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How to…write a good research question


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This paper, on writing research questions, is the first in a series that aims to support novice researchers within clinical education, particularly those undertaking their first qualitative study. Put simply, a research question is a question that a research project sets out to answer. Most research questions will lead to a project that aims to generate new insights, but the target audience and the methodology will vary widely. The term ‘evaluation question’ is used less commonly, but the same principles apply. The key difference is that evaluation questions are typically more focused on the immediate context: for example, the effectiveness of an educational intervention in a particular setting. Whether your ambition is for research or evaluation, we hope that you will find this paper helpful for designing your own educational projects. A research question is a question that a research project sets out to answer
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104104 © 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education. THE CLINICAL TEACHER 2018; 15: 104–108
How to...
How to…write a good
research question
Karen Mattick
, Jenny Johnston
and Anne de la Croix
Centre for Research in Professional Learning , University of Exeter , Exeter , UK
School of Medicine , Dentistry and Biomedical Sciences , Queen s University Belfast ,
Belfast , Northern Ireland , UK
LEARN! Academy , Vrije Universiteit Amsterdam , Amsterdam , the Netherlands
VUmc School of Medical Sciences, Amsterdam , the Netherlands
This paper, on writing research
questions, is the fi rst in a series
that aims to support novice
researchers within clinical educa-
tion, particularly those undertak-
ing their fi rst qualitative study.
Put simply, a research question
is a question that a research
project sets out to answer. Most
research questions will lead to a
project that aims to generate new
insights, but the target audi-
ence and the methodology will
vary widely. The term ‘evaluation
question’ is used less commonly,
but the same principles apply. The
key difference is that evaluation
questions are typically more fo-
cused on the immediate context:
for example, the effectiveness of
an educational intervention in a
particular setting. Whether your
ambition is for research or evalu-
ation, we hope that you will fi nd
this paper helpful for designing
your own educational projects.
A research
question is a
question that a
research project
sets out to
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© 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education. THE CLINICAL TEACHER 2018; 15: 104–108 105
Most clinical teachers will
undertake a research
project, evaluate their
education practice or prepare a
conference poster at some point
in their careers. Most clinical
teachers will also explore the
published literature on a topic
relevant to their practice: for
example, a teaching innovation,
assessment strategy or student
support approach. These activi-
ties can be enhanced by writing a
research question in order to
think clearly about what you are
doing and why; however, not all
clinical teachers have had
training in how to write a good
research question, and this is not
as straightforward as it may
seem. Writing questions for
qualitative research, in particular,
might be new for many health
professionals. This article aims to
share some tips and frameworks
that the authors (medical
education researchers who have
published quite extensively) have
found useful, which we hope will
support clinical teachers who are
novice researchers in the educa-
tion sphere, and perhaps provide
a helpful refresher for more
experienced researchers.
A good question can make
people pause and see things in
a different way, or can motivate
them to learn more through
discussion, an internet search or
literature review. When a child
asks their parents why the sea
is blue, the parents may need to
consult an information resource
before providing a well- informed
answer! Thinking critically about
everyday taken- for- granted
assumptions or practice prob-
lems, to enable new potentially
transformative viewpoints to
be articulated (a process called
‘problematising’), is one of the
most useful ways of generat-
ing research questions. A good
research question will send the
researcher on a quest to identify
or collect data that can be ana-
lysed and interpreted, such that
it provides new insights.
So what are the features of a
good question? First and fore-
most, the question should focus
on an important topic. Ask
yourself what will happen if this
research is not done – does it
really matter? Who will benefi t
from it? Good questions are
often co- created with those who
may use or benefi t from the
ndings. Look at the priorities
identifi ed by journals, funding
bodies or priority- setting
exercises in the clinical educa-
tion fi eld to see what others
think are important questions.
Sometimes new data might
prompt a research question: from
the fi ndings of a national survey,
for example. Other research
questions are driven by a theory
or hypothesis about what is
happening in practice. It is not
uncommon for research questions
to start out by being quite ‘local
and particular’, focused on the
immediate educational context,
but they can often be developed
into questions with broader
Good research questions are
usually quite narrow or specifi c,
but often do not start out that
way. You might start with a
general theme or idea for
research (e.g. motivation for
learning), which develops into a
more specifi c question over time
(e.g. how do medical school
graduates engage with e- learning
resources outside their working
hours?). Novices often ask very
broad questions, but these are
unlikely to be answered in a
short time frame and can lack
direction and impact.
developing a research question,
you will need to consider whether
it can be answered through the
existing published literature or
whether new data must be
collected. Reviewing the litera-
ture is only manageable if the
question has clear boundaries. In
research, we are often contribut-
ing a tiny step to the existing
knowledge, rather than making
huge leaps. Small contributions
are better than no changes at all.
So a long, specifi c question is
likely to be preferable to a short
vague question.
To illustrate these points
Table 1 provides some specifi c
examples, and in the next section
we discuss some key
Here, we highlight some things
to think about as you develop
your research question, building
on the points raised above. These
analyses are not intended to be
undertaken in any specifi c order.
The considerations fall into three
main categories (Figure 1 ), which
can be thought of as broadly con-
cerning the relevance, originality
and rigour of the research ques-
tion, and which are interrelated
and partly inspired by the UK
Research Excellence Framework.
You may start with any one of
the categories and revisit each
one multiple times. In doing so,
you may change your research
question slightly or completely.
Don t be disheartened if you go
through many iterations; time
spent on this process is always
well invested.
Begin by identifying and ar-
ticulating the important societal
or practice problem that you
wish to research. To consider
the signifi cance of the research
question for different audiences,
try articulating the problem in
multiple ways, perhaps working
with different stakeholders from
the clinical education fi eld to
do this (Box 1 ). Talk about your
project idea in lay terms and
observe people s reactions with
an open mind. The process will
require you to think clearly and
from different perspectives.
Ask yourself
what will
happen if this
research is not
done - does it
really matter?
Who will
benefi t from it?
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Ensure that the
research ques-
tion will lead to
original work
that generates
new insights
Another key consideration is to
ensure that the research question
will lead to original work that
generates new insights and does
not duplicate previous research,
which can be determined through
a literature review. There are many
different approaches to literature
so you can tailor this
to the purpose. If you can fi nd an
existing research study or review
article on your topic of interest
that answers (or partially answers)
the question you are trying to de-
ne, then you may not need to do
the study you had fi rst envisaged.
This is good news, as your time
can now be spent extending that
work and contributing to knowl-
edge, rather than unintentionally
duplicating what is already known.
Rigour: is the question aligned
with the methods? Do the
research tools generate
appropriate data to answer the
Originality: what is
already known about
the topic? Which debate
does it add to?
Relevance: what is the
importance or relevance
of the topic for
Figure 1 . Three interrelated elements of research question development
Table 1 . Examples of research questions in clinical education
Research question Source Our comments
How do people learn? Created by the authors Too broad! The question spans many disci-
plines (education, psychology, sociology,
anthropology) and the answer is likely to
depend upon the ‘people’ studied.
Do postgraduate trainees
like lectures? An interview
Created by the authors Not aligned! The question demands a yes/
no answer, but the methodology will
provide words as data. The question also
focuses on learner satisfaction, but could
be developed to consider knowledge gain
or behaviour change.
How can we increase the
number of applications for
a fi xed number of medical
school places?
Created by the authors This question is only important if there
are insuffi cient high- quality applicants
to fi ll the places. Its importance could
be increased signifi cantly by focusing on
particular demographic groups who are
underrepresented at medical school.
What interactional struc-
tures are used in feedback
sequences during general
practice bedside teaching
Rizan et al. (2014)
The importance of this research question for
clinical education is clear. This is a ques-
tion that is probably better suited to data
in the form of words.
How does cognitive empathy
specifi c to the doctor–
patient relationship, as
assessed in much of the
previous work, change
over the course of medical
Smith et al. (2017)
This long, specifi c question explicitly builds
on previous work and is probably better
suited to quantitative data collection.
In PICO terms, the population repre-
sents medical students, the intervention
is a medical school, the comparison is
between students at the beginning and
end of medical school and the outcome is
cognitive empathy.
PICO: patient, intervention, control/comparison, outcome.
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© 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education. THE CLINICAL TEACHER 2018; 15: 104–108 107
Once you have identifi ed the prob-
lem that you wish to research and
know what research has already
been undertaken, you will be able
to articulate the gap in the lit-
erature that you wish to address.
Lingard s paper on ‘Problem, Gap,
Hook’, which suggests articulating
a current problem, highlighting
an important knowledge gap and
convincing the audience that this
gap is problematic, is a useful way
of thinking about this.
Ensuring that the research
question and methods of data
collection and data analysis are
aligned is a key element of rigour.
Research questions may suggest a
particular type of answer. For ex-
ample, some questions demand a
yes or no answer, some require a
number or a ranking as an answer,
and some may be better answered
with data in the form of words .
It is worth noting that different
people may be drawn to particular
types of question: some favour
‘What’, and some favour ‘Why’ or
‘How’, and these preferences are
shaped by their knowledge and
prior experiences. Generally, ques-
tions focusing on experiences,
viewpoints, group processes and
personal development tend to
lend themselves better to qualita-
tive research.
Questions may also be shaped
by researchers’ preferred meth-
odological tools, which are
inevitably interlinked with the
way that they see the world:
example, whether they have a
qualitative or quantitative
orientation. Talk to fellow
researchers. What kind of study
design would they anticipate
from this question? What kinds of
theories and methodologies
might be useful in answering this
question? Even towards the end
of your research project, when
drawing conclusions, refer back
to the research question to
ensure the coherence of the
When drafting your research
question, there are some useful
frameworks that you can use
to help you think clearly about
what you are doing and about
the components of your research
question. Readers might be
familiar with Kirkpatrick s model
for evaluating learning and the
expanded version described
by Barr et al., which consid-
ers different types of education
outcome that may be explored.
Much clinical education research
to date has focused on learner
satisfaction, but it is possible
to design research that consid-
ers knowledge gain, behaviour
change or patient outcomes.
Bloom s taxonomy is useful for
thinking about the descriptors
used in relation to educational
Readers might
also be familiar with the PICO
(patient, intervention, control/
comparison, outcome) frame-
with SPIDER (sample,
phenomenon of interest, design,
evaluation, research type) pro-
viding a qualitative alternative.
The SPIDER framework can help
to spell out the key elements of
a question for qualitative work.
Once you have started your
research project, revisit the
research question regularly. Some
projects evolve and drift during
the study, and ultimately do not
answer the research question. It
is easy to lose sight of the
question in the midst of the
all- absorbing research process.
Different elements of research
need constant realignment with
each other and Agee reminds us
that this is critical to the shaping
of research studies, particularly
qualitative studies.
Keep the
research question foremost in
your mind throughout the
A good research question takes
time to create, but time in-
vested in this process is always
1 . Dennis AA , Cleland JA , Johnston
P , Ker JS , Lough M , Rees CE .
Exploring stakeholders’ views of
medical education research priori-
ties: a national survey . Med Educ
2014 ; 48 ( 11 ): 1078 1091 .
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the science and the art . Med Educ
2002 ; 36 ( 7 ): 596 597 .
3 . Anonymous . Research Excellence
Framework . Available at http:// . Accessed on 8
January 2018.
Questions may
also be shaped
by researchers’
Box 1 . Examples of stakeholders in clinical education
Teachers and learners in health care disciplines
o undergraduate
o postgraduate
o continuing professional development
Patients and the public
o of all ages and demographic groups
o in hospital and community settings
o individually and through patient groups
Policy makers
o universities
o hospitals
Health care systems
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108 © 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education. THE CLINICAL TEACHER 2018; 15: 104–108
Keep the
research ques-
tion foremost
in your mind
throughout the
4 . Wong G . Literature reviews: who
is the audience? In: Cleland J ,
Durning SJ , eds. Researching Medical
Education . Chichester, UK : John
Wiley & Sons, Ltd ; 2015 : pp. 25 34 .
5 . Lingard L . Joining a conversa-
tion: the problem/gap/hook
heuristic . Perspect Med Educ
2015 ; 4 ( 5 ): 252 253 .
6 . Tai J , Ajjawi R . Undertaking and
reporting qualitative research . Clin
Teach 2016 ; 13 ( 3 ): 175 182 .
7 . Bunniss S , Kelly DR
. Research
paradigms in medical
education research . Med Educ
2010 ; 44 ( 4 ): 358 366 .
8 . Kirkpatrick Partners . The
Kirkpatrick Model . Available at
Kirkpatrick-Model . Accessed on
13 December 2017.
9 . Barr H , Freeth D , Hammick M ,
Koppel I , Reeves S . Evaluating
Interprofessional Education: A
United Kingdom Review for Health
and Social Care . London, UK :
The British Educational Research
Association (BERA) and the United
Kingdom Centre for Advancement
of Interprofessional Education
(CAIPE) ; 1999 .
10 . Bloom BS , Engelhart MD , Furst EJ ,
Hill WH , Krathwohl DR . Taxonomy
of educational objectives: The classifi -
cation of educational goals. Handbook
I: Cognitive Domain . New York, NY :
Longmans, Green and Co. ; 1956 .
11 . Schardt C , Adams MB , Owens T ,
Keitz S , Fontelo P . Utilization of
the PICO framework to improve
searching PubMed for clinical
questions .
BMC Med Inform Decis Mak
2007 ; 7 : 16 21 .
12 . Cooke A , Smith D , Booth A .
Tool for Qualitative Evidence
Synthesis . Qual Health Res
2012 ; 22 ( 10 ): 1435 1443 .
13 . Agee J . Developing qualita-
tive research questions: a
refl ective process . Int J Qual
Stud Educ 2009 ; 22 ( 4 ):
431 447 .
14 . Rizan C , Elsey C , Lemon T , Grant
A , Monrouxe LV . Feedback in
action within bedside teaching
encounters: a video etho-
nographic study . Med Educ
2014 ; 48 ( 9 ): 902 920
15 . Smith KE , Norman GJ , Decety J .
The complexity of empathy dur-
ing medical school training: evi-
dence for positive changes . Med
Educ 2017 ; 51 ( 11 ): 1146 1159 .
Corresponding author s contact details: Prof. Karen Mattick, Centre for Research in Professional Learning, University of Exeter, St Luke s
Campus, Heavitree Road, Exeter, EX1 2LU, UK. E-mail:
Funding: None.
Confl ict of interest: All three authors teach on this topic to postgraduate students and supervise Masters and Doctoral-level project
students, giving feedback on these kinds of issues. KM is Senior Associate Editor for The Clinical Teacher .
Acknowledgements: We thank Esther Helmich, Aileen Barrett, Deirdre Bennett, Anu Kajamaa and Terese Stenfors for providing feed-
back on the draft manuscript. They, together with the authors, form a research network named the European Centre of Excellence in
Qualitative Study and Inquiry in Training and Education (EXQUISITE), led by Esther Helmich at the University of Groningen.
Ethical approval: No ethical approval was sought, as the work is based on secondary data and on our own experiences. No primary data
are presented.
doi: 10.1111/tct.12776
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... Good research questions are complex involving critical thinking and are relevant, focused, and feasible (Mattick et al., 2018;McCombes, 2019). The FINER criteria is a useful tool for writing good research questions (Cummings et al., 2013); FINER is an acronym for feasible, interesting, novel, ethical, and relevance. ...
... To establish relevance of a topic or issue, Mattick et al. (2018) advise using the following questions as a guide: "What will happen if this research is not done -does it really matter?" and "Who will benefit from it?" (p. ...
... 105). Additional guidance for establishing relevance is gaining familiarity with current literature on the topic/ issue and journal/funding organization research priorities (Mattick et al., 2018;McCombes, 2019). Keeping abreast of the literature helps with identification of a gap, thus strengthening the relevance of the study. ...
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Implementation of evidence-based practices is an expectation in healthcare and nursing, requiring knowledge and understanding of evidence-based practice (EBP) and research. Recent evidence shows that nurses' lack of knowledge contributes to nurses' lack of participation in EBP and research and their ability to differentiate between the two posing challenges with writing clinical questions and research questions. The purpose of this article is to provide foundational education on the differences, similarities, and relationship between EBP and research, and provide guidance for writing clinical practice and research questions.
... Focused literature on this topic is also not common. [1][2][3][4][5] Improper research questions are one of the foremost causes of manuscript rejection. 6 Research questions are often generated by either observing regularities or irregularities, the latter contributing a larger share. ...
... Several frameworks have been suggested for constructing a comprehensive research question in medicine. They include PICOT (patient, intervention, control, outcome, and time frame), FINER (feasible, interesting, novel, ethical, and relevant), and SPIDER (sample, phenomenon of interest, design, evaluation, and research type).[2][3][4][5] While the critical significance of a research question in the scientific process cannot be underestimated, what counts is, how it is put into action. ...
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This text is freely available on the net or researchgate
... In the following section, the approach of partially automating the SLR conduction is presented. As mentioned in [1,6,11], it is essential as a first step of SLR, to formulate research questions (RQ). As shown in Fig.1, the first stage of the SLR cannot be automated as researchers need to identify what they want to capture from the SLR process and why. ...
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Systematic Literature Reviews aim at investigating current approaches to conclude a research gap or determine a futuristic approach. They represent a significant part of a research activity, from which new concepts stem. However, with the massive availability of publications at a rapid growing rate, especially digitally, it becomes challenging to efficiently screen and assess relevant publications. Another challenge is the continuous assessment of related work over a long period of time and the consequent need for a continuous update, which can be a time-consuming task. Knowledge graphs model entities in a connected manner and enable new insights using different reasoning and analysis methods. The objective of this work is to present an approach to partially automate the conduction of a Systematic Literature Review as well as classify and visualize the results as a knowledge graph. The designed software prototype was used for the conduction of a review on context-awareness in automation systems with considerably accurate results compared to a manual conduction.
... Despite decades of use of the PICO/PECO format or modifications thereof, researchers often fail to include key elements when stating their research question [1,[5][6][7]. This practice of failing to adopt a strong framework for research questions has been reported frequently as a flaw in many areas of research [1,8,9] and identified as a factor in rejecting a manuscript [10]. ...
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Purpose Strongly framed research questions are clear as to the population (P), the exposures or interventions (E/I), comparison groups (C), outcomes (O), time when relevant (T), and what the investigator wants to know. A solid framework sets up the measurement model, analysis, and anticipated results. The purpose of this study was to estimate the extent to which research questions in journals that focused on patient-reported outcome measures (PROM) and quality of life (QOL) are clear. Methods All 440 research articles published in four PROM journals in 2020. excluding reviews, psychometric, and qualitative papers, were reviewed. Research questions were classified as: (i) adequately framed (ii) poorly framed; or (iii) unframed based on clarity criteria. Examples from each journal were presented and reframed to match results in the article. Results Of 440 articles, 195 (44.3%) were classified as adequately framed; 230 (52.2%) as poorly framed; and 15 (3.4%) as unframed. There was heterogeneity across journals (Chi-square: 20.8; 6 df; p = 0.002). Only 29% were framed according to what the investigators wanted to know; 72% were framed like a “to do” list; and 6% were framed as a research agenda. Conclusion Almost half of the questions were poorly framed or unframed a practice that could contribute to research wastage. Even “adequately framed” questions rarely stated what they wanted to know a priori, increasing the risk of biased reporting. Researchers, reviewers, and editors should encourage the use established frameworks for research questions.
... 15 Furthermore, research questions must be concrete and specific (novicesẗend to ask questions that are too broad). 17 Although asking research questions seems like a relatively simple matter, in reality it is not. These questions are basic because they set the tone for the entire investigation and guide the search for answers throughout the process. ...
Knowing how to properly prepare a research proposal is a real challenge — and being able to prepare an excellent research proposal is increasingly a requirement to compete for funding with assurances of success. With this in mind, we aim to share with the reader our experience (in many cases, unsuccessful) as applicants on the most important aspects of preparing a research proposal and securing its approval and funding. This article aims not only to list theoretical recommendations but also to share some personal and eminently practical suggestions on the following elements of a research proposal: the title, the abstract, the introduction, the objectives, the methodology, the work plan or schedule, the proposal's consistency and coherence, its viability, its applicability, the importance of the principal investigator and the research team, the proposal’s limitations and alternatives, its budget, its references, and, finally, the research proposal's form or wording. In summary, a research proposal is a carefully written plan that includes all the scientific, ethical and logistical aspects of the study to be conducted. Writing a good research proposal requires considerable effort and a great deal of time, but it's worth it.
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The purpose of this study was to investigate, within the sociocultural context of Korea, mothers' experiences caring for their child being treated in a hospital for leukemia. Study participants included 11 mothers who visited a hospital for their child's follow-up care after treatment for leukemia. The researchers investigated the mothers' experiences in caring for their children using a qualitative study design. Through interviews, the researchers identified five categories of experiences among participants, including, "Death anxiety," "Feeling guilty," "Fulfilling responsibilities as a mom," "Feeling overwhelmed by life," and "Feeling grateful." In the course of treatment, mothers tended to feel pressured to be a good mother, and sometimes felt overwhelmed by life. Healthcare providers need to grasp the difficulties faced by mothers taking care of their children hospitalized for treatment of leukemia, and must develop programs to reduce the burden on mothers and increase their families' functioning.
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Context: Empathy is an essential aspect of clinical care, associated with improved patient satisfaction, increased adherence to treatment, and fewer malpractice complaints. Previous studies suggest that empathy declines during medical training. However, past research relied on a single narrowly operationalised, self-report measure of empathy. As empathy is a complex socio-emotional construct, it is critical to assess changes across its distinct components using multiple measures in order to better understand how it is influenced by medical training. Methods: In a longitudinal study, medical students completed a series of self-report and behavioural measures twice per year during the first 3 years of their study (2012-2015). These included the previously used Jefferson Scale of Physician Empathy (JSPE), designed to assess empathy in the clinical context, the Questionnaire of Cognitive and Affective Empathy (QCAE), designed to assess overall empathy and its main components, and behavioural measures of sensitivity to others' pain and understanding of others' emotions, both of which are important aspects of empathy. The employment of multiple measures allowed for a more complete assessment of medical students' empathy and related processes. Results: In reflection of findings in previous work, students' empathy assessed by the JSPE decreased over training. However, on the QCAE, aspects of students' empathy, specifically overall cognitive empathy and its subcomponent perspective taking, and the emotion contagion subcomponent of affective empathy improved, whereas the remaining subcomponents remained stable. During medical school, students also exhibited comparable growth in their understanding of others' emotions and increased sensitivity to others' pain. Conclusions: Changes in empathy during medical school cannot be simply characterised as representing an overall decline. Indeed, aspects of empathy thought to be valuable in positive physician-patient interactions improve during training. Overall, this study points to the importance of assessing the distinct components of empathy using multiple forms of measurement in order to better understand the mechanisms involved in empathy changes in medical practice.
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In the writer’s craft section we offer simple tips to improve your writing in one of three areas: Energy, Clarity and Persuasiveness. Each entry focuses on a key writing feature or strategy, illustrates how it commonly goes wrong, teaches the grammatical underpinnings necessary to understand it and offers suggestions to wield it effectively. We encourage readers to share comments on or suggestions for this section on Twitter, using the hashtag: #how’syourwriting?
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Standardized systematic search strategies facilitate rigor in research. Current search tools focus on retrieval of quantitative research. In this article we address issues relating to using existing search strategy tools, most typically the PICO (Population, Intervention, Comparison, Outcome) formulation for defining key elements of a review question, when searching for qualitative and mixed methods research studies. An alternative search strategy tool for qualitative/mixed methods research is outlined: SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type). We used both the SPIDER and PICO search strategy tools with a qualitative research question. We have used the SPIDER tool to advance thinking beyond PICO in its suitable application to qualitative and mixed methods research. However, we have highlighted once more the need for improved indexing of qualitative articles in databases. To constitute a viable alternative to PICO, SPIDER needs to be refined and tested on a wider range of topics.
Editors' note: As the authors of this informative toolbox article attest, many clinical teachers have been educated within a quantitative framework. We frequently come to qualitative research late in our training, and have to learn a new vocabulary and change the way that we gather, interpret, and report on data and evidence. This transition can be very challenging, particularly as some colleagues may consider qualitative methodologies an easier option. 'Becoming qualitative' opens up a whole new literature, a small part of which is cited in this toolbox article. At The Clinical Teacher we acknowledge the diffi culties of presenting qualitative work within our limited word count. We aim to publish innovative and practical studies, and therefore accept work that might not be as in-depth as is required by other journals that publish much lengthier articles. We do expect a rationale for methods, a clear description of data collection, a recognised (and referenced) way of analysing the data and a synthesis of fi ndings that does not need the reader to do the main work of interpretation, however. We hope this toolbox article is helpful for both reading and carrying out qualitative research.
This chapter explores the range of review approaches and provides guidance on how to decide which one is best for your purpose. Literature reviews are undertaken for a range of different purposes. Examples of commonly used review approaches are used here to illustrate this variation. Furthermore, the type of documents that may be legitimately included in a literature review varies. Some will only include studies of a particular type, others published and unpublished documents. The chapter explains the importance of the audience's perspective in literature reviews. There are many different ‘brands’ or approaches to literature reviews, some of the more mainstream approaches are covered here. Cochrane reviews are probably one of the most widely recognised literature review approaches. Realist synthesis and meta-narrative reviews are two relatively newer literature review approaches compared to Cochrane and other related literature review approaches. Taking the perspective of who the audience(s) might be for a review is one way to address the issue of when to use a particular review approach. This perspective can also help researchers to decide how a review should be undertaken. Where consensus is high on the appropriate use of and processes within a review, working out what an audience expects is easier. Where there is less agreement, more time and effort will be needed to justify the choice of a particular review approach and how it will be carried out.
ContextSetting research priorities is important when exploring complex issues with limited resources. Only two countries (Canada and New Zealand) have previously conducted priority-setting exercises for medical education research (MER). This study aimed to identify the views of multiple stakeholders on MER priorities in Scotland.Methods This study utilised a two-stage design to explore the views of stakeholders across the medical education continuum using online questionnaires. In Stage 1, key informants outlined their top three MER priorities and justified their choices. In Stage 2, participants rated 21 topics generated in Stage 1 according to importance and identified or justified their top priorities. A combination of qualitative (i.e. framework analysis) and quantitative (e.g. exploratory factor analysis) data analyses were employed.ResultsViews were gathered from over 1300 stakeholders. A total of 21 subthemes (or priority areas) identified in Stage 1 were explored further in Stage 2. The 21 items loaded onto five factors: the culture of learning together in the workplace; enhancing and valuing the role of educators; curriculum integration and innovation; bridging the gap between assessment and feedback, and building a resilient workforce. Within Stage 2, the top priority subthemes were: balancing conflicts between service and training; providing useful feedback; promoting resiliency and well-being; creating an effective workplace learning culture; selecting and recruiting doctors to reflect need, and ensuring that curricula prepare trainees for practice. Participant characteristics were related to the perceived importance of the factors. Finally, five themes explaining why participants prioritised items were identified: patient safety; quality of care; investing for the future; policy and political agendas, and evidence-based education.Conclusions This study indicates that, across the spectrum of stakeholders and geography, certain MER priorities are consistently identified. These priority areas are in harmony with a range of current drivers in UK medical education. They provide a platform of evidence on which to base decisions about MER programmes in Scotland and beyond.
ContextFeedback associated with teaching activities is often synonymous with reflection on action, which comprises the evaluative assessment of performance out of its original context. Feedback in action (as correction during clinical encounters) is an underexplored, complementary resource facilitating students' understanding and learning.Objectives The purpose of this study was to explore the interactional patterns and correction modalities utilised in feedback sequences between doctors and students within general practice-based bedside teaching encounters (BTEs).MethodsA qualitative video ethnographic approach was used. Participants were recorded in their natural settings to allow interactional practices to be contextually explored. We examined 12 BTEs recorded across four general practices and involving 12 patients, four general practitioners and four medical students (209 minutes and 20 seconds of data) taken from a larger corpus. Data analysis was facilitated by Transana video analysis software and informed by previous conversation analysis research in ordinary conversation, classrooms and health care settings.ResultsA range of correction strategies across a spectrum of underlying explicitness were identified. Correction strategies classified at extreme poles of this scale (high or low explicitness) were believed to be less interactionally effective. For example, those using abrupt closing of topics (high explicitness) or interactional ambiguity (low explicitness) were thought to be less effective than embedded correction strategies that enabled the student to reach the correct answer with support.Conclusions We believe that educators who are explicitly taught linguistic strategies for how to manage feedback in BTEs might manage learning more effectively. For example, clinicians might maximise learning moments during BTEs by avoiding abrupt or ambiguous feedback practices. Embedded correction strategies can enhance student participation by guiding students towards the correct answer. Clinician corrections can sensitively manage student face-saving by minimising the exposure of student error to patients. Furthermore, we believe that the effective practices highlighted by our analysis might facilitate successful transformation of feedback in action into feedback for action.
The reflective and interrogative processes required for developing effective qualitative research questions can give shape and direction to a study in ways that are often underestimated. Good research questions do not necessarily produce good research, but poorly conceived or constructed questions will likely create problems that affect all subsequent stages of a study. In qualitative studies, the ongoing process of questioning is an integral part of understanding the unfolding lives and perspectives of others. This article addresses both the development of initial research questions and how the processes of generating and refining questions are critical to the shaping of a qualitative study.