Editor's Note: The online version of this article contains a figure of the steps of the qualitative research process described in the Rip Out series.
The Qualitative Collaborative
Qualitative inquiry is an increasingly popular way of answering important questions in graduate medical education (GME). Qualitative inquiry primarily focuses on the lived experiences of individuals in multidimensional and unique social contexts. It is also used to examine social settings and their affiliated processes. Given these focal areas, qualitative approaches are particularly well suited to answering “why” and “how” questions. Answers to such questions are critical to the exploration and understanding of different social phenomena.
For example, GME scholars might ask the following:
Why are third-year residents in this program struggling with interprofessional collaboration?
How do residents navigate the competing demands of meeting professionalism expectations and circumventing health care system constraints?
Why do residents perceive a particular educational intervention as a successful training tool for some skills but not others?
These are important areas of inquiry and areas that may be difficult to explore using only quantitative methods.
Qualitative inquiry is fundamentally different from quantitative inquiry, as each is based on different scientific traditions and world views. As a result, even when a GME clinician educator is familiar with quantitative research, those experiences and skills are generally not directly transferable to qualitative research. Given this situation, clinician educators regularly seek out researchers with qualitative expertise for advice.
When clinicians pose questions about qualitative research to their qualitative colleagues, clinician educators soon learn that there are few unambiguous, straightforward answers to their questions. In fact, and perhaps frustratingly, the answers to these practical questions are often: “It depends” or “That's not possible.” For instance, consider the following common question: How many interviews do I need to conduct to answer my question? The answer: It depends. The number of interviews you will need to conduct is contingent on (1) the question you are asking and (2) the methodology you are using to answer that question.
Deborah Simpson, PhD, Deputy Editor, JGME
Anthony R. Artino Jr, PhD, Deputy Editor, JGME
The Journal of Graduate Medical Education's (JGME) Rip Out section was introduced in June 2011 to facilitate readers' ongoing development as educators. Rip Outs are meant to provide practical, evidence-based approaches that align with the roles and responsibilities of graduate medical education (GME) faculty and leaders. As these Rip Outs are now among the most frequently accessed JGME content, we are introducing a new Rip Out focus that will appear in parallel with the existing series. These new Rip Outs are designed to answer readers' questions about approaches in GME research and evaluation, whether they wish to more fully understand the literature or are considering participating in this research.
The first Rip Outs in this new series offer practical information about qualitative research, including some of the different methodologies, associated data analysis approaches, and underlying principles inherent to qualitative inquiry. These qualitative Rip Outs grow out of the questions commonly asked by GME leaders and faculty that, if systematically answered, could advance scholarly inquiry in GME. Using the Journal's established Rip Out format, JGME Deputy Editor Anthony R. Artino Jr, PhD; JGME Qualitative Rip Out Series Editor, Lara Varpio, PhD; and a diverse team of experts in qualitative research provide succinct, action-oriented guidance on how to conduct qualitative inquiry. Each qualitative Rip Out is grounded in examples commonly seen in GME, and covers a breadth of topics ranging from the analysis of evaluation comments and observations to providing advice for conducting effective interviews and focus groups.
While seeking advice from qualitatively savvy colleagues is advisable, it has been our experience that the number of qualitatively trained scholars in medical education is insufficient to meet the demand in GME. In the spirit of helping members of the GME community with their qualitative research endeavors, the Journal of Graduate Medical Education (JGME) has commissioned a series of research-oriented Rip Outs to focus on qualitative inquiry. The authors of these Rip Outs (collectively represented in the authorship line as “The Qualitative Collaborative” and introduced individually in the box) present some common questions GME educators ask about how to engage in qualitative scholarship. In addition to explaining the “it depends” and “that's not possible” answers to common questions, each Rip Out describes clearly defined next steps GME scholars can take to move their qualitative inquiry forward. Each of these publications will also include a list of resources for different qualitative topics. Thus, while these Rip Outs will not provide sufficient information to make the reader a qualitative research expert, they will answer questions with which scholars new to qualitative inquiry often struggle.
Lara Varpio, PhD, Qualitative Rip Out Series Editor, Associate Professor, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
Dorene Balmer, PhD, Associate Professor, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
Sayra Cristancho, PhD, Assistant Professor, Department of Surgery, Centre for Education Research & Innovation, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
Maria Athina (Tina) Martimianakis, PhD, Assistant Professor, Department of Paediatrics, Cross Appointed Scientist, Wilson Centre, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Maria Mylopoulos, PhD, Assistant Professor, Department of Paediatrics, Cross Appointed Scientist, Wilson Centre, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Stella Ng, PhD, FAAA, Assistant Professor, Department of Speech-Language Pathology, Director of Research, Centre for Faculty Development Scientist, Centre for Ambulatory Care Education, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Laura Nimmon, PhD, Postdoctoral Fellow, Centre for Health Education Scholarship, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
Bridget O'Brien, PhD, Associate Professor, Department of Medicine, Office of Research and Development in Medical Education, University of California, San Francisco, California
Elise Paradis, PhD, Assistant Professor, Department of Anesthesia, Scientist, The Wilson Centre and Postgraduate Medical Education, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Terese Stenfors-Hayes, PhD, Assistant Professor, Department of Learning, Informatics, Management, and Ethics, Karolinska Institutet, Solna, Sweden
Arianne Teherani, PhD, Associate Professor, Department of Medicine, School of Medicine, Office of Research and Development in Medical Education, University of California, San Francisco, California
Sarah Wright, PhD, MBA, Assistant Professor, Toronto East General Hospital and Centre for Ambulatory Care Education, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
We have organized these Rip Outs in an order that mirrors the steps of the research process and have answered questions that tend to arise at each stage (figure provided as online supplemental material). Through these Rip Outs we hope to answer the mail that frequently populates our inboxes.
We faced a particular challenge in developing this series of Rip Outs: providing practical, concise support to GME scholars while at the same time providing enough explanation of the philosophies and traditions that underlie qualitative inquiry to be true to the breadth and rigor of it. In this series of qualitative Rip Outs, we aim to honor both of these demands. We hope these Rip Outs will inspire and support GME educators to engage in qualitative inquiry, but we also want to be transparent about the time and expertise required to do rigorous qualitative studies. In this way, we hope to balance theory and practice to answer some common questions about qualitative inquiry in GME.
The views expressed herein are those of the authors and do not necessarily reflect those of the US Department of Defense or other US government agencies.