of personal data would be maintained,
and how data will be recorded, stored (for how long), and accessed (by whom). While questions relating to the above issues are general in nature, the ethics committees raised three issues that pertained specifically to the shadowing method. Below is a brief explanation of the issues that were raised and explanations as to how they were addressed.
Sampling
Similar to other shadowing studies, my study proposed the use of a small sample size (four top managers) (Mintzberg, 1973; Tengblad, 2006; Vie, 2010). As a qualitative
researcher, I did not consider a small sample size to be an issue for the ethics review, least of all because the objective of the research was not to make generalizations, but rather to generate new insights into the work behaviours of top managers. However, despite emphasizing this point, concerns were nonetheless expressed surrounding ‘sampling biases’. Specifically, that the sample may not be representative of top managers in the health sector, and that the sample may be skewed in some form (e.g. towards managers who are available (less busy), or those more comfortable with academic research, possibly those with postgraduate education or research backgrounds). Considering that a key characteristic of qualitative research is that it generally relies on small numbers to study phenomenon in depth, and in detail (Miles and Huberman, 1994), and unlike quantitative research does not have hard and fast rules about sampling, I was both surprised and alarmed with the concerns. However, setting my reservations aside to move the project forward (as I believe many researches do in these situations) I chose to appease the review board. This was done by outlining an additional step in the research process in which the initial results of the study would be presented to groups of top managers (leadership teams in each of the organizations under study) to test the ‘validity’ of emerging findings. Making this revision I was successful in getting one step closer to data collection. However, the experience left me thinking whether ethics boards and committees are adequately versed in qualitative research methodologies (Holloway and Wheeler, 2010) and wondering how many qualitative research proposals have been inappropriately judged using quantitative quality constructs. I also wondered how the design of qualitative research studies is being impacted by similar concerns and
requests made by ethics boards and committees. While it was not the case in this study, is rich, descriptive data being sacrificed for larger samples?
Informed consent
Given that exposure to a diverse range of situations and people is a key attribute of shadowing studies, (McDonald, 2005), the issue of how informed consent would be taken and maintained throughout the study was considered to be a serious concern. This issue was addressed with the ethics committee on two separate fronts: (1) with the primary participant under study (shadowee); and (2) the individuals who came into contact with the shadowee in meetings and other occurrences:
(1) Shadowee: Before the research commenced (on the first day) it was proposed that a meeting would be conducted with a proposed shadowee. During this 30-45 minute meeting the details of the study would be thoroughly explained by going through the information sheet section by section. At the end of this meeting the manager would be asked to sign a consent form. However, similar to other studies of this kind it would also be communicated to the participant that the consent form was not an ‘all access three-week pass’ to observe their work, and that access would be verbally re-negotiated on a continuous basis (e.g. for each meeting and work session) (Czarniawska, 2007; Sin, 2005).
(2) Secondary observations: Upon recruitment of a shadowee (CEO), I indicated that written notification would be sent to all employees in the organization from the office of the CEO. This would explain that their CEO was participating in a
research project that involved shadowing, and that they may receive an invitation to be observed in a scheduled event, such as a meeting. This invitation would be accompanied by an information sheet about the study that indicated the potential benefits and risks of participating and made it clear that participation would be voluntary and that withdrawal from the study could occur at any time without giving a reason. The letter also included contact information, which would allow potential participants to ask questions in advance of participation. Thus, in the event of a planned internal meeting, participants would be able to provide informed consent by signing a consent form prior to its commencement. In the event of an unscheduled meeting, it was maintained that those involved would be informed of the study verbally, and written consent would be sought following the meeting at a convenient time and place (post-hoc). Finally, it was indicated that in the event of meetings with individuals external to the organization, a similar post-hoc process would be followed in which the study would be explained and consent would be sought immediately prior to or following the encounter.
Participant discomforts
Considering the extended period of time the managers would be shadowed (3 weeks each), it was suggested that there might be some uncomfortable situations and/or periods where the managers may want to be alone or not observed. To address this potential discomfort, the research ethics committees were assured that all requests
from managers that would ease the burden of the researcher’s presence would be adhered to, and at all times private information heard or observed would be treated as confidential and not discussed in any of the findings.
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