Specified criteria for data interpretation

Validity and reliability, in interpretive approaches, are defined by the authenticity of the selected methodology for data collection and analysis (Ulin, Robinson and Tolley, 2004). However, there are certain criticisms raised when considering case study as a research method. The major criticism concerns reliability. Robson & McCartan (2016) alleged that the case study method over-simplifies and exaggerates findings based on selective or limited interpretation of the data, influenced by the researcher’s pre-conceptions. Others have criticised the case study method as unscientific and opportunity-based, providing only a partial view and therefore not capable of supporting conclusions that can be applied more generally (Blaxter et al., 2006).

Terms of reliability and validity are relevant in establishing the quality and robust findings in qualitative research and particularly in case study design (Yin, 2014; Robson & McCartan, 2016). By following the research protocol (Yin, 2009), reliability and validity were established throughout the data collection and analysis phase. To establish validity Yin proposed four tests that can establish credibility of case studies as a recognised method of qualitative enquiry in social sciences (2009, p. 41; 2014, p. 45). These measures are as follows:

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3.3.5.1 Construct validity

According to Yin (2009) to achieve construct validity in case studies, rigorous data planning, collecting and analysis is required. Yin proposed that in order to establish construct validity, careful planning to collect multiple sources of evidence within each case was necessary. Such planning and multiple approaches to data collection, enable data triangulation which affirms the authenticity and construct- validity of a case study finding. Triangulation helps the researcher to develop data convergence based on a variety of sources of information (Creswell, 1998). By rigorous data collection methods using multiple techniques and data triangulation the quality of a case study design can be assured (Yin, 2014; Robson & McCartan, 2016). In this research, different methods including semi structured interviews, focus group studies and document reviews were used to maintain the rigour and

authenticate the validity of findings using data triangulation. The details and rationale of choosing multiple data collection methods for this research and the process of data triangulation will be further discussed in Chapter Four.

3.3.5.2 Internal validity

Internal validity is “the strength of a cause - effect link made by a case study” (Yin 2014, p. 239). Internal validity determines the nature of underlying causes and their relationship to the findings, to justify the uniqueness of each case. Case study tactics relevant to internal validity include pattern matching, explanation building for each case, addressing rival explanations and logical models to explain the findings. As Yin (2014, p.143) explains:

For a case study analysis, one of the most desirable techniques is to use a pattern matching logic. Such a logic (Trochim, 1989) compares an empirically based pattern - that is, one based on the findings from your case study-with a predicted one made before you collected your data (or with several alternative predications) …If the empirical and predicted patters appears to be similar, the result can help a case study to strengthen its internal validity. To establish internal validity, data from each case was analysed using a template analysis approach. The process of template development and data analysis is discussed in Chapter Four (4.2.5.1). By using template analysis similar and contrasting patterns were identified for any rival explanation. Rival explanation is a possible alternative finding that is different from the initial propositions set for the case study (Yin, 2014). A summary of each case discussing the rival explanations was developed to signify the exclusiveness of each case and present the internal validity. Using template analysis, a

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logic model based on themes and sub-themes was developed for each case (King & Brooks, 2017). The process has been explained in depth in Chapter Four (4.3.1). Chapter Five discusses Case Study A; Chapter Six presents Case Study B and Chapter Seven Case Study C. Chapters Eight-Nine present data collected from incomplete cases D, and E.

3.3.5.3 External Validity

“The extent to which the findings from a case study can be analytically generalised to other situations that were not part of the original study is known as External validity” (Yin 2014, p.238). Yin (2009, 2014) conceded that for single case study, external validity was a challenge. In the present study, external validity was achieved using replication logic and multiple case studies. The limitation of findings based on the interpretation of data from a single case was mitigated by taking a small group of cases. This enabled the researcher to conduct a richer analysis looking for replication between cases but also taking note of contrasting findings. The process is discussed in depth in Chapter Four that covers how data was interpreted and themes established using the template analysis approach (King & Brooks, 2017). Chapter Nine presents the cross-case synthesis to establish the external validity of the three main case studies.

3.3.5.4 Reliability

A consistent and repeatable approach of the research procedures determines the reliability of a case study (Yin, 2014). Yin suggested the use of a case study protocol to develop case study data

enhanced the reliability of research findings. The study protocol should include the following (Yin, 2009, p.81):

1. An overview of the case study project: (This includes project aim and objectives and relevant reading about the topic to be investigated).

For establishing reliability of this study, detailed discussion on the research aim, objectives and rationale and scope of the study has been presented in Chapter One. To establish the importance of the research question, a literature review from 1993-2017 is discussed in Chapter Two.

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2. Field procedures: (Presentation of credentials, access to case study sites, sources of data are important in maintaining reliability of a case study).

For this research, ethical approval was sought from the host university and multiple case sites. Accessing and recruiting participants involved email correspondence between undergraduate programme leaders, course administrators, educators and students; informing them about the research project. Also, a small power point presentation was delivered to orient potential participants to the aims and scope of the research project. Multiple sources of data were used, including semi structured interviews with nursing educators, focus groups with students and curriculum review of the undergraduate nursing courses. The details about field procedures covering, ethics approval, access issues, recruiting, and modes of data collection are discussed in detail in Chapter Four.

3. Case study questions: (Specific questions and potential sources to be identified to seek information and plan research).

Yin’s reliability framework emphasises questioning the case at different levels. Since the aim of this study was to inquire how spirituality is integrated in nursing education; multiple sources of information including curriculum, students and educators were required to investigate the issue. Hence, separate information sheets (Appendix 3 for student nurses and Appendix 4 for nursing educators) were developed to access potential participants for the study. Also, separate interview guides were developed for conducting interviews with educators (Appendix 7) and focus groups with student nurses (Appendix 8). The detailed discussion on conducting interviews, focus group studies and document reviews is presented in Chapter Four.

The process of pattern-matching during cross-case synthesis and relating it to the gaps identified in the literature review is discussed in Chapter Twelve and is illustrated in Appendix 11.

4. A guide for the case study report: (Outline for the data, use and presentation of other documents).

Separate folders were developed to keep progress records for each case. This included keeping a log of emails, correspondence, the time frame used in ethics clearance and in accessing and recruiting participants. Data collected from each case in the form of recorded interviews and documents accessed for curriculum review; was kept anonymous and confidential following university and legal

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data protection guidelines. These measures helped by keeping an audit trail and avoiding any bias in performing data analysis (Yin, 2009, 2014). Chapter Four discusses all steps taken for data collection in detail.

3.4 Chapter Summary

Various qualitative approaches could have been used to conduct this study. However, the nature of the research question established the best methodology for this study. This chapter identified the limited scope of other qualitative approaches compared with case study design in addressing the research question. Furthermore, this chapter explained different types of case studies and highlighted the scope of exploratory multiple case studies for this research. Finally, based on Yin (2009, 2014) case study design, each step towards a successful case study design was explained and related to the study plan.

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Chapter Four: Research Methods

4.1 Introduction

This chapter discusses how the research protocol was carried forward as field proceedings suggested by Yin (2009, 2014) and discussed in Chapter Three. This chapter discusses the entire process of data collection and analysis in depth. Several stages were involved in the data collection process. These included obtaining ethical approval, accessing and recruiting study participants and establishing validity and reliability throughout data collection and data analysis for quality control. However, there were difficulties and challenges at each stage. The chapter explains the nature of problems faced at different stages, particularly during data collection and how those issues were addressed constructively.