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Encouraging the use of reflexivity in the writing up of qualitative research



There is no set formula to guide researchers in writing up qualitative research projects. Much writing up of any research tends to eliminate the self-analysis of the researcher. This article analyses the author's position in relation to the qualitative research process. Reflexive research is defined as a method that fully embraces and exploits the subjectivity of the researcher. Increasing reflexivity of research can increase the credibility and trustworthiness of qualitative data. In this article, examples from a qualitative study are used to illustrate how much of the reflexive self-analysis undertaken as part of the original design was lost in the study's formal scientific write-up. The reasons why writers are reluctant to write about the ‘self’ in published journals are explored. Two different approaches to qualitative writing up are discussed: the ‘realist’ and the ‘confessional’ approaches. The confessional approaches that were lost in the design and process of this study are described, taking power relationships as a theme for the examples cited. The need for both confessional and realist tales in the writing up of qualitative research is considered in relation to participant visibility and service user empowerment.
Issues relating to how authors represent them-
selves in text are becoming more important
and more frequently discussed as a way of
increasing the quality and trustworthiness of
qualitative research (Denzin and Lincoln, 1998).
Writing is not just a ‘mopping up’ activity at the
end of the research project; it should also be a way
of knowing – a method of discovery and analysis.
There seems, however, to be little uniformity in the
way qualitative researchers report their work and
Miles and Huberman (1984) have confirmed this
view. They write:
‘There are no fixed formats, and the
ways data are being analysed and
interpreted are getting more and more
various. As qualitative analysts we have
few shared canons of how our studies
should be reported.’
Indeed, in traditional social science the focus origi-
nally was on ‘minimizing the self…denying it and
protecting its vulnerability’ (Krieger, 1991). While
recognizing the necessity of some researchers to
present quantitative results in an objective way, it
has been said that writing in a purely scientific way
for a scientific journal has a tendency to invoke a
passive, unengaged reader.
International Journal of Therapy and Rehabilitation, May 2006, Vol 13, No 5 209
Encouraging the use of
reflexivity in the writing up of
qualitative research
Barone (1990) feels that reading the kind of
texts, both quantitative and in more qualitative
approaches to social research, ‘which focus just on
facts to be retained’ and ‘actions to be performed’,
can only offer ‘one verbal version of reality’ and,
as such, could be regarded as unidimensional and
superficial. Barone advocates writing more reflex-
ively and revealing the self to portray a range of
worlds and experiences. Richardson (2000) also
advocates trying different writing styles in order to
discover new aspects of the chosen topic. However,
journals have not always been keen to publish a
variety of styles.
Greater illumination of the self in the research
and during writing up generates more realistic
qualitative research (Smith, 1996). Sparkes (2002)
echoes this and discusses a range of different
approaches to the writing up of qualitative work.
In this article, two of these different approaches
explored by Sparkes are discussed: realist tales and
confessional tales in relation to the writing up of
a specific qualitative research project (Smith et al,
2002; Smith and Roberts, 2005). It explores how
much of the reflexive discussion and self-aware-
ness, which emerged from gradually carrying out
a research project, is often lost from the final writ-
There is no set formula to guide researchers in writing up qualitative research projects. Much writing
up of any research tends to eliminate the self-analysis of the researcher. This article analyses the
author’s position in relation to the qualitative research process.
Reflexive research is defined as a method that fully embraces and exploits the subjectivity of
the researcher. Increasing reflexivity of research can increase the credibility and trustworthiness of
qualitative data. In this article, examples from a qualitative study are used to illustrate how much
of the reflexive self-analysis undertaken as part of the original design was lost in the study’s formal
scientific write-up.
The reasons why writers are reluctant to write about the ‘self’ in published journals are explored.
Two different approaches to qualitative writing up are discussed: the ‘realist’ and the ‘confessional’
approaches. The confessional approaches that were lost in the design and process of this study
are described, taking power relationships as a theme for the examples cited. The need for both
confessional and realist tales in the writing up of qualitative research is considered in relation to
participant visibility and service user empowerment.
Key words: reflexivity, qualitative research, writing up, realist tale, confessional tale
Smith S (2006) Encouraging the use of reflexivity in the writing up of qualitative research. Int J Ther Rehabil 13(5): 209–15
Susan Smith is
Principal Lecturer in
Physiotherapy, School
of Allied Health
Professions, Leeds
Metropolitan University,
Leeds LS8 1NX, UK
Susan Smith
as a method that fully embraces and exploits the
subjectivity of the researcher (Rolfe et al, 2001). It
has also been defined as the extent to which indi-
viduals can reflect upon themselves and modify
their actions and thought processes accordingly.
(West, 1994). Effective reflexivity means the ability
to treat oneself as the object of inquiry within the
world (Schon, 1987).
The notion of reflexivity implies a shift in
people’s understanding of the data and its col-
lection towards something that is accomplished
through internal dialogue and a constant scru-
tiny of ‘what I know’ and ‘how I know it’ (Hertz,
1997). Researchers, as authors, need to address
their position in relation to the research process
and all the other people involved in it (Coe, 1991).
Thus, researchers may need to think about the
political dimensions of their fieldwork and discuss
the different power relationships that might have
The need to consider how issues of gen-
der, class, age and disability might shape the
construction of knowledge must be considered.
All these issues may influence the researcher’s
interactions in the field; who gets studied, which
questions are asked and which are left unasked
(Sparkes, 2002), and how knowledge of the par-
ticipants in the study is constructed and portrayed
through text.
Reflexivity to enhance credibility
The concepts of ‘reliability’ and ‘validity’ are often
discussed in relation to the successful execution of
quantitative research. However, these words are not
appropriate terminology when discussing the legiti-
mization of qualitative research.
Denzin and Lincoln (1998) discuss credibility,
dependability and transferability as the key con-
cepts that increase the trustworthiness of qualita-
tive research. Rolfe et al (2001) discuss how to put
this into practice in qualitative research studies.
They suggest a number of ways that rigour can be
enhanced, ranging from making the process more
auditable, enhancing transparency of informal dis-
cussions, the researchers themselves reflecting on
and in action (Schon, 1987) and comprehensive
discussion and documentation of the involvement
of the self and the research practices to make the
process more visible.
Reluctance to put ‘the self’ in the research
It is not an easy process to write oneself into the
research. Authors shy away from the potential
for embarrassment and that their flaws might be
revealed in the public arena. As a result, research
reports are often rendered ‘devoid of human emo-
tion and self-reflection(Krizek, 1998).
International Journal of Therapy and Rehabilitation, May 2006, Vol 13, No 5 211
210 International Journal of Therapy and Rehabilitation, May 2006, Vol 13, No 5
ing up of a report and as such, is not permanently
recorded to enhance future practice.
This article does not concentrate on the specific
nature of the results themselves, but on issues relat-
ing to the reflexive behaviour of the project team
that were lost in the two objective (realist) write
ups of the project (Smith et al, 2002; Smith and
Roberts, 2005).
The article will also explore the concept of
reflexivity in relation to understanding data and the
credibility of the research itself. Reasons why writ-
ers are reluctant to write about the self in published
journals are explored. Confessional examples from
the study are cited and the reasons why much of
this thinking was not included in the realist tale are
The research sTudy: an ouTline
In this article, a qualitative study is used to illus-
trate examples of a more reflexive approach to the
analysis of the research process and the subsequent
write up. The study in question investigated current
occupational therapy and physiotherapy practice in
community rehabilitation to elicit areas of role dif-
ference, skill sharing and commonality within the
two professions (Smith and Roberts, 2005). The
study was carried out with service users, therapists
and managers to explore experiences of rehabilita-
tion practice.
The methodological framework was guided by
grounded theory concepts (Strauss and Corbin,
1998). This approach is based on developing a
theoretical understanding of all the participants’
lived experiences. ‘Thick descriptions’ (Denzin
and Lincoln, 1998) were therefore generated of
experiences, incorporating information about
context, actions and common-sense understand-
ings of therapy and rehabilitation. Focus groups
were chosen as the most effective way to gather
data (Kitzinger and Barbour, 1999). Transcripts
were analysed using thematic content analysis
(Atkinson, 1992), with a range of themes and
categories emerging.
The project coordinator (SS), a research assist-
ant and a steering committee of therapists, serv-
ice users and academic staff managed the project’s
design and execution.
In recent years, one of the emerging innovations
in qualitative methodology has been the impor-
tance that researchers place on reflexivity and it is
increasingly being used within both research and
the teaching and practice of health care. In terms of
research terminology, reflexive research is posited
Ellis and Bochner (2000) note that most writing
in the social sciences is in the third person, a pas-
sive voice as if written from nowhere by nobody.
They argue that traditional conventions militate
against personal writing:
‘Once the anonymous essay
became the norm, then the
personal autobiographical story
became a delinquent form of
expression…exercises in self-
indulgence autoethnographies – fear
of embarrassing yourself through
melodramatic self-exposure.’
The conFessional Tale
and The realisT Tale
Two approaches, commonly used in the writing up
of educationally-based research, which were also
considered appropriate for this particular qualita-
tive study, are discussed below. Both approaches
consider the effect of the presence or absence of
the researcher from the finished text.
Realist tales
Realist tales enhance the researcher’s role as an
impersonal source of information for information.
The measured intellectual style of the text is uncon-
taminated by personal bias or moral judgments. The
participants’ views are emphasized in realist tales
(Van Maanen, 1988). Realist tales are common in
qualitative research and personal experiences are
described using inductive forms of analysis. The
reader is subsequently able to gain insights into the
Realist approaches to the writing up of qualita-
tive projects have been published with confessional
tales of the same work, but often confessional tales
are regarded as an adjunct (Sparkes, 2002) and not
part of the ‘real data’ of the study.
Confessional tales
In contrast to the realist tale, where the voice of
the researcher is barely heard, the confessional
tale (Sparkes, 2002) emphasizes the voice of the
researcher. Such writing is intended to show how
each particular work came into being and to reveal
the tensions and dilemmas inherent in the process.
The fieldwork journey and the problems of the
process are the main facts rather than the findings.
Clear acknowledgement and exploration of bias,
character flaws, anxieties and vulnerabilities helps
to develop a self-portrait that readers can identify
with. For example, Van Maanen (1988) appealingly
describes how the author is the ‘active agent inven-
tive at getting by and winning little victories in the
research setting’.
International Journal of Therapy and Rehabilitation, May 2006, Vol 13, No 5 211
210 International Journal of Therapy and Rehabilitation, May 2006, Vol 13, No 5
Gorelick (1991) has considered how the
researcher is transformed in the process of
research, influenced and taught by her respond-
ents or participants as she influences them. She
emphasizes how these changes to the self of the
researcher should be clearly described in both the
writing up and any subsequent publication in order
to reveal the issues to the reader. Confessional tales
are ideal for this role.
Sparkes (2002) advocates that confessional tales
should exist in a symbiotic relationship to the real-
ist tales of the same research studies ‘by saying
what is often regarded as unsayable in the real-
ist tellings’. As such, they do not replace realist
accounts but stand beside them.
Confessional or realist?
The way the authors wrote up the project
A solely realist approach was adopted for the
writing up of this qualitative project (Smith and
Roberts, 2005). The way the original research report
was structured, how the sampling is described,
the underpinning literature review and the results
section are examples of this realist approach to
writing up.
This was because of the authors’ desire at the
time to present the findings in a ‘pure form’, and
primarily satisfy the write-up requirements of the
commissioning funders. All the group and self-
reflection was actually done outside the confines
of the formally presented content of the text.
There are only a few obvious examples of self-
exposure and reflexivity in the report (Smith et
al, 2002) and the realist tale (Smith and Roberts,
2005). For example, the authors clearly address
the method of analysis with a more confessional
approach in terms of discussing problems of the
interim analysis based on Miles and Hubermans
(1984) work. For example:
‘Such continuous analysis seemed
inevitable in this kind of qualitative
research. Because we were “in the
field” collecting the data and managing
the project on a daily basis, it was
impossible not to start thinking about
what was being seen and heard.’ (Smith
and Roberts, 2005)
The whole issue of reflective field notes is reported
in an objective way, primarily because of the need
to adopt a realist approach because of the house
style of the journal. Field notes and reflective
notes were written as the project proceeded. These
were sifted through and interpreted during regular
Emergent findings and methodological concerns
were discussed at the steering group meetings
(Smith and Roberts, 2005).
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212 International Journal of Therapy and Rehabilitation, May 2006, Vol 13, No 5
‘losT’ eXaMPles
The following section gives examples from the
study of areas where issues relating to how the
researchers represented themselves and others in
the text were discussed but not articulated in the
written report or realist tale. Specific adjuncts to
help reflection during the research process are
mentioned, as well as cited examples of informa-
tion revealed by the participants that influenced the
author’s thinking, but which were left out of the
formal realist tale.
Considerable self-exposure was undertaken by
the researchers relating to awareness of the needs
of the participants, the inherent power relationships
and issues relating to how the study could be fed
back into teaching practice at the university.
Field notes
Analysis of the researcher’s field notes and
‘hunches’ was used as part of the first stage of the
thematic content analysis. However, the majority
of these processes, logs and discussions were not
written into the f inal report. In fact, a large pro-
portion of the verbal discussions were never min-
uted at all. These issues (including whether to make
notes of informal conversations of meaning about
the project) have subsequently been raised at length
during the dissemination process at conferences, in
house feedback and in research meetings.
The reflective log
The researcher kept a reflective log for personal
development and to use as a trigger for discussions
during steering group meetings and supervisory
meetings. Reflective frameworks (Gibbs, 1988;
Atkins and Murphy, 1994) were used to structure
the documentation of critical incidents in the log.
Even so, it would be realistic to state that in prac-
tice, time pressure to complete the formal writing
up and the realist tale to meet the deadline meant
that much of the detail of the reflective log was not
brought into the open.
Many of the research assistant’s reflective obser-
vations made were sidelined because of the need
to meet the submission deadlines for the funded
project. Retrospective, comprehensive review of
these points has helped formulate good practice
points for a subsequent qualitative study undertaken
with a similar design.
The design
The Department of Health (2000) has made clear
the importance of the need to involve users and car-
ers in health service evaluation and research. With
this in mind, there were many discussions in the
planning stage with the service users about how to
engage them in the design, planning and evalua-
tion of this project. Issues that were discussed were
academic staff feeling unsure how to harness users
views effectively, perceived feelings of threat and
fear from all parties, the venues of planning meet-
ings and how this in itself can effectively disem-
power the service user. Roberts et al (2003) have
subsequently discussed a model for developing and
evaluating services based on issues raised from this
project and other projects with users in Derbyshire.
Steering group
A group of academics, clinicians and service users
was formed to advise the planning, ethical approval
and progress of the project. This group met three
times during the year-long project. Discussion was
based around a formal agenda with time allocated
for more informal chat about the project. Ideas for
this discussion came from the research assistants
reflective log. It was this ‘off the record’ discussion
which generated much useful information about the
flaws and strengths of the process the authors were
Many concerns, which were initially regarded
as ‘trivial’, ‘informal’ or ‘unimportant’, actually
became major discussion points when members
were encouraged to discuss them in the full group
– for example, issues relating to the outnumbering
of the service users by the clinical and academic
staff and the perceived threat this may have caused.
The service user participant found membership of
the group valuable. She said:
‘It wasn’t easy. It was interesting but
daunting at first. Over time I got drawn
in more and I got over my anxieties. Was
it worth it? Yes. I too learnt to look at
things differently, from the professional’s
point of view.’ (Roberts et al, 2003)
Steering group meetings were minuted in a loose
free-flowing style so the essences of the discussion
could be captured.
Power relationships or reciprocal
Researchers often ask participants to reveal their
vulnerabilities whereas the researchers reveal noth-
ing or little of themselves. By revealing oneself as
a researcher, one is attempting some form of reci-
There were clear attempts at reciprocity made
during this project. Empathetic questions were used
during the focus groups, social trigger questions
and responses written into the question framework
for the focus groups. However, after listening to the
tapes again it was clear that although the facilita-
tor was encouraging participants to relax, she was
revealing very little information about herself.
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212 International Journal of Therapy and Rehabilitation, May 2006, Vol 13, No 5
The counter argument could be that by reveal-
ing these tantalizing snippets of selected personal
information, all one was doing was encourag-
ing the participants to reveal more of themselves
and their thoughts. Consequently, this produces
the richer data, which could then be ascribed as
quotes to the already vulnerable participants. A
truly reciprocal relationship in qualitative research
is almost certainly more of a myth than reality
(Sparkes, 2002).
Manning (1997) states that the relationship
between the researcher and the researched is not
devoid of power differences. Negotiation of
this power often fails or, at a minimum, remains
problematic throughout the research. When the
researcher publishes the research and gains privi-
lege and advantages, such as recognition and tenure
from others’ lives, it is often impossible to fully
resolve inherent power differences.
In fact, it could be argued that a realist tale
that emphasizes the participants rather than
the researcher is a fairer way of redressing the
power relationship, which tends to advantage the
researcher over the participant. Are researchers, by
encouraging more reflection of self, in fact making
qualitative research reports less visible in terms of
the needs and views of the participant?
Some of the issues that related to the webs of
power that circulated in the research process are
outlined in Table 1. These were initially noted dur-
ing detailed field notes of the planning meetings,
focus groups and in the reflective log. In turn, this
catalysed discussion at the steering group meetings
about how to practically manage these issues
Despite the fact that different styles of writing up
(particularly in well-respected qualitative research
journals) are now being more frequently accepted,
there is still a tendency to shy away from a more
confessional stance.
Specific literature looking at allied health profes-
sionals also suggests that there may be a crisis of
Power relationship Manifested by participants Manifested by researchers Resolved by
Therapist clinicians n Clinicians expressing they were n Researchers feeling wary n Clear description of project
vs researchers wary of research, because they or nervous of clinicians’ n Ethical approval
had not been participants before criticism n Clear participant consent
n Perceived anxiety of n Focus group observation forms
confidentiality issues and leader expressed n Open-all-hours contact
concerns about dealing telephone numbers
with professional staff
in the focus group
All participants vs n Unclear about research process n Clear knowledge of n Formal and informal
researchers n Expectations of researchers design, process and plan briefing about expectations
n Poor understanding of focus n Question-and-answer
group purpose leading to session
anxiety about their performance n Facilitator encouraged to
discuss in a light-hearted
way other focus groups
and what went wrong or
right (generating the
sense that the facilitator
is a person not ‘at a
Service users vs n The disabled service users’ n Researcher’s desire for n Instigated easy access, taxi
researchers anxieties about accessibility of the group to run smoothly trips, etc.
chosen venue, problems with with optimum attendance n User choice over alternative
transport venues
n Not wanting to inconvenience n Flexible start times,
or burden the researchers opportunity to bring a
n Worry that future groups would friend or carer
clash with hospital appointments n Refreshments for all
n Thank-you letters
n Pre-focus group visit to
home to explain project
and leave contact number
Perceived power relationships between different research project participants and the research team
confidence in the profession and the current drive
for evidence-based practice is causing some thera-
pists to doubt their credibility (Richardson, 1999).
This dilemma is even more tricky when rehabilita-
tion therapists are interested in and sit on the cusp of
social science and research, which sits in more of a
science or health domain that has traditionally been
familiar with more formal styles of writing.
It is clear that research into health and social care
needs to highlight the needs of the service users
and the views of the participants. The more tradi-
tional realist style, which focuses on the findings
and subdues the researchers’ voices, has its place as
it identifies and publicizes needs and concerns and
helps pave the way to improving services. It could
be argued that the interests of the participants are
compromised by the confessional tale.
Self-reflection is all very well, but if health pro-
fessials are doing research in areas that have tra-
ditionally been neglected (rehabilitation, therapy
services and disenfranchised services users), then
their needs should be a priority. However, it is only
by critiquing their own work that professionals can
use it as a method of improving their own self-
reflection and the quality of their own research and
research of the future. There is no point in produc-
ing qualitative research that explores the needs of
the disempowered if the process is flawed and the
researchers continue to go on making the same mis-
takes in the future.
The writing up and publication of a full confes-
sional tale of qualitative work to complement the
traditional realist writing up of qualitative data is a
useful way of enhancing self-reflection, increasing
the credibility of research. It also provides a perma-
nent record of the small details of both the author’s
and the participants’ thinking, which may have a
deeper significance when analysed formally by the
research project team. This may be particularly valu-
able in highlighting and exploring broader social
issues affecting the researched, which may otherwise
have been lost.
Conflict of interest: none.
Atkins S, Murphy K (1994) Reflective practice. Nurs Stand
8(39): 49–54
Atkinson P (1992) The ethnography of the medical setting.
Qual Health Res 2(4): 451–74
Barone T (1990) Using the narrative text as an occasion for
conspiracy. In: Eisner E, Peskin A, eds. Qualitative Inquiry
in Education. Teachers College Press, New York: 315
Coe D (1991) Levels of knowing in ethnographic inquiry. Int
J Qual Stud Educ 4: 313–31
Denzin NK, Lincoln YS (1998) Collecting and Interpreting
Qualitative Materials. Sage, London
Department of Health (2000) The NHS Plan: A Plan for
Investment. A Plan for Reform. The Stationery Office,
Ellis C, Bochner A (2000) Autoethnography, personal narra-
tive, reflexivity. In: Denzin N, Lincoln Y, eds. Handbook of
Qualitative Research. 2nd edn. Sage Publications, London:
Gibbs G (1988) Learning by Doing: A Guide to Teaching and
Learning Methods. Oxford Further Education Unit, Oxford
Gorelick S (1991) Contradictions of feminist methodology.
Gender Soc 5(4): 459–77
Hertz R (1997) Introduction. In: Hertz R, ed. Reflexivity and
Voice. Sage Publications, London
Kitzinger J, Barbour RS (1999) The challenge and promise
of focus groups. In: Developing Focus Group Research:
Politics, Theory and Practice. Sage Publications, London
Krieger S (1991) Social Science and the Self. Rutgers
University Press, New Brunswick: 47
Krizek R (1998) Lessons. In: Banks A, Banks S, eds. Fiction
and Social Research. Altamira Press, London: 89–113
Manning K (1997) Authenticity in constructivist inquiry:
methodological considerations without prescription. Qual
Inq 3(1): 94–5
Miles M, Huberman A (1984) Qualitative Data Analysis.
Sage, London
Richardson B (1999) Professional development: professional
socialisation and professionalisation. Physiotherapy 85(9):
Richardson L (2000) Writing. In: Denzin N, Lincoln Y,
eds. Handbook of Qualitative Research. 2nd edn. Sage
Publications, London: 923
Roberts PA, Smith SV, Womack C (2003) Involving serv-
ice users and carers in developing and evaluating therapy
services. Abstract and presentation. Proceedings of 14th
International Congress of the World Confederation for
Physical Therapy, Barcelona
Rolfe G, Freshwater D, Jasper M (2001) Critical Reflection
for Nursing and the Helping Professions: A User’s Guide.
Palgrave Macmillan, Basingstoke
Schon D (1987) Educating the Reflective Practitioner. Jossey
Bass, San Francisco
Smith SV (1996) Ethnographic inquiry in physiother-
apy research 2. The role of self in qualitative research.
Physiotherapy 82: 349–52
Smith S, Roberts P (2005) An investigation of occupational
therapy and physiotherapy roles in a community setting.
Int J Ther Rehabil 12(1): 21–8
Smith S, Roberts P, Oldham N (2002) A Qualitative
Investigation of Occupational Therapy and Physiotherapy
Practice in a Community Rehabilitation Setting. Report for
the Faculty of Health and Environment, Leeds Metropolitan
University, Leeds
Sparkes AC (2002) Telling Tales in Sport and Physical
Activity: A Qualitative Journey. Human Kinetics Europe,
Strauss A, Corbin J (1998) Basics of Qualitative Research:
Techniques and Procedures for Developing Grounded
Theory. 2nd edn. Sage Publications, London
Van Maanen J (1988) Tales of the Field. University of
Chicago Press, Chicago: 46–7
West M (1994) Effective Teamwork. British Psychological
Society/Blackwell, Oxford
nThe reflexivity of the author should be regarded as an important way of
improving the quality of qualitative research in health and social care.
nMany different tools, such as reflective logs and discussion points generated
from field notes, can be used to enhance the author’s greater self-
n‘Confessional’ approaches to writing up of research should be encouraged
to complement more traditional ways of writing up research studies.
nThere is a dilemma between emphasizing the views and needs of under-
researched participants and using the self-reflective approach frequently
enough to encourage researchers to review their own process and practice.
nConfessional tales may expose the nature of the relationship the researcher
has with the participant, which may help redress the power balance
between the two.
nMore health- and social-care journals should embrace more reflexive writing
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214 International Journal of Therapy and Rehabilitation, May 2006, Vol 13, No 5
Accounting for reflexivity enhances
quality and increases researcher
sensitivity to informants’ concerns.
Reflexivity, then, is a matter of both
quality and ethics. Researchers are
reflexive when they are aware of
the multiple influences they have
on research processes and on how
research processes affect them.
There are many reasons to
account for researchers’ reflexivity.
Besides the promise of deepening
and broadening understanding of
the topical area to be researched,
accounting for reflexivity can add
to the integrity of the research. We
researchers are subjective, fallible
human beings who are full of biases
and favourite theories.
Ongoing scrutiny of ourselves
is a way for us to ‘come clean’ so
that we are less likely to unwit-
tingly impose our perspectives on
research participants and more likely
to provide an open venue for the
perspectives of informants to blos-
som. Indeed, through engagement
in such processes, the dependability
and authenticity of our findings will
be greatly enhanced.
We can account for our own
reflexivity in a several ways and at dif-
ferent points in the research process:
n Before and during the design
n During implementation processes
n While conducting the analysis
n During the write-up
n In the course of dissemination
n While applying findings to prac-
tice, teaching and other research.
I have found that both writing out
relevant thoughts, experiences and
emotions and talking to others
about them engages researchers
in processes of reflexivity. In team
meetings, researchers can share not
only their scholarly interpretations
of what they are learning from
informants, but also their personal
and professional interpretations.
Because qualitative research
often focuses on sensitive areas,
researchers’ own personal expe-
riences and traumas may be
triggered. I do not believe that
researchers are obligated to share
sensitive personal information in
team meetings, but they can keep
reflective journals for more private
considerations and have private
dialogues with significant others if
personal issues arise.
How much of our own accounts
of reflexivity do we put into research
reports? We as researchers should
include only those bits of reflexivity
that add to understanding research
processes, findings and applications.
After all, the research is about inform-
ants. Anything about researcher per-
spectives must advance the purposes
of the report (Gilgun, 2005).
We often are unaware of what
we think and feel until we write
about them and discuss them.
Thus, survey researchers and oth-
ers who are more quantitatively ori-
ented would enhance their work by
engaging in these processes as well.
Jane F Gilgun
Professor, School of Social Work
University of Minnesota
St Paul MN 55108
Gilgun JF (2005) ‘Grab’ and good science:
writing up the results of qualitative
research. Qual Health Res 15(2): 256–62
Reflexivity, in its basic form, is sim-
ply the process of turning something
back on itself. Freshwater and Rolfe
(2001) point out that for researchers,
this can mean one of two things.
On the one hand, reflexivity can
mean turning thought back on
itself; for example, when we reflect
on the thinking, planning and deci-
sions that we make as part of the
research process. On the other
hand, it can mean turning action
back on itself; for example, when
we modify what we do as research-
ers as a direct result of observing the
outcomes of our prior actions.
The author of this article focuses
almost entirely on the former of
these two processes, and in partic-
ular on the ‘confessional tale’, the
reflexive and necessarily subjective
writing up of her reflections on the
research journey. Her conclusion,
which is echoed by a number of
other writers (Mantzoukas, 2005;
Rolfe, 2006), is that such a ‘confes-
sional tale’ should accompany the
more traditional ‘realist tale’ as part
of the research report.
I wish to focus on the other,
perhaps more contested, meaning
of reflexive research as the turning
back of our actions on themselves.
This reflexive approach regards
research as praxis, or what Schön
(1987) referred to as reflection-in-
action, in which the researcher is
continuously modifying the research
process in response to the ongoing
and unfolding situation.
For example, the researcher might
take the decision to modify her
questioning technique in the middle
of an interview, based on her evalu-
ation that her current approach is
not generating useful data.
In Schön’s words, the reflex-
ive researcher is operating in the
‘swampy lowlands’ of practice
where nothing is certain and rigid,
predetermined ‘technical’ solutions
rarely resolve the complexities of
the real-life practice of research.
If, as the reflexive researcher
argues, predetermined, rigorous (in
the sense of being inflexible) rules
for the ‘best practice’ of research
cannot guarantee a successful out-
come, then the usual notion of valid
research is called into question.
Whereas traditional approaches
to research measure validity by
the extent to which the researcher
conforms to a predetermined
and previously validated method,
the reflexive researcher devel-
ops and changes the method as
she progresses. Clearly, such an
approach to research can make no
claim to objectivity. As Alvesson and
Skoldberg (2000) observe:
‘There is no one-way street
between the researcher and
the object of study; rather,
the two affect each other
mutually and continually in
the course of the research
The reflexive researcher makes no
pretence of detachment; she does
not claim to objectively and unob-
trusively observe the situation from
a distance and collect ‘pure’ uncon-
taminated data. Rather, she recog-
nizes that she is an integral part of
the research situation in which she
is participating.
Such a reflexive stance is of par-
ticular relevance for research con-
ducted in practice disciplines such as
physiotherapy, since it implies that
the researcher exerts an influence
over the practice she is attempting
to measure or understand.
Further, this influence is far more
extensive than the indirect effect
suggested by the Hawthorne effect
(Roethlisberger and Dickson, 1939),
and extends into territory that most
practitioners and researchers would
consider out of bounds or invalid.
If reflexive research is taken to
its logical conclusion, the distinc-
tion between researcher and prac-
titioner (and, significantly, research
and practice) are blurred or even
dissolved: practice becomes a form
of research, and research becomes
a way of doing practice.
Gary Rolfe
Professor of Nursing
School of Health Science
University of Wales
Swansea SA2 8PP, UK
Alvesson M, Skoldberg K (2000) Reflexive
Methodology: New Vistas for
Qualitative Research. Sage, London
Freshwater D, Rolfe G (2001) Critical reflexivity:
a politically and ethically engaged research
method for nursing. NT Research 6(1):
Mantzoukas S (2005) The inclusion of bias in
reflective and reflexive research. J Res Nurs
10(3): 279–95
Roethlisberger FJ, Dickson WJ (1939)
Management and the Worker. Harvard
University Press, Cambridge, MA
Rolfe G (2006) Validity, trustworthiness and
rigour: quality and the idea of qualitative
research. J Adv Nurs 56(3): 304–10
... Power and positionality are inherent with all research studies; yet we argue that a critically reflexive approach to IKT can better realize a critical analysis of power dynamics, language use, and Eurocentrism in the academy. Reflexivity is a "method that fully embraces and exploits the subjectivity of research" [64]. It is the active acknowledgment by the researcher that their own actions and decisions will inevitably impact the interpretation and context of the research inquiry [65]. ...
... Reflexivity is more than reflection; it requires a critical consciousness-raising and action derived from the researcher's positionality and understanding of the study [55]. Understanding the researcher's position within the study allows for insights into various power relationships that include intersectional systems of power such as racism, ageism, ableism, classism, and so forth [64]. Reflexivity also shifts the researcher's understanding of the data by considering the ontological, epistemological, and axiological components of the self, intersubjectivity, and the colonization of knowledge [65]. ...
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In Canada, the Eurocentric epistemological foundations of knowledge translation (KT) approaches and practices have been significantly influenced by the Canadian Institutes of Health Research (CIHR) KT definition. More recently, integrated knowledge translation (IKT) has emerged in part as epistemic resistance to Eurocentric discourse to critically analyse power relations between researcher and participants. Yet, despite the proliferation of IKT literature, issues of power in research relationships and strategies to equalize relationships remain largely unaddressed. In this paper, we analyse the gaps in current IKT theorizing against the backdrop of the CIHR KT definition by drawing on critical scholars, specifically those writing about standpoint theory and critical reflexivity, to advance IKT practice that worked to surface and change research-based power dynamics within the context of health research systems and policy.
... Within the current study, a service user representative was involved in discussions related to the design of Phase 1, and the service user also read all research documentation relevant to Phase 1. Having service user involvement in the design of the study can improve both the quality and relevance of research, and can ensure that research is tailored to the needs of participants (NIHR, 2021). Additionally, reflexivity is regarded as an important way of improving the quality of qualitative research (Smith, 2006). In the current study, the researcher wrote a pre-and post-data collection reflexive statement which made their beliefs, motivations and positions relevant to the research project explicit. ...
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Adults with autism are at high risk of experiencing mental health difficulties. It is therefore surprising that very little is known about the needs and experiences of this population in relation to accessing adult mental health services. This study had three aims: (1) to explore the needs and experiences of adults with co-existing autism and mental health disorder, (2) to establish whether a Health Board’s adult mental health services met the needs of these service users, and (3) to evaluate the knowledge of ASD amongst mental health professionals working within adult mental health services. This study utilised a parallel mixed-method design, consisting of two-phases of data collection. The first phase involved semi-structured interviews with adults with co-existing autism and mental health disorder(s) to explore their needs and experiences of accessing adult mental health services (N = 20). The second phase involved an online questionnaire to establish professionals’ knowledge of ASD, as well as the confidence that professionals had in their ASD knowledge (N = 58). The qualitative interviews from Phase 1 were analysed using Interpretative Phenomenological Analysis (IPA). Five superordinate themes were identified relevant to the needs and experiences of service users with co-existing autism and mental health disorder(s): (1) Experience of Autism Diagnosis, (2) Staff Awareness of Autism, (3) Facilitating Communication, (4) Dissatisfaction, and (5) Making Accommodations. The quantitative findings from Phase 2 indicated that mental health professionals may not possess adequate levels of ASD knowledge. Additionally, ASD knowledge held by professionals who had undertaken ASD training was significantly higher than those who had not received training, indicating that providing ASD training could be a means to increasing professionals’ ASD knowledge. The current study contributed to knowledge in the following ways: (1) it explored the experiences of adults with co-existing autism and mental health disorder(s) and identified the service needs of this population, (2) it established the current level of ASD knowledge and ASD confidence held by mental health professionals working in an adult mental health service, and (3) it resulted in the development of a questionnaire that can measure individuals’ ASD knowledge and ASD confidence. Recommendations for practice generated from the findings of the current study include a need for a clear and consistent pathway for autism diagnosis. Staff working within adult mental health services need to be provided with autism training, with staff also needing to ensure that they ask service users about their communication preferences. Mental health services need to move away from a crisis-driven provision to a service that works proactively to prevent mental health decline. A need for the Crisis Team to modify the way they currently provide support to the current population was evident as well as a need for healthcare environments to be accessible to adults with autism. Recommendations for future research are also provided within this thesis.
... A line-by-line coding procedure was introduced to analyze and categorize the data fragments. To minimize the research bias during the coding procedure, coders compared and contrasted the theoretical memos and engaged in reflexive behaviors, being aware of the social context in which data could be interpreted (Smith, 2006). After the open-coding process, an axial coding procedure was used to reassemble the data into major, higher-order categories. ...
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The bullet-screen function is an augmented comment feature that has been adopted by the majority of Over-the-Top (OTT) services to foster users’ interaction and watching experience. This feature empowers sports customers to post and view numerous, short, and fast-moving comments that overlap over the screen while watching live stream sports events in real time. This research aims to investigate how sports fans embrace the bullet-screen feature while watching live stream sports. Through a combination of thematic analyzing bullet-screen comments from a National Basketball Association Finals game, and semi-structured interviews among bullet-screen users ( N = 15), the results indicate that sport fans’ bullet-screen messages could be classified into five categories: critical commentary, socialization, supportive interactions, random messages, and trash talk. Four motives for sports fans to engage with bullet-screen posting were identified: entertainment, gathering information, interaction, and finding belonging. The study also showed that the inappropriateness of comments and too much overlay on the screen could prevent sports fans from utilizing the service. Theoretical and practical implications have also been discussed.
... En lo personal, estoy de acuerdo porque creo que esto serviría para enriquecer la investigación y nos permitiría proporcionar relatos valiosos para nuestros archivos, fortaleciendo así, nuestra memoria colectiva de la pandemia como investigadores. Sin embargo, todavía hay una renuencia a poner el "yo" en la investigación, ya que muchos académicos creen que cualquier movimiento fuera del recuento tradicional de un estudio en tercera persona, disminuiría su calidad (Smith, 2006). ...
... Four criteria were applied to achieve trustworthiness: credibility, transferability, dependability, and confirmability (Lincoln & Guba, 1985). An overarching reflexive stance was maintained throughout the research process to maintain the research's trustworthiness (Smith, 2006). ...
Parental Mentalization (PM) refers to parents’ capacity to understand internal experiences of their children. It is linked with the development of children, as deficiencies in PM can lead to adverse life outcomes. PM measures assess the quality of parental mentalizing capacities, which may then inform intervention and research. However, current measures are limited by complexity of use and sensitivity to assessing the multiple features of mentalizing. Hence, understanding the essential elements required in PM measures is needed to capture PM in ways which are ecologically valid while also being practical to administer in routine practice. This current study aimed to provide a qualitative understanding of how PM may be best captured. Specifically, it aimed to identify essential elements necessary in the development of accurate PM measures for use in clinical and research settings. The study reports data from semi-structured interviews with five leading experts in PM. Interviews were analyzed using thematic analysis. Three themes were identified: “Capturing the breadth and depth of multiple dimensions,” “Capturing natural interactions between parent and child,” and “Parent profiling.” This study highlights the essential elements which should be considered when choosing or developing PM measures. Clinical implications and further research for measure development are discussed.
... The interviews were conducted and recorded in conjunction with the collection of field notes [36][37][38]. This was to increase the trustworthiness and rigour of the data as well as the transferability of the findings [38]. ...
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Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) is a rare disease with no known etiology. It affects 0.4% of the population, 25% of which experience the severe and very severe categories; these are defined as being wheelchair-, house-, and bed-bound. Currently, the absence of biomarkers necessitates a diagnosis by exclusion, which can create stigma around the illness. Very little research has been conducted with the partly defined severe and very severe categories of CFS/ME. This is in part because the significant health burdens experienced by these people create difficulties engaging in research and healthcare provision as it is currently delivered. This qualitative study explores the experiences of five individuals living with CFS/ME in its most severe form through semi-structured interviews. A six-phase themed analysis was performed using interview transcripts, which included identifying, analysing, and reporting patterns amongst the interviews. Inductive analysis was performed, coding the data without trying to fit it into a pre-existing framework or pre-conception, allowing the personal experiences of the five individuals to be expressed freely. Overarching themes of ‘Lived Experience’, ‘Challenges to daily life’, and ‘Management of the condition’ were identified. These themes highlight factors that place people at greater risk of experiencing the more severe presentation of CFS/ME. It is hoped that these insights will allow research and clinical communities to engage more effectively with the severely affected CFS/ME population.
... As recommended by Smith, Flowers, and Larkin (2009), a reflexive log was kept of reflections on the interview process. These were used to encourage critical thinking and provide transparency (Smith, 2006). An interpretative process was adopted to help make sense of the data, identify patterns for both within and between the interviews and during the development of the themes. ...
Background: Professional rugby is an aggressive sport. Consequently, injuries are an inevitable part of a rugby player's career. It is therefore crucial for sports medicine professionals to understand the subjective experience of injured athletes in order to optimize their care. Objectives: The purpose of this study was to take a lifeworld perspective to explore how living with injury was meaningful to professional rugby players. Methods: A purposive sample of five participants were recruited and data collection undertaken via semi-structured interviews. Audio-recordings were transcribed verbatim and analyzed using interpretative phenomenological analysis methodology to develop the themes. Findings: Three master themes emerged from the analysis, each comprising of two subthemes; 1) Sense of Uncertainty (1a. Fear of the Unknown, 1b. Lack of Control), 2) Experienced Change in Relationships (2a. Lived Human Relations, 2b. Coping), 3) Sense of Self (3a. Isolation and Belonging, 3b. ''Being" an Athlete). Conclusion: Participants described the challenge to their sense of self and 'being' athletes', as the isolation from the team deprived them of their sense of belonging. Participants illustrated the experienced significance of their relationships, the uncertainty over their lives and the unique strategies to cope. Emotions of anxiety, grief, anger, and shock reverberate throughout their accounts.
This is a reflexive account of the messiness experienced by a Persian-Australian doctoral researcher interviewing social work and human service practitioners and people seeking asylum in Germany. This data collection was part of a cross-national comparative study of the impacts of policy on the experiences and perceptions of people seeking asylum and social work and human service practitioners in Bavaria and Western Australia. Through interview stories and the work of others, this article offers a first person account of the complexities, ambiguities and dilemmas that can occur before, during and after data collection, how these were navigated through the use of Finlay's (2012) five lenses for the reflexive interviewer, and some of the lessons learnt.
Many children experience some form of adversity in their childhood. These adverse childhood experiences (ACEs) can have long-term implications. Parenting group interventions were designed to support parents who struggle to act as the protective buffer against adversity, and provide skills and tools to be able to avoid maltreatment. Despite the wide-ranging impacts of ACEs, their influence on parenting intervention outcomes is relatively unknown. This study used a mixed-methods, triangulation design incorporating repeated measures, pre-post quantitative elements (n = 30) with qualitative aspects (n = 6) to evaluate the acceptability and effectiveness of a 10-week integrative parenting group, Understanding your Child’s Behaviour (UYCB; Douglas & Ginty, 2001) in an Irish-based sample. As the group also explores a parents’ own experiences of being parented, the effects of cumulative parental ACE scores on outcomes were also assessed. This is the first study evaluating the UYCBP in an Irish sample, and the first evaluating the effect of ACEs on UYCB outcomes. The group was experienced as ‘acceptable’. Perceived stress and parental self-regulation showed significant improvements, but no significant improvements on child-based measures were observed. There was no significant effect of ACEs at baseline or on intervention outcomes. Qualitative data revealed salient themes of “Seeing” the child; Parental self-regulation; and Experiences of being parented. The importance of adopting broader, more sensitive methods of researching ACEs as well as tracking parent progression over longer periods are discussed.
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This qualitative study investigated current occupational therapy and physiotherapy practice in a community rehabilitation setting to elicit areas of role difference, skill sharing and commonality within the two professions. The study was carried out with service users (n=4), occupational therapy and physiotherapy clinicians (n=11) and therapy service managers (n=9) to try and explore as many different opinions and experiences as possible. Focus groups were used to gather the data. The findings from this study were broad ranging. Service users were frequently unable to identify the difference between occupational therapists and physiotherapists. Skill sharing and the blurring of professional boundaries between occupational therapists and physiotherapists occured on a daily basis. Interdisciplinary team working was regarded as essential for an effective needs-led service by all the participants of the study. However, despite this, it appeared that professional tribalism existed between the two professional groups, which hampered effective team working at times. There was a general feeling that increasing interprofessional education at as early a stage in undergraduate training as possible was vital and would help increase awareness of other professional roles and prepare therapists for the reality of working life.
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Traditional interpretations of research tend to bifurcate research knowledge and practice knowledge, with knowledge derived from practice and direct interaction with patients being perceived as knowledge that is not formally admissible by the traditional scientific model. This paper proposes a research method that legitimises practice as a source of knowledge. Building upon the concepts of situational understanding and contingent knowledge, we advocate an integral research methodology, one which draws on the notion of the researcher-practitioner. Beginning with an analysis of knowledge and power we explore the contribution of reflexivity to the development of a politically and ethically engaged research process in nursing. In discussing critical reflexivity as a research method, we will outline the focus of reflexive research and the role of the reflexive researcher. Arguing against the superiority of theoretical research over practitioner research, we present a challenge to technical rationality, suggesting not only a new approach to research but also a new approach to practice.
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Principles concerning authenticity in constructivist inquiry are described in the context of the emergent paradigm. Suggestions are offered from which the researcher can choose to work toward, though never prescriptively guarantee, high-quality research findings.
Aim and intended learning outcomes The aim of this article is to encourage and enable nurses to develop an understanding of the nature of reflective practice and how this may enhance personal and professional learning. After reading this article, the nurse should be able to.
This article is a reflection on the analysis of ethnographic data gathered from a medical setting. On the basis of a rereading of field notes, the article identifies two modes of reading. The first, shared with many standard approaches to analysis, is based on the fragmentation of the text into categories and instances. The second seeks to recapture the narrative flow and order. It is suggested that the latter mode of reading illuminates the poetics of medical work.
Many feminists have aruged that researchers must “give voice” to hitherto silenced women by adopting “the view from below.” Critically reviewing the literature on feminist methodology, the author argues that this perspective, while absolutely essential, is not sufficient. Confining research to induction-based methods ignores the limits to such research: Ideologies of oppression are often internalized, while the underlying structures of oppression are hidden. Marxist approaches may help reveal hidden determinants of oppression, but they risk exacerbating inequalities between researcher and researched. Women's experience of a world shaped (and often segregated) by structures of inequality produces contradictory relationships among researcher and researched and requires a methodology that deals with difference and the blindness of privilege among women. Women's oppression is “a complex of many contradictions” and necessitates a new standpoint-based methodology, created by researchers and participants of diverse race, class, and other oppressed groups, refocusing and re-visioning knowledge based on theory, action, and experience.