Research methodologies used within interpretivism

Creswell (2013) lists five qualitative approaches to inquiry within the interpretivism research philosophy: narrative research, phenomenology, grounded theory, ethnography and case studies. Qualitative observational methods may also be used. Key aspects of these are considered in Table 2.6.

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Table 2.6 Key aspects of narrative research, phenomenology, grounded theory, ethnography, case studies and qualitative observational approaches in research Adapted from Creswell 2013

Research method Key aspects

Narrative research “Experiences as expressed in lived and told stories of [one or two] individuals” p. 70

Phenomenology Examines the lived experience of a phenomenon as experienced by research participants

Grounded theory Research starts in the absence of a hypothesis or a priori theoretical underpinning. Data are gathered into themes which are used to construct a new theory

Ethnography Used to explore cultural phenomena; the researcher embeds him/herself in the community or group being studied

Case studies A case or a small number of cases are explored through detailed examination using different methods and several sources of information

Qualitative

obervational methods

The researcher acts as a neutral observer and makes field notes, recordings and videos which are then analysed thematically

2.5.1 Phenomenology

A phenomenological approach was used in this programme of research.

According to Creswell (2013, p.76):

“A phenomenological study describes the common meaning for several individuals of their lived experiences of a concept or a phenomenon.”

Creswell (p.81 and p.82) goes on to describe the steps in conducting phenomenological research:

 the suitability of the research area for a phenomenological approach should be assessed. Creswell suggests using phenomenology when exploring “individuals’ common or shared experiences of a phenomenon”

to understand it further or to develop practice or policies

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 the researcher should acknowledge and bracket out his/ her own

experiences; this is particularly the case in psychological or transcendental phenomenology

 potential participants are identified who have experienced the

phenomenon. Data are generated often by means of in-depth interview/s although other methods of data generation such as observation and diaries may also be used

 participants are asked a few open questions about their experience of the phenomenon and influences on this

 data are analysed, looking for “significant statements” which offer an insight into participants’ lived experiences of the phenomenon. These may be synthesised to produce themes

 “significant statements” and themes are used to produce a “textural description” of the phenomenon and a “structural description” of the context or setting that influenced participants’ experience of the phenomenon

 finally, these are used to create a composite statement of the “essence” of the phenomenon

2.5.2 Justification for the use of phenomenology in this programme of research

Alternative research approaches as in Table 2.6 will be considered briefly, then aspects of phenomenology will be outlined and considered in relation to this programme of research thereby justifying the use of this approach.

As in Table 2.6, narrative research focuses on the stories of one or two individuals and would not therefore be suitable. As described in Chapter 1,

influences on medical prescribing have been identified and some related research has been carried out among NMPs. A theory could be proposed based on what is already known so grounded theory would not be appropriate for this study, nor

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would ethnography, which looks closely at a particular social group over a period of time. This programme of research is concerned with the personal views and experiences of several individuals experiencing the phenomenon of prescribing decision-making and so a case study approach would not be suitable. Qualitative observational methods have been used in combination with pre-and

post-consultation interviews in case study research on influences on medical

prescribing (Barry et al. 1999, Barry et al. 2000, Britten et al. 2000, Stevenson et al. 2000, Stevenson et al. 2001, Barry et al. 2001, Jenkins et al. 2003). This multi-method, case study research was carried out by a team of researchers who none the less acknowledged limitations in the approach.

In this study, the lived experience of the phenomenon of prescribing decision-making was explored among a sample of non-medical prescribers who make these decisions as part of their usual professional roles. In-depth semi-structured interviews (Chapter 4), participants' self-recorded reflections on

"noteworthy" prescribing decisions and critical incident-type interviews based on these (Chapter 5) were used to generate data. Interviews were recorded

verbatim and analysed thematically using the Framework Approach (Ritchie et al.

2014), the domains of the Theoretical Domains Framework (TDF) being used to create the initial framework (Cane, O’Connor and Michie 2012). "Significant statements" (p.82) were synthesised to produce themes, which were illustrated using representative quotations (Bowling 2002). "Structural descriptions" (p.82) of influences on participants' prescribing decision-making in general and more specifically may be found in Chapters 4 and 5 respectively. Finally Chapter 6 provides a composite statement of the "essence" (p.82) of the phenomenon of prescribing decision-making by non-medical prescribers.

Two types of phenomenology have been identified:

 hermeneutical phenomenology (van Manen 1990) where the researcher takes an overt role, interpreting or mediating between participants’ lived experiences

 psychological or transcendental phenomenology (Moustakas 1994) where the researcher brackets his/her own experiences and focuses on describing the experiences of research participants.

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As above, Creswell (2013, p.36) describes the epistemological approach in

interpretivism as when “Reality is co-constructed between the researcher and the researched and shaped by individual experiences”. Notwithstanding this, the doctoral student believes that as far as possible the researcher should

acknowledge his or her previous experience then bracket it to minimise his/ her influence on the data generation process. The doctoral student and her

supervisors felt that transcendental or psychological phenomenology resonated with this belief and this approach was taken. This will be considered in a

structured way in the section on Reflexivity.

2.5.3 Bracketing

LeVasseur (2003) considered the role of bracketing in phenomenology and used the analogy of a familiar object hidden from view inside a paper bag.

Preconceptions based on previous knowledge of the object are bracketed by the researcher’s inability to see and therefore recognise it. The researcher must explore the object afresh and will develop new understandings through this exploration. LeVasseur (p.419) goes on to assert that:

“The project of bracketing attempts to get beyond the ordinary

assumptions of understanding and stay persistently curious about new phenomena.”

Creswell (2013) suggests that bracketing should be addressed by an initial statement of the researcher’s background and relevant experience of the phenomenon, as has been done in the Foreword to this thesis and in Section 2.11 Reflexivity.