codes, concepts and categories, oh my! building your skills in · categories, oh my! building your...
TRANSCRIPT
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Codes,conceptsandcategories,ohmy!Buildingyourskillsin
qualitativedataanalysisASSOCIATIONOFPEDIATRIC PROGRAMDIRECTORS
ANAHEIM2017
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Welcome!AlyssaBogetz,MSW(StanfordUniversity)
ErikaAbramson,MD,MS(WeillCornellMedicalCollege)
HilaryHaftel,MD,MHPE(UniversityofMichigan,AnnArbor)
MelissaKlein,MD,MEd(CincinnatiChildren’s)
Su-TingLi,MD,MPH(UniversityofCalifornia,Davis)
KateMichelson,MD,MMSc (BostonMedicalCenter)
ArabellaSimpkin,MD,MA(HarvardMedicalSchool)
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DisclosuresTheauthorshavenofinancialrelationshipsorconflictsofinteresttodisclose
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Objectives1. Defineanddifferentiate3commonqualitativeanalytical
approaches
2. Recognizewhichanalyticalapproachisappropriateforagivenresearchquestionandgoal
3. Analyzequalitativedatathroughthedevelopmentofyourowncodingschemeandthemes
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Agenda1. Briefintroductiontoqualitativeresearch 3:15-3:25pm2.Discuss theconceptandprocessofcoding,categoryandthemecreation
3:25-3:35
3.Activity1:Codeatranscript 3:35-4:004.Activity2:Create categoriesandthemes 4:00-4:205. Discusshowtoselectananalyticalapproach 4:20-4:306.Q&A,summary andworkshopevaluation 4:30-4:45
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WhatisQualitativeResearch?ANDWHENSHOULDYOUUSEIT
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QualitativeResearch•Designedtounderstandtheperspectivesandexperiencesofindividualsorgroups
•Subjective• Emphasizesmeaning,interpretation
•Inductive• Goalistogeneratehypotheses,developtheories
•Reflective• Acknowledgesresearcher’sroleandbiases
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Whenshouldyouusequalitativemethods?•Explore aproblemorissueindepth
•Understandvariablesthataredifficulttomeasurequantitatively• Informsurveydesign
•Empowerindividualstosharetheirstories,giveavoice
•Explain howideaslinktogetherinexistingtheoriesormodels
•Generatenewtheories
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QualitativeResearchRequiresRigorQuantitativeCriteria
QualitativeCounterpart
Definition
InternalValidity Credibility Truthvalue
ExternalValidity Transferability Applicability
Reliability Dependability Consistency
Objectivity Confirmability Neutrality
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QualitativeResearchRequiresRigorQuantitativeCriteria
QualitativeCounterpart
Definition
InternalValidity Credibility Truthvalue
ExternalValidity Transferability Applicability
Reliability Dependability Consistency
Objectivity Confirmability Neutrality
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QualitativeResearchRequiresRigorQuantitativeCriteria
QualitativeCounterpart
Definition
InternalValidity Credibility Truthvalue
ExternalValidity Transferability Applicability
Reliability Dependability Consistency
Objectivity Confirmability Neutrality
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AnalyzingDataCODING,CATEGORYANDTHEMECREATION
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AnalysisConsiderations•Whowillbepartofyouranalysisteam?
•Howwillyoudividethework?• Everyonecodesalltranscripts• EveryonecodesfirstXtranscripts,agreesoncodingschemaandthendividesuptheremainingtranscripts
•Whatwillyouusetohelporganizeyouranalysis?• Qualitativeanalysissoftware(Atlas.ti,Dedoose,Hyperresearch,Nvivo,etc.)• Excel• Notecards
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DataAnalysisSteps•Readthroughdata•Developpreliminarycodelist• Code– word/phrase(oftentakenverbatimfromtext)whichrepresentsasingleidea• Singlewords,phrases,sentences,orparagraphscanbecoded•Discusscodelistwithcolleaguestofinalizelistandcreatecodebook(iterativeprocess)•Coderemainingtranscriptsusingcodebook•Organizecodesintolargercategories•Organizecategoriesintolarger,overarchingthemes(thematicanalysis)
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Code→Category→Theme
Theme
Category Category CategoryCategory
Theme
Code – word/phrasewhichrepresentsasingleidea
Category – word/phrasetodescribeagroupofcodes
Theme – word/phrasetodescribebroader,overarchingidea
Code Code Code Code Code Code Code
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Topic:Self-DirectedLife-LongLearninginMedicineQuotesThereseemstonotbeenoughtimeintheday.SometimesIfindI’mjusttootiredtofocusonreading.Morepressingissues ofday-to-dayworkandpatientcareTimeconstraints withworkTimeWhenI’mhomeIwanttodootherthingsBeingtiredHavingtoomanyotherpressingmatters toattendtoBeingconstantly tiredTimeBalancing workandfamily
LiST,etal.SuccessfulSelf-DirectedLife-LongLearninginMedicine:AConceptualModelDerivedfromQualitativeAnalysisofaNationalSurveyofPediatricResidents.AcademicMedicine.2010;85(7):1229-1236.
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Self-DirectedLife-LongLearninginMedicineQuotes CodeListThereseemstonotbeenoughtimeintheday.SometimesIfindI’mjusttootired tofocusonreading.
Time
Morepressingissues ofday-to-dayworkandpatientcareTimeconstraints withworkTimeWhenI’mhomeIwanttodootherthingsBeingtiredHavingtoomanyotherpressingmatters toattendtoBeingconstantly tiredTimeBalancingworkandfamily
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Self-DirectedLife-LongLearninginMedicineQuotes CodeListThereseemstonotbeenoughtimeintheday.SometimesIfindI’mjusttootired tofocusonreading.
Time
Morepressingissues ofday-to-dayworkandpatientcare
Tired
Timeconstraints withworkTimeWhenI’mhomeIwanttodootherthingsBeingtiredHavingtoomanyotherpressingmatters toattendtoBeingconstantly tiredTimeBalancingworkandfamily
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Self-DirectedLife-LongLearninginMedicineQuotes CodeListThereseemstonotbeenoughtimeintheday.SometimesIfindI’mjusttootired tofocusonreading.
Time
Morepressingissues ofday-to-dayworkandpatientcare
Tired
Timeconstraints withwork Patient care/learnerbalance
TimeWhenI’mhomeIwanttodootherthingsBeingtiredHavingtoomanyotherpressingmatters toattendtoBeingconstantly tiredTimeBalancingworkandfamily
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Self-DirectedLife-LongLearninginMedicineQuotes CodeListThereseemstonotbeenoughtimeintheday.SometimesIfindI’mjusttootired tofocusonreading.
Time
Morepressingissues ofday-to-dayworkandpatientcare
Tired
Timeconstraints withwork Patient care/learnerbalance
Time BalancinglifeandworkWhenI’mhomeIwanttodootherthingsBeingtiredHavingtoomanyotherpressingmatters toattendtoBeingconstantly tiredTimeBalancingworkandfamily
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FromCodestoCategories
Codes Categories• Time pressures• Tired
??
• Balancing pt.care/learning
• Balancinglife/work
??
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FromCodestoCategories
Codes Categories• Time pressures• Tired
Environmental Strain
• Balancing pt.care/learning
• Balancinglife/work
CompetingDemands
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Code→Category→Theme
Theme
Category EnvironmentalStrain
CompetingDemandsCategory
???
Code – word/phrasewhichrepresentsasingleidea
Category – word/phrasetodescribeagroupofcodes
Theme – word/phrasetodescribebroader,overarchingidea
Code Code Code Time Tired Pt-care Life-work
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Code→Category→Theme
Theme
Category EnvironmentalStrain
CompetingDemandsCategory
BarrierstoAchievingLearningGoals
Code – word/phrasewhichrepresentsasingleidea
Category – word/phrasetodescribeagroupofcodes
Theme – word/phrasetodescribebroader,overarchingidea
Code Code Code Time Tired Pt-care Life-work
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Theme:BarrierstoAchievingLearningGoalsQuotes Code Category
• Thereseemstonotbeenoughtimeintheday
• Time• Timeconstraints withwork
Timepressures
Environmental Strain
• SometimesIfindI’mjusttootired tofocusonreading
• Beingtired• Beingconstantly tired
Tired
• Havingtoomanyotherpressingmatters toattendto
• Morepressingissues ofday-to-dayworkandpatientcare
Patientcare-learnerbalance
CompetingDemands
• Balancingworkandfamily• WhenI’mhomeIwanttodo
otherthings
Life-workbalance
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Howmanycodes?•Dependsonresearchquestion•Startwithlargenumber,thenrefineovertimethroughadditionalanalysis(iterative)anddiscussion(peerdebriefing)
•Endresult=25-30codes->4-5themes
•Singletranscript=10-15codes
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SmallGroupActivity1:PracticeCoding1. Independentlyreadthetranscriptanddevelopa
preliminarylistofcodesusingtheworksheetprovided
2. Insmallgroupsof3-4,discussyourcodelistsanddevelop1agreed-uponlist
3. Reapplyagreeduponcodelisttoyourowntranscripts
25min
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SmallGroupActivity2:CreateCategoriesandThemes1. Inyoursmallgroupsof3-4,reviewyourcoded
transcriptsanddecidehowtoorganizeyourcodesintocategories
2. Fromyourcategories,develop2-4themesthatrepresentthedataandhowideasarerelated
3. Bepreparedtoshareyourthemeswithyourtable
20min
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3ApproachestoAnalysisCONTENT,THEMATICANDGROUNDEDTHEORY
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SelectingAnApproach1. Researchgoal
2.Datathatyouhave
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Research Goal Type ofData
Content • Describedataasis• Quantifycodesorcategories• Comparefrequencyof
categoriesbetweengroups(residentsv.fellows)
• Open-endedsurveyquestions
• Structuredinterviewsorfocusgroups
• Essays/narratives
Thematic • Develop themes• Interpret”bigpicture”
meaningofdata
• Structured orsemi-structuredinterviewsorfocusgroups
• Essays/narrativesGroundedTheory
• Generateatheoryorconceptualmodelabout aprocess/socialphenomenon
• Semi-structured interviewsorfocusgroups
• Essays/narratives
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ResearchQuestions
Howdoresidentsandfellowsdifferinthestrategiestheyusetocultivatetheirownwellnessduringtraining?
Whatfactorsfacilitateresidentwellnessduringresidencytraining?
Whatfactorsfacilitateresidentwellnessand whatistherelationshipbetweenthese?
ContentAnalysis
ThematicAnalysis
GroundedTheory
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Descriptive ⇢ Transformative
Code Code Code
ContentAnalysisThematicAnalysis
GroundedTheory
Developcategories
Countfrequencyofcategories
Developcategories
Combinecategoriesintothemes
Developcategories
Combinecategoriesintothemes
Generatetheory/modelforhowthemesrelate
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Whatdoesitmeantobe“well”duringresidency?CONTENT,THEMATICANDGROUNDEDTHEORYANALYSIS
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ContentAnalysisCodes Categories
• Finding moments• Notagoal
Wellness isaprocess
• Effort• Practice• Dailyoccurrence
Requiresdeliberatepractice
• Mindfulness• Deepbreathing• Attention/awareness• Gratitude
Involvesconnectingto oneself
• Meaningful connectionwithpatients, co-residents,significant others/friends
Involves connectingtoothers
• Peace• Joy• Grounding
Outcomes ofwellness
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ThematicAnalysisCodes Categories Themes• Finding moments• Notagoal
Wellness isaprocess
EffortEveryDay• Effort• Practice• Dailyoccurrence
Requiresdeliberatepractice
• Mindfulness• Deepbreathing• Attention/awareness• Gratitude
Involvesconnectingtooneself
Connection
• Meaningful connectionwithpatients, co-residents, significantothers/friends
Involves connectingtoothers
• Peace• Joy• Grounding
Outcomes ofwellness BeingWell
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ThematicAnalysisEffortEveryDay◦ Wellnessisaprocess,notanendpoint,andrequiresintentional,dailyeffort.
Connection◦ Wellnessinvolvesseekingandcultivatingasenseofconnection:tooneselfthroughmindfulnessandattention;topatientsandcolleaguesthroughmeaningfulrelationships;andtoone’sworkandworkplacethroughengagement.
BeingWell◦ Whenpracticed,wellnessleadstoasenseofgrounding,joyandpeace.
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Beingwell(Peace,joy,gratitude,grounding)
Connection(Withoneselfandothers)
EffortEveryDay(Deliberateeffortandpracticeovertime)
GroundedTheory
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Descriptive ⇢ Transformative
Code Code Code
ContentAnalysisThematicAnalysis
GroundedTheory
Developcategories
Countfrequencyofcategories
Developcategories
Combinecategoriesintothemes
Developcategories
Combinecategoriesintothemes
Generatetheory/modelforhowthemesrelate
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Conclusions•Codingisthebuildingblockofallqualitativeanalysis•Approachyouselectdependson:• Researchgoal• Typeofdata•Analyticalapproachshouldbedeterminedearly:• Researchquestionandstudydesign•Embracetheprocess,consultwithqualitativeresearcherifpublicationisgoal
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