A critical approach to research requires that the researcher’s position is overt and stated. The researcher, activists, participants and other audiences contribute to the research as critical participants. The critical researcher must take ethical responsibility for his/her own subjectivity (Jones & Watt, 2010).
I entered this research acutely aware of my position as a CCN. I had worked in a metropolitan unit where the tone of discussions, between nurses, toward the implemented CPD changed. As a nurse, I was concerned with the approaches being taken, for I was confused, as were others, by the processes of the impending changes related to CPD. I talked with other nurses, and I did not understand the model or its underlying intent before embarking on this research. I hold strong views on employers that promote meeting the mandatory CPD of the Nursing and Midwifery Board of Australia (NMBA) by completing the institutions mandatory competencies. I view the hospital mandated employee competencies such as hand hygiene, fire training, occupational health and safety and clinical skills, such as medication administration or basic life support, as a requirement of employment rather than CPD that posits new or expanded knowledge. I am astutely aware of my position surrounding the need for new knowledge that can benefit patients I care for, to be considered CPD. Self-
awareness of my views was essential to protect the perceptions of my participants from becoming lost under my own views and beliefs or obscured. Acknowledging feelings generated by observing and being in the social world of research must be acknowledged by the researcher (Thomas, 1993). Critical ethnography is complex requiring multiple voices, multiple subjectivities and multiple meanings (Jones & Watt, 2010). This requires deep reflection with articulation and ownership of beliefs, feelings and experiences of the research remaining at the forefront of the analysis. Subjectivity in critical ethnography is an interplay of self with those within the research field. If it was all about my experience this would be an autobiography.
Critical ethnography demands positionality and awareness on the part of the researcher that his/her actions in studying and representing people and situations are acts of domination. Positionality forces the researcher to acknowledge their own power, biases and privileges just as they denounce the power that surrounds the subject and field (Madison, 2012).
Positionality is sometimes understood as reflective ethnography (Wolcott, 2008). This requires consideration and accountability for our research paradigms, our positions of authority and our moral responsibility related to representation and interpretation of the social group. Important questions of positionality need to be addressed in reflexive ethnography. In particular the use of the research, that is, who ultimately benefits and who gives the authority to make the claims we do about what we have been witness to? The background and the history of the ethnographer also need to be clarified. Do they share commonality with the social group, or do they have no past connection to the research topic (Madison, 2012)? This awareness is embraced to protect the research and findings from the researcher.
Critical ethnography is heavily entrenched in the dialogue with others. This is driven by our concern for others. Ethnographic positionality should not be confused with subjectivity, which is a domain of positionality. But positionality demands we project our attention beyond our individual or subjective self. Instead, we attend to our subjectivity in relation to and in our interactions with
others. We are subjects in dialogue with others to co-construct meaning from multiple perspectives (Madison, 2012). Madison (2012) contends that “critical ethnography is always a meeting of multiple sides in an encounter with and among others. One in which there is negotiation and dialogue toward substantial and viable meanings that make a difference in others’ worlds” (p. 10).
Critical ethnographic reflection examines culture, knowledge and action. It broadens the capacity to see, hear and feel expanding horizons and make choices. Critical ethnographers describe, analyse, open up hidden agendas to scrutiny, exposing power centres and assumptions that inhibit, repress and constrain. As individuals we live in a world where reality is taken for granted. This taken-for-granted world often seems too confusing, powerful or mysterious to delve beneath the surface. It is complex and difficult to see clearly and address the fundamental problems of social existence experienced on a daily basis (Thomas, 1993).
3.4.1 Ethical aspects of methodology
Critical researchers acting ethically have a responsibility to uncover injustices and challenge power. Care must be taken to not label a group oppressed if they do not believe they are oppressed (Madison, 2012). Research objectivity is a potential and dangerous illusion. Critical ethnography allows a researcher to commit to uncovering accounts that may reveal further questions. This provides depth and richness that can be found lacking in other research (Jones & Watt, 2010).
Critical ethnography begins with an ethical responsibility to address unfairness or injustice in a lived social field/domain. The ethical responsibility that is identified as the motivator for a critical ethnographic approach references a sense of duty, commitment and passion for compassion to enhance the lives of those individuals in this world/domain (Madison, 2012).
Critical ethnography demands the critique of the notion of objectivity as well as subjectivity (Madison, 2012). This critique demands that care be taken to avoid passing perceptions and feelings as fact. This includes ensuring that researchers are positioning conclusions that have convincing theoretical and empirical
linkage. Through exposing the researcher’s positionality, we allow accessibility and transparency while welcoming vulnerability to judgment and evaluation. This provides ethical responsibility for our own subjectivity as researchers and our political perspectives, resisting the trap of self-centeredness or presenting an interpretation as if free of ‘self’ with no accountability for consequences and effects (Madison, 2012).
Fieldwork is complex and personal experience is aligned with the philosophical positioning and theoretical framework of the research. Our intuition, senses and emotions are woven into who we are as individuals and researchers. These are inseparable from the processes of data collection. As researchers we invite the ethics of accountability and take a chance in being proven wrong (Madison, 2012).
3.5 Conclusion
Critical social constructionism with critical ethnography underpin the exploration of the research topic. It is core to this research to identify the approaches and perceptions of the Critical Care Registered Nurse toward CPD and social accountability. Critical social constructionism provides the avenue to explore ‘how’ nurses achieve this, while critical ethnography provides the ‘what’. This researcher aligns with the ethical requirements of researcher positioning. The intent is to bring positive change to a system of mandatory CPD that has a distinct mismatch between the rhetoric and reality. It is also viewed as having greater potential than what is currently being achieved.
This research needed to do more than describe how it is. A critical methodological approach provided the scaffolding to achieve this. The combinations of critical social constructionism, the exposing of power, with critical ethnography, the experience, the ability to ask what may be, contributed to possibilities of change. This research goes beyond explaining the situation as it is and creates thoughts of what could be.
In the next chapter, the methods will be discussed with a particular focus on congruency with the methodology.
Chapter 4
Research Design and Methods
4.1 Introduction
The design and methods of this research are grounded in the philosophical stance, theoretical perspective and methodology discussed in the previous chapter. This section of the thesis identifies and justifies the research processes used with detailed explanations of the techniques applied and the setting in which the research was undertaken (Crotty, 1998). This research embraced the complexity, details and contexts that surround the engagement of Critical Care Nurses (CCNs) with Continuing Professional Development (CPD).
The research design emerged with refinement of the data collection. Qualitative research embraces a non-linear approach more aligned with a circle, with continual examination and interpretation of the data to make decisions that guide the research in moving forward (Polit & Beck, 2012). Some decisions were made early on, such as the application of social constructionism and ethnography and the use of a collective case study design plus methods (e.g. interviews), to collect the data. Other insights and decisions, such as moving to a critical analytical lens, occurred only after gaining of insights from participants and greater understanding of the phenomena.
This chapter will present the choices and decisions made about design, sample, setting, rigour and ethical issues, providing an audit trail for a researcher to follow, which also speaks to the rigour of the study.