ethnography qualitative research methods literature review

Running head: QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 1

Ethnography Qualitative Research Methods Literature Review

Bonnie Marko

University of Regina

Elizabeth Cooper

QUALITATIVE RESEARCH METHODS LITERATURE REVIEW 2

Ethnography

There are many methods of qualitative research that are successful in the analysis and

collection of data. Additionally, these methods enable researchers to become more knowledgeable

by utilizing their specific concerns or inquiries. It also allows researchers to understand individuals,

groups, or populations from the perspective and experiences. Ethnography is an effective way to

collect and gather data in qualitative research. Through my analysis of research articles, some

potential challenges and barriers may be present in some research settings.

Ethnography is a qualitative research method that involves a researcher putting themself

into a social environment for a prolonged period. It analyzes the individual's activities and actions

under the study observed by the researcher. While using ethnographic methods, the terms

"participant observation" and "ethnography" go together (Bryman & Bell, 2019). The role of the

participant observant is essential and necessary for success in ethnography. Additionally, access is

another feature of ethnography that is important and difficult. The researcher has to gain access to

the area that they desire to research.

There are two types of settings for ethnographic research, open and closed. Available

locations include libraries, parks, sidewalks, and secure grounds include firms, schools, and cults.

There may be challenges for a researcher to access both settings, and they may have to incorporate

a covert or overt role to gain access when necessary. Achieving access for a researcher to closed

locations requires planning, dedication, and sometimes luck. Access to open settings can require

assistance because researchers can get sponsors or gatekeepers to help them.

Ethnographers conducting research need to make notes or field notes. Quality fieldnotes

allow them to document events that they may forget later on. This method of note-taking includes


mental notes, jotted notes, and full-field notes. There are also analytic memos on all the

observations that reflect initial thoughts on what they may mean. Visual ethnography is every day

by ethnographers, and this involves photographs, video recordings, and visual media. This method

can be used for data collection and enhanced discussion among research participants. For example,

photovoice is a visual ethnography method where participants present photos to other participants

and document their perceptions and views to empower them while doing this activity.

Institutional ethnography is an approach that investigates how an institution influences

people's experiences, and relationships illuminate the power and control within the broader

population. Therefore, ethnographers will interview many individuals in the institution that will

provide any information for their research. Often, snowball sampling is used for the researcher to

identify further contacts and knowledge on the topic of study. This type of sample allows the

researcher to have access to information that is needed.

When researchers conduct ethnography research, their role can shift in the environment.

They can alternate from the complete participant, participant as an observer, observer as a

participant, and complete observer. One of the challenges or setbacks when a researcher immerses

themselves in a study, can forget their role as researchers. Moreover, researchers may have

negative feelings about the settings and situations in ethnographic research, causing biases and

distorting the research findings.

Lastly, ethnographers may have difficulties ending their research as there are no specific

hypotheses for testing. It can cause challenges for lack of a natural end of the research project, and

the researcher may be forced to end the research based on alternate factors. These factors include

stressful situations, exhaustion of funding, or the ethnographer's personal life can interfere. In any

case, the ethnographer has to provide a good reason as to why they ended the research. Ethical


considerations should be followed to keep all the individuals and social settings anonymous

(Brymann & Bell).

Underlying Ethnography. Qualitative Health Research, 26(7), 875–876.

https://doi.org/10.1177/1049732316645320

This article showcases and highlights the steps of ethnography and its' strengths and

weaknesses. Ethnography is a useful research method if conducted with the right approach, the

appropriate purpose, and the right environment. The researcher has to devote time to

ethnographic research and multiple data sets. There have been many changes to ethnography

over the years, and technological advances have taken place. There is much versatility in

ethnographic studies, and focus where the methods can change depending on the direction that

the investigation goes. It is a primary method for research in healthcare.

Ethnography in qualitative educational research: AMEE Guide No. 80. 35(8), 1365-e1379,

http://doi.org/ 10.3109/0142159X.2013.804977

This article highlights the methods of ethnographic research, and its benefits to

qualitative data collection. It includes gathering data, interviews, and documentaries in medical

research settings. Ethnography requires extensive periods to collect data and can require high

amounts of resources to sustain. Ethnography investigates different social and cultural groups

and individuals in a particular setting. It also allows the researcher to engage in the social and

environmental atmosphere of the area of research. Ethnography can be historically linked to the

1900s and involved the study of social groups. Some observational tools used in ethnography are

text, photos, videos, interviews, and history for data collection.

https://doi.org/10.1177/1049732316645320

http://doi.org/%2010.3109/0142159X.2013.804977


Moreover, the two main areas of data collection are fieldnotes and the final results. There

are many types of ethnographic studies that have evolved. These include feminist ethnography,

realist ethnography, genre ethnography, rapid ethnography, critical ethnography, online

ethnography, autoethnography, Theoretical discovery, and Theoretical refinement. By using

different ethnological methods by researchers, will improve their future health research quality.

(Reeves, Peller, & Goldman, 2013).

Ethnographic Article Analysis

Children's and Parents' Conceptualization of Quality of Life in Children with Brain Tumors: A

Meta-Ethnographic Exploration. Qualitative Health Research. 2019;29(1):55-68. https://doi-

org.libproxy.uregina.ca/10.1177/1049732318786484

This journal article was about an ethnographic study involving clinicians and parents of

children with brain tumors. This study was conducted to show the quality of life of children and

young people who have brain tumors. Ethical principles were necessary for this study, so

informed consent and debriefing of the survey with participants—the study aimed at looking at

their children's quality of life while dealing with brain tumors. A meta-ethnographic review of

the research determined the children's quality of life with brain tumors internationally from

2007-2016. The researchers used screening methods of peer-reviewed journals and found six

articles that matched the criteria.

Researchers interviewed young patients from four of these studies. In one of the studies

conducted, parents and children were interviewed. In one of the previous research, a parent

represented the deceased child. There are three main ethnography methods: reciprocal

translational, refutational synthesis, and lines of argument synthesis. These methods allowed the

https://doi-org.libproxy.uregina.ca/10.1177/1049732318786484



researchers to find the main concepts from the previous studies, and critical concepts were put

into data tables. This study's research results determined that the new circumstances of their

illness determined the survivors of brain tumors' quality of life. This study helped identify how

life quality differs from clinicians, parents, and patients with brain tumors. There is no universal

method of understanding quality of life and health-related quality of life for every person with

brain tumors, so the clinicians, parents have to discuss all factors that could influence this as

things could change.

The study showcases the current deficits for quality of life and health quality for brain

tumor patients and families. More recommended ethnographic research needs to follow families

and observe their consultations for how their quality of life changes and the disease progresses.

The researchers' initial review of previous articles lacked clinicians' quality of life understanding

and minimal about parents. There were also discrepancies in the locations of studies, which

impacts the quality of life and healthcare.

Ethnography is an excellent method for this study because the researchers analyzed

previous research and then took vital concepts about the influences of quality of life for brain

tumor patients and determined new normalcy after an illness. In this study, many unanswered

questions are still present, and researchers need more interaction with families, clinicians, and

young brain tumor patients. There is still little knowledge about how each of these groups feels

about the quality of life.


Participatory Ethnographic Evaluation and Research: Reflections on the Research Approach

Used to Understand the Complexity of Maternal Health Issues in South Sudan. Qualitative

Health Research. 2017;27(9):1345-1358.


The study was carried out in Sudanese women for 6 weeks, where 3 in-depth,

conversational interviews with each of 3 of their friends on 3 themes (each interview was based

on 1 theme). The researchers sought ethical consent and participant approval, where 16 women

were recruited initially but 2 discontinued. This study involved the method of participatory

ethnographic evaluation and research (PEER), which is a research method that enables people from

the community to gather information to make a difference in health care policies and procedures.

Most of the PEER researchers did not read and write so they would draw pictures as part of the

questioning process. The data collection in this study was carried out using an inclusive criterion

in women from Sudan who were of reproductive age, married with at least two children, able to

communicate orally in Arabic and not holding a specific position in the village they lived in.

Results were analyzed using the thematic data analysis. The strengths of PEER research in

ethnography is that it eliminates the time and challenge of building relationships with the

population of study for the researchers. Some difficulties that PEER research can cause is not

accurately reporting and verifying of the stories been provided. Moreover, in this study, some of

the participants were illiterates and images were used in interviews which become very subjective

with interpretation. The conclusion reflected the results that were generated in study.



Researching Reflexively with Patients and Families: Two Studies Using Video-Reflexive

Ethnography to Collaborate with Patients and Families in Patient Safety Research. Qualitative

Health Research. 2016;26(7):979-993.


This study was carried out in patients, families, and health care professionals in acute health

care settings. There were 2 studies, study 1 focused on patient safety in end of life care while study

2 focused on infection prevention and control study. The university and health care institution

granted ethics approval for the studies of end of life and infection control in acute care. The study

made use of Video Reflexively ethnography, which uses visual methods to involve patients and

families to the purpose of the study, in this case, patient safety. The researchers worked with

patients, clinicians and families to gather data in this study. An indigenous ethical framework was

used to analyze the data in this study. This framework focuses on participation and the participants

point of view. Video-Reflexively ethnography is described in this study and why it was beneficial

to the researchers. The results/data acquired on video were analyzed by clinicians and researchers.

The strengths of this research method allowed the researchers to build trusting relationships

and understanding of what all the groups perspectives were and how this was impacting their lives.

There were challenges due to ethical concerns and realities of patients, families and clinicians.

There were also difficulties with the researchers being more flexible with the participants and not

having more structured guidelines and this made it difficult for the research goals to be met. I think

that this method was a successful way to collect the desired data, but the researchers should have

incorporated more structured guidelines for participation. The researchers could have offered more

of an incentive if the budget allowed to increase the participation guidelines.



Catalyzing Trans disciplinarity: A Systems Ethnography of Cancer–Obesity Comorbidity and

Risk Coincidence. Qualitative Health Research. 27(6), 877-892. https://doi-

org.libproxy.uregina.ca/10.1177/1049732316656162

This research addressed the issues of obesity and cancer and utilized participation from

health care professionals working with cancer or obesity issues. Ethical consideration and

participant consent were acquired. This included data collection from a wide range of primary

informants such as nutritionists, community health educators, survivorship coach, community

screening educator, radiation and surgical oncologists, advocacy director, survivorship coach,

primary care physicians, nurse practitioners and endocrinologists. The researchers observed these

healthcare professionals in their work environments. A combination of purposive and snowball

sampling were used to identify the range of observations. After this period of observation semi

structured interviews were conducted to illuminate barriers present and how professionals work

together to treat obesity and cancer. The data was analyzed using conventional qualitative content

analysis and qualitative modelling.

Although this research highlights some of the causes of the obesity and cancer relationship,

it does not show all the factors that are present to showcase other important causative factors. Some

additional factors would include low-economic status and access to care in the United States. This

use of qualitative modelling is an added effective method that can capture important behavior

patterns and automatically producing descriptions close to personal insights. However, the

limitation to the modelling dwells in its idealization and simplification of reality, which needs to

be sometimes interpreted with caution. The sampling method of snowballing introduces selection

bias and limits the extrapolative and generalization of results. When addressing cancer and obesity




it is imperative that practice and protocols focus on collaborative medical care to address all the

factors and concerns involved.

More Than Words: The Use of Video in Ethnographic Research with People with Intellectual

Disabilities. Qualitative Health Research, 29(7), 931–943.

https://doi.org/10.1177/1049732318811704

This study investigates people with intellectual disabilities and beneficial programs for

people in 3 care farm organizations in the United Kingdom. Ethical permission was acquired as

well as consent from participants. Seven case study participants were selected and identified as

having an intellectual disability from the enrollment at the care farm. The study used a case study

design, where two rounds of data collection were performed longitudinally. This study was

conducted over the course of ten months to determine how the care farms effected the case study

participants. The researchers collected data by visiting the care farms and collected field notes as

well as video elicitation interviews, photographic participation and interviews. The research was

conducted through video to get more first-hand participation from the people with intellectual

disabilities as they have very little input into decision making research for programs. The

researchers used video to capture facial expressions, body language and physical interactions from

participants of the study.

Analysis from notes and visual data were analysed using inductive and interpretive approaches.

This was followed by a cross-case analysis. Although, a small sample size limits the power of the

study. The methods of visual ethnography in this study was beneficial and useful. It allowed the

researchers to have contribution of information and opinions from people with intellectual

disabilities in a different form and allows new outlets for data collection that may not have been

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used before. The researchers identified patterns and differences in the data sets to determine the

final common themes. Some challenges of this study were getting all the participants cooperation

based on their level of disability and cognitive challenges. In addition to this difficulty, secondary

information from caretakers, parents could be non-reflective. There were also varying

communication styles from many of the participants.

Potential Motivations for and Perceived Risks in Research Participation: Ethics in Health

Research. Qualitative Health Research, 23(7), 999–1009.

https://doi.org/10.1177/1049732313490076

This article is an ethnographic study in South Africa, and the research is on sensitive

subjects and gender-based violence. The participants were interested in this study for their

benefit and personal interests and others' use. There was a fear of reporting this study due to the

possible breach of confidentiality and gender biases. There are some risks associated with

working with human participants. The researchers conducted an initial survey and then did

another survey interview 2-3 months later. The first researcher initially introduced himself to the

community, got permission to conduct the study, and lived for three months there. The researcher

stayed in the community and participated in community gatherings, activities, and went out with

people in the community. Eventually, he found two research assistants, which he recruited to help

him select participants.

Potential participants were chosen from many diverse areas to encourage possible diverse

perspectives. The participants were selected based on different characteristics like age and

gender. The interviews were conducted in Zulu and Setswana, and the researcher did 22

interviews. The researcher kept notes during his stay in the community and was included in the

https://doi.org/10.1177/1049732313490076


analysis. He documented people's feelings about topics and the experiences and emotions he

encountered while interacting with others during the interviews. The video recordings and notes

were transcribed, and all identifying factors of the participants were removed. The gender

dynamics show that more women were available to do interviews, and men were more difficult

to find as they were working.

Sensitive questions were asked of the participants about gender violence, sexual violence.

A grounded theory was employed to analyze data and an inductive analysis performed then

assigned codes were given based on the transcripts. This research's strength is the researcher being

able to be in the community and analyze behaviors and situations from his perspective to address

specific issues reported in the interviews. A weakness of the interviews and data collection would

be the fear of participants to disclose all the information for fear of being judged or scrutinized.

This study could have been conducted differently, as many of the participants were scared

about the confidentiality of the topics and the subject's sensitivity was high. There were many

topics that they felt were sensitive and would be embarrassing to describe. There was positivity

in the research setting, being safe, and offering a chance to speak about these issues for the

participants.

An Auto-Ethnographic Study of the Disembodied Experience of a Novice Researcher Doing

Qualitative Cancer Research. Qualitative Health Research, 26(4), 482–489.

https://doi.org/10.1177/1049732315616625

This research examined illnesses and the effects of difficult work environments that

researchers may encounter. Consent from this research project was given by the researcher’s

current supervisor and the research project team. The study was revised to protect the identities of

the people in the study and consent was obtained from the ethical committee. The researcher used

https://doi.org/10.1177/1049732315616625


ethnography as the research method to document three situations that happened as a result of

suppression of emotions, traumatization and overidentification with participant. An auto-

ethnography was used, which incorporates evocative or emotional aspects. It reflects how a

researcher can experience different effects when dealing with participants who are in end-stage

diseases like 32 cancer patients that were part of the research. The researcher was assigned to study

these cancer patients who lived alone. She thought she could handle the situation and put her

feelings aside to take on this two-year research endeavor.

Due to the researcher making this research about herself, she has her thoughts and feelings

paired with the experiences of what happened to lead her to anxiety included in the research article.

During the research and the interviews, she was having flash backs to what the participants had

said and how it was affecting her while analyzing the results. She was also over identifying with

the participants which caused her own health and mental health issues. A limitation to this, can be

some sort of bias and skewness since she is assessing herself. The strength of this research method

is that the researcher got to talk about her own experiences doing research and how it caused her

emotional distress and things that need to be addressed for young researchers conducting research

on sensitive subjects in the future. The weakness of this research method is that the researcher is

conducting research on herself so it can be bias or just from her point of view and not geared

towards a larger population. She should have interviewed other researchers that encountered

similar situations. Focusing on support measures for researchers facing emotional distress from

doing sensitive research is imperative. This method of research could have been improved by

incorporating other participants and offering a survey or focus group to gather other thoughts and

feelings in this research setting.


The Differences in Antibiotic Decision-making Between Acute Surgical and Acute Medical

Teams: An Ethnographic Study of Culture and Team Dynamics Clinical Infectious Diseases, (69)

1, 12–20. https://doi.org/10.1093/cid/ciy844

This article discusses the use of antibiotics in medical and surgical acute care settings in

the United Kingdom. An ethnographic study was conducted in the London teaching hospital to

look at the Antibiotic Stewardship Program through observations and interviews with informants

within these settings. The results in this study determined that much of the decision making

depends on collaboration from pharmacists, infectious disease specialists and medical

microbiology teams.

Ethics approval was secured and consent from participants acquired. For a 2-year period,

participants were sampled through convenient sampling and data was collected through

observations, face-to-face interviews, and document analysis. The interviews were done prior to

the observations so it would not affect any of the antibiotic decision-making behaviors. Notes were

taken of the observations and other notes were taken of what the observer’s perceptions of the

recordings were. The method of ethnography was a beneficial tool for the researchers to utilize

because they could encounter the process by observation of the healthcare providers in the acute

care setting and analyze those findings compared to what the policies and guidelines are in

comparison. Data were analyzed using ground theory approach, using mainly inductive methods

of enquiry. The conclusion of this study determines that infection diagnosis in the emergency

department in the acute care setting in London determines antibiotic use. Different approaches

need to be addressed further to investigate methods to combat this systemic healthcare dilemma.

https://doi.org/10.1093/cid/ciy844


Navigating Nuances of Language and Meaning: Challenges of Cross-Language Ethnography

Involving Shona Speakers Living with Schizophrenia. Qualitative Health Research, 28(6), 927–

938. https://doi.org/10.1177/1049732318758645

This article shows how ethnography was used to analyze people's experiences living with

Schizophrenia living in Zimbabwe. This research was done by a bilingual mental health nurse to

interact and understand the participants. This ethnography's focus was to focus on this particular

culture and how they specifically are living with a specific illness. There are some ethical

considerations when doing cross-language research, which can reflect some ethical concerns.

The responsibilities that these studies have are different relations according to culture and beliefs

and practices. This study was approved by the University of Tasmania Ethics Committee and the

Zimbabwe Medical Research Council. Access to the participants had to be negotiated through

gatekeepers. The study was explained to the participants in their fluent language, and informed

consent was obtained. Researching people with mental health concerns requires ethical

sensitivity.

Semi-structured interviews were conducted and recorded. After the interview, a

questionnaire was completed to determine the participant's overall quality of life.The data

collection took place from September to November 2015. Semi-structured interviews were used

to collect data as well as recordings. After the interview a questionnaire was used to determine

the participants overall quality of life. Audiotaped interviews were analyzed.

This research's challenges and weaknesses were during language translation and

explaining emotional distress in a different language. Additionally, the researchers could have

cultural biases towards the participants due to the language barriers they encountered. They

could also misinterpret the participants' emotional cues, facial expressions, and opinions due to

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cultural differences. One strength of this research method is the ability to gather information and

data about living with mental illness in a different culture.

Facilitation of a Person-Centered Approach in Health Assessment of patients with chronic pain:

An Ethnographic Study. Qualitative Health Research, 29(4), 471–483.

https://doi.org/10.1177/1049732318770628

This article is an ethnographic study that focuses on the perception of the patient's chronic

pain from their perspective. The researchers analyzed a documentation tool with nurses and

patients that would gauge the patient's chronic pain and if it works well for the nurses and the

patients. This study focused on holistic patient-centered care and other factors involved with

chronic pain among patients. The limitation of this study is the Hermes tool that the research was

analyzing could be very subjective and not incredibly user friendly. Moreover, the study's

challenges are that this was only done at one rehabilitation facility, and it should have been done

at many facilities. The strength of this data collection method is that the researchers can observe

how the Hermes tool was used and strengthen the format of health documentation and assessment

strategies.

The data was collected through observational methods and semi-structured interviews with

the nurses. The sample size was small in this study, 14 people in total. There were only two men

and 12 women, so this data is skewed and cannot be generalized to men. This method was an

appropriate way to collect the data. However, the researchers could have interviewed more

healthcare workers involved in the care of patients in the rehab facility, increased the sample size,

and ensured that the sample included equal numbers of men and women.

https://doi.org/10.1177/1049732318770628


Identifying patient safety problems during team rounds: an ethnographic study

BMJ Quality & Safety 2014;23:667-669 http://dx.doi.org.libproxy.uregina.ca/10.1136/bmjqs-

2013-002324

This ethnographic study involves the observational data collection of patient safety

reporting methods collected for the Accreditation Council for Graduate Medical Education from

the academic veterans' affairs medical center. The method for data collection included a

structured data collection form. The patient safety issues were categorized, and the consequences

of each were collected. Descriptive statistics were performed. Eighty-eight patient safety issues

were noted in this study, and the most common patient safety issues were medication accounting

for 20% of cases. The research did not include possible adverse events that did not cause harm.

Ethical approval was granted, and consent was given. This study's limitations were that

most of the observations were done with one observer, and only one institution was used. The

sample size was small, and it would be hard to generalize to the population, and these factors and

variables could cause selection bias. The observational data collection method limitations for this

study are lack of interviews, so data collection would be hard to be observed. The data would be

biased because the information would only be taken from the two observers and no medical

staff's opinions or information. This study found that rounds in the hospital can enhance patient

safety in the hospital setting with education and participation. This method of analysis was

successful in gathering that data.

http://dx.doi.org.libproxy.uregina.ca/10.1136/bmjqs-2013-002324



Living with pulmonary hypertension: unique insights from an international ethnographic study

BMJ Open 2014; 4:004735. http://dx.doi.org.libproxy.uregina.ca/10.1136/bmjopen-2013-004735

This article represents an ethnographic study done with video footage, field notes, and

patient diaries to capture how pulmonary hypertension impacts patients' lives. The patients were

observed in their homes by the researchers to analyze their everyday life. Patients with pulmonary

arterial hypertension or chronic who were receiving Pulmonary Hypertension specific medication

were recruited through healthcare professionals and patient associations in seven countries across

four continents. 39 patients with pulmonary hypertension 19-91 years old and on specific

medications were selected for this study internationally. However, many of the patients had a poor

understanding of their illness. Patients were given informed consent, and the course was explained

to them before participation. They were also given study information from their health care

providers and patient associations.

This study's strengths are that it is the first ethnographic study that examined patients living

with pulmonary hypertension, which illuminates findings that other qualitative study methods may

not. It also has a broader sample selection and many variables as it focused on an international

demographic. This would be more applicable to a general population and allows for analysis of

disease traits and how patients' location influences the prevalence of the disease. This study's

limitation is that 75% were female, so the study could not be generalized to men.

Data collection for this study was done with observations and discussions to assess these patients'

real-life and experiences. The focus was on watching and listening to the patients, not questioning,

and diaries were given to the patients for their disease perspective. The data collection analysis

was done with footage from the seven countries the data was collected from. The footage was

transcribed into text in English, and critical themes were gathering through coding.


Some key themes were medication, social supports, compliance, and therapy. These themes

were compared and to showcase the patient's reported and actual behavior. This method was the

best method to use as it incorporated the patient's quality of life through videos and diaries to

collect data. The study showcased how patients perceive their illness as many patients in the study

is very secretive about the disease. Through the use of ethnography, the researchers could collect

data from seven different countries.

An ethnographic study of tobacco control in hospital settings Tobacco Control 2006; 15:317-322

http://dx.doi.org.libproxy.uregina.ca/10.1136/tc.2005.015388

This article's ethnographic study focuses on tobacco control and smoking cessation help

within by registered nurses. The study was conducted at two different hospitals in British Columbia,

Canada. Ethical approval was given from the University of British Columbia Behavioral Ethics

Board, and each of the two hospitals' ethical review boards. Data collection was done by observing

workplace activities within the hospital and designated smoking areas. There were unstructured

conversations with nurses and collected documents on 16 wards. Informed consent was obtained

from all the participants that talked with the researcher. This study included field notes, hand notes,

conversations, and photographs of the smoking areas.

The results of the findings from this study show the difficulties in managing tobacco use

in hospital settings. Many of the interviewed nurses believed that tobacco use in the hospital setting

was not the primary concern within their workplace priorities, and it smoking cessation is a task

for when the patient is treated and discharged home. Therefore, according to the research in this

study, nurses have a vague understanding of nicotine addiction in the hospital setting. Ethnographic

analysis used a non-linear inductive process that includes coding, sorting, theorizing, and reflecting



upon the analytic process. This study's strength is that two hospitals were used to illuminate the

findings and compare the dynamics of both hospitals to make the results more generalizable to a

population. Although not every workplace is the same so further research should explore different

workplace environments.

Causes of intravenous medication errors: an ethnographic study BMJ Quality & Safety, 12, 343-

347. http://dx.doi.org.libproxy.uregina.ca/10.1136/qhc.12.5.343

This article is based on an ethnographic study interested in the findings related to

intravenous medication errors and whether it is based on human error. An observer from this study

followed nurses while they were giving IV drugs on ten different wards in two hospital settings in

the United Kingdom. The human error theory was used to detect the causes of medication errors.

265 Intravenous drug errors were detected in the study. Data for this study was collected on 6-10

days in a row between June -December 1999. The observer made notes of details about what they

saw during IV preparation and administration. The researchers also talked to the staff during the

observations. The study was conducted and presented to the team as research to show common

challenges with the preparation and administration of IV drugs. The researchers obtained

permission to observe from every nurse. Ethics approval was granted from both the hospitals that

were involved in the study. The healthcare staff and pharmacies of the hospital gave permission as

well.

This ethnographic method's strength was using observation in this study as it allowed the

observer to see errors or mistakes that may not have been disclosed when the staff was interviewed.

The weakness is that although the analysis was performed in two hospitals, there should have been

more research done in different hospitals to make the findings more generalized to the healthcare

http://dx.doi.org.libproxy.uregina.ca/10.1136/qhc.12.5.343


population. Additionally, the observation could affect the results because the healthcare staff is

aware that they are being watched. They could feel pressure and not be able to perform their duties

at work in a natural manner.

This study detected that errors are being made by the nursing staff, but it is an issue of the

whole system. This study could have gathered further information if they interviewed more of the

healthcare team involved in the drug administration process and policies. The researchers could

have observed the pharmacists see how the medication is dispensed to the medical unit.

Creating Spaces in Intensive Care for Safe Communication: A Video-Reflexive Ethnographic

Study BMJ Quality & Safety, 23,1007-1013. http://dx.doi.org.libproxy.uregina.ca/10.1136/bmjqs-

2014-002835

This ethnographic study focuses on enabling a safe environment for healthcare staff to

communicate freely to enhance the workplace within two intensive care units. This study was

conducted in 2011 and included two intensive care units within one hospital in Sydney, Australia.

This study was part of a more significant three-year study, and there were 87 participants involved.

This study used video-reflexive ethnographic methods to determine how healthcare staff

effectively communicated in the fast-paced hospital environment. They did semi-structured

interviews and observations for five weeks with nursing, medical, healthcare staff members, and

administrative staff. They then did focus groups with the participants to discuss possible areas of

concern.

Ethics approvals for this study was granted from the University of Technology and the local

hospitals that participated. The participants had to consent before and after the video clips were

filmed, and they could refuse to be recorded at any time in the observation. It was found in this




study that healthcare providers and staff need space to effectively communicate and do their job

correctly, which affects patient safety.

This method of the study's strength reflected through interviews, observations, and focus

groups enabled the healthcare team to devise plans to make the intensive care unit safe for better

quality care. It also allowed the participants to be interactive with how improvements could be

made. This study's limitations are that the research was conducted in only one hospital's two

intensive care units. It makes the study results hard to generalize to other hospital units.

Additionally, there was no follow-up to find out if the solutions that were put in place worked or

did not work.

This study's ethnographic method was suitable because it allowed the individuals' feedback

to encounter private space difficulties in this environment to work on developing ways and

solutions to solve the problem. Further data is still needed to see if these solutions worked, and

more research needs to determine if this was helpful.

Beyond hand hygiene, a qualitative study of the everyday work of preventing cross-

contamination on hospital wards. BMJ Quality & Safety.26,552-558.


This article focuses on an ethnographic study highlighting the risks of cross-contamination

and infection transmission from surfaces and objects within the hospital setting. The study uses

reflexive video methods, including interviews, observation, video recording, and focus groups to

collect data. There were nurses, medical staff, students, administration, and cleaning staff as

participants. The study was part of a three-year project conducted in two hospitals in South Wales,

Australia. Ethics approval was granted from the University of Tasmania and the hospital's research



ethics committees. All the participants gave consent for interviews, recording, and observations

and could discontinue the video recording process at any time. The fieldwork was done for three

months in a 16-bed intensive care unit in one hospital in the study.

The remaining fieldwork was done at two other hospitals in two general surgical units.

A limitation of this study is that the methods used may not apply to all sites or hospital settings.

Further comparisons and research would need to be conducted to collect additional data analysis.

This study's strength is that utilizing reflexive video ethnography allows the researcher to collect

data multiple ways and allows the input from the participants to develop solutions to challenges

within their healthcare setting. The spread of infectious diseases in clinical practice is an ongoing

dilemma, and hand hygiene compliance is still not eliminating the problem. It was determined

through this study that moving bodies and objects have to be done in a methodical way to avoid

the spread of infectious diseases within the hospital environment.

Ethnography was the most beneficial method for this study. It is essential for researchers

to observe and get feedback from all different healthcare workers to enable research to influence

solutions and policy changes in infection prevention and the spread of pathogens.

Patients' perceptions of early supported discharge for chronic obstructive pulmonary disease: a

qualitative study. BMJ Quality & Safety,19, 95-98.

http://dx.doi.org.libproxy.uregina.ca/10.1136/qshc.2007.025668

This article is about an ethnographic study that describes patients' opinions about a supported

discharge service for people with chronic obstructive pulmonary disease. This early discharge

service shortens the patient's hospital stay from 3.5 days to 9.5 days with some home care services

in place. The participants selected for this study were 23 older adults with COPD that was

http://dx.doi.org.libproxy.uregina.ca/10.1136/qshc.2007.025668


exacerbated in 2005. Fourteen patients approved the first discharge service, while 9 of the patients

refused. These patients were from a lower socio-economical setting in England. Men and women

from different ethnic backgrounds were selected. They were invited to participate through a letter

or face-face interviews at their houses. The method for this ethnographic study was audiotaping,

semi-structured interviews, and face-face interviews. Ethics approval was obtained for this study

from the East London Research Ethics Committee. Data was analyzed through a grounded theory

approach from the interviews.

Some limitations of this study are that it was a small study with the participants from the

same England area. Many of the patients approached for the interviews were not available, and

most who did participate were not pleased with their care from the hospital. Their attitudes may

be subjective and, as a result, may create biases in their participation in the study. A limitation in

the hospital program was that many patients did not remember or understand the early discharge

program.

This study's strength is that it did answer the research question about how patients felt

about their care and the program that was offered. It showcases how early discharge programs can

be beneficial to patients and how they can prevent faster recoveries. One other study has looked at

this same topic and patients' perceptions of it. This method of research is beneficial for patients

and healthcare systems. It shows the effectiveness of programs like this. There is a need for further

research on patients' knowledge about the program's goals, consent issues, and how to manage

their chronic conditions at home properly.


The frequency of intravenous medication administration errors related to smart infusion pumps: a

multihospital observational study. BMJ Quality & Safety (2017). 26, 131-140.


This article is an ethnographic study about errors in administering intravenous medications

despite the use of smart pump technology. This study was conducted at numerous sites in the USA.

Ten hospitals using the intelligent pumps for IV administration were analyzed, and data was

collected based on the errors associated with their use. Based on the administrations, 60 % had one

or more associated errors.

There was an intensive care unit, surgical intensive care unit, a general surgical unit, and a

medical unit in the ten hospitals. This study was approved by the institutional review boards at all

the selected hospitals. All the personal health information went through a process to de-identify

the data. Two observers, a nurse and a pharmacist at each hospital, would collect data 2-4 days a

week from February to August 2013. The observers would like asses if compliance with the

medication administration policies were being followed. If a critical error were present, the

observer would identify it and let the nurse know immediately.

The study's limitations are that it was geared to point out the prevalence of the occurrence

and included a few observations. Only the administrations that would cause harm were identified

in this study, but the ones that caused harm after the administration were not investigated. The

researchers did realize that the errors that reached the patient were not being documented, so they

did decide to include this information in the study. This study also involves selection biases as the

hospitals were not chosen randomly. Many intravenous medications were not included in this

study; only the researchers and observers observed.



The strengths of this study are that the researchers recruited trained observers to analyze

the process of smart pump IV administration. They would be able to detect potential errors

correctly and possible adverse events that could happen. This ethnographic study method research

effectively collected the data, but further research needs to identify the potential effects of IV

medications administered through the smart pump in different randomly selected hospitals.

Elizabeth Cooper - Sat, 14 Nov 2020, 9:24 PM

Bonnie,

Remember to watch the instructions for the assignment. You were to provide the keywords for each article (-5%)

Part 1: I’m not entirely sure what you did here, but you did capture some of the key items that you need for the method. I

would have liked to see a little more about analysis.

Part 2: I am missing the summary of the key points of the articles. Instead, you seem to go directly into the application of the

method. You were able to capture most of the key issues related to ethnography, you identified key analysis features and

strengths/challenges in many cases. I wasn’t always clear on the ethical process or if you believed that other methods would

resonate better to answer the questions posed.

Really good work.

86%-5%=81%

TOTAL: 24.3

https://urcourses.uregina.ca/user/view.php?id=112014&course=14731


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ethnography qualitative research methods literature review

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