Process for Analysing Data 1 Overview of Data Analysis

This section provides an outline of the method employed to analyse the data from the transcripts of the qualitative interviews, including the process used for data reduction.

4.3.2 Data Reduction

The volume of data produced from the transcripts of the 30 key informant interviews was considerable; therefore it was essential for the researcher to identify a means of synthesising the key themes and significant points from the data in an effective manner. This process has been termed data reduction and is an integral part of data analysis as it ‘sharpens, sorts, focuses, discards, or organizes data is such a way that ‘final’ conclusions can be drawn and verified’ (Miles and Huberman 1994, p.11). Prior to undertaking data reduction, there is a need for the researcher to become fully immersed in the data, a process Ritchie and Spencer (2002, p.312) referred to as ‘familiarisation’. In this thesis the involvement of the researcher in completing several of the verbatim transcripts and checking others against the original recordings facilitated this familiarisation stage.

The transcripts were prepared with large margins on both the left and right hand sides of the pages, enabling the researcher to detail the themes identified at the edge of the page close to the relevant text. During this process the interview transcripts were reviewed several times to identify and reaffirm the key themes present in the data. As a means of providing assurance that the researcher’s interpretation of the interview transcripts was reliable, a colleague of the researcher who is an experienced qualitative researcher undertook a review of a sample of interview transcripts to verify the key themes identified. The feedback provided was that the themes recorded were considered appropriate. This was beneficial to the researcher as it was critical to ensure that a robust approach was applied to the data coding and subsequent analysis.

4.3.3 Selection of Data Analysis Method 4.3.3.1 FrameWork

The researcher initially planned to use ‘FrameWork’ methodology (Ritchie and Spencer 1994) and software from the National Centre for Social Research (NatCen) to analyse the data from the qualitative interviews. The researcher undertook training on the ‘FrameWork CAQDAS’ package to gain a greater understanding of its functionality but on trying to apply the tool in the context of this study, challenges were experienced as the researcher felt constrained principally because the identification of topic guides and themes, required by this approach, forced the researcher to identify a list of key themes which would then be applied to the transcripts as opposed to the themes emerging from the transcripts. Table 4.1 below provides an overview of the themes identified using the ‘FrameWork’ methodology.

Table 4.1 Thematic Framework

Topic Guide Index

Impact of devolution Policies developed to meet local needs Divergence of health policy across UK Ministers are more accessible (positive) Ministers are more accessible (negative)

New supply Positive impact of targets Negative impact of targets Financial investment Widening entry gate Better working conditions International recruitment HCSW route to registration Marketing of profession

Student Attrition Lack of support in clinical placements Academic status (positive)

Academic status (negative)

Nursing seen as route to alternative career

Retention Positive impact of Agenda for Change Negative impact of Agenda for Change Improving working lives / flexibility Workload

Role diversity Pension

Lure of working overseas

Financial pressures / loss of posts

New roles Support for Nurse Consultant

Lack of support for Nurse Consultant Support for Modern Matron

Lack of support for Modern Matron

Impact of other professions on development of new roles e.g. Modernising Medical Careers

Policies National policy successful National policy not successful Policy disconnect

Impact of individuals

Topic Guide Index

Pace of policy change (negative)

Workforce planning function

Strategy in place No strategy in place Effective processes

Lack of effective processes Continuity

Lack of continuity

Support for profession based workforce planning Lack of support for profession based workforce planning

Support for competency based workforce planning Lack of support for competency based workforce planning

The researcher likened this approach to pre-judging the outcomes of the analysis or forcing information gleaned from the transcripts into the pre- defined categories of the ‘thematic framework’ (Ritchie, Spencer and O’Connor 2003, p220). This is a commonly cited limitation of software packages for qualitative data analysis whereby the choice of software dictates how the researcher undertakes the analysis (Coffey and Atkinson 1996). Another shortcoming is that the relative ease of using software packages can encourage corners to be cut during the data analysis stages (Weitzman 2000).

The researcher therefore had to identify an alternative methodology for data analysis, which allowed more freedom in identifying the themes emerging from the interviewees’ feedback and which was compatible with the principles of realist review and ensured an appropriate level of rigour.

4.3.3.2 Mind Maps

The alternative method adopted involved detailing the emergent themes on a series of mind maps which were then reviewed and analysed by the researcher and used to generate the findings as detailed in chapter six Analysis of Interview Data and Reporting of Findings.

Mind Maps were originally developed during the 1960s by Tony Buzan to enhance memory, concentration, creativity and learning skills (Buzan 1974; Buzan 1993). The use of mind maps has since evolved to include their role in both data collection and analysis in qualitative research (Brightman 2003; Tattersall, Watts and Vernon 2007; Meier 2007; Wheeldon and Faubert 2009; Tattersall et al. 2011). They are one of a range of tools which support the implementation of ideas mapping and the benefits of this compared with more traditional approaches to analysing qualitative data include the flexibility provided by the ‘unconstrained structure’ and the ability to ‘create an association of ideas’ (Davies 2011, pp.281, 282), whilst providing the ‘visual ability to spot patterns, shapes and connections as a form of analysis’ (Reason 2010, p.5).

Mind maps are valuable tools in developing a comprehensive understanding of the key concepts of the subject matter under review (Meier 2007), whilst encouraging ‘a high level of critical thinking’ (Brightman 2003, p.8). Additionally they enable the researcher to have greater control over the data analysis which is an important issue when analysing large amounts of complex interview material (Kvale 1996).

The mind mapping process begins with the documentation of the central issue being considered for example devolution. A particular strength of mind mapping over traditional ‘code and retrieve’ approaches to analysing qualitative data is the generation of inter-relationships between ideas including ‘multiple perspectives, alternate realities [and] non-linear recording’ of emerging themes. Furthermore mind mapping supports the on-going identification of linkages between data provided at any point during the interview whereas the ‘code and retrieve’ methods follow the order by which the data is recorded in the transcript (Brightman 2003, p.11).

4.3.4 Application of the Data Analysis Method

The process undertaken to transfer the key themes identified in the original transcripts onto the mind maps was to identify the broad topic areas and note these on the centre of the mind maps. A large A2 artist’s pad was used to ensure there was sufficient space to develop the mind maps and to include as much detailed information as possible. Mind maps were developed for the following topic areas:

 devolution

 key health policies  pace of policy change  nursing workforce planning

 responsibility for workforce implications when policies are developed  integration of workforce planning and centralised versus decentralised

workforce planning  recruitment and retention  new roles / advanced practice  Modernising Nursing Careers  Agenda for Change

 graduate status.

These topic areas were chosen as they were in line with the key themes identified in the literature review (chapter three) or from the themes which emerged from the interview transcripts.

Data from the interviews from each of the four countries was recorded on the mind maps using the colour coding detailed below:

 England / UK-wide role – black  Scotland - red

 Wales – blue

The key themes identified were noted on the relevant mind map along with details of the interviewee’s unique, anonymised code for example on the mind map relating to integration of workforce planning the following interviewees were recorded as having reported the need for better integration of workforce, service and financial planning: ENG04, ENG06, ENG08, ENG09, SC05 and NI01. This enabled the researcher to identify at a glance the key themes and trends emerging from the transcripts as well as relationships between themes, whist the use of different colours created visual imagery highlighting the strength of a particular theme either within individual countries or across the UK. A photograph of the devolution mind map is included in Appendix XIV as an example for information.

When constructing the mind maps the researcher started populating each one with data from a different country, on a rotating basis, for example if the first mind map was initially populated with data from England then the next would be initially populated with data from Scotland and so on. The reason for this was to ensure that potential bias or dominance from any one country was minimised.

The process undertaken was that the interview transcripts for each country were reviewed and the key themes relating to the topic area of the specific mind map were documented in the relevant colour on that particular mind map. A tick was then placed on the transcript next to each theme documented on the mind map, thus avoiding duplication of the same information on different mind maps. Following completion of the mind maps, each transcript was reviewed to identify any key themes which had not been included on a mind map and a decision was then taken by the researcher to either include this information on a mind map or to exclude the data from the study.

The mind maps evolved and improved as the researcher became more confident and experienced with the process. The most challenging mind map

to complete was the key health policies map but this was principally due to the large number and diversity of responses to this line of questioning. The data analysis for this particular topic area was supplemented by the development of an excel table.

Following completion of all the mind maps, the researcher reviewed each individual mind map to develop the narrative which is detailed in chapter six Analysis of Interview Data and Reporting of Findings. As information from a mind map was documented in the relevant section of chapter six, a tick was recorded beside the source data on the corresponding mind map. This process was repeated until all the data was recorded in the text. Subsequently during editing phases throughout the development and refinement of this thesis, some of the data recorded was removed as it was determined not to be directly relevant to addressing the research questions posed in this thesis.

During the data analysis process consideration was given to the potential relationships between themes identified in the data and each interviewee’s job role and / or employing organisation. The reason for this was to establish if particular responses or viewpoints were common amongst interviewees who were employed in similar roles or organisations, for example those who worked in professional organisations or trade unions. This review of the data did not identify evidence of strong associations between specific themes and interviewees from a particular role or employing organisation.

4.3.5 Reflection on the Data Transcription and Analysis Processes

Towards the end of the data transcription and analysis phases of this thesis, the researcher reflected on the methods used to identify if these could have been streamlined. On completion of the verbatim transcripts of the individual interviews the researcher sent a copy to each interviewee for verification. This created additional work for the researcher as it involved chasing interviewees for responses, although it did provide assurance that the

interviewees were in agreement with the data reported in an anonymised format in the thesis.

On reflection the data transcription, reduction and analysis phases of this study were more time consuming and onerous than the researcher had originally envisaged, however it was essential to the quality of this study that the processes were robust.

4.3.6 Summary of Key Points on Data Analysis

This section of the Research Approach Chapter detailed the process used for analysing the data in this thesis. The rationale behind the selection of mind mapping was explored, followed by an explanation of how the mind maps were developed and used to analyse the data from the 30 qualitative interviews.