Sampling

For multiple case studies, the logic of selecting multiple case sampling is not based on identifying any prevalence of the inquired phenomenon. Rather, the logic of identifying multiple cases is based on finding similar or contrasting underlying aspects of the situation studied. The resultant findings enable comparisons to be made and the extent and type of replication found, enables some conclusions to be drawn about common and unique characteristics across multiple cases (Yin, 2009, 2014).

For this, opportunity or convenience sampling was used to select five universities where an undergraduate nursing programme was offered across England. The selections were made on the basis of who responded first, showing interest and availability within the limited time set for

recruitment (Robinson, 2014). Due to the challenges mentioned in section 4.2.1, the sampling was based on convenience to avoid further delays in recruitment, considering the limited time frame for the PhD project.

These schools of nursing, represented five different geographical, historical and cultural contexts in England. This enabled the researcher to examine underlying variations in the approach to education around spirituality in nursing and the inclusion (or exclusion) of spirituality as part of core and clinical teaching. This variation restricted generalization to a local level to avoid abstract decontextualization, which could have affected the reliability of this research (Yin, 2014). Different learning environments, academic culture, curriculum structures and institutional priorities were found in the cases studied and this supports the external validity of the study by using replication logic across multiple case studies, (Yin, 2009, Robson & McCartan, 2016).

4.2.2.1 Accessing and recruiting participants:

As discussed in Chapter Three, to develop construct validity and reliability, a research protocol was developed. Information about the project was disseminated well in advance to give participants sufficient time to plan their availability for the project (Yin, 2009; Robson & McCartan, 2016).

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After identifying potential cases as described above, formal permission was sought from Deans or Heads of School to carry out the study (Blaxter et al., 2006). Once, the initial permission was granted, communication with related programme coordinators and programme heads was started by

approaching all nursing educators teaching in undergraduate nursing programmes and student nurses, interested in exploring issues related to integrating spirituality in nursing education. Also, a ten-minute presentation was scheduled with nursing students to introduce the research aims and scope of the study. A small power point presentation was developed to specify the nature of research and the aims behind conducting the focus group study with students (Appendix 5). The talk was scheduled after receiving permission from the course leaders across the five identified cases.

After getting replies from interested participants including both educators and students, via email and telephone, potential interviewees were approached via email. A brief outline detailing the nature and purpose of this research was shared with departmental heads. After receiving responses from interested participants, an information sheet, along with a formal consent form was sent via email. The information sheet included the possibility of a telephone conversation to clarify any issues before a decision to consent for the research study. All participants were given the information and consent sheet one-month prior to scheduling interview dates and time so that participants could reflect on the necessary and relevant information to explore any potential sensitivities on personal level; before signing the informed consent (Blaxter et al. 2006; Yin 2009). A copy of each document developed is appended, including separate information sheets for nursing students (Appendix 3), nursing educators (Appendix 4), power point presentation (Appendix 5) and consent form (Appendix 6) for the

introductory talk to nursing students.

The process of recruitment was not as simple as had been hoped due to students’ limited availability during clinical placements or exam schedules. Due to academic involvement, accessing nursing educators for 1:1 interviews was a challenge too. After the long process of gaining ethical approval to access participants from the five universities, getting an inadequate response from nursing educators and nursing students could have affected the rigour and validity of findings (Yin, 2014; Robson & McCartan, 2016). There were universities where recruiting participants was facilitated by the head of departments and course leaders which resulted in very active and timely schedules.

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Hence, various adaptation and flexible planning was offered to departmental heads, nursing

programme administrators and to participants (where allowed); to negotiate accessibility options when participants could be less busy (Blaxter et al., 2006; Richards, 2015; Robson & McCartan, 2016). There were instances, where educators were interested to be part of the study but could not meet the researcher on face-to-face, hence the alternative option of skype interviews was offered (Hanna, 2012; Robson & McCartan, 2016). Also, there were occasions, where despite early commitments by the students, focus group studies had to be rescheduled due to last minute disappointment where no or only one student turned up. However, regardless of such challenges and disappointments,

reasonably complete data sets were obtained for three cases. Table 2 presents a Case Specific Summary of the Challenges faced during accessing and recruiting participants.

Table 2: Case specific Summary of challenges

Case Initial contact with the department/ Heads Access to Nursing Educators Access to Nursing students Introductory session with students

A Aug 2014 Oct 2014- Nov 2015 Oct 2014-

Nov 2015

1. Nov 2014 2. Oct 2015

B Jan 2015 Jan-May 2015 May 2015 May 2015

C Sep 2015 Oct -Nov 2015 Oct-Jan 2016 Not required

D Sep 2015 Nov 2015 Nov 2015-

Jan 2016 No Response- Recruitment Declined

Nov 2015

E Oct 2015 Nov 2015- Jan 2016

No Response-

Recruitment Declined

Nov 2015- Jan 2016

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