why use qualitative research in education

Qualitative research in education : Background information

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Neag School of Education

Educational Research Basics by Del Siegle

Qualitative research.

Although researchers in anthropology and sociology have used the approach known as qualitative research  for a century, the term was not used in the social sciences until the late 1960s. The term qualitative research is used as an umbrella term to refer to several research strategies. Five common types of qualitative research are grounded theory , ethnographic , narrative research , case studies , and phenomenology.

It is unfair to judge qualitative research by a quantitative research paradigm, just as it is unfair to judge quantitative research from the qualitative research paradigm .

“Qualitative researchers seek to make sense of personal stories and the ways in which they intersect” (Glesne & Peshkin, 1992). As one qualitative researcher noted, “I knew that I was not at home in the world of numbers long before I realized that I was at home in the world of words.”

The data collected in qualitative research has been termed “soft”, “that is, rich in description of people, places, and conversations, and not easily handled by statistical procedures.” Researchers do not approach their research with specific questions to answer or hypotheses to test. They are concerned with understanding behavior from the subject’s own frame of reference. Qualitative researcher believe that “multiple ways of interpreting experiences are available to each of us through interacting with others, and that it is the meaning of our experiences that constitutes reality. Reality, consequently,  is ‘socially constructed'” (Bogdan & Biklen, 1992).

Data is usually collected through sustained contact with people in the settings where they normally spend their time. Participant observations and in-depth interviewing are the two most common ways to collect data. “The researcher enters the world of the people he or she plans to study, gets to know, be known, and trusted by them, and systematically keeps a detailed written record of what is heard and observed. This material is supplemented by other data such as [artifacts], school memos and records, newspaper articles, and photographs” (Bogdan & Biklen, 1992).

Rather than test theories, qualitative researchers often inductively analyze their data and develop theories through a process that Strauss called ” developing grounded theory “. They use purposive sampling to select the people they study. Subjects are selected because of who they are and what they know, rather than by chance.

Some key terms:

Access to a group is often made possible by a gate keeper . The gate keeper is the person who helps you gain access to the people you wish to study. In a school setting it might be a principal.

Most qualitative studies involve at least one key informant . The key informant knows the inside scoop and can point you to other people who have valuable information. The “key informant” is not necessarily the same as the gate keeper. A custodian might be a good key informant to understanding faculty interactions. The process of one subject recommending that you talk with another subject is called “ snowballing .”

Qualitative researchers use rich-thick description when they write their research reports. Unlike quantitative research where the researcher wished to generalize his or her findings beyond the sample from whom the data was drawn, qualitative researcher provide rich-thick descriptions for their readers and let their readers determine if the situation described in the qualitative study applies to the reader’s situation. Qualitative researchers do not use the terms validity and reliability. Instead they are concerned about the trustworthiness of their research.

Qualitative researchers often begin their interviews with grand tour questions . Grand tour questions are open ended questions that allow the interviewee to set the direction of the interview. The interviewer then follows the leads that the interviewee provides. The interviewer can always return to his or her preplanned interview questions after the leads have been followed.

Qualitative researchers continue to collect data until they reach a point of data saturation . Data saturation occurs when the researcher is no longer hearing or seeing new information. Unlike quantitative researchers who wait until the end of the study to analyze their data, qualitative researcher analyze their data throughout their study.

Note:   It is beyond the scope of this course to provide an extensive overview of qualitative research. Our purpose is to make you aware of this research option, and hopefully help you develop an appreciation of it. Qualitative research has become a popular research procedure in education.

Del Siegle, PhD [email protected] www.delsiegle.info

Qualitative vs. Quantitative Research: Comparing the Methods and Strategies for Education Research

No matter the field of study, all research can be divided into two distinct methodologies: qualitative and quantitative research. Both methodologies offer education researchers important insights.

Education research assesses problems in policy, practices, and curriculum design, and it helps administrators identify solutions. Researchers can conduct small-scale studies to learn more about topics related to instruction or larger-scale ones to gain insight into school systems and investigate how to improve student outcomes.

Education research often relies on the quantitative methodology. Quantitative research in education provides numerical data that can prove or disprove a theory, and administrators can easily share the number-based results with other schools and districts. And while the research may speak to a relatively small sample size, educators and researchers can scale the results from quantifiable data to predict outcomes in larger student populations and groups.

Qualitative vs. Quantitative Research in Education: Definitions

Although there are many overlaps in the objectives of qualitative and quantitative research in education, researchers must understand the fundamental functions of each methodology in order to design and carry out an impactful research study. In addition, they must understand the differences that set qualitative and quantitative research apart in order to determine which methodology is better suited to specific education research topics.

Generate Hypotheses with Qualitative Research

Qualitative research focuses on thoughts, concepts, or experiences. The data collected often comes in narrative form and concentrates on unearthing insights that can lead to testable hypotheses. Educators use qualitative research in a study’s exploratory stages to uncover patterns or new angles.

Form Strong Conclusions with Quantitative Research

Quantitative research in education and other fields of inquiry is expressed in numbers and measurements. This type of research aims to find data to confirm or test a hypothesis.

Differences in Data Collection Methods

Keeping in mind the main distinction in qualitative vs. quantitative research—gathering descriptive information as opposed to numerical data—it stands to reason that there are different ways to acquire data for each research methodology. While certain approaches do overlap, the way researchers apply these collection techniques depends on their goal.

Interviews, for example, are common in both modes of research. An interview with students that features open-ended questions intended to reveal ideas and beliefs around attendance will provide qualitative data. This data may reveal a problem among students, such as a lack of access to transportation, that schools can help address.

An interview can also include questions posed to receive numerical answers. A case in point: how many days a week do students have trouble getting to school, and of those days, how often is a transportation-related issue the cause? In this example, qualitative and quantitative methodologies can lead to similar conclusions, but the research will differ in intent, design, and form.

Taking a look at behavioral observation, another common method used for both qualitative and quantitative research, qualitative data may consider a variety of factors, such as facial expressions, verbal responses, and body language.

On the other hand, a quantitative approach will create a coding scheme for certain predetermined behaviors and observe these in a quantifiable manner.

Qualitative Research Methods

• Case Studies : Researchers conduct in-depth investigations into an individual, group, event, or community, typically gathering data through observation and interviews.
• Focus Groups : A moderator (or researcher) guides conversation around a specific topic among a group of participants.
• Ethnography : Researchers interact with and observe a specific societal or ethnic group in their real-life environment.
• Interviews : Researchers ask participants questions to learn about their perspectives on a particular subject.

Quantitative Research Methods

• Questionnaires and Surveys : Participants receive a list of questions, either closed-ended or multiple choice, which are directed around a particular topic.
• Experiments : Researchers control and test variables to demonstrate cause-and-effect relationships.
• Observations : Researchers look at quantifiable patterns and behavior.
• Structured Interviews : Using a predetermined structure, researchers ask participants a fixed set of questions to acquire numerical data.

Choosing a Research Strategy

When choosing which research strategy to employ for a project or study, a number of considerations apply. One key piece of information to help determine whether to use a qualitative vs. quantitative research method is which phase of development the study is in.

For example, if a project is in its early stages and requires more research to find a testable hypothesis, qualitative research methods might prove most helpful. On the other hand, if the research team has already established a hypothesis or theory, quantitative research methods will provide data that can validate the theory or refine it for further testing.

It’s also important to understand a project’s research goals. For instance, do researchers aim to produce findings that reveal how to best encourage student engagement in math? Or is the goal to determine how many students are passing geometry? These two scenarios require distinct sets of data, which will determine the best methodology to employ.

In some situations, studies will benefit from a mixed-methods approach. Using the goals in the above example, one set of data could find the percentage of students passing geometry, which would be quantitative. The research team could also lead a focus group with the students achieving success to discuss which techniques and teaching practices they find most helpful, which would produce qualitative data.

5 Examples of Qualitative Data in Education

Qualitative data is a game-changer in education, unlocking valuable insights into students’ experiences, perspectives, and behaviors. Capturing the richness and depth of human experiences empowers educators to make informed decisions, revamp teaching strategies, and shape impactful school policies.

In this article, we’ll explore five examples of qualitative data in education, unraveling their significance and tackling potential challenges along the way. Let’s dive in!

• Understanding Qualitative Data in Education
• Examples of Qualitative Data in Education
• The Role of Qualitative Data in Educational Improvement
• Challenges in Collecting and Analyzing Qualitative Data

1.  Understanding Qualitative Data in Education

Before we delve into the examples, let’s first define what qualitative data entails. In education, qualitative data refers to non-numerical and descriptive information gathered through interviews, observations, surveys, or the analysis of documents and artifacts. Its purpose is to understand the nuances and complexities of educational phenomena, going beyond surface-level statistics.

Qualitative data encompasses a wide range of sources, such as open-ended survey responses, transcripts of interviews, and field notes from classroom observations. It provides detailed accounts of individuals’ thoughts, feelings, and experiences, shedding light on the why and how of educational processes.

For example, in a study on student motivation, qualitative data may include interviews with students where they express their personal goals, aspirations, and challenges. These insights can help educators understand the underlying factors that drive or hinder student engagement and achievement.

Read next: How data analytics is reshaping the education industry

The Importance of Qualitative Data in Education

Qualitative data complements quantitative data , providing a holistic view of students’ learning journeys. It helps educators understand the contextual factors influencing student performance, identify patterns and trends, and gain deeper insights into the effectiveness of educational interventions.

For instance, when analyzing the impact of a new teaching method, qualitative data can reveal the specific strategies or activities that resonate with students, leading to improved learning outcomes. This information can guide educators in refining their instructional practices and tailoring their approaches to meet the diverse needs of their students.

Moreover, qualitative data allows us to give voice to marginalized groups, acknowledging their unique perspectives and experiences. It fosters inclusivity and helps educators create equitable learning environments.

For example, through qualitative research, educators can explore the experiences of students from underrepresented communities and gain a deeper understanding of the barriers they face. This knowledge can inform the development of targeted interventions and support systems to address these challenges and promote educational equity.

2.  Examples of Qualitative Data in Education

In this section, we’ll take a look at five examples of qualitative data in education.

• Observational data in classroom settings
• Interview and survey responses from students
• Teachers’ reflective journal entries
• Parent-teacher meeting notes
• Student artifacts and portfolios

Each of these types of data in education tell us something different. Let’s take a closer look!

Observational Data in Classroom Settings

Observational data involves systematically observing students’ behaviors and interactions within the classroom. It provides valuable insights into students’ engagement levels, social dynamics, and learning styles. By observing how students respond to different teaching strategies, educators can refine their approaches and tailor instruction to individual needs.

For example, observing a student struggling with a particular concept can prompt educators to provide targeted support or adapt instructional materials, ensuring every student has a fair chance to succeed.

Furthermore, through careful observation, educators can also identify patterns of behavior that may indicate underlying issues affecting student learning. For instance, noticing that a group of students consistently disengages during a specific activity may prompt educators to investigate potential barriers to their participation and implement strategies to address them.

Observational data can also shed light on the social dynamics within the classroom. By observing students’ interactions, educators can gain insights into the formation of peer groups, the emergence of leadership roles, and the impact of these dynamics on learning outcomes. This information can inform educators’ decisions on group assignments, seating arrangements, and fostering a positive classroom culture.

Interview and Survey Responses from Students

Conducting interviews and collecting survey responses directly from students allows educators to understand their opinions, beliefs, and experiences. This qualitative data provides a nuanced understanding of student motivation, attitudes towards learning, and the impact of educational practices on their lives.

Through interviews and surveys, educators can identify students’ strengths and challenges, gather feedback on classroom experiences, and tailor their teaching to better meet students’ needs. It also encourages student agency, as they feel heard and valued in shaping their own educational journey.

Moreover, interviews and surveys can uncover valuable insights about students’ interests and aspirations beyond the classroom. By understanding their extracurricular activities, hobbies, and future goals, educators can make connections between students’ personal interests and the curriculum, creating more meaningful and engaging learning experiences.

Additionally, interviews and surveys can be used to explore students’ perspectives on broader social issues, such as diversity, equity, and inclusion. By giving students a platform to share their thoughts and experiences, educators can foster empathy, understanding, and a sense of belonging within the classroom.

Teachers’ Reflective Journal Entries

Reflective journals, written by teachers, provide a unique window into their thoughts, emotions, and reflections on their teaching practices. These personal accounts offer valuable qualitative data that helps educators examine their teaching strategies and goals, analyze the impact of their actions, and make informed decisions to improve student learning.

By critically reflecting upon their own practice, teachers can identify areas for growth, address challenges, and share successful strategies with colleagues. Reflective journals foster a culture of continuous professional development and collaboration among educators.

In addition to self-reflection, teachers’ reflective journal entries can also capture the evolving nature of the teaching profession. They can document the changing educational landscape, the integration of technology, and the impact of policy decisions on classroom practices. These insights can contribute to broader discussions on educational reform and inform decision-making at the institutional level.

Furthermore, teachers’ reflective journal entries can serve as a source of inspiration and support for other educators. By sharing their experiences, challenges, and triumphs, teachers can create a community of practice that promotes innovation, resilience, and growth.

Parent-Teacher Meeting Notes

During parent-teacher meetings, qualitative data is gathered through conversations and notes taken by educators. These insights highlight parents’ perspectives on their child’s learning, their concerns, and aspirations. Understanding parental views is essential in fostering effective home-school partnerships.

By actively listening and engaging with parents, educators can tailor their support, provide resources, and build trust. Collaborating with parents helps create a holistic understanding of students’ needs and enables educators to create learning environments that align with students’ home lives.

Parent-teacher meeting notes can also reveal valuable information about students’ learning preferences, family dynamics, and cultural backgrounds. This knowledge can guide educators in designing culturally responsive instruction and creating inclusive classroom environments that celebrate diversity.

Furthermore, parent-teacher meetings provide an opportunity for educators to share insights and strategies for supporting student learning at home. By establishing open lines of communication, educators and parents can work together to reinforce learning goals, address challenges, and celebrate student achievements.

Student Artifacts and Portfolios

Student artifacts, such as essays, artwork, or projects, provide qualitative evidence of students’ learning and growth. Portfolios, in particular, are collections of student work that showcase their progress over time. These tangible representations illustrate students’ knowledge, skills, and creativity.

By analyzing student artifacts and portfolios, educators can gain insights into individual strengths, challenges, and areas for improvement. They can also identify patterns across multiple students, informing instructional decisions and shaping curriculum design.

Moreover, student artifacts and portfolios can serve as a catalyst for self-reflection and goal-setting. By reviewing their own work, students can identify areas of growth, set targets for improvement, and take ownership of their learning journey. This metacognitive process enhances students’ self-awareness and empowers them to become active participants in their education.

Student artifacts and portfolios can also be used as a means of assessment beyond traditional tests and quizzes. By evaluating the quality and depth of students’ work, educators can gain a more comprehensive understanding of their learning outcomes and provide targeted feedback for further improvement.

Furthermore, student artifacts and portfolios can be shared with peers, parents, and the wider community, fostering a sense of pride and accomplishment. This public display of students’ work promotes a positive learning culture and encourages students to strive for excellence.

3.  The Role of Qualitative Data in Educational Improvement

Informing teaching strategies.

Qualitative data helps educators tailor their teaching strategies to meet students’ diverse needs. By understanding students’ preferences, learning styles, and perceptions of their classroom experiences, educators can create engaging and inclusive learning environments.

For instance, qualitative data might reveal that students respond well to hands-on activities or small group discussions. Armed with this knowledge, educators can integrate these strategies into their lessons, maximizing student engagement and learning outcomes.

Enhancing Student Engagement

Qualitative data allows educators to uncover factors that influence student engagement, such as classroom environment, relationships with peers and teachers, and the relevance of the curriculum to students’ lives. This information enables educators to create meaningful and culturally responsive learning experiences.

By actively involving students in the design of their educational journey and incorporating their voices and interests, educators can promote a sense of ownership and foster intrinsic motivation, leading to increased student engagement and achievement.

Shaping School Policies

Qualitative data has a powerful role to play in shaping school policies and decision-making processes. It provides rich insights into students’ experiences, perceptions of the learning environment, and the impact of educational practices on their overall well-being.

By utilizing qualitative data, educators and policymakers can identify areas of improvement, address systemic inequities, and advocate for change. By considering multiple perspectives and experiences, schools can create policies that meet the needs of all students.

To learn more, read our complete guide to using qualitative data to improve student outcomes.

4.  Challenges in Collecting and Analyzing Qualitative Data

Ensuring data authenticity.

One of the challenges with qualitative data is ensuring its authenticity and credibility. Researchers and educators must be vigilant when collecting and analyzing data, employing rigorous methodologies and strategies to minimize bias and subjectivity.

By implementing clear protocols, involving multiple data sources, and engaging in reflexivity, educators can enhance the trustworthiness and reliability of qualitative data, leading to more accurate insights into students’ experiences.

Dealing with Subjectivity

Qualitative data, by its nature, is subjective. It relies on individual interpretations and perspectives. While this subjectivity can provide rich insights, it also poses challenges when comparing or generalizing findings across different contexts or individuals.

To address this challenge, researchers and educators employ triangulation, seeking multiple corroborating sources of evidence, such as interviews, observations, and documents. This helps build a comprehensive and nuanced understanding of complex educational phenomena.

Time and Resource Constraints

Collecting and analyzing qualitative data can be time-consuming and resource-intensive. Conducting interviews, observations, or analyzing reflective journals requires careful planning, organization, and sufficient resources.

Despite these constraints, the value of qualitative data in education cannot be understated. Administrators must prioritize allocating time and resources to support educators in collecting and analyzing qualitative data, recognizing its significant contribution to educational improvement.

Examples of qualitative data in education provide crucial insights into students’ experiences, perspectives, and needs. By embracing qualitative data in research and practice, educators can create transformative educational experiences that empower students, foster their academic and personal growth, and build inclusive learning communities.

Understanding qualitative data is only half the battle; presenting it in a manner that drives decision-making is equally crucial. After exploring these five examples, why not take the next step with our Inno™ Starter Kits ? They’re tailored for educators looking to seamlessly plug in their student data , offering clear visual representations that illuminate student experiences and insights. Dive deeper, connect the dots, and use your data to shape the future of education with the Inno™ Starter Kits.

Thank you for sharing!

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The qualitative orientation in medical education research

Qualitative research is very important in educational research as it addresses the “how” and “why” research questions and enables deeper understanding of experiences, phenomena and context. Qualitative research allows you to ask questions that cannot be easily put into numbers to understand human experience. Getting at the everyday realities of some social phenomenon and studying important questions as they are really practiced helps extend knowledge and understanding. To do so, you need to understand the philosophical stance of qualitative research and work from this to develop the research question, study design, data collection methods and data analysis. In this article, I provide an overview of the assumptions underlying qualitative research and the role of the researcher in the qualitative process. I then go on to discuss the type of research objectives which are common in qualitative research, then introduce the main qualitative designs, data collection tools, and finally the basics of qualitative analysis. I introduce the criteria by which you can judge the quality of qualitative research. Many classic references are cited in this article, and I urge you to seek out some of these further reading to inform your qualitative research program.

Introduction

When we speak of “quantitative” or “qualitative” methodologies, we are in the final analysis speaking about an interrelated set of assumptions about the social world which are philosophical, ideological, and epistemological. They encompass more than just data collection methodologies [ 1 ].

It is easy to assume that the differences between quantitative and qualitative research are solely about how data is collected—the randomized controlled trial versus ethnographic fieldwork, the cohort study versus the semi-structured interview. However, quantitative and qualitative approaches make different assumptions about the world [ 2 ], about how science should be conducted, and about what constitutes legitimate problems, solutions and criteria of “proof” [ 3 ].

Why is it important to understand differences in assumptions, or philosophies, of research? Why not just go ahead and do a survey or carry out some interviews? First, the assumptions behind the research tools you choose provide guidance for conducting your research. They indicate whether you should be an objective observer or whether you have a contributory role in the research process. They guide whether or not you must slavishly ask each person in a study the same questions or whether your questions can evolve as the study progresses. Second, you may wish to submit your work as a dissertation or as a research paper to be considered for publication in a journal. If so, the chances are that examiners, editors, and reviewers might have knowledge of different research philosophies from yours and may be unwilling to accept the legitimacy of your approach unless you can make its assumptions clear. Third, each research paradigm has its own norms and standards, its accepted ways of doing things. You need to “do things right”. Finally, understanding the theoretical assumptions of the research approach helps you recognize what the data collection and analysis methods you are working with do well and what they do less well, and lets you design your research to take full advantage of their strengths and compensate for their weaknesses.

In this short article, I will introduce the assumptions of qualitative research and their implications for research questions, study design, methods and tools, and analysis and interpretation. Readers who wish a comparison between qualitative and quantitative approaches may find Cleland [ 4 ] useful.

Ontology and epistemology

We start with a consideration of the ontology (assumptions about the nature of reality) and epistemology (assumptions about the nature of knowledge) of qualitative research.

Qualitative research approaches are used to understand everyday human experience in all its complexity and in all its natural settings [ 5 ]. To do this, qualitative research conforms to notions that reality is socially constructed and that inquiry is unavoidably value-laden [ 6 ]. The first of these, reality is socially constructed, means reality cannot be measured directly—it exists as perceived by people and by the observer. In other words, reality is relative and multiple, perceived through socially constructed and subjective interpretations [ 7 ]. For example, what I see as an exciting event may be seen as a threat by other people. What is considered a cultural ritual in my country may be thought of as quite bizarre elsewhere. Qualitative research is concerned with how the social world is interpreted, understood, experienced, or constructed. Mann and MacLeod [ 8 ] provide a very good overview of social constructivism which is a excellent starting point for understanding this.

The idea of people seeing things in diverse ways also holds true in research process, hence inquiry being valued-laden. Different people have different views of the same thing depending on their upbringing and other experiences, their training, and professional background. Someone who has been trained as a social scientist may “see” things differently from someone who has been medically trained. A woman may see things differently to a man. A more experienced researcher will see things differently from a novice. A qualitative researcher will have very different views of the nature of “evidence” than a quantitative researcher. All these viewpoints are valid. Moreover, different researchers can study the same topic and try to find solutions to the same challenges using different study designs—and hence come up with different interpretations and different recommendations. For example, if your position is that learning is about individual, cognitive, and acquisitive processes, then you are likely to research the use of simulation training in surgery in terms of the effectiveness and efficacy of training related to mastery of technical skills [ 9 , 10 ]. However, if your stance is that learning is inherently a social activity, one which involves interactions between people or groups of people, then you will look to see how the relationships between faculty members, participants and activities during a simulation, and the wider social and cultural context, influence learning [ 11 , 12 ].

Whether researchers are explicit about it or not, ontological and epistemological assumptions will underpin how they study aspects of teaching and learning. Differences in these assumptions shape not only study design, but also what emerges as data, how this data can be analysed and even the conclusions that can be drawn and recommendations that can be made from the study. This is referred to as worldview, defined by Creswell [ 13 ] as “a general orientation about the world and the nature of research that a researcher holds.” McMillan [ 14 ] gives a very good explanation of the importance of this phenomenon in relation to medical education research. There is increasing expectation that researchers make their worldview explicit in research papers.

The research objective

Given the underlying premise that reality is socially constructed, qualitative research focuses on answering “how” and “why” questions, of understanding a phenomena or a context. For example, “Our study aimed to answer the research question: why do assessors fail to report underperformance in medical students? [ 15 ]”, “The aim of this work was to investigate how widening participation policy is translated and interpreted for implementation at the level of the individual medical school [ 4 ].”

Common verbs in qualitative research questions are identify, explore, describe, understand, and explain. If your research question includes words like test or measure or compare in your objectives, these are more appropriate for quantitative methods, as they are better suited to these types of aims. Bezuidenhout and van Schalkwyk [ 16 ] provide a good guide to developing and refining your research question. Lingard [ 17 ]’s notion of joining the conversation and the problem-gap-hook heuristic are also very useful in terms of thinking about your question and setting it out in the introduction to a paper in such a way as to interest journal editors and readers.

Do not think formulating a research question is easy. Maxwell [ 18 ] gives a good overview of some of the potential issues including being too general, making assumptions about the nature of the issue/problem and using questions which focus the study on difference rather than process. Developing relevant, focused, answerable research questions takes time and generating good questions requires that you pay attention not just to the questions themselves but to their connections with all the other components of the study (the conceptual lens/theory, the methods) [ 18 ].

Theory can be applied to qualitative studies at different times during the research process, from the selection of the research phenomenon to the write-up of the results. The application of theory at different points can be described as follows [ 19 , 20 , 21 ]: (1) Theory frames the study questions, develops the philosophical underpinnings of the study, and makes assumptions to justify or rationalize the methodological approach. (2) Qualitative investigations relate the target phenomenon to the theory. (3) Theory provides a comparative context or framework for data analysis and interpretation. (4) Theory provides triangulation of study findings.

Schwartz-Barcott et al. [ 20 ] characterized those processes as theoretical selectivity (the linking of selected concepts with existing theories), theoretical integration (the incorporation and testing of selected concepts within a particular theoretical perspective), and theory creation (the generation of relational statements and the development of a new theory). Thus, theory can be the outcome of the research project as well as the starting point [ 22 ].

However, the emerging qualitative researcher may wish a little more direction on how to use theory in practice. I direct you to two papers: Reeves et al. [ 23 ] and Bordage [ 24 ]. These authors clearly explain the utility of theory, or conceptual frameworks, in qualitative research, how theory can give researchers different “lenses” through which to look at complicated problems and social issues, focusing their attention on different aspects of the data and providing a framework within which to conduct their analysis. Bordage [ 24 ] states that “conceptual frameworks represent ways of thinking about a problem or a study, or ways of representing how complex things work the way they do. Different frameworks will emphasise different variables and outcomes.” He presents an example in his paper and illustrates how different lens highlight or emphasise different aspects of the data. Other authors suggest that two theories are potentially better than one in exploring complex social issues [ 25 ]. There is an example of this in one of my papers, where we used the theories of Bourdieu [ 26 ] and Engestrom [ 27 , 28 ] nested within an overarching framework of complexity theory [ 29 ] to help us understand learning at a surgical bootcamp. However, I suggest that for focused studies and emerging educational researchers, one theoretical framework or lens is probably sufficient.

So how to identify an appropriate theory, and when to use it? It is crucially important to read widely, to explore lots of theories, from disciplines such as (but not only) education, psychology, sociology, and economics, to see what theory is available and what may be suitable for your study. Carefully consider any theory, check its assumptions [ 30 ] are congruent with your approach, question, and context before final selection [ 31 ] before deciding which theory to use. The time you spend exploring theory will be time well spent in terms not just of interpreting a specific data set but also to broadening your knowledge. The second question, when to use it, depends on the nature of the study, but generally the use of theory in qualitative research tends to be inductive; that is, building explanations from the ground up, based on what is discovered. This typically means that theory is brought in at the analysis stage, as a lens to interpret data.

In the qualitative approach, the activities of collecting and analyzing data, developing and modifying theory, and elaborating or refocusing the research questions, are usually going on more or less simultaneously, each influencing all of the others for a useful model of qualitative research design [ 18 ]. The researcher may need to reconsider or modify any design decision during the study in response to new developments. In this way, qualitative research design is less linear than quantitative research, which is much more step-wise and fixed.

This is not the same as no structure or plan. Most qualitative projects are pre-structured at least in terms of the equivalent of a research protocol, setting out what you are doing (aims and objectives), why (why is this important), and how (theoretical underpinning, design, methods, and analysis). I have provided a brief overview of common approaches to qualitative research design below and direct you to the numerous excellent textbooks which go into this in more detail [ 32 , 33 , 34 , 35 ].

There are five basic categories of qualitative research design: ethnography, narrative, phenomenological, grounded theory, and case study [ 13 , 32 ].

2. Ethnography

In ethnography, you immerse yourself in the target participants’ environment to understand the goals, cultures, challenges, motivations, and themes that emerge. Ethnography has its roots in cultural anthropology where researchers immerse themselves within a culture, often for years. Through multiple data collection approaches—observations, interviews and documentary data, ethnographic research offers a qualitative approach with the potential to yield detailed and comprehensive accounts of different social phenomenon (actions, behavior, interactions, and beliefs). Rather than relying on interviews or surveys, you experience the environment first hand, and sometimes as a “participant observer” which gives opportunity to gather empirical insights into social practices which are normally “hidden” from the public gaze. Reeves et al. [ 36 ] give an excellent guide to ethnography in medical education which is essential reading if you are interested in using this approach.

3. Narrative

The narrative approach weaves together a sequence of events, usually from just one or two individuals to form a cohesive story. You conduct in-depth interviews, read documents, and look for themes; in other words, how does an individual story illustrate the larger life influences that created it. Often interviews are conducted over weeks, months, or even years, but the final narrative does not need to be in chronological order. Rather it can be presented as a story (or narrative) with themes, and can reconcile conflicting stories and highlight tensions and challenges which can be opportunities for innovation.

4. Phenomenology

Phenomenology is concerned with the study of experience from the perspective of the individual, “bracketing” taken-for-granted assumptions and usual ways of perceiving. Phenomenological approaches emphasise the importance of personal perspective and interpretation. As such they are powerful for understanding subjective experience, gaining insights into people’s motivations and actions, and cutting through the clutter of taken-for-granted assumptions and conventional wisdom.

Phenomenological approaches can be applied to single cases or to selected samples. A variety of methods can be used in phenomenologically-based research, including interviews, conversations, participant observation, action research, focus meetings, and analysis of personal texts. Beware though—phenomenological research generates a large quantity data for analysis.

The phenomenological approach is used in medical education research and there are some good articles which will familiarise you with this approach [ 37 , 38 ].

5. Grounded theory

Whereas a phenomenological study looks to describe the essence of an activity or event, grounded theory looks to provide an explanation or theory behind the events. Its main thrust is to generate theories regarding social phenomena: that is, to develop higher level understanding that is “grounded” in, or derived from, a systematic analysis of data [ 39 ]. Grounded theory is appropriate when the study of social interactions or experiences aims to explain a process, not to test or verify an existing theory. Rather, the theory emerges through a close and careful analysis of the data.

The key features of grounded theory are its iterative study design, theoretical (purposive) sampling, and cycles of simultaneous data collection and analysis, where analysis informs the next cycle of data collection. In keeping with this iterative design, the sample is not set at the outset but is selected purposefully as the analysis progresses; participants are chosen for their ability to confirm or challenge an emerging theory. As issues of interest are noted in the data, they are compared with other examples for similarities and differences.

Grounded theory was first proposed by Glaser and Strauss [ 40 ] in 1967 but since then there have been many interpretations of this approach, each with their own processes and norms [ 41 , 42 , 43 ].

Beware—grounded theory is often done very badly, and numerous studies are rejected by journals because they claim to use grounded theory but do not actually do so, or do so badly.

6. Case study

Researcher Yin [ 44 ] defines the case study research method as an empirical inquiry that investigates a contemporary phenomenon within its real-life context; when the boundaries between phenomenon and context are not clearly evident; and in which multiple sources of evidence are used. The case study method enables a researcher to closely examine the data within a specific context—for example, in a small geographical area or a very limited number of individuals as the subjects of study. Case studies explore and investigate contemporary real-life phenomenon through detailed contextual analysis of a limited number of events or conditions, and their relationships. A case study involves a deep understanding through multiple types of data sources. For example, we used case study methodology recently to explore the nature of the clinical learning environment in a general surgical unit, and used both documents and interviews as data sources. Case studies can be explanatory, exploratory, or describing an event [ 44 ] and case study design can be very open or more structured [ 45 ]. Case studies are a useful approach where the focus is to explain the complexities of real life situations.

While the five methods generally use similar data collection techniques (observation, interviews, and reviewing text—see below), the purpose of the study differentiates them.

Data collection methods

The qualitative methods most commonly used for research purposes can be classified in three broad categories: (1) interviews (individual or group), (2) observation methods, and (3) document review.

The qualitative research interview seeks to describe and gain understanding of certain themes in the life world of the subjects. Interviews can be organised one-to-one or group (focus groups) depending on the topic under study, the cultural context, and the aims of the project. Observational data collection in qualitative research involves the detailed observation of people and events to learn about behaviors and interactions in natural settings [ 46 ]. Such study designs are useful when the study goal is to understand cultural aspects of a setting or phenomenon [ 47 ], when the situation of interest is hidden, (tacit), or when subjects in the setting appear to have notably different views to other groups. Written materials or documents such as institutional records, personal diaries, and historical public documents may also serve as a valuable source of secondary data, providing insight into the lives and experiences of the group under study. For example, in one of my recent studies we used document analysis to uncover the thinking behind the design of a new medical school, then carried out interviews with “users” of the new building to explore how the intentions of the planners played out in reality. However, this is only one way of incorporating document analysis into a study: see Bowen [ 48 ] for an excellent introduction to the purpose and practicalities of document review within qualitative research.

See Dicicco-Bloom and Crabtree [ 49 ] for a useful summary of the content and process of the qualitative research interview, Creswell [ 50 ] for further discussion of the many different approaches in qualitative research and their common characteristics.

1. Data management

Qualitative research may use some form of quantification, but statistical forms of analysis are not central [ 51 ]. Instead, qualitative data analysis aims to uncover emerging themes, patterns, concepts, insights, and understandings [ 52 ]. The data are allowed to “speak for themselves” by the emergence of conceptual categories and descriptive themes. Trying to squeeze narratives into boxes (like “0” and “1”) would result in the loss of contextualisation and narrative layering. The researcher must immerse themselves in the data in order to be able to see meaningful patterns and themes, making notes as they go through the processes of data collection and analysis, and then using these notes to guide the analysis strategy.

Qualitative data has to be managed before it can be analysed—you can generate a lot of data from just a few interviews or observations! You may want to use a specialist qualitative database to facilitate data management and analysis. NVivo is a well-known qualitative data analysis software package (note that qualitative software packages enable you to make and store notes, and explanations of your codes, so you do not need to juggle bits of paper and electronic data files). These and similar databases are available commercially (i.e., at a cost) and are used widely by universities. The choice of database may be dictated by the resources of your institution, your personal preference, and/or what technical support is available locally. However, if you do not have access to qualitative data management software, then use paper and pencil: read and re-read transcripts, take notes on specifics and the bigger patterns, and label different themes with different coloured pen. You do all this in a software package anyway, as data management software does not describe or analyse your data for you. See Cleland et al. [ 53 ] for comprehensive guidance on how to use qualitative databases in education research.

Data analysis

While bearing in mind that qualitative data collection and analysis are iterative rather than linear (see earlier), Miles and Huberman [ 54 ] explain the process of qualitative data analysis as (1) data reduction (extracting the essence), (2) data display (organizing for meaning), and (3) drawing conclusions (explaining the findings).

Data analysis usually follows an inductive approach where the data are allowed to “speak for themselves” by the emergence of conceptual categories and descriptive themes. The researcher must be open to multiple possibilities or ways to think about a problem, engaging in “mental excursions” using multiple stimuli, “side-tracking” or “zigzagging,” changing patterns of thinking, making linkages between the “seemingly unconnected,” and “playing at it,” all with the intention of “opening the world to us in some way” [ 52 ]. The researcher must immerse themselves in the data in order to be able to see meaningful patterns and themes, making notes as they go through the processes of data collection and analysis, and then using these notes to guide the analysis strategy and the development of a coding framework.

In this way, good qualitative research has a logical chain of reasoning, multiple sources of converging evidence to support an explanation, and rules out rival hypotheses with convincing arguments and solid data. The wider literature and theory are used to derive analytical frameworks as the process of analysis develops and different interpretations of the data are likely to be considered before the final argument is built. For example, one of our own studies aimed to explore how widening access policy is translated and implemented at the level of individual medical schools [ 4 ]. Data was collected via individual interviews with key personnel. We initially conducted a primary level thematic analysis to determine themes. After the themes emerged, and following further team discussion, we explored the literature, identified and considered various theories, in some depth, before identifying the most appropriate theory or conceptual lens for a secondary, theory-driven analysis.

There are some excellent text books which discuss qualitative data analysis in detail [ 35 , 55 ].

Judging the quality of research

There are various criteria by which you can judge the quality of qualitative research. These link to efforts by the research team to consider their findings. The most common ways of doing so are triangulation, respondent validation, reflexivity, detail and process, and fair dealing [ 56 ] (but see also Varpio et al. [ 57 ] for a detailed discussion of the limitations of some of these methods).

Triangulation compares the results from either two or more different methods of data collection (for example, interviews and observation) or, more simply, two or more data sources (for example, interviews with different people). The researcher looks for patterns of convergence to develop or corroborate an overall interpretation. This is as a way of ensuring comprehensiveness. Respondent validation, or “member checking,” includes techniques in which the investigator’s account is compared with those of the research subjects to establish the level of correspondence between the two sets. Study participants’ reactions to the analyses are then incorporated into the study findings. Providing a clear account of the process of data collection and analysis is important. By the end of the study, it should be possible to provide a clear account of how early, simple coding evolved into more sophisticated coding structures and thence into clearly defined concepts and explanations for the data collected. Reflexivity is discussed earlier but in terms of analysis reflexivity means sensitivity to the ways in which the researcher and the research process have shaped the collected data, including the role of prior assumptions and experience. These two points address credibility, whether the study has been conducted well and the findings seem reasonable. It is important to pay attention to “negative cases,” data that contradict, or seem to contradict, the emerging explanation of the phenomena under study. These can be a very useful source of information in terms of refining the analysis and thinking beyond the obvious. The final technique is to ensure that the research design explicitly incorporates a wide range of different perspectives. In practice this can mean presenting data from a wide range of diverse participants. A very practical point is worth mentioning here—any reviewer will want to see quotes labelled in some way; for example, P11FFG2 would be participant 11, female, focus group 2). This helps the reader see that your data does not just represent the view of one or two people, but that there is indeed some sort of pattern or commonality to report.

Guba and Lincoln [ 58 ] provide the following criteria for judging qualitative research: credibility, transferability, dependability, and confirmability. I direct you to the original resource and to a very good explanation of these criteria in Mann and MacLeod [ 8 ].

Qualitative research is very important in educational research as it addresses the “how” and “why” research questions and enables deeper understanding of experiences, phenomena, and context. Qualitative research allows you to ask questions that cannot be easily put into numbers to understand human experience. Getting at the everyday realities of some social phenomenon and studying important questions as they are really practiced helps answer big questions. To do so, you need to understand the philosophical stance of qualitative research and work from this to develop the research question, study design, data collection methods, and data analysis.

Chapter 1. Introduction

“Science is in danger, and for that reason it is becoming dangerous” -Pierre Bourdieu, Science of Science and Reflexivity

Why an Open Access Textbook on Qualitative Research Methods?

I have been teaching qualitative research methods to both undergraduates and graduate students for many years.  Although there are some excellent textbooks out there, they are often costly, and none of them, to my mind, properly introduces qualitative research methods to the beginning student (whether undergraduate or graduate student).  In contrast, this open-access textbook is designed as a (free) true introduction to the subject, with helpful, practical pointers on how to conduct research and how to access more advanced instruction.  

Textbooks are typically arranged in one of two ways: (1) by technique (each chapter covers one method used in qualitative research); or (2) by process (chapters advance from research design through publication).  But both of these approaches are necessary for the beginner student.  This textbook will have sections dedicated to the process as well as the techniques of qualitative research.  This is a true “comprehensive” book for the beginning student.  In addition to covering techniques of data collection and data analysis, it provides a road map of how to get started and how to keep going and where to go for advanced instruction.  It covers aspects of research design and research communication as well as methods employed.  Along the way, it includes examples from many different disciplines in the social sciences.

The primary goal has been to create a useful, accessible, engaging textbook for use across many disciplines.  And, let’s face it.  Textbooks can be boring.  I hope readers find this to be a little different.  I have tried to write in a practical and forthright manner, with many lively examples and references to good and intellectually creative qualitative research.  Woven throughout the text are short textual asides (in colored textboxes) by professional (academic) qualitative researchers in various disciplines.  These short accounts by practitioners should help inspire students.  So, let’s begin!

What is Research?

When we use the word research , what exactly do we mean by that?  This is one of those words that everyone thinks they understand, but it is worth beginning this textbook with a short explanation.  We use the term to refer to “empirical research,” which is actually a historically specific approach to understanding the world around us.  Think about how you know things about the world. [1] You might know your mother loves you because she’s told you she does.  Or because that is what “mothers” do by tradition.  Or you might know because you’ve looked for evidence that she does, like taking care of you when you are sick or reading to you in bed or working two jobs so you can have the things you need to do OK in life.  Maybe it seems churlish to look for evidence; you just take it “on faith” that you are loved.

Only one of the above comes close to what we mean by research.  Empirical research is research (investigation) based on evidence.  Conclusions can then be drawn from observable data.  This observable data can also be “tested” or checked.  If the data cannot be tested, that is a good indication that we are not doing research.  Note that we can never “prove” conclusively, through observable data, that our mothers love us.  We might have some “disconfirming evidence” (that time she didn’t show up to your graduation, for example) that could push you to question an original hypothesis , but no amount of “confirming evidence” will ever allow us to say with 100% certainty, “my mother loves me.”  Faith and tradition and authority work differently.  Our knowledge can be 100% certain using each of those alternative methods of knowledge, but our certainty in those cases will not be based on facts or evidence.

For many periods of history, those in power have been nervous about “science” because it uses evidence and facts as the primary source of understanding the world, and facts can be at odds with what power or authority or tradition want you to believe.  That is why I say that scientific empirical research is a historically specific approach to understand the world.  You are in college or university now partly to learn how to engage in this historically specific approach.

In the sixteenth and seventeenth centuries in Europe, there was a newfound respect for empirical research, some of which was seriously challenging to the established church.  Using observations and testing them, scientists found that the earth was not at the center of the universe, for example, but rather that it was but one planet of many which circled the sun. [2]   For the next two centuries, the science of astronomy, physics, biology, and chemistry emerged and became disciplines taught in universities.  All used the scientific method of observation and testing to advance knowledge.  Knowledge about people , however, and social institutions, however, was still left to faith, tradition, and authority.  Historians and philosophers and poets wrote about the human condition, but none of them used research to do so. [3]

It was not until the nineteenth century that “social science” really emerged, using the scientific method (empirical observation) to understand people and social institutions.  New fields of sociology, economics, political science, and anthropology emerged.  The first sociologists, people like Auguste Comte and Karl Marx, sought specifically to apply the scientific method of research to understand society, Engels famously claiming that Marx had done for the social world what Darwin did for the natural world, tracings its laws of development.  Today we tend to take for granted the naturalness of science here, but it is actually a pretty recent and radical development.

To return to the question, “does your mother love you?”  Well, this is actually not really how a researcher would frame the question, as it is too specific to your case.  It doesn’t tell us much about the world at large, even if it does tell us something about you and your relationship with your mother.  A social science researcher might ask, “do mothers love their children?”  Or maybe they would be more interested in how this loving relationship might change over time (e.g., “do mothers love their children more now than they did in the 18th century when so many children died before reaching adulthood?”) or perhaps they might be interested in measuring quality of love across cultures or time periods, or even establishing “what love looks like” using the mother/child relationship as a site of exploration.  All of these make good research questions because we can use observable data to answer them.

What is Qualitative Research?

“All we know is how to learn. How to study, how to listen, how to talk, how to tell.  If we don’t tell the world, we don’t know the world.  We’re lost in it, we die.” -Ursula LeGuin, The Telling

At its simplest, qualitative research is research about the social world that does not use numbers in its analyses.  All those who fear statistics can breathe a sigh of relief – there are no mathematical formulae or regression models in this book! But this definition is less about what qualitative research can be and more about what it is not.  To be honest, any simple statement will fail to capture the power and depth of qualitative research.  One way of contrasting qualitative research to quantitative research is to note that the focus of qualitative research is less about explaining and predicting relationships between variables and more about understanding the social world.  To use our mother love example, the question about “what love looks like” is a good question for the qualitative researcher while all questions measuring love or comparing incidences of love (both of which require measurement) are good questions for quantitative researchers. Patton writes,

Qualitative data describe.  They take us, as readers, into the time and place of the observation so that we know what it was like to have been there.  They capture and communicate someone else’s experience of the world in his or her own words.  Qualitative data tell a story. ( Patton 2002:47 )

Qualitative researchers are asking different questions about the world than their quantitative colleagues.  Even when researchers are employed in “mixed methods” research ( both quantitative and qualitative), they are using different methods to address different questions of the study.  I do a lot of research about first-generation and working-college college students.  Where a quantitative researcher might ask, how many first-generation college students graduate from college within four years? Or does first-generation college status predict high student debt loads?  A qualitative researcher might ask, how does the college experience differ for first-generation college students?  What is it like to carry a lot of debt, and how does this impact the ability to complete college on time?  Both sets of questions are important, but they can only be answered using specific tools tailored to those questions.  For the former, you need large numbers to make adequate comparisons.  For the latter, you need to talk to people, find out what they are thinking and feeling, and try to inhabit their shoes for a little while so you can make sense of their experiences and beliefs.

Examples of Qualitative Research

You have probably seen examples of qualitative research before, but you might not have paid particular attention to how they were produced or realized that the accounts you were reading were the result of hours, months, even years of research “in the field.”  A good qualitative researcher will present the product of their hours of work in such a way that it seems natural, even obvious, to the reader.  Because we are trying to convey what it is like answers, qualitative research is often presented as stories – stories about how people live their lives, go to work, raise their children, interact with one another.  In some ways, this can seem like reading particularly insightful novels.  But, unlike novels, there are very specific rules and guidelines that qualitative researchers follow to ensure that the “story” they are telling is accurate , a truthful rendition of what life is like for the people being studied.  Most of this textbook will be spent conveying those rules and guidelines.  Let’s take a look, first, however, at three examples of what the end product looks like.  I have chosen these three examples to showcase very different approaches to qualitative research, and I will return to these five examples throughout the book.  They were all published as whole books (not chapters or articles), and they are worth the long read, if you have the time.  I will also provide some information on how these books came to be and the length of time it takes to get them into book version.  It is important you know about this process, and the rest of this textbook will help explain why it takes so long to conduct good qualitative research!

Example 1 : The End Game (ethnography + interviews)

Corey Abramson is a sociologist who teaches at the University of Arizona.   In 2015 he published The End Game: How Inequality Shapes our Final Years ( 2015 ). This book was based on the research he did for his dissertation at the University of California-Berkeley in 2012.  Actually, the dissertation was completed in 2012 but the work that was produced that took several years.  The dissertation was entitled, “This is How We Live, This is How We Die: Social Stratification, Aging, and Health in Urban America” ( 2012 ).  You can see how the book version, which was written for a more general audience, has a more engaging sound to it, but that the dissertation version, which is what academic faculty read and evaluate, has a more descriptive title.  You can read the title and know that this is a study about aging and health and that the focus is going to be inequality and that the context (place) is going to be “urban America.”  It’s a study about “how” people do something – in this case, how they deal with aging and death.  This is the very first sentence of the dissertation, “From our first breath in the hospital to the day we die, we live in a society characterized by unequal opportunities for maintaining health and taking care of ourselves when ill.  These disparities reflect persistent racial, socio-economic, and gender-based inequalities and contribute to their persistence over time” ( 1 ).  What follows is a truthful account of how that is so.

Cory Abramson spent three years conducting his research in four different urban neighborhoods.  We call the type of research he conducted “comparative ethnographic” because he designed his study to compare groups of seniors as they went about their everyday business.  It’s comparative because he is comparing different groups (based on race, class, gender) and ethnographic because he is studying the culture/way of life of a group. [4]   He had an educated guess, rooted in what previous research had shown and what social theory would suggest, that people’s experiences of aging differ by race, class, and gender.  So, he set up a research design that would allow him to observe differences.  He chose two primarily middle-class (one was racially diverse and the other was predominantly White) and two primarily poor neighborhoods (one was racially diverse and the other was predominantly African American).  He hung out in senior centers and other places seniors congregated, watched them as they took the bus to get prescriptions filled, sat in doctor’s offices with them, and listened to their conversations with each other.  He also conducted more formal conversations, what we call in-depth interviews, with sixty seniors from each of the four neighborhoods.  As with a lot of fieldwork , as he got closer to the people involved, he both expanded and deepened his reach –

By the end of the project, I expanded my pool of general observations to include various settings frequented by seniors: apartment building common rooms, doctors’ offices, emergency rooms, pharmacies, senior centers, bars, parks, corner stores, shopping centers, pool halls, hair salons, coffee shops, and discount stores. Over the course of the three years of fieldwork, I observed hundreds of elders, and developed close relationships with a number of them. ( 2012:10 )

When Abramson rewrote the dissertation for a general audience and published his book in 2015, it got a lot of attention.  It is a beautifully written book and it provided insight into a common human experience that we surprisingly know very little about.  It won the Outstanding Publication Award by the American Sociological Association Section on Aging and the Life Course and was featured in the New York Times .  The book was about aging, and specifically how inequality shapes the aging process, but it was also about much more than that.  It helped show how inequality affects people’s everyday lives.  For example, by observing the difficulties the poor had in setting up appointments and getting to them using public transportation and then being made to wait to see a doctor, sometimes in standing-room-only situations, when they are unwell, and then being treated dismissively by hospital staff, Abramson allowed readers to feel the material reality of being poor in the US.  Comparing these examples with seniors with adequate supplemental insurance who have the resources to hire car services or have others assist them in arranging care when they need it, jolts the reader to understand and appreciate the difference money makes in the lives and circumstances of us all, and in a way that is different than simply reading a statistic (“80% of the poor do not keep regular doctor’s appointments”) does.  Qualitative research can reach into spaces and places that often go unexamined and then reports back to the rest of us what it is like in those spaces and places.

Example 2: Racing for Innocence (Interviews + Content Analysis + Fictional Stories)

Jennifer Pierce is a Professor of American Studies at the University of Minnesota.  Trained as a sociologist, she has written a number of books about gender, race, and power.  Her very first book, Gender Trials: Emotional Lives in Contemporary Law Firms, published in 1995, is a brilliant look at gender dynamics within two law firms.  Pierce was a participant observer, working as a paralegal, and she observed how female lawyers and female paralegals struggled to obtain parity with their male colleagues.

Fifteen years later, she reexamined the context of the law firm to include an examination of racial dynamics, particularly how elite white men working in these spaces created and maintained a culture that made it difficult for both female attorneys and attorneys of color to thrive. Her book, Racing for Innocence: Whiteness, Gender, and the Backlash Against Affirmative Action , published in 2012, is an interesting and creative blending of interviews with attorneys, content analyses of popular films during this period, and fictional accounts of racial discrimination and sexual harassment.  The law firm she chose to study had come under an affirmative action order and was in the process of implementing equitable policies and programs.  She wanted to understand how recipients of white privilege (the elite white male attorneys) come to deny the role they play in reproducing inequality.  Through interviews with attorneys who were present both before and during the affirmative action order, she creates a historical record of the “bad behavior” that necessitated new policies and procedures, but also, and more importantly , probed the participants ’ understanding of this behavior.  It should come as no surprise that most (but not all) of the white male attorneys saw little need for change, and that almost everyone else had accounts that were different if not sometimes downright harrowing.

I’ve used Pierce’s book in my qualitative research methods courses as an example of an interesting blend of techniques and presentation styles.  My students often have a very difficult time with the fictional accounts she includes.  But they serve an important communicative purpose here.  They are her attempts at presenting “both sides” to an objective reality – something happens (Pierce writes this something so it is very clear what it is), and the two participants to the thing that happened have very different understandings of what this means.  By including these stories, Pierce presents one of her key findings – people remember things differently and these different memories tend to support their own ideological positions.  I wonder what Pierce would have written had she studied the murder of George Floyd or the storming of the US Capitol on January 6 or any number of other historic events whose observers and participants record very different happenings.

This is not to say that qualitative researchers write fictional accounts.  In fact, the use of fiction in our work remains controversial.  When used, it must be clearly identified as a presentation device, as Pierce did.  I include Racing for Innocence here as an example of the multiple uses of methods and techniques and the way that these work together to produce better understandings by us, the readers, of what Pierce studied.  We readers come away with a better grasp of how and why advantaged people understate their own involvement in situations and structures that advantage them.  This is normal human behavior , in other words.  This case may have been about elite white men in law firms, but the general insights here can be transposed to other settings.  Indeed, Pierce argues that more research needs to be done about the role elites play in the reproduction of inequality in the workplace in general.

Example 3: Amplified Advantage (Mixed Methods: Survey Interviews + Focus Groups + Archives)

The final example comes from my own work with college students, particularly the ways in which class background affects the experience of college and outcomes for graduates.  I include it here as an example of mixed methods, and for the use of supplementary archival research.  I’ve done a lot of research over the years on first-generation, low-income, and working-class college students.  I am curious (and skeptical) about the possibility of social mobility today, particularly with the rising cost of college and growing inequality in general.  As one of the few people in my family to go to college, I didn’t grow up with a lot of examples of what college was like or how to make the most of it.  And when I entered graduate school, I realized with dismay that there were very few people like me there.  I worried about becoming too different from my family and friends back home.  And I wasn’t at all sure that I would ever be able to pay back the huge load of debt I was taking on.  And so I wrote my dissertation and first two books about working-class college students.  These books focused on experiences in college and the difficulties of navigating between family and school ( Hurst 2010a, 2012 ).  But even after all that research, I kept coming back to wondering if working-class students who made it through college had an equal chance at finding good jobs and happy lives,

What happens to students after college?  Do working-class students fare as well as their peers?  I knew from my own experience that barriers continued through graduate school and beyond, and that my debtload was higher than that of my peers, constraining some of the choices I made when I graduated.  To answer these questions, I designed a study of students attending small liberal arts colleges, the type of college that tried to equalize the experience of students by requiring all students to live on campus and offering small classes with lots of interaction with faculty.  These private colleges tend to have more money and resources so they can provide financial aid to low-income students.  They also attract some very wealthy students.  Because they enroll students across the class spectrum, I would be able to draw comparisons.  I ended up spending about four years collecting data, both a survey of more than 2000 students (which formed the basis for quantitative analyses) and qualitative data collection (interviews, focus groups, archival research, and participant observation).  This is what we call a “mixed methods” approach because we use both quantitative and qualitative data.  The survey gave me a large enough number of students that I could make comparisons of the how many kind, and to be able to say with some authority that there were in fact significant differences in experience and outcome by class (e.g., wealthier students earned more money and had little debt; working-class students often found jobs that were not in their chosen careers and were very affected by debt, upper-middle-class students were more likely to go to graduate school).  But the survey analyses could not explain why these differences existed.  For that, I needed to talk to people and ask them about their motivations and aspirations.  I needed to understand their perceptions of the world, and it is very hard to do this through a survey.

By interviewing students and recent graduates, I was able to discern particular patterns and pathways through college and beyond.  Specifically, I identified three versions of gameplay.  Upper-middle-class students, whose parents were themselves professionals (academics, lawyers, managers of non-profits), saw college as the first stage of their education and took classes and declared majors that would prepare them for graduate school.  They also spent a lot of time building their resumes, taking advantage of opportunities to help professors with their research, or study abroad.  This helped them gain admission to highly-ranked graduate schools and interesting jobs in the public sector.  In contrast, upper-class students, whose parents were wealthy and more likely to be engaged in business (as CEOs or other high-level directors), prioritized building social capital.  They did this by joining fraternities and sororities and playing club sports.  This helped them when they graduated as they called on friends and parents of friends to find them well-paying jobs.  Finally, low-income, first-generation, and working-class students were often adrift.  They took the classes that were recommended to them but without the knowledge of how to connect them to life beyond college.  They spent time working and studying rather than partying or building their resumes.  All three sets of students thought they were “doing college” the right way, the way that one was supposed to do college.   But these three versions of gameplay led to distinct outcomes that advantaged some students over others.  I titled my work “Amplified Advantage” to highlight this process.

These three examples, Cory Abramson’s The End Game , Jennifer Peirce’s Racing for Innocence, and my own Amplified Advantage, demonstrate the range of approaches and tools available to the qualitative researcher.  They also help explain why qualitative research is so important.  Numbers can tell us some things about the world, but they cannot get at the hearts and minds, motivations and beliefs of the people who make up the social worlds we inhabit.  For that, we need tools that allow us to listen and make sense of what people tell us and show us.  That is what good qualitative research offers us.

How Is This Book Organized?

This textbook is organized as a comprehensive introduction to the use of qualitative research methods.  The first half covers general topics (e.g., approaches to qualitative research, ethics) and research design (necessary steps for building a successful qualitative research study).  The second half reviews various data collection and data analysis techniques.  Of course, building a successful qualitative research study requires some knowledge of data collection and data analysis so the chapters in the first half and the chapters in the second half should be read in conversation with each other.  That said, each chapter can be read on its own for assistance with a particular narrow topic.  In addition to the chapters, a helpful glossary can be found in the back of the book.  Rummage around in the text as needed.

Chapter Descriptions

Chapter 2 provides an overview of the Research Design Process.  How does one begin a study? What is an appropriate research question?  How is the study to be done – with what methods ?  Involving what people and sites?  Although qualitative research studies can and often do change and develop over the course of data collection, it is important to have a good idea of what the aims and goals of your study are at the outset and a good plan of how to achieve those aims and goals.  Chapter 2 provides a road map of the process.

Chapter 3 describes and explains various ways of knowing the (social) world.  What is it possible for us to know about how other people think or why they behave the way they do?  What does it mean to say something is a “fact” or that it is “well-known” and understood?  Qualitative researchers are particularly interested in these questions because of the types of research questions we are interested in answering (the how questions rather than the how many questions of quantitative research).  Qualitative researchers have adopted various epistemological approaches.  Chapter 3 will explore these approaches, highlighting interpretivist approaches that acknowledge the subjective aspect of reality – in other words, reality and knowledge are not objective but rather influenced by (interpreted through) people.

Chapter 4 focuses on the practical matter of developing a research question and finding the right approach to data collection.  In any given study (think of Cory Abramson’s study of aging, for example), there may be years of collected data, thousands of observations , hundreds of pages of notes to read and review and make sense of.  If all you had was a general interest area (“aging”), it would be very difficult, nearly impossible, to make sense of all of that data.  The research question provides a helpful lens to refine and clarify (and simplify) everything you find and collect.  For that reason, it is important to pull out that lens (articulate the research question) before you get started.  In the case of the aging study, Cory Abramson was interested in how inequalities affected understandings and responses to aging.  It is for this reason he designed a study that would allow him to compare different groups of seniors (some middle-class, some poor).  Inevitably, he saw much more in the three years in the field than what made it into his book (or dissertation), but he was able to narrow down the complexity of the social world to provide us with this rich account linked to the original research question.  Developing a good research question is thus crucial to effective design and a successful outcome.  Chapter 4 will provide pointers on how to do this.  Chapter 4 also provides an overview of general approaches taken to doing qualitative research and various “traditions of inquiry.”

Chapter 5 explores sampling .  After you have developed a research question and have a general idea of how you will collect data (Observations?  Interviews?), how do you go about actually finding people and sites to study?  Although there is no “correct number” of people to interview , the sample should follow the research question and research design.  Unlike quantitative research, qualitative research involves nonprobability sampling.  Chapter 5 explains why this is so and what qualities instead make a good sample for qualitative research.

Chapter 6 addresses the importance of reflexivity in qualitative research.  Related to epistemological issues of how we know anything about the social world, qualitative researchers understand that we the researchers can never be truly neutral or outside the study we are conducting.  As observers, we see things that make sense to us and may entirely miss what is either too obvious to note or too different to comprehend.  As interviewers, as much as we would like to ask questions neutrally and remain in the background, interviews are a form of conversation, and the persons we interview are responding to us .  Therefore, it is important to reflect upon our social positions and the knowledges and expectations we bring to our work and to work through any blind spots that we may have.  Chapter 6 provides some examples of reflexivity in practice and exercises for thinking through one’s own biases.

Chapter 7 is a very important chapter and should not be overlooked.  As a practical matter, it should also be read closely with chapters 6 and 8.  Because qualitative researchers deal with people and the social world, it is imperative they develop and adhere to a strong ethical code for conducting research in a way that does not harm.  There are legal requirements and guidelines for doing so (see chapter 8), but these requirements should not be considered synonymous with the ethical code required of us.   Each researcher must constantly interrogate every aspect of their research, from research question to design to sample through analysis and presentation, to ensure that a minimum of harm (ideally, zero harm) is caused.  Because each research project is unique, the standards of care for each study are unique.  Part of being a professional researcher is carrying this code in one’s heart, being constantly attentive to what is required under particular circumstances.  Chapter 7 provides various research scenarios and asks readers to weigh in on the suitability and appropriateness of the research.  If done in a class setting, it will become obvious fairly quickly that there are often no absolutely correct answers, as different people find different aspects of the scenarios of greatest importance.  Minimizing the harm in one area may require possible harm in another.  Being attentive to all the ethical aspects of one’s research and making the best judgments one can, clearly and consciously, is an integral part of being a good researcher.

Chapter 8 , best to be read in conjunction with chapter 7, explains the role and importance of Institutional Review Boards (IRBs) .  Under federal guidelines, an IRB is an appropriately constituted group that has been formally designated to review and monitor research involving human subjects .  Every institution that receives funding from the federal government has an IRB.  IRBs have the authority to approve, require modifications to (to secure approval), or disapprove research.  This group review serves an important role in the protection of the rights and welfare of human research subjects.  Chapter 8 reviews the history of IRBs and the work they do but also argues that IRBs’ review of qualitative research is often both over-inclusive and under-inclusive.  Some aspects of qualitative research are not well understood by IRBs, given that they were developed to prevent abuses in biomedical research.  Thus, it is important not to rely on IRBs to identify all the potential ethical issues that emerge in our research (see chapter 7).

Chapter 9 provides help for getting started on formulating a research question based on gaps in the pre-existing literature.  Research is conducted as part of a community, even if particular studies are done by single individuals (or small teams).  What any of us finds and reports back becomes part of a much larger body of knowledge.  Thus, it is important that we look at the larger body of knowledge before we actually start our bit to see how we can best contribute.  When I first began interviewing working-class college students, there was only one other similar study I could find, and it hadn’t been published (it was a dissertation of students from poor backgrounds).  But there had been a lot published by professors who had grown up working class and made it through college despite the odds.  These accounts by “working-class academics” became an important inspiration for my study and helped me frame the questions I asked the students I interviewed.  Chapter 9 will provide some pointers on how to search for relevant literature and how to use this to refine your research question.

Chapter 10 serves as a bridge between the two parts of the textbook, by introducing techniques of data collection.  Qualitative research is often characterized by the form of data collection – for example, an ethnographic study is one that employs primarily observational data collection for the purpose of documenting and presenting a particular culture or ethnos.  Techniques can be effectively combined, depending on the research question and the aims and goals of the study.   Chapter 10 provides a general overview of all the various techniques and how they can be combined.

The second part of the textbook moves into the doing part of qualitative research once the research question has been articulated and the study designed.  Chapters 11 through 17 cover various data collection techniques and approaches.  Chapters 18 and 19 provide a very simple overview of basic data analysis.  Chapter 20 covers communication of the data to various audiences, and in various formats.

Chapter 11 begins our overview of data collection techniques with a focus on interviewing , the true heart of qualitative research.  This technique can serve as the primary and exclusive form of data collection, or it can be used to supplement other forms (observation, archival).  An interview is distinct from a survey, where questions are asked in a specific order and often with a range of predetermined responses available.  Interviews can be conversational and unstructured or, more conventionally, semistructured , where a general set of interview questions “guides” the conversation.  Chapter 11 covers the basics of interviews: how to create interview guides, how many people to interview, where to conduct the interview, what to watch out for (how to prepare against things going wrong), and how to get the most out of your interviews.

Chapter 12 covers an important variant of interviewing, the focus group.  Focus groups are semistructured interviews with a group of people moderated by a facilitator (the researcher or researcher’s assistant).  Focus groups explicitly use group interaction to assist in the data collection.  They are best used to collect data on a specific topic that is non-personal and shared among the group.  For example, asking a group of college students about a common experience such as taking classes by remote delivery during the pandemic year of 2020.  Chapter 12 covers the basics of focus groups: when to use them, how to create interview guides for them, and how to run them effectively.

Chapter 13 moves away from interviewing to the second major form of data collection unique to qualitative researchers – observation .  Qualitative research that employs observation can best be understood as falling on a continuum of “fly on the wall” observation (e.g., observing how strangers interact in a doctor’s waiting room) to “participant” observation, where the researcher is also an active participant of the activity being observed.  For example, an activist in the Black Lives Matter movement might want to study the movement, using her inside position to gain access to observe key meetings and interactions.  Chapter  13 covers the basics of participant observation studies: advantages and disadvantages, gaining access, ethical concerns related to insider/outsider status and entanglement, and recording techniques.

Chapter 14 takes a closer look at “deep ethnography” – immersion in the field of a particularly long duration for the purpose of gaining a deeper understanding and appreciation of a particular culture or social world.  Clifford Geertz called this “deep hanging out.”  Whereas participant observation is often combined with semistructured interview techniques, deep ethnography’s commitment to “living the life” or experiencing the situation as it really is demands more conversational and natural interactions with people.  These interactions and conversations may take place over months or even years.  As can be expected, there are some costs to this technique, as well as some very large rewards when done competently.  Chapter 14 provides some examples of deep ethnographies that will inspire some beginning researchers and intimidate others.

Chapter 15 moves in the opposite direction of deep ethnography, a technique that is the least positivist of all those discussed here, to mixed methods , a set of techniques that is arguably the most positivist .  A mixed methods approach combines both qualitative data collection and quantitative data collection, commonly by combining a survey that is analyzed statistically (e.g., cross-tabs or regression analyses of large number probability samples) with semi-structured interviews.  Although it is somewhat unconventional to discuss mixed methods in textbooks on qualitative research, I think it is important to recognize this often-employed approach here.  There are several advantages and some disadvantages to taking this route.  Chapter 16 will describe those advantages and disadvantages and provide some particular guidance on how to design a mixed methods study for maximum effectiveness.

Chapter 16 covers data collection that does not involve live human subjects at all – archival and historical research (chapter 17 will also cover data that does not involve interacting with human subjects).  Sometimes people are unavailable to us, either because they do not wish to be interviewed or observed (as is the case with many “elites”) or because they are too far away, in both place and time.  Fortunately, humans leave many traces and we can often answer questions we have by examining those traces.  Special collections and archives can be goldmines for social science research.  This chapter will explain how to access these places, for what purposes, and how to begin to make sense of what you find.

Chapter 17 covers another data collection area that does not involve face-to-face interaction with humans: content analysis .  Although content analysis may be understood more properly as a data analysis technique, the term is often used for the entire approach, which will be the case here.  Content analysis involves interpreting meaning from a body of text.  This body of text might be something found in historical records (see chapter 16) or something collected by the researcher, as in the case of comment posts on a popular blog post.  I once used the stories told by student loan debtors on the website studentloanjustice.org as the content I analyzed.  Content analysis is particularly useful when attempting to define and understand prevalent stories or communication about a topic of interest.  In other words, when we are less interested in what particular people (our defined sample) are doing or believing and more interested in what general narratives exist about a particular topic or issue.  This chapter will explore different approaches to content analysis and provide helpful tips on how to collect data, how to turn that data into codes for analysis, and how to go about presenting what is found through analysis.

Where chapter 17 has pushed us towards data analysis, chapters 18 and 19 are all about what to do with the data collected, whether that data be in the form of interview transcripts or fieldnotes from observations.  Chapter 18 introduces the basics of coding , the iterative process of assigning meaning to the data in order to both simplify and identify patterns.  What is a code and how does it work?  What are the different ways of coding data, and when should you use them?  What is a codebook, and why do you need one?  What does the process of data analysis look like?

Chapter 19 goes further into detail on codes and how to use them, particularly the later stages of coding in which our codes are refined, simplified, combined, and organized.  These later rounds of coding are essential to getting the most out of the data we’ve collected.  As students are often overwhelmed with the amount of data (a corpus of interview transcripts typically runs into the hundreds of pages; fieldnotes can easily top that), this chapter will also address time management and provide suggestions for dealing with chaos and reminders that feeling overwhelmed at the analysis stage is part of the process.  By the end of the chapter, you should understand how “findings” are actually found.

The book concludes with a chapter dedicated to the effective presentation of data results.  Chapter 20 covers the many ways that researchers communicate their studies to various audiences (academic, personal, political), what elements must be included in these various publications, and the hallmarks of excellent qualitative research that various audiences will be expecting.  Because qualitative researchers are motivated by understanding and conveying meaning , effective communication is not only an essential skill but a fundamental facet of the entire research project.  Ethnographers must be able to convey a certain sense of verisimilitude , the appearance of true reality.  Those employing interviews must faithfully depict the key meanings of the people they interviewed in a way that rings true to those people, even if the end result surprises them.  And all researchers must strive for clarity in their publications so that various audiences can understand what was found and why it is important.

The book concludes with a short chapter ( chapter 21 ) discussing the value of qualitative research. At the very end of this book, you will find a glossary of terms. I recommend you make frequent use of the glossary and add to each entry as you find examples. Although the entries are meant to be simple and clear, you may also want to paraphrase the definition—make it “make sense” to you, in other words. In addition to the standard reference list (all works cited here), you will find various recommendations for further reading at the end of many chapters. Some of these recommendations will be examples of excellent qualitative research, indicated with an asterisk (*) at the end of the entry. As they say, a picture is worth a thousand words. A good example of qualitative research can teach you more about conducting research than any textbook can (this one included). I highly recommend you select one to three examples from these lists and read them along with the textbook.

A final note on the choice of examples – you will note that many of the examples used in the text come from research on college students.  This is for two reasons.  First, as most of my research falls in this area, I am most familiar with this literature and have contacts with those who do research here and can call upon them to share their stories with you.  Second, and more importantly, my hope is that this textbook reaches a wide audience of beginning researchers who study widely and deeply across the range of what can be known about the social world (from marine resources management to public policy to nursing to political science to sexuality studies and beyond).  It is sometimes difficult to find examples that speak to all those research interests, however. A focus on college students is something that all readers can understand and, hopefully, appreciate, as we are all now or have been at some point a college student.

Recommended Reading: Other Qualitative Research Textbooks

I’ve included a brief list of some of my favorite qualitative research textbooks and guidebooks if you need more than what you will find in this introductory text.  For each, I’ve also indicated if these are for “beginning” or “advanced” (graduate-level) readers.  Many of these books have several editions that do not significantly vary; the edition recommended is merely the edition I have used in teaching and to whose page numbers any specific references made in the text agree.

Barbour, Rosaline. 2014. Introducing Qualitative Research: A Student’s Guide. Thousand Oaks, CA: SAGE.  A good introduction to qualitative research, with abundant examples (often from the discipline of health care) and clear definitions.  Includes quick summaries at the ends of each chapter.  However, some US students might find the British context distracting and can be a bit advanced in some places.  Beginning .

Bloomberg, Linda Dale, and Marie F. Volpe. 2012. Completing Your Qualitative Dissertation . 2nd ed. Thousand Oaks, CA: SAGE.  Specifically designed to guide graduate students through the research process. Advanced .

Creswell, John W., and Cheryl Poth. 2018 Qualitative Inquiry and Research Design: Choosing among Five Traditions .  4th ed. Thousand Oaks, CA: SAGE.  This is a classic and one of the go-to books I used myself as a graduate student.  One of the best things about this text is its clear presentation of five distinct traditions in qualitative research.  Despite the title, this reasonably sized book is about more than research design, including both data analysis and how to write about qualitative research.  Advanced .

Lareau, Annette. 2021. Listening to People: A Practical Guide to Interviewing, Participant Observation, Data Analysis, and Writing It All Up .  Chicago: University of Chicago Press. A readable and personal account of conducting qualitative research by an eminent sociologist, with a heavy emphasis on the kinds of participant-observation research conducted by the author.  Despite its reader-friendliness, this is really a book targeted to graduate students learning the craft.  Advanced .

Lune, Howard, and Bruce L. Berg. 2018. 9th edition.  Qualitative Research Methods for the Social Sciences.  Pearson . Although a good introduction to qualitative methods, the authors favor symbolic interactionist and dramaturgical approaches, which limits the appeal primarily to sociologists.  Beginning .

Marshall, Catherine, and Gretchen B. Rossman. 2016. 6th edition. Designing Qualitative Research. Thousand Oaks, CA: SAGE.  Very readable and accessible guide to research design by two educational scholars.  Although the presentation is sometimes fairly dry, personal vignettes and illustrations enliven the text.  Beginning .

Maxwell, Joseph A. 2013. Qualitative Research Design: An Interactive Approach .  3rd ed. Thousand Oaks, CA: SAGE. A short and accessible introduction to qualitative research design, particularly helpful for graduate students contemplating theses and dissertations. This has been a standard textbook in my graduate-level courses for years.  Advanced .

Patton, Michael Quinn. 2002. Qualitative Research and Evaluation Methods . Thousand Oaks, CA: SAGE.  This is a comprehensive text that served as my “go-to” reference when I was a graduate student.  It is particularly helpful for those involved in program evaluation and other forms of evaluation studies and uses examples from a wide range of disciplines.  Advanced .

Rubin, Ashley T. 2021. Rocking Qualitative Social Science: An Irreverent Guide to Rigorous Research. Stanford : Stanford University Press.  A delightful and personal read.  Rubin uses rock climbing as an extended metaphor for learning how to conduct qualitative research.  A bit slanted toward ethnographic and archival methods of data collection, with frequent examples from her own studies in criminology. Beginning .

Weis, Lois, and Michelle Fine. 2000. Speed Bumps: A Student-Friendly Guide to Qualitative Research . New York: Teachers College Press.  Readable and accessibly written in a quasi-conversational style.  Particularly strong in its discussion of ethical issues throughout the qualitative research process.  Not comprehensive, however, and very much tied to ethnographic research.  Although designed for graduate students, this is a recommended read for students of all levels.  Beginning .

Patton’s Ten Suggestions for Doing Qualitative Research

The following ten suggestions were made by Michael Quinn Patton in his massive textbooks Qualitative Research and Evaluations Methods . This book is highly recommended for those of you who want more than an introduction to qualitative methods. It is the book I relied on heavily when I was a graduate student, although it is much easier to “dip into” when necessary than to read through as a whole. Patton is asked for “just one bit of advice” for a graduate student considering using qualitative research methods for their dissertation.  Here are his top ten responses, in short form, heavily paraphrased, and with additional comments and emphases from me:

• Make sure that a qualitative approach fits the research question. The following are the kinds of questions that call out for qualitative methods or where qualitative methods are particularly appropriate: questions about people’s experiences or how they make sense of those experiences; studying a person in their natural environment; researching a phenomenon so unknown that it would be impossible to study it with standardized instruments or other forms of quantitative data collection.
• Study qualitative research by going to the original sources for the design and analysis appropriate to the particular approach you want to take (e.g., read Glaser and Straus if you are using grounded theory )
• Find a dissertation adviser who understands or at least who will support your use of qualitative research methods. You are asking for trouble if your entire committee is populated by quantitative researchers, even if they are all very knowledgeable about the subject or focus of your study (maybe even more so if they are!)
• Really work on design. Doing qualitative research effectively takes a lot of planning.  Even if things are more flexible than in quantitative research, a good design is absolutely essential when starting out.
• Practice data collection techniques, particularly interviewing and observing. There is definitely a set of learned skills here!  Do not expect your first interview to be perfect.  You will continue to grow as a researcher the more interviews you conduct, and you will probably come to understand yourself a bit more in the process, too.  This is not easy, despite what others who don’t work with qualitative methods may assume (and tell you!)
• Have a plan for analysis before you begin data collection. This is often a requirement in IRB protocols , although you can get away with writing something fairly simple.  And even if you are taking an approach, such as grounded theory, that pushes you to remain fairly open-minded during the data collection process, you still want to know what you will be doing with all the data collected – creating a codebook? Writing analytical memos? Comparing cases?  Having a plan in hand will also help prevent you from collecting too much extraneous data.
• Be prepared to confront controversies both within the qualitative research community and between qualitative research and quantitative research. Don’t be naïve about this – qualitative research, particularly some approaches, will be derided by many more “positivist” researchers and audiences.  For example, is an “n” of 1 really sufficient?  Yes!  But not everyone will agree.
• Do not make the mistake of using qualitative research methods because someone told you it was easier, or because you are intimidated by the math required of statistical analyses. Qualitative research is difficult in its own way (and many would claim much more time-consuming than quantitative research).  Do it because you are convinced it is right for your goals, aims, and research questions.
• Find a good support network. This could be a research mentor, or it could be a group of friends or colleagues who are also using qualitative research, or it could be just someone who will listen to you work through all of the issues you will confront out in the field and during the writing process.  Even though qualitative research often involves human subjects, it can be pretty lonely.  A lot of times you will feel like you are working without a net.  You have to create one for yourself.  Take care of yourself.
• And, finally, in the words of Patton, “Prepare to be changed. Looking deeply at other people’s lives will force you to look deeply at yourself.”
• We will actually spend an entire chapter ( chapter 3 ) looking at this question in much more detail! ↵
• Note that this might have been news to Europeans at the time, but many other societies around the world had also come to this conclusion through observation.  There is often a tendency to equate “the scientific revolution” with the European world in which it took place, but this is somewhat misleading. ↵
• Historians are a special case here.  Historians have scrupulously and rigorously investigated the social world, but not for the purpose of understanding general laws about how things work, which is the point of scientific empirical research.  History is often referred to as an idiographic field of study, meaning that it studies things that happened or are happening in themselves and not for general observations or conclusions. ↵
• Don’t worry, we’ll spend more time later in this book unpacking the meaning of ethnography and other terms that are important here.  Note the available glossary ↵

An approach to research that is “multimethod in focus, involving an interpretative, naturalistic approach to its subject matter.  This means that qualitative researchers study things in their natural settings, attempting to make sense of, or interpret, phenomena in terms of the meanings people bring to them.  Qualitative research involves the studied use and collection of a variety of empirical materials – case study, personal experience, introspective, life story, interview, observational, historical, interactional, and visual texts – that describe routine and problematic moments and meanings in individuals’ lives." ( Denzin and Lincoln 2005:2 ). Contrast with quantitative research .

In contrast to methodology, methods are more simply the practices and tools used to collect and analyze data.  Examples of common methods in qualitative research are interviews , observations , and documentary analysis .  One’s methodology should connect to one’s choice of methods, of course, but they are distinguishable terms.  See also methodology .

A proposed explanation for an observation, phenomenon, or scientific problem that can be tested by further investigation.  The positing of a hypothesis is often the first step in quantitative research but not in qualitative research.  Even when qualitative researchers offer possible explanations in advance of conducting research, they will tend to not use the word “hypothesis” as it conjures up the kind of positivist research they are not conducting.

The foundational question to be addressed by the research study.  This will form the anchor of the research design, collection, and analysis.  Note that in qualitative research, the research question may, and probably will, alter or develop during the course of the research.

An approach to research that collects and analyzes numerical data for the purpose of finding patterns and averages, making predictions, testing causal relationships, and generalizing results to wider populations.  Contrast with qualitative research .

Data collection that takes place in real-world settings, referred to as “the field;” a key component of much Grounded Theory and ethnographic research.  Patton ( 2002 ) calls fieldwork “the central activity of qualitative inquiry” where “‘going into the field’ means having direct and personal contact with people under study in their own environments – getting close to people and situations being studied to personally understand the realities of minutiae of daily life” (48).

The people who are the subjects of a qualitative study.  In interview-based studies, they may be the respondents to the interviewer; for purposes of IRBs, they are often referred to as the human subjects of the research.

The branch of philosophy concerned with knowledge.  For researchers, it is important to recognize and adopt one of the many distinguishing epistemological perspectives as part of our understanding of what questions research can address or fully answer.  See, e.g., constructivism , subjectivism, and  objectivism .

An approach that refutes the possibility of neutrality in social science research.  All research is “guided by a set of beliefs and feelings about the world and how it should be understood and studied” (Denzin and Lincoln 2005: 13).  In contrast to positivism , interpretivism recognizes the social constructedness of reality, and researchers adopting this approach focus on capturing interpretations and understandings people have about the world rather than “the world” as it is (which is a chimera).

The cluster of data-collection tools and techniques that involve observing interactions between people, the behaviors, and practices of individuals (sometimes in contrast to what they say about how they act and behave), and cultures in context.  Observational methods are the key tools employed by ethnographers and Grounded Theory .

Research based on data collected and analyzed by the research (in contrast to secondary “library” research).

The process of selecting people or other units of analysis to represent a larger population. In quantitative research, this representation is taken quite literally, as statistically representative.  In qualitative research, in contrast, sample selection is often made based on potential to generate insight about a particular topic or phenomenon.

A method of data collection in which the researcher asks the participant questions; the answers to these questions are often recorded and transcribed verbatim. There are many different kinds of interviews - see also semistructured interview , structured interview , and unstructured interview .

The specific group of individuals that you will collect data from.  Contrast population.

The practice of being conscious of and reflective upon one’s own social location and presence when conducting research.  Because qualitative research often requires interaction with live humans, failing to take into account how one’s presence and prior expectations and social location affect the data collected and how analyzed may limit the reliability of the findings.  This remains true even when dealing with historical archives and other content.  Who we are matters when asking questions about how people experience the world because we, too, are a part of that world.

The science and practice of right conduct; in research, it is also the delineation of moral obligations towards research participants, communities to which we belong, and communities in which we conduct our research.

An administrative body established to protect the rights and welfare of human research subjects recruited to participate in research activities conducted under the auspices of the institution with which it is affiliated. The IRB is charged with the responsibility of reviewing all research involving human participants. The IRB is concerned with protecting the welfare, rights, and privacy of human subjects. The IRB has the authority to approve, disapprove, monitor, and require modifications in all research activities that fall within its jurisdiction as specified by both the federal regulations and institutional policy.

Research, according to US federal guidelines, that involves “a living individual about whom an investigator (whether professional or student) conducting research:  (1) Obtains information or biospecimens through intervention or interaction with the individual, and uses, studies, or analyzes the information or biospecimens; or  (2) Obtains, uses, studies, analyzes, or generates identifiable private information or identifiable biospecimens.”

One of the primary methodological traditions of inquiry in qualitative research, ethnography is the study of a group or group culture, largely through observational fieldwork supplemented by interviews. It is a form of fieldwork that may include participant-observation data collection. See chapter 14 for a discussion of deep ethnography. 

A form of interview that follows a standard guide of questions asked, although the order of the questions may change to match the particular needs of each individual interview subject, and probing “follow-up” questions are often added during the course of the interview.  The semi-structured interview is the primary form of interviewing used by qualitative researchers in the social sciences.  It is sometimes referred to as an “in-depth” interview.  See also interview and  interview guide .

A method of observational data collection taking place in a natural setting; a form of fieldwork .  The term encompasses a continuum of relative participation by the researcher (from full participant to “fly-on-the-wall” observer).  This is also sometimes referred to as ethnography , although the latter is characterized by a greater focus on the culture under observation.

A research design that employs both quantitative and qualitative methods, as in the case of a survey supplemented by interviews.

An epistemological perspective that posits the existence of reality through sensory experience similar to empiricism but goes further in denying any non-sensory basis of thought or consciousness.  In the social sciences, the term has roots in the proto-sociologist August Comte, who believed he could discern “laws” of society similar to the laws of natural science (e.g., gravity).  The term has come to mean the kinds of measurable and verifiable science conducted by quantitative researchers and is thus used pejoratively by some qualitative researchers interested in interpretation, consciousness, and human understanding.  Calling someone a “positivist” is often intended as an insult.  See also empiricism and objectivism.

A place or collection containing records, documents, or other materials of historical interest; most universities have an archive of material related to the university’s history, as well as other “special collections” that may be of interest to members of the community.

A method of both data collection and data analysis in which a given content (textual, visual, graphic) is examined systematically and rigorously to identify meanings, themes, patterns and assumptions.  Qualitative content analysis (QCA) is concerned with gathering and interpreting an existing body of material.    

A word or short phrase that symbolically assigns a summative, salient, essence-capturing, and/or evocative attribute for a portion of language-based or visual data (Saldaña 2021:5).

Usually a verbatim written record of an interview or focus group discussion.

The primary form of data for fieldwork , participant observation , and ethnography .  These notes, taken by the researcher either during the course of fieldwork or at day’s end, should include as many details as possible on what was observed and what was said.  They should include clear identifiers of date, time, setting, and names (or identifying characteristics) of participants.

The process of labeling and organizing qualitative data to identify different themes and the relationships between them; a way of simplifying data to allow better management and retrieval of key themes and illustrative passages.  See coding frame and  codebook.

A methodological tradition of inquiry and approach to analyzing qualitative data in which theories emerge from a rigorous and systematic process of induction.  This approach was pioneered by the sociologists Glaser and Strauss (1967).  The elements of theory generated from comparative analysis of data are, first, conceptual categories and their properties and, second, hypotheses or generalized relations among the categories and their properties – “The constant comparing of many groups draws the [researcher’s] attention to their many similarities and differences.  Considering these leads [the researcher] to generate abstract categories and their properties, which, since they emerge from the data, will clearly be important to a theory explaining the kind of behavior under observation.” (36).

A detailed description of any proposed research that involves human subjects for review by IRB.  The protocol serves as the recipe for the conduct of the research activity.  It includes the scientific rationale to justify the conduct of the study, the information necessary to conduct the study, the plan for managing and analyzing the data, and a discussion of the research ethical issues relevant to the research.  Protocols for qualitative research often include interview guides, all documents related to recruitment, informed consent forms, very clear guidelines on the safekeeping of materials collected, and plans for de-identifying transcripts or other data that include personal identifying information.

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What questions are best answered using qualitative research, countering some misconceptions, in conclusion, qualitative research: its value and applicability.

Published online by Cambridge University Press:  02 January 2018

Qualitative research has a rich tradition in the study of human social behaviour and cultures. Its general aim is to develop concepts which help us to understand social phenomena in, wherever possible, natural rather than experimental settings, to gain an understanding of the experiences, perceptions and/or behaviours of individuals, and the meanings attached to them. The effective application of qualitative methods to other disciplines, including clinical, health service and education research, has a rapidly expanding and robust evidence base. Qualitative approaches have particular potential in psychiatry research, singularly and in combination with quantitative methods. This article outlines the nature and potential application of qualitative research as well as attempting to counter a number of misconceptions.

Qualitative research has a rich tradition in the social sciences. Since the late 19th century, researchers interested in studying the social behaviour and cultures of humankind have perceived limitations in trying to explain the phenomena they encounter in purely quantifiable, measurable terms. Anthropology, in its social and cultural forms, was one of the foremost disciplines in developing what would later be termed a qualitative approach, founded as it was on ethnographic studies which sought an understanding of the culture of people from other societies, often hitherto unknown and far removed in geography. Reference Bernard 1 Early researchers would spend extended periods of time living in societies, observing, noting and photographing the minutia of daily life, with the most committed often learning the language of peoples they observed, in the hope of gaining greater acceptance by them and a more detailed understanding of the cultural norms at play. All academic disciplines concerned with human and social behaviour, including anthropology, sociology and psychology, now make extensive use of qualitative research methods whose systematic application was first developed by these colonial-era social scientists.

Their methods, involving observation, participation and discussion of the individuals and groups being studied, as well as reading related textual and visual media and artefacts, form the bedrock of all qualitative social scientific inquiry. The general aim of qualitative research is thus to develop concepts which help us to understand social phenomena in, wherever possible, natural rather than experimental settings, to gain an understanding of the experiences, perceptions and/or behaviours of those studied, and the meanings attached to them. Reference Bryman 2 Researchers interested in finding out why people behave the way they do; how people are affected by events, how attitudes and opinions are formed; how and why cultures and practices have developed in the way they have, might well consider qualitative methods to answer their questions.

It is fair to say that clinical and health-related research is still dominated by quantitative methods, of which the randomised controlled trial, focused on hypothesis-testing through experiment controlled by randomisation, is perhaps the quintessential method. Qualitative approaches may seem obscure to the uninitiated when directly compared with the experimental, quantitative methods used in clinical research. There is increasing recognition among researchers in these fields, however, that qualitative methods such as observation, in-depth interviews, focus groups, consensus methods, case studies and the interpretation of texts can be more effective than quantitative approaches in exploring complex phenomena and as such are valuable additions to the methodological armoury available to them. Reference Denzin and Lincoln 3

In considering what kind of research questions are best answered using a qualitative approach, it is important to remember that, first and foremost, unlike quantitative research, inquiry conducted in the qualitative tradition seeks to answer the question ‘What?’ as opposed to ‘How often?’. Qualitative methods are designed to reveal what is going on by describing and interpreting phenomena; they do not attempt to measure how often an event or association occurs. Research conducted using qualitative methods is normally done with an intent to preserve the inherent complexities of human behaviour as opposed to assuming a reductive view of the subject in order to count and measure the occurrence of phenomena. Qualitative research normally takes an inductive approach, moving from observation to hypothesis rather than hypothesis-testing or deduction, although the latter is perfectly possible.

When conducting research in this tradition, the researcher should, if possible, avoid separating the stages of study design, data collection and analysis, but instead weave backwards and forwards between the raw data and the process of conceptualisation, thereby making sense of the data throughout the period of data collection. Although there are inevitable tensions among methodologists concerned with qualitative practice, there is broad consensus that a priori categories and concepts reflecting a researcher's own preconceptions should not be imposed on the process of data collection and analysis. The emphasis should be on capturing and interpreting research participants' true perceptions and/or behaviours.

Using combined approaches

The polarity between qualitative and quantitative research has been largely assuaged, to the benefit of all disciplines which now recognise the value, and compatibility, of both approaches. Indeed, there can be particular value in using quantitative methods in combination with qualitative methods. Reference Barbour 4 In the exploratory stages of a research project, qualitative methodology can be used to clarify or refine the research question, to aid conceptualisation and to generate a hypothesis. It can also help to identify the correct variables to be measured, as researchers have been known to measure before they fully understand the underlying issues pertaining to a study and, as a consequence, may not always target the most appropriate factors. Qualitative work can be valuable in the interpretation, qualification or illumination of quantitative research findings. This is particularly helpful when focusing on anomalous results, as they test the main hypothesis formulated. Qualitative methods can also be used in combination with quantitative methods to triangulate findings and support the validation process, for example, where three or more methods are used and the results compared for similarity (e.g. a survey, interviews and a period of observation in situ ).

‘There is little value in qualitative research findings because we cannot generalise from them’

Generalisability refers to the extent that the account can be applied to other people, times and settings other than those actually studied. A common criticism of qualitative research is that the results of a study are rarely, if ever, generalisable to a larger population because the sample groups are small and the participants are not chosen randomly. Such criticism fails to recognise the distinctiveness of qualitative research where sampling is concerned. In quantitative research, the intent is to secure a large random sample that is representative of the general population, with the purpose of eliminating individual variations, focusing on generalisations and thereby allowing for statistical inference of results that are applicable across an entire population. In qualitative research, generalisability is based on the assumption that it is valuable to begin to understand similar situations or people, rather than being representative of the target population. Qualitative research is rarely based on the use of random samples, so the kinds of reference to wider populations made on the basis of surveys cannot be used in qualitative analysis.

Qualitative researchers utilise purposive sampling, whereby research participants are selected deliberately to test a particular theoretical premise. The purpose of sampling here is not to identify a random subgroup of the general population from which statistically significant results can be extrapolated, but rather to identify, in a systematic way, individuals that possess relevant characteristics for the question being considered. Reference Strauss and Corbin 5 The researchers must instead ensure that any reference to people and settings beyond those in the study are justified, which is normally achieved by defining, in detail, the type of settings and people to whom the explanation or theory applies based on the identification of similar settings and people in the study. The intent is to permit a detailed examination of the phenomenon, resulting in a text-rich interpretation that can deepen our understanding and produce a plausible explanation of the phenomenon under study. The results are not intended to be statistically generalisable, although any theory they generate might well be.

‘Qualitative research cannot really claim reliability or validity’

In quantitative research, reliability is the extent to which different observers, or the same observers on different occasions, make the same observations or collect the same data about the same object of study. The changing nature of social phenomena scrutinised by qualitative researchers inevitably makes the possibility of the same kind of reliability problematic in their work. A number of alternative concepts to reliability have been developed by qualitative methodologists, however, known collectively as forms of trustworthiness. Reference Guba 6

One way to demonstrate trustworthiness is to present detailed evidence in the form of quotations from interviews and field notes, along with thick textual descriptions of episodes, events and settings. To be trustworthy, qualitative analysis should also be auditable, making it possible to retrace the steps leading to a certain interpretation or theory to check that no alternatives were left unexamined and that no researcher biases had any avoidable influence on the results. Usually, this involves the recording of information about who did what with the data and in what order so that the origin of interpretations can be retraced.

In general, within the research traditions of the natural sciences, findings are validated by their repeated replication, and if a second investigator cannot replicate the findings when they repeat the experiment then the original results are questioned. If no one else can replicate the original results then they are rejected as fatally flawed and therefore invalid. Natural scientists have developed a broad spectrum of procedures and study designs to ensure that experiments are dependable and that replication is possible. In the social sciences, particularly when using qualitative research methods, replication is rarely possible given that, when observed or questioned again, respondents will almost never say or do precisely the same things. Whether results have been successfully replicated is always a matter of interpretation. There are, however, procedures that, if followed, can significantly reduce the possibility of producing analyses that are partial or biased. Reference Altheide, Johnson, Denzin and Lincoln 7

Triangulation is one way of doing this. It essentially means combining multiple views, approaches or methods in an investigation to obtain a more accurate interpretation of the phenomena, thereby creating an analysis of greater depth and richness. As the process of analysing qualitative data normally involves some form of coding, whereby data are broken down into units of analysis, constant comparison can also be used. Constant comparison involves checking the consistency and accuracy of interpretations and especially the application of codes by constantly comparing one interpretation or code with others both of a similar sort and in other cases and settings. This in effect is a form of interrater reliability, involving multiple researchers or teams in the coding process so that it is possible to compare how they have coded the same passages and where there are areas of agreement and disagreement so that consensus can be reached about a code's definition, improving consistency and rigour. It is also good practice in qualitative analysis to look constantly for outliers – results that are out of line with your main findings or any which directly contradict what your explanations might predict, re-examining the data to try to find a way of explaining the atypical finding to produce a modified and more complex theory and explanation.

Qualitative research has been established for many decades in the social sciences and encompasses a valuable set of methodological tools for data collection, analysis and interpretation. Their effective application to other disciplines, including clinical, health service and education research, has a rapidly expanding and robust evidence base. The use of qualitative approaches to research in psychiatry has particular potential, singularly and in combination with quantitative methods. Reference Crabb and Chur-Hansen 8 When devising research questions in the specialty, careful thought should always be given to the most appropriate methodology, and consideration given to the great depth and richness of empirical evidence which a robust qualitative approach is able to provide.

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• Volume 37, Issue 6
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• DOI: https://doi.org/10.1192/pb.bp.113.042770

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When Does a Researcher Choose a Quantitative, Qualitative, or Mixed Research Approach?

• Published: 26 November 2021
• Volume 53 , pages 113–131, ( 2022 )

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• Feyisa Mulisa   ORCID: orcid.org/0000-0002-0738-6554 1  

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In educational studies, the paradigm war over quantitative and qualitative research approaches has raged for more than half a century. The focus in the late twentieth century was on the distinction between the two approaches, and the motivation was to retain one of the approaches’ supremacy. Since the early twenty-first century, there has been a growing interest in situating in the middle position and combining both approaches into a single study or a series of studies. Despite these signs of progress, when it comes to using the appropriate research approach at the right time, beginner educational researchers remain perplexed. This paper, therefore, provides useful guidelines that facilitate the choice of quantitative, qualitative, or mixed research approaches in educational inquiry. To achieve this objective, this article comprises three distinct and underlying areas of interest, which have been structured into three sections. The first section highlights the distinctions between quantitative and qualitative research approaches. The second section discusses the paradigm views that underpin the choice of a particular research approach. Finally, an effort has been made to determine the appropriate time to opt for any of the research approaches that facilitate successful educational investigations. Since truth and the means used to discover it are both dynamic, it is also essential to foresight innovative approaches to research with distinguishing features of applications to educational research.

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Mulisa, F. When Does a Researcher Choose a Quantitative, Qualitative, or Mixed Research Approach?. Interchange 53 , 113–131 (2022). https://doi.org/10.1007/s10780-021-09447-z

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Feminist theory and its use in qualitative research in education.

• Emily Freeman Emily Freeman University of North Carolina at Chapel Hill
• https://doi.org/10.1093/acrefore/9780190264093.013.1193
• Published online: 28 August 2019

Feminist theory rose in prominence in educational research during the 1980s and experienced a resurgence in popularity during the late 1990s−2010s. Standpoint epistemologies, intersectionality, and feminist poststructuralism are the most prevalent theories, but feminist researchers often work across feminist theoretical thought. Feminist qualitative research in education encompasses a myriad of methods and methodologies, but projects share a commitment to feminist ethics and theories. Among the commitments are the understanding that knowledge is situated in the subjectivities and lived experiences of both researcher and participants and research is deeply reflexive. Feminist theory informs both research questions and the methodology of a project in addition to serving as a foundation for analysis. The goals of feminist educational research include dismantling systems of oppression, highlighting gender-based disparities, and seeking new ways of constructing knowledge.

• feminist theories
• qualitative research
• educational research
• positionality
• methodology

Introduction

Feminist qualitative research begins with the understanding that all knowledge is situated in the bodies and subjectivities of people, particularly women and historically marginalized groups. Donna Haraway ( 1988 ) wrote,

I am arguing for politics and epistemologies of location, position, and situating, where partiality and not universality is the condition of being heard to make rational knowledge claims. These are claims on people’s lives I’m arguing for the view from a body, always a complex, contradictory, structuring, and structured body, versus the view from above, from nowhere, from simplicity. Only the god trick is forbidden. . . . Feminism is about a critical vision consequent upon a critical positioning in unhomogeneous gendered social space. (p. 589)

By arguing that “politics and epistemologies” are always interpretive and partial, Haraway offered feminist qualitative researchers in education a way to understand all research as potentially political and always interpretive and partial. Because all humans bring their own histories, biases, and subjectivities with them to a research space or project, it is naïve to think that the written product of research could ever be considered neutral, but what does research with a strong commitment to feminism look like in the context of education?

Writing specifically about the ways researchers of both genders can use feminist ethnographic methods while conducting research on schools and schooling, Levinson ( 1998 ) stated, “I define feminist ethnography as intensive qualitative research, aimed toward the description and analysis of the gendered construction and representation of experience, which is informed by a political and intellectual commitment to the empowerment of women and the creation of more equitable arrangements between and among specific, culturally defined genders” (p. 339). The core of Levinson’s definition is helpful for understanding the ways that feminist educational anthropologists engage with schools as gendered and political constructs and the larger questions of feminist qualitative research in education. His message also extends to other forms of feminist qualitative research. By focusing on description, analysis, and representation of gendered constructs, educational researchers can move beyond simple binary analyses to more nuanced understandings of the myriad ways gender operates within educational contexts.

Feminist qualitative research spans the range of qualitative methodologies, but much early research emerged out of the feminist postmodern turn in anthropology (Behar & Gordon, 1995 ), which was a response to male anthropologists who ignored the gendered implications of ethnographic research (e.g., Clifford & Marcus, 1986 ). Historically, most of the work on feminist education was conducted in the 1980s and 1990s, with a resurgence in the late 2010s (Culley & Portuges, 1985 ; DuBois, Kelly, Kennedy, Korsmeyer, & Robinson, 1985 ; Gottesman, 2016 ; Maher & Tetreault, 1994 ; Thayer-Bacon, Stone, & Sprecher, 2013 ). Within this body of research, the majority focuses on higher education (Coffey & Delamont, 2000 ; Digiovanni & Liston, 2005 ; Diller, Houston, Morgan, & Ayim, 1996 ; Gabriel & Smithson, 1990 ; Mayberry & Rose, 1999 ). Even leading journals, such as Feminist Teacher ( 1984 −present), focus mostly on the challenges of teaching about and to women in higher education, although more scholarship on P–12 education has emerged in recent issues.

There is also a large collection of work on the links between gender, achievement, and self-esteem (American Association of University Women, 1992 , 1999 ; Digiovanni & Liston, 2005 ; Gilligan, 1982 ; Hancock, 1989 ; Jackson, Paechter, & Renold, 2010 ; National Coalition for Women and Girls in Education, 2002 ; Orenstein, 1994 ; Pipher, 1994 ; Sadker & Sadker, 1994 ). However, just because research examines gender does not mean that it is feminist. Simply using gender as a category of analysis does not mean the research project is informed by feminist theory, ethics, or methods, but it is often a starting point for researchers who are interested in the complex ways gender is constructed and the ways it operates in education.

This article examines the histories and theories of U.S.–based feminism, the tenets of feminist qualitative research and methodologies, examples of feminist qualitative studies, and the possibilities for feminist qualitative research in education to provide feminist educational researchers context and methods for engaging in transformative and subversive research. Each section provides a brief overview of the major concepts and conversations, along with examples from educational research to highlight the ways feminist theory has informed educational scholarship. Some examples are given limited attention and serve as entry points into a more detailed analysis of a few key examples. While there is a large body of non-Western feminist theory (e.g., the works of Lila Abu-Lughod, Sara Ahmed, Raewyn Connell, Saba Mahmood, Chandra Mohanty, and Gayatri Spivak), much of the educational research using feminist theory draws on Western feminist theory. This article focuses on U.S.–based research to show the ways that the utilization of feminist theory has changed since the 1980s.

Histories, Origins, and Theories of U.S.–Based Feminism

The normative historiography of feminist theory and activism in the United States is broken into three waves. First-wave feminism (1830s−1920s) primarily focused on women’s suffrage and women’s rights to legally exist in public spaces. During this time period, there were major schisms between feminist groups concerning abolition, rights for African American women, and the erasure of marginalized voices from larger feminist debates. The second wave (1960s and 1980s) worked to extend some of the rights won during the first wave. Activists of this time period focused on women’s rights to enter the workforce, sexual harassment, educational equality, and abortion rights. During this wave, colleges and universities started creating women’s studies departments and those scholars provided much of the theoretical work that informs feminist research and activism today. While there were major feminist victories during second-wave feminism, notably Title IX and Roe v. Wade , issues concerning the marginalization of race, sexual orientation, and gender identity led many feminists of color to separate from mainstream white feminist groups. The third wave (1990s to the present) is often characterized as the intersectional wave, as some feminist groups began utilizing Kimberlé Crenshaw’s concept of intersectionality ( 1991 ) to understand that oppression operates via multiple categories (e.g., gender, race, class, age, ability) and that intersecting oppressions lead to different lived experiences.

Historians and scholars of feminism argue that dividing feminist activism into three waves flattens and erases the major contributions of women of color and gender-nonconforming people. Thompson ( 2002 ) called this history a history of hegemonic feminism and proposed that we look at the contributions of multiracial feminism when discussing history. Her work, along with that of Allen ( 1984 ) about the indigenous roots of U.S. feminism, raised many questions about the ways that feminism operates within the public and academic spheres. For those who wish to engage in feminist research, it is vital to spend time understanding the historical, theoretical, and political ways that feminism(s) can both liberate and oppress, depending on the scholar’s understandings of, and orientations to, feminist projects.

Standpoint Epistemology

Much of the theoretical work that informs feminist qualitative research today emerged out of second-wave feminist scholarship. Standpoint epistemology, according to Harding ( 1991 , 2004 ), posits that knowledge comes from one’s particular social location, that it is subjective, and the further one is from the hegemonic norm, the clearer one can see oppression. This was a major challenge to androcentric and Enlightenment theories of knowledge because standpoint theory acknowledges that there is no universal understanding of the world. This theory aligns with the second-wave feminist slogan, “The personal is political,” and advocates for a view of knowledge that is produced from the body.

Greene ( 1994 ) wrote from a feminist postmodernist epistemology and attacked Enlightenment thinking by using standpoint theory as her starting point. Her work serves as an example of one way that educational scholars can use standpoint theory in their work. She theorized encounters with “imaginative literature” to help educators conceptualize new ways of using reading and writing in the classroom and called for teachers to think of literature as “a harbinger of the possible.” (Greene, 1994 , p. 218). Greene wrote from an explicitly feminist perspective and moved beyond simple analyses of gender to a larger critique of the ways that knowledge is constructed in classrooms.

Intersectionality

Crenshaw ( 1991 ) and Collins ( 2000 ) challenged and expanded standpoint theory to move it beyond an individual understanding of knowledge to a group-based theory of oppression. Their work, and that of other black and womanist feminists, opened up multiple spaces of possibility for feminist scholars and researchers because it challenged hegemonic feminist thought. For those interested in conducting feminist research in educational settings, their work is especially pertinent because they advocate for feminists to attend to all aspects of oppression rather than flattening them to one of simple gender-based oppression.

Haddix, McArthur, Muhammad, Price-Dennis, and Sealey-Ruiz ( 2016 ), all women-of-color feminist educators, wrote a provocateur piece in a special issue of English Education on black girls’ literacy. The four authors drew on black feminist thought and conducted a virtual kitchen-table conversation. By symbolically representing their conversations as one from the kitchen, this article pays homage to women-of-color feminism and pushes educators who read English Education to reconsider elements of their own subjectivities. Third-wave feminism and black feminism emphasize intersectionality, in that different demographic details like race, class, and gender are inextricably linked in power structures. Intersectionality is an important frame for educational research because identifying the unique experiences, realities, and narratives of those involved in educational systems can highlight the ways that power and oppression operate in society.

Feminist Poststructural Theory

Feminist poststructural theory has greatly informed many feminist projects in educational research. Deconstruction is

a critical practice that aims to ‘dismantle [ déconstruire ] the metaphysical and rhetorical structures that are at work, not in order to reject or discard them, but to reinscribe them in another way,’ (Derrida, quoted in Spivak, 1974 , p. lxxv). Thus, deconstruction is not about tearing down, but about looking at how a structure has been constructed, what holds it together, and what it produces. (St. Pierre, 2000 , p. 482)

Reality, subjectivity, knowledge, and truth are constructed through language and discourse (cultural practices, power relations, etc.), so truth is local and diverse, rather than a universal experience (St. Pierre, 2000 ). Feminist poststructuralist theory may be used to question structural inequality that is maintained in education through dominant discourses.

In Go Be a Writer! Expanding the Curricular Boundaries of Literacy Learning with Children , Kuby and Rucker ( 2016 ) explored early elementary literacy practices using poststructural and posthumanist theories. Their book drew on hours of classroom observations, student interviews and work, and their own musings on ways to de-standardize literacy instruction and curriculum. Through the process of pedagogical documentation, Kuby and Rucker drew on the works of Barad, Deleuze and Guattari, and Derrida to explore the ways they saw children engaging in what they call “literacy desiring(s).” One aim of the book is to find practical and applicable ways to “Disrupt literacy in ways that rewrite the curriculum, the interactions, and the power dynamics of the classroom even begetting a new kind of energy that spirals and bounces and explodes” (Kuby & Rucker, 2016 , p. 5). The second goal of their book is not only to understand what happened in Rucker’s classroom using the theories, but also to unbound the links between “teaching↔learning” (p. 202) and to write with the theories, rather than separating theory from the methodology and classroom enactments (p. 45) because “knowing/being/doing were not separate” (p. 28). This work engages with key tenets of feminist poststructuralist theory and adds to both the theoretical and pedagogical conversations about what counts as a literacy practice.

While the discussion in this section provides an overview of the histories and major feminist theories, it is by no means exhaustive. Scholars who wish to engage in feminist educational research need to spend time doing the work of understanding the various theories and trajectories that constitute feminist work so they are able to ground their projects and theories in a particular tradition that will inform the ethics and methods of research.

Tenets of Feminist Qualitative Research

Why engage in feminist qualitative research.

Evans and Spivak ( 2016 ) stated, “The only real and effective way you can sabotage something this way is when you are working intimately within it.” Feminist researchers are in the classroom and the academy, working intimately within curricular, pedagogical, and methodological constraints that serve neoliberal ideologies, so it is vital to better understand the ways that we can engage in affirmative sabotage to build a more just and equitable world. Spivak’s ( 2014 ) notion of affirmative sabotage has become a cornerstone for understanding feminist qualitative research and teaching. She borrowed and built on Gramsci’s role of the organic intellectual and stated that they/we need to engage in affirmative sabotage to transform the humanities.

I used the term “affirmative sabotage” to gloss on the usual meaning of sabotage: the deliberate ruining of the master’s machine from the inside. Affirmative sabotage doesn’t just ruin; the idea is of entering the discourse that you are criticizing fully, so that you can turn it around from inside. The only real and effective way you can sabotage something this way is when you are working intimately within it. (Evans & Spivak, 2016 )

While Spivak has been mostly concerned with literary education, her writings provide teachers and researchers numerous lines of inquiry into projects that can explode androcentric universal notions of knowledge and resist reproductive heteronormativity.

Spivak’s pedagogical musings center on deconstruction, primarily Derridean notions of deconstruction (Derrida, 2016 ; Jackson & Mazzei, 2012 ; Spivak, 2006 , 2009 , 2012 ) that seek to destabilize existing categories and to call into question previously unquestioned beliefs about the goals of education. Her works provide an excellent starting point for examining the links between feminism and educational research. The desire to create new worlds within classrooms, worlds that are fluid, interpretive, and inclusive in order to interrogate power structures, lies at the core of what it means to be a feminist education researcher. As researchers, we must seriously engage with feminist theory and include it in our research so that feminism is not seen as a dirty word, but as a movement/pedagogy/methodology that seeks the liberation of all (Davis, 2016 ).

Feminist research and feminist teaching are intrinsically linked. As Kerkhoff ( 2015 ) wrote, “Feminist pedagogy requires students to challenge the norms and to question whether existing practices privilege certain groups and marginalize others” (p. 444), and this is exactly what feminist educational research should do. Bailey ( 2001 ) called on teachers, particularly those who identify as feminists, to be activists, “The values of one’s teaching should not be separated sharply from the values one expresses outside the classroom, because teaching is not inherently pure or laboratory practice” (p. 126); however, we have to be careful not to glorify teachers as activists because that leads to the risk of misinterpreting actions. Bailey argued that teaching critical thinking is not enough if it is not coupled with curriculums and pedagogies that are antiheteronormative, antisexist, and antiracist. As Bailey warned, just using feminist theory or identifying as a feminist is not enough. It is very easy to use the language and theories of feminism without being actively feminist in one’s research. There are ethical and methodological issues that feminist scholars must consider when conducting research.

Feminist research requires one to discuss ethics, not as a bureaucratic move, but as a reflexive move that shows the researchers understand that, no matter how much they wish it didn’t, power always plays a role in the process. According to Davies ( 2014 ), “Ethics, as Barad defines it, is a matter of questioning what is being made to matter and how that mattering affects what it is possible to do and to think” (p. 11). In other words, ethics is what is made to matter in a particular time and place.

Davies ( 2016 ) extended her definition of ethics to the interactions one has with others.

This is not ethics as a matter of separate individuals following a set of rules. Ethical practice, as both Barad and Deleuze define it, requires thinking beyond the already known, being open in the moment of the encounter, pausing at the threshold and crossing over. Ethical practice is emergent in encounters with others, in emergent listening with others. It is a matter of questioning what is being made to matter and how that mattering affects what it is possible to do and to think. Ethics is emergent in the intra-active encounters in which knowing, being, and doing (epistemology, ontology, and ethics) are inextricably linked. (Barad, 2007 , p. 83)

The ethics of any project must be negotiated and contested before, during, and after the process of conducting research in conjunction with the participants. Feminist research is highly reflexive and should be conducted in ways that challenge power dynamics between individuals and social institutions. Educational researchers must heed the warning to avoid the “god-trick” (Haraway, 1988 ) and to continually question and re-question the ways we seek to define and present subjugated knowledge (Hesse-Biber, 2012 ).

Positionalities and Reflexivity

According to feminist ethnographer Noelle Stout, “Positionality isn’t meant to be a few sentences at the beginning of a work” (personal communication, April 5, 2016 ). In order to move to new ways of experiencing and studying the world, it is vital that scholars examine the ways that reflexivity and positionality are constructed. In a glorious footnote, Margery Wolf ( 1992 ) related reflexivity in anthropological writing to a bureaucratic procedure (p. 136), and that resonates with how positionality often operates in the field of education.

The current trend in educational research is to include a positionality statement that fixes the identity of the author in a particular place and time and is derived from feminist standpoint theory. Researchers should make their biases and the identities of the authors clear in a text, but there are serious issues with the way that positionality functions as a boundary around the authors. Examining how the researchers exert authority within a text allows the reader the opportunity to determine the intent and philosophy behind the text. If positionality were used in an embedded and reflexive manner, then educational research would be much richer and allow more nuanced views of schools, in addition to being more feminist in nature. The rest of this section briefly discussrs articles that engage with feminist ethics regarding researcher subjectivities and positionality, and two articles are examined in greater depth.

When looking for examples of research that includes deeply reflexive and embedded positionality, one finds that they mostly deal with issues of race, equity, and diversity. The highlighted articles provide examples of positionality statements that are deeply reflexive and represent the ways that feminist researchers can attend to the ethics of being part of a research project. These examples all come from feminist ethnographic projects, but they are applicable to a wide variety of feminist qualitative projects.

Martinez ( 2016 ) examined how research methods are or are not appropriate for specific contexts. Calderon ( 2016 ) examined autoethnography and the reproduction of “settler colonial understandings of marginalized communities” (p. 5). Similarly, Wissman, Staples, Vasudevan, and Nichols ( 2015 ) discussed how to research with adolescents through engaged participation and collaborative inquiry, and Ceglowski and Makovsky ( 2012 ) discussed the ways researchers can engage in duoethnography with young children.

Abajian ( 2016 ) uncovered the ways military recruiters operate in high schools and paid particular attention to the politics of remaining neutral while also working to subvert school militarization. She wrote,

Because of the sensitive and also controversial nature of my research, it was not possible to have a collaborative process with students, teachers, and parents. Purposefully intervening would have made documentation impossible because that would have (rightfully) aligned me with anti-war and counter-recruitment activists who were usually not welcomed on school campuses (Abajian & Guzman, 2013 ). It was difficult enough to find an administrator who gave me consent to conduct my research within her school, as I had explicitly stated in my participant recruitment letters and consent forms that I was going to research the promotion of post-secondary paths including the military. Hence, any purposeful intervention on my part would have resulted in the termination of my research project. At the same time, my documentation was, in essence, an intervention. I hoped that my presence as an observer positively shaped the context of my observation and also contributed to the larger struggle against the militarization of schools. (p. 26)

Her positionality played a vital role in the creation, implementation, and analysis of military recruitment, but it also forced her into unexpected silences in order to carry out her research. Abajian’s positionality statement brings up many questions about the ways researchers have to use or silence their positionality to further their research, especially if they are working in ostensibly “neutral” and “politically free” zones, such as schools. Her work drew on engaged anthropology (Low & Merry, 2010 ) and critical reflexivity (Duncan-Andrade & Morrell, 2008 ) to highlight how researchers’ subjectivities shape ethnographic projects. Questions of subjectivity and positionality in her work reflect the larger discourses around these topics in feminist theory and qualitative research.

Brown ( 2011 ) provided another example of embedded and reflexive positionality of the articles surveyed. Her entire study engaged with questions about how her positionality influenced the study during the field-work portion of her ethnography on how race and racism operate in ethnographic field-work. This excerpt from her study highlights how she conceived of positionality and how it informed her work and her process.

Next, I provide a brief overview of the research study from which this paper emerged and I follow this with a presentation of four, first-person narratives from key encounters I experienced while doing ethnographic field research. Each of these stories centres the role race played as I negotiated my multiple, complex positionality vis-á-vis different informants and participants in my study. These stories highlight the emotional pressures that race work has on the researcher and the research process, thus reaffirming why one needs to recognise the role race plays, and may play, in research prior to, during, and after conducting one’s study (Milner, 2007 ). I conclude by discussing the implications these insights have on preparing researchers of color to conduct cross-racial qualitative research. (Brown, 2011 , p. 98)

Brown centered the roles of race and subjectivity, both hers and her participants, by focusing her analysis on the four narratives. The researchers highlighted in this section thought deeply about the ethics of their projects and the ways that their positionality informed their choice of methods.

Methods and Challenges

Feminist qualitative research can take many forms, but the most common data collection methods include interviews, observations, and narrative or discourse analysis. For the purposes of this article, methods refer to the tools and techniques researchers use, while methodology refers to the larger philosophical and epistemological approaches to conducting research. It is also important to note that these are not fixed terms, and that there continues to be much debate about what constitutes feminist theory and feminist research methods among feminist qualitative researchers. This section discusses some of the tensions and constraints of using feminist theory in educational research.

Jackson and Mazzei ( 2012 ) called on researchers to think through their data with theory at all stages of the collection and analysis process. They also reminded us that all data collection is partial and informed by the researcher’s own beliefs (Koro-Ljungberg, Löytönen, & Tesar, 2017 ). Interviews are sites of power and critiques because they show the power of stories and serve as a method of worlding, the process of “making a world, turning insight into instrument, through and into a possible act of freedom” (Spivak, 2014 , p. xiii). Interviews allow researchers and participants ways to engage in new ways of understanding past experiences and connecting them to feminist theories. The narratives serve as data, but it is worth noting that the data collected from interviews are “partial, incomplete, and always being re-told and re-membered” (Jackson & Mazzei, 2012 , p. 3), much like the lived experiences of both researcher and participant.

Research, data collection, and interpretation are not neutral endeavors, particularly with interviews (Jackson & Mazzei, 2009 ; Mazzei, 2007 , 2013 ). Since education research emerged out of educational psychology (Lather, 1991 ; St. Pierre, 2016 ), historically there has been an emphasis on generalizability and positivist data collection methods. Most feminist research makes no claims of generalizability or truth; indeed, to do so would negate the hyperpersonal and particular nature of this type of research (Love, 2017 ). St. Pierre ( 2016 ) viewed the lack of generalizability as an asset of feminist and poststructural research, rather than a limitation, because it creates a space of resistance against positivist research methodologies.

Denzin and Giardina ( 2016 ) urged researchers to “consider an alternative mode of thinking about the critical turn in qualitative inquiry and posit the following suggestion: perhaps it is time we turned away from ‘methodology’ altogether ” (p. 5, italics original). Despite the contention over the term critical among some feminist scholars (e.g. Ellsworth, 1989 ), their suggestion is valid and has been picked up by feminist and poststructural scholars who examine the tensions between following a strict research method/ology and the theoretical systems out of which they operate because precision in method obscures the messy and human nature of research (Koro-Ljungberg, 2016 ; Koro-Ljungberg et al., 2017 ; Love, 2017 ; St. Pierre & Pillow, 2000 ). Feminist qualitative researchers should seek to complicate the question of what method and methodology mean when conducting feminist research (Lather, 1991 ), due to the feminist emphasis on reflexive and situated research methods (Hesse-Biber, 2012 ).

Examples of Feminist Qualitative Research in Education

A complete overview of the literature is not possible here, due to considerations of length, but the articles and books selected represent the various debates within feminist educational research. They also show how research preoccupations have changed over the course of feminist work in education. The literature review is divided into three broad categories: Power, canons, and gender; feminist pedagogies, curriculums, and classrooms; and teacher education, identities, and knowledge. Each section provides a broad overview of the literature to demonstrate the breadth of work using feminist theory, with some examples more deeply explicated to describe how feminist theories inform the scholarship.

Power, Canons, and Gender

The literature in this category contests disciplinary practices that are androcentric in both content and form, while asserting the value of using feminist knowledge to construct knowledge. The majority of the work was written in the 1980s and supported the creation of feminist ways of knowing, particularly via the creation of women’s studies programs or courses in existing departments that centered female voices and experiences.

Questioning the canon has long been a focus of feminist scholarship, as has the attempt to subvert its power in the disciplines. Bezucha ( 1985 ) focused on the ways that departments of history resist the inclusion of both women and feminism in the historical canon. Similarly, Miller ( 1985 ) discussed feminism as subversion when seeking to expand the canon of French literature in higher education.

Lauter and Dieterich ( 1972 ) examined a report by ERIC, “Women’s Place in Academe,” a collection of articles about the discrepancies by gender in jobs and tenure-track positions and the lack of inclusion of women authors in literature classes. They also found that women were relegated to “softer” disciplines and that feminist knowledge was not acknowledged as valid work. Culley and Portuges ( 1985 ) expanded the focus beyond disciplines to the larger structures of higher education and noted the varies ways that professors subvert from within their disciplines. DuBois et al. ( 1985 ) chronicled the development of feminist scholarship in the disciplines of anthropology, education, history, literature, and philosophy. They explained that the institutions of higher education often prevent feminist scholars from working across disciplines in an attempt to keep them separate. Raymond ( 1985 ) also critiqued the academy for not encouraging relationships across disciplines and offered the development of women’s, gender, and feminist studies as one solution to greater interdisciplinary work.

Parson ( 2016 ) examined the ways that STEM syllabi reinforce gendered norms in higher education. She specifically looked at eight syllabi from math, chemistry, biology, physics, and geology classes to determine how modal verbs showing stance, pronouns, intertextuality, interdiscursivity, and gender showed power relations in higher education. She framed the study through poststructuralist feminist critical discourse analysis to uncover “the ways that gendered practices that favor men are represented and replicated in the syllabus” (p. 103). She found that all the syllabi positioned knowledge as something that is, rather than something that can be co-constructed. Additionally, the syllabi also favored individual and masculine notions of what it means to learn by stressing the competitive and difficult nature of the classroom and content.

When reading newer work on feminism in higher education and the construction of knowledge, it is easy to feel that, while the conversations might have shifted somewhat, the challenge of conducting interdisciplinary feminist work in institutions of higher education remains as present as it was during the creation of women’s and gender studies departments. The articles all point to the fact that simply including women’s and marginalized voices in the academy does not erase or mitigate the larger issues of gender discrimination and androcentricity within the silos of the academy.

Feminist Pedagogies, Curricula, and Classrooms

This category of literature has many similarities to the previous one, but all the works focus more specifically on questions of curriculum and pedagogy. A review of the literature shows that the earliest conversations were about the role of women in academia and knowledge construction, and this selection builds on that work to emphasize the ways that feminism can influence the events within classes and expands the focus to more levels of education.

Rich ( 1985 ) explained that curriculum in higher education courses needs to validate gender identities while resisting patriarchal canons. Maher ( 1985 ) narrowed the focus to a critique of the lecture as a pedagogical technique that reinforces androcentric ways of learning and knowing. She called for classes in higher education to be “collaborative, cooperative, and interactive” (p. 30), a cry that still echoes across many college campuses today, especially from students in large lecture-based courses. Maher and Tetreault ( 1994 ) provided a collection of essays that are rooted in feminist classroom practice and moved from the classroom into theoretical possibilities for feminist education. Warren ( 1998 ) recommended using Peggy McIntosh’s five phases of curriculum development ( 1990 ) and extending it to include feminist pedagogies that challenge patriarchal ways of teaching. Exploring the relational encounters that exist in feminist classrooms, Sánchez-Pardo ( 2017 ) discussed the ethics of pedagogy as a politics of visibility and investigated the ways that democratic classrooms relate to feminist classrooms.

While all of the previously cited literature is U.S.–based, the next two works focus on the ways that feminist pedagogies and curriculum operate in a European context. Weiner ( 1994 ) used autobiography and narrative methodologies to provide an introduction to how feminism has influenced educational research and pedagogy in Britain. Revelles-Benavente and Ramos ( 2017 ) collected a series of studies about how situated feminist knowledge challenges the problems of neoliberal education across Europe. These two, among many European feminist works, demonstrate the range of scholarship and show the trans-Atlantic links between how feminism has been received in educational settings. However, much more work needs to be done in looking at the broader global context, and particularly by feminist scholars who come from non-Western contexts.

The following literature moves us into P–12 classrooms. DiGiovanni and Liston ( 2005 ) called for a new research agenda in K–5 education that explores the hidden curriculums surrounding gender and gender identity. One source of the hidden curriculum is classroom literature, which both Davies ( 2003 ) and Vandergrift ( 1995 ) discussed in their works. Davies ( 2003 ) used feminist ethnography to understand how children who were exposed to feminist picture books talked about gender and gender roles. Vandergrift ( 1995 ) presented a theoretical piece that explored the ways picture books reinforce or resist canons. She laid out a future research agenda using reader response theory to better comprehend how young children question gender in literature. Willinsky ( 1987 ) explored the ways that dictionary definitions reinforced constructions of gender. He looked at the definitions of the words clitoris, penis , and vagina in six school dictionaries and then compared them with A Feminist Dictionary to see how the definitions varied across texts. He found a stark difference in the treatment of the words vagina and penis ; definitions of the word vagina were treated as medical or anatomical and devoid of sexuality, while definitions of the term penis were linked to sex (p. 151).

Weisner ( 2004 ) addressed middle school classrooms and highlighted the various ways her school discouraged unconventional and feminist ways of teaching. She also brought up issues of silence, on the part of both teachers and students, regarding sexuality. By including students in the curriculum planning process, Weisner provided more possibilities for challenging power in classrooms. Wallace ( 1999 ) returned to the realm of higher education and pushed literature professors to expand pedagogy to be about more than just the texts that are read. She challenged the metaphoric dichotomy of classrooms as places of love or battlefields; in doing so, she “advocate[d] active ignorance and attention to resistances” (p. 194) as a method of subverting transference from students to teachers.

The works discussed in this section cover topics ranging from the place of women in curriculum to the gendered encounters teachers and students have with curriculums and pedagogies. They offer current feminist scholars many directions for future research, particularly in the arena of P–12 education.

Teacher Education, Identities, and Knowledge

The third subset of literature examines the ways that teachers exist in classrooms and some possibilities for feminist teacher education. The majority of the literature in this section starts from the premise that the teachers are engaged in feminist projects. The selections concerning teacher education offer critiques of existing heteropatriarchal normative teacher education and include possibilities for weaving feminism and feminist pedagogies into the education of preservice teachers.

Holzman ( 1986 ) explored the role of multicultural teaching and how it can challenge systematic oppression; however, she complicated the process with her personal narrative of being a lesbian and working to find a place within the school for her sexual identity. She questioned how teachers can protect their identities while also engaging in the fight for justice and equity. Hoffman ( 1985 ) discussed the ways teacher power operates in the classroom and how to balance the personal and political while still engaging in disciplinary curriculums. She contended that teachers can work from personal knowledge and connect it to the larger curricular concerns of their discipline. Golden ( 1998 ) used teacher narratives to unpack how teachers can become radicalized in the higher education classroom when faced with unrelenting patriarchal and heteronormative messages.

Extending this work, Bailey ( 2001 ) discussed teachers as activists within the classroom. She focused on three aspects of teaching: integrity with regard to relationships, course content, and teaching strategies. She concluded that teachers cannot separate their values from their profession. Simon ( 2007 ) conducted a case study of a secondary teacher and communities of inquiry to see how they impacted her work in the classroom. The teacher, Laura, explicitly tied her inquiry activities to activist teacher education and critical pedagogy, “For this study, inquiry is fundamental to critical pedagogy, shaped by power and ideology, relationships within and outside of the classroom, as well as teachers’ and students’ autochthonous histories and epistemologies” (Simon, 2007 , p. 47). Laura’s experiences during her teacher education program continued during her years in the classroom, leading her to create a larger activism-oriented teacher organization.

Collecting educational autobiographies from 17 college-level feminist professors, Maher and Tetreault ( 1994 ) worried that educators often conflated “the experience and values of white middle-class women like ourselves for gendered universals” (p. 15). They complicated the idea of a democratic feminist teacher, raised issues regarding the problematic ways hegemonic feminism flattens experience to that of just white women, and pushed feminist professors to pay particular attention to the intersections of race, class, gender, and sexuality when teaching.

Cheira ( 2017 ) called for gender-conscious teaching and literature-based teaching to confront the gender stereotypes she encountered in Portuguese secondary schools. Papoulis and Smith ( 1992 ) conducted summer sessions where teachers experienced writing activities they could teach their students. Conceptualized as an experiential professional development course, the article revolved around an incident where the seminar was reading Emily Dickinson and the men in the course asked the two female instructors why they had to read feminist literature and the conversations that arose. The stories the women told tie into Papoulis and Smith’s call for teacher educators to interrogate their underlying beliefs and ideologies about gender, race, and class, so they are able to foster communities of study that can purposefully and consciously address feminist inquiry.

McWilliam ( 1994 ) collected stories of preservice teachers in Australia to understand how feminism can influence teacher education. She explored how textual practices affect how preservice teachers understand teaching and their role. Robertson ( 1994 ) tackled the issue of teacher education and challenged teachers to move beyond the two metaphors of banking and midwifery when discussing feminist ways of teaching. She called for teacher educators to use feminist pedagogies within schools of education so that preservice teachers experience a feminist education. Maher and Rathbone ( 1986 ) explored the scholarship on women’s and girls’ educational experiences and used their findings to call for changes in teacher education. They argued that schools reinforce the notion that female qualities are inferior due to androcentric curriculums and ways of showing knowledge. Justice-oriented teacher education is a more recent iteration of this debate, and Jones and Hughes ( 2016 ) called for community-based practices to expand the traditional definitions of schooling and education. They called for preservice teachers to be conversant with, and open to, feminist storylines that defy existing gendered, raced, and classed stereotypes.

Bieler ( 2010 ) drew on feminist and critical definitions of dialogue (e.g., those by Bakhtin, Freire, Ellsworth, hooks, and Burbules) to reframe mentoring discourse in university supervision and dialogic praxis. She concluded by calling on university supervisors to change their methods of working with preservice teachers to “Explicitly and transparently cultivat[e] dialogic praxis-oriented mentoring relationships so that the newest members of our field can ‘feel their own strength at last,’ as Homer’s Telemachus aspired to do” (Bieler, 2010 , p. 422).

Johnson ( 2004 ) also examined the role of teacher educators, but she focused on the bodies and sexualities of preservice teachers. She explored the dynamics of sexual tension in secondary classrooms, the role of the body in teaching, and concerns about clothing when teaching. She explicitly worked to resist and undermine Cartesian dualities and, instead, explored the erotic power of teaching and seducing students into a love of subject matter. “But empowered women threaten the patriarchal structure of this society. Therefore, women have been acculturated to distrust erotic power” (Johnson, 2004 , p. 7). Like Bieler ( 2010 ), Johnson ( 2004 ) concluded that, “Teacher educators could play a role in creating a space within the larger framework of teacher education discourse such that bodily knowledge is considered along with pedagogical and content knowledge as a necessary component of teacher training and professional development” (p. 24). The articles about teacher education all sought to provoke questions about how we engage in the preparation and continuing development of educators.

Teacher identity and teacher education constitute how teachers construct knowledge, as both students and teachers. The works in this section raise issues of what identities are “acceptable” in the classroom, ways teachers and teacher educators can disrupt oppressive storylines and practices, and the challenges of utilizing feminist pedagogies without falling into hegemonic feminist practices.

Possibilities for Feminist Qualitative Research

Spivak ( 2012 ) believed that “gender is our first instrument of abstraction” (p. 30) and is often overlooked in a desire to understand political, curricular, or cultural moments. More work needs to be done to center gender and intersecting identities in educational research. One way is by using feminist qualitative methods. Classrooms and educational systems need to be examined through their gendered components, and the ways students operate within and negotiate systems of power and oppression need to be explored. We need to see if and how teachers are actively challenging patriarchal and heteronormative curriculums and to learn new methods for engaging in affirmative sabotage (Spivak, 2014 ). Given the historical emphasis on higher education, more work is needed regarding P–12 education, because it is in P–12 classrooms that affirmative sabotage may be the most necessary to subvert systems of oppression.

In order to engage in affirmative sabotage, it is vital that qualitative researchers who wish to use feminist theory spend time grappling with the complexity and multiplicity of feminist theory. It is only by doing this thought work that researchers will be able to understand the ongoing debates within feminist theory and to use it in a way that leads to a more equitable and just world. Simply using feminist theory because it may be trendy ignores the very real political nature of feminist activism. Researchers need to consider which theories they draw on and why they use those theories in their projects. One way of doing this is to explicitly think with theory (Jackson & Mazzei, 2012 ) at all stages of the research project and to consider which voices are being heard and which are being silenced (Gilligan, 2011 ; Spivak, 1988 ) in educational research. More consideration also needs to be given to non-U.S. and non-Western feminist theories and research to expand our understanding of education and schooling.

Paying close attention to feminist debates about method and methodology provides another possibility for qualitative research. The very process of challenging positivist research methods opens up new spaces and places for feminist qualitative research in education. It also allows researchers room to explore subjectivities that are often marginalized. When researchers engage in the deeply reflexive work that feminist research requires, it leads to acts of affirmative sabotage within the academy. These discussions create the spaces that lead to new visions and new worlds. Spivak ( 2006 ) once declared, “I am helpless before the fact that all my essays these days seem to end with projects for future work” (p. 35), but this is precisely the beauty of feminist qualitative research. We are setting ourselves and other feminist researchers up for future work, future questions, and actively changing the nature of qualitative research.

Acknowledgements

Dr. George Noblit provided the author with the opportunity to think deeply about qualitative methods and to write this article, for which the author is extremely grateful. Dr. Lynda Stone and Dr. Tanya Shields are thanked for encouraging the author’s passion for feminist theory and for providing many hours of fruitful conversation and book lists. A final thank you is owed to the author’s partner, Ben Skelton, for hours of listening to her talk about feminist methods, for always being a first reader, and for taking care of their infant while the author finished writing this article.

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• Published: 13 September 2024

A qualitative study on reasons for women’s loss and resumption of Option B plus care in Ethiopia

• Wolde Facha   ORCID: orcid.org/0000-0002-7463-524X 1 ,
• Takele Tadesse 1 ,
• Eskinder Wolka 1 &
• Ayalew Astatkie 2  

Scientific Reports volume  14 , Article number:  21440 ( 2024 ) Cite this article

Metrics details

• Health care
• Medical research

Loss to follow-up (LTFU) from Option B plus, a lifelong antiretroviral therapy (ART) for pregnant women living with human immunodeficiency virus (HIV), irrespective of their clinical stage and CD4 count, threatens the elimination of vertical transmission of the virus from mothers to their infants. However, evidence on reasons for LTFU and resumption after LTFU to Option B plus care among women has been limited in Ethiopia. Therefore, this study explored why women were LTFU from the service and what made them resume or refuse resumption after LTFU in Ethiopia. An exploratory, descriptive qualitative study using 46 in-depth interviews was employed among purposely selected women who were lost from Option B plus care or resumed care after LTFU, health care providers, and mother support group (MSG) members working in the prevention of mother-to-child transmission unit. A thematic analysis using an inductive approach was used to analyze the data and build subthemes and themes. Open Code Version 4.03 software assists in data management, from open coding to developing themes and sub-themes. We found that low socioeconomic status, poor relationship with husband and/or family, lack of support from partners, family members, or government, HIV-related stigma, and discrimination, lack of awareness on HIV treatment and perceived drug side effects, religious belief, shortage of drug supply, inadequate service access, and fear of confidentiality breach by healthcare workers were major reasons for LTFU. Healthcare workers' dedication to tracing lost women, partner encouragement, and feeling sick prompted women to resume care after LTFU. This study highlighted financial burdens, partner violence, and societal and health service-related factors discouraged compliance to retention among women in Option B plus care in Ethiopia. Women's empowerment and partner engagement were of vital importance to retain them in care and eliminate vertical transmission of the virus among infants born to HIV-positive women.

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Introduction.

Lost to follow-up is a major challenge in the prevention of mother-to-child transmission (PMTCT) of HIV among HIV-exposed infants (HEI). Globally, about 1.5 million children under 15 years old were living with HIV, and 130,000 acquired the virus in 2022 1 . In the African region, an estimated 1.3 million children aged 0–14 were living with HIV at the end of 2022, and 109,000 children were newly infected 2 . Five out of six paediatric HIV infections occurred in sub-Saharan Africa in 2022 3 . Most of these infections are due to mother-to-child transmission (MTCT), accounting for around 90% of all new infections 4 , 5 . Without any intervention, between 15 and 45 percent of infants born to HIV-positive mothers are likely to acquire the virus from their mothers, with half dying before their second birthday without treatment 3 . Almost 70% of new HIV infections were due to mothers not receiving ART or dropping off during pregnancy or breastfeeding 3 .

In Ethiopia, the burden of MTCT of HIV is high, with a pooled prevalence ranging from 5.6% to 11.4% 6 , 7 , 8 , 9 , 10 . Ethiopia adopted the 2013 World Health Organization’s Option B plus recommendations as the preferred strategy for the PMTCT of HIV in 2013 11 , 12 , 13 , 14 . Accordingly, a combination of triple antiretroviral (ARV) drugs was provided for all HIV-infected pregnant and/or breastfeeding women, irrespective of their CD4 count and World Health Organization (WHO) clinical staging 11 , 13 . Besides, the drug type was switched from an EFV-based to a DTG-based regimen to enhance maternal life quality and decrease LTFU from Option B plus care 11 , 15 . The Efavirenz-based regimen consists of Tenofovir (TDF), Lamivudine (3TC), and Efavirenz (EFV), while the DTG-based regimen consists of TDF, 3TC, and DTG 13 , 15 , 16 . The change in regimen was due to better tolerability and rapid viral suppression, thereby retaining women in care and achieving MTCT of HIV targets 17 , 18 .

The trend of women accessing ART for PMTCT services increases, and new HIV infections decrease over time 3 , 19 , 20 . However, the effectiveness of Option B plus depends not only on service coverage but also on drug adherence and retention in care 4 , 15 , 21 . In this regard, quantitative studies conducted in Ethiopia showed that the prevalence of LTFU from Option B plus ranged from 4.2% to 18.2% 22 , 23 , 24 . Besides, the overall incidence of LTFU ranged from 9 to 9.4 per 1000 person-months of observation 25 , 26 , which is a challenge for the success of the program.

Qualitative studies also revealed that the main reasons for LTFU among women were maternal educational status, drug side effects, lack of partner and family support, lack of HIV status disclosure, poverty, discordant HIV test results, religious belief, stigma, and discrimination, long distance to the health facility, and history of poor adherence to ART 27 , 28 , 29 , 30 , 31 , 32 . Reasons for resumption to care were a decline in health status, a desire to have an uninfected child, and support from others 30 , 33 . Unless the above risk factors for LTFU are managed, the national plan to eliminate the MTCT of HIV by 2025 will not be achieved 34 .

Currently, because of its fewer side effects and better tolerability, a Dolutegravir (DTG)-based regimen is given as a preferred first-line regimen to pregnant and/or breastfeeding women to reduce the risk of LTFU 13 , 16 . The goal is to reduce new HIV transmissions and achieve Sustainable Development Goal (SDG) 3.3 of ending Acquired Immunodeficiency Syndrome (AIDS) as a public health threat by 2030 35 , 36 , 37 . As mentioned above, there is rich information on the prevalence and risk factors of LTFU among women on Option B plus care before the DTG-based regimen was implemented. Besides, the previous qualitative studies addressed the reasons for LTFU from providers’ and/or women’s perspectives rather than including mother support group (MSG) members. However, there was a lack of evidence that explored the reasons for LTFU and resumption of care after LTFU from the perspectives of MSG members, lost women, and healthcare workers (HCWs) providing care to women. Therefore, this study aimed to explore the reasons why women LTFU and resumed Option B plus care after the implementation of a DTG-based regimen in Ethiopia.

Materials and methods

Study design and setting.

An exploratory, descriptive qualitative study 38 was conducted between June and October 2023. This study was conducted in two regions of Ethiopia: Central Ethiopia and South Ethiopia. These neighbouring regions were formed on August 19, 2023, after the disintegration of the Southern Nations, Nationalities, and Peoples' Region after a successful referendum 39 . The authors included these nearby regions to get an adequate sample size and cover a wider geographic area. In these regions, 140 health facilities (49 hospitals and 91 health centers) provided PMTCT and ART services to 28,885 patients at the time of the study, of whom 1,236 were pregnant or breastfeeding women (675 in South Ethiopia and 561 in Central Ethiopia).

Participants and data collection

Study participants were women who were lost from PMTCT care or resumed PMTCT care after LTFU, MSG members, and HCWs provided PMTCT care. Mother support group members were HIV-positive women working in the PMTCT unit to share experiences and provide counselling services on breastfeeding, retention, and adherence, and to trace women when they lost Option B plus care 11 , 40 . Healthcare workers were nurses or midwives working in the PMTCT unit to deliver services to women enrolled in Option B plus care.

Purposive criterion sampling was employed to select study participants from twenty-one facilities (nine health centers and twelve hospitals) providing PMTCT service. A total of 46 participants were included in the study. The interview included 15 women (eleven lost and four resumed care after LTFU), 14 providers, and 17 MSG members. Healthcare workers and MSG members were chosen based on the length of time they spent engaging with women on Option B plus care; the higher the work experience, the more they were selected to get adequate information about the study participants. Including the study participants in each group continued until data saturation.

The principal investigator, with the help of HCWs and MSG members, identified lost women from the PMTCT registration books and appointment cards. A woman's status was recorded as LTFU if she missed the last clinic appointment for at least 28 days without documented death or transfer out to another facility 15 . Providers contacted women based on their addresses recorded during enrolment in Option B plus care, either via phone (if functional) or by conducting home visits for those unable to be reached. Informed written consent was obtained, and the research assistants conducted in-depth interviews at women’s homes or health facilities based on their preferences. After an interview, eleven women who lost care were counselled to resume PMTCT care, but nine returned to care and two refused to resume care. Besides, the principal investigator, HCWs, and MSG members identified women who resumed care after LTFU, called them via phone to visit the health facility at their convenience, and conducted the interview after obtaining consent. The research team covered transportation costs and provided adherence counselling to women post-interview. A woman resumed care if she came back to PMTCT care on her own or healthcare workers’ efforts after LTFU.

One-on-one, in-depth interviews were conducted with eligible MSG members and HCWs at respective health facilities. A semi-structured interview guide translated into the local language (Amharic) was used to collect data. The guide comprises the following constructs: why women are lost to follow-up from PMTCT care, what made them resume caring after LTFU, and why they did not resume Option B plus care after LTFU with probing questions (Supplementary File 1 ). The interview was conducted for 18 to 37 min with each participant, and the duration was communicated to study participants before the interview. The interview was audio-taped, and field notes were taken during the interviews.

Data management and analysis

Thematic analysis was used to analyze the data. The research assistants transcribed the interviews verbatim within 48 h of data collection and translated them from the local language (Amharic) to English for analysis. The principal investigator read the translated document several times to get a general sense of the content. An inductive approach was applied to allow the conceptual clustering of ideas and patterns to emerge. The authors preferred an inductive approach to analyze data since there were no pre-determined categories. The core meaning of the phrases and sentences relevant to the research aim was searched. Codes were assigned to the phrases and sentences in the transcript, which were later used to develop themes and subthemes. The subthemes were substantiated by quotes from the interviews. The interviews developed two themes: reasons for LTFU and the reasons for resumption after LTFU. The findings were triangulated from healthcare workers, MSG members, and client responses. Open code software version 4.03 was used to assist in data management, from open coding to the development themes and sub-themes.

Background characteristics of the study participants

We successfully interviewed 46 participants (14 providers, 15 women, and 17 MSG members) until data saturation. The mean (± standard deviation [SD]) of age was 25.53 (± 0.99) years for women, 32.5 (± 1.05) years for MSG members, and 32.2 (± 1.05) years for care providers. Three out of fifteen women did not disclose their HIV status to their partner, and 5/15 women’s partners were discordant. The mean (± SD) service years in the PMTCT unit were 10.3 (± 1.3) for MSG members and 3.29 (± 0.42) for care providers (Supplementary File 2 ).

Reasons for LTFU

Women who started ART to prevent MTCT of HIV were lost from care due to different reasons. Societal and individual-related factors and health facility-related factors were the two main dimensions that made women LTFU. The societal and individual-related factors were socioeconomic status, relations with husbands or families, lack of support, HIV-related stigma and discrimination, lack of awareness and perceived antiretroviral (ARV) side effects, and religious belief. Health facility-related factors such as lack of confidentiality, drug supply shortages, and inadequate service access led to women's loss from Option B plus care (Supplementary File 3 ).

Societal and individual-related factors

Socioeconomic status.

Lack of money to buy food was a major identified problem for women’s LTFU. Women who did not have adequate food to eat became undernourished, which significantly increased the risk of LTFU. Besides, they did not want to swallow ARV drugs with an empty stomach and thus did not visit health facilities to collect their drugs.

“My life is miserable. I have nothing to eat at my home. How would I take the drug on an empty stomach? Let the disease kill me rather than die due to hunger. This is why I stopped to take the medicine and LTFU.” (W-02, 30-year-old woman, divorced, daily labourer)

Women also disappeared from PMTCT care due to a lack of money to cover transportation costs to reach health facilities.

I need a lot of money to pay for transportation that I can’t afford. Sometimes I came to the hospital borrowing money for transportation. It is challenging to attend a follow-up schedule regularly to collect ART medications.” (W-11, 26-year-old woman, married, housewife)

Relationships with husbands and/or families

Fear of violence and divorce by sexual partners were identified as major reasons for the LTFU of women from PMTCT care. Due to fear of partner violence and divorce, women did not want to be seen by their partners while visiting health facilities for Option B plus care and swallowing ARV drugs. As a result, they missed clinic appointments, did not swallow the drugs, and consequently lost care.

“Due to discordant test results, my husband divorced me. Then I went to my mother's home with my child. I haven’t returned to take the drug since then and have lost PMTCT care.” (W-03, 25-year-old woman, divorced, commercial sex worker)

Women did not disclose their HIV status to their discordant sexual partners and family members due to fear of stigma and discrimination. As a result, they did not swallow drugs in front of others and were unable to collect the drugs from health facilities.

“I know a mother who picked up her drugs on market day as if she came to the market to buy goods. No one knows her status. She hides the drug and swallows it when her husband sleeps.” (P-05, 29-year-old provider, female, 3 years of experience in the PMTCT unit) “I don't want to be seen at the ART unit. I have no reason to convince the discordant husband to visit a health facility after delivery. My husband kills me if he knows that I am living with HIV. This is why I discontinued the care.” (W-12, 18-year-old woman, married, housewife)

Women who lack partner support in caring for children at home during visits to health facilities find it difficult to adhere to clinic visits. Besides, women who did not get financial and psychological support from their partners faced difficulties in retaining care.

“Taking care of children is not business for my husband. How could I leave my two children alone at home? Or can I bring them biting with my teeth?” (W-05, 24-year-old woman, divorced, daily labourer) “ I didn't get any financial or psychological support from my husband. This made me drop PMTCT care.” (W-15, 34-year-old woman, married, daily labourer) Lack of support

Women living with HIV also had complaints of lack of support from the government, non-governmental organizations (NGOs), and HIV-related associations in cash and in kind. As a result, they were disappointed to remain in care.

"Previously, we got financial and material support from NGOs. Besides, the government arranged places for material production and goods sale to improve our economic status. However, now we didn't get any support from anywhere. This made our lives hectic to retain PMTCT care.” (W-06, 29-year-old woman, married, daily labourer)

HIV-related stigma and discrimination

Fear of stigma and discrimination by sexual partners, family members, and the community were mentioned as reasons for LTFU. Gossip, isolation, and rejection from societal activities were the dominant stigma experiences the women encountered. As a result, they did not want to be seen by others who knew them while collecting ARV drugs from health facilities, and consequently, they were lost from care and treatment.

“Despite getting PMTCT service at the nearby facility, some women come to our hospital traveling long distances. They don't want to be seen by others while taking ARV drugs there due to fear of stigma and discrimination by the community.” (P-10, 34-year-old provider, female, 2 years of experience in the PMTCT unit) “I am a daily labourer and bake ‘injera’ (a favourite food in Ethiopia) at someone's house to run my life. If the owner knew my status, I am sure she would not allow me to continue the job. In that case, what would I give my child to eat?” (W-12, 18-year-old woman, married, housewife) “My family did not know that I was living with the virus. If they knew it, I am sure they would not allow me to contact them during any events. Thus, I am afraid of telling them that I had the virus in my blood.” (W-05, 24-year-old woman, divorced, daily labourer)

Lack of awareness and perceived ARV side effects

Sometimes women went to another area for different reasons without taking ARV drugs with them. As per the Ethiopian national treatment guidelines 13 , they could get the drugs temporarily from any nearby facility that delivers PMTCT service. However, those who did not know that they could get the drugs from other nearby PMTCT facilities lost their care until their return. Others were lost, considering that ARV drugs harm the health status of their babies.

“One mother refused to retain in care after the delivery of a congenitally malformed baby (no hands at birth). She said, 'This abnormal child was born due to the drug I was taking for HIV. I delivered two healthy children before taking this medication. I don't want to re-use the drug that made me give birth to a malformed baby." (P-14, 32-year-old provider, female, 4 years of experience in the PMTCT unit)

When they did not encounter any health problems, women were lost from care, considering that they had become healthy and not in need of ART. Some of them also believe that having HIV is a result of sin, not a disease. Besides, some women believed that it was not possible to have a discordant test result with their partner.

“I didn't commit any sexual practice other than with my husband. His test result is negative. So, from where did I get the virus? I don't want to take the drug again.” (W-02, 30-year-old woman, divorced, daily labourer)

Religious belief

Some study participants mentioned religious belief as a reason for LTFU and a barrier to resumption after LTFU. Women discontinued Option B plus care due to their religious faith and refused to resume care as they were cured by the Holy Water and prayer by religious leaders.

“I went to Holy Water and was there for two months. My health status resumed due to prayer by monks and priests there. Despite not taking the drugs during my stay, God cured me of this evil disease with Holy Water. Now I am healthy, and there is no need to take the medicine again.” (W-09, 25-year-old woman, married, daily labourer)

Some women believed that God cured them and made their children free of the virus despite not taking ART for themselves and not giving ARV prophylaxis for their infants.

“Don't raise this issue again (when MSG asked to resume PMTCT care). I don't want to use the medicine. I am cured of the disease by the word of God, and my child is too. My God did not lie in His word.” (MSG-16, 32-year-old MSG, married, 16 years of service experience “Don't come to my home again. I don't have the virus now. I have been praying for it, and God cured me.” (W-03, 25-year-old woman, divorced, commercial sex worker)

Health facility-related factors

Shortage of drug supply.

Women were not provided with all HIV-related services free of charge and were required to pay for therapeutic and prophylactic drugs for themselves and their infants. Most facilities face a shortage of prophylactic drugs, primarily cotrimoxazole and nevirapine syrups, for infants and women, and other drugs used to treat opportunistic infections. As a result, women lost their PMTCT care when told to buy prophylactic syrups for infants and therapeutic drugs to treat opportunistic infections for themselves.

“Lack of cotrimoxazole syrup is one of the major reasons for women to miss PMTCT clinic visits. In our facility, it was out of stock for the last three months. Women can't afford its cost due to their economic problems.” (MSG-03, 34-year-old provider, married, 12 years of service experience)

Inadequate service access

Most women travelled long distances to reach health facilities to get PMTCT service due to the absence of a PMTCT site in their area. Due to a lack of transportation access and/or cost, they were forced to miss clinic visits for PMTCT care.

“In this district, there were only two PMTCT sites. Women travelled long distances to get the service. To reach our facility, they must travel half a day or pay more than three hundred Ethiopian birr for a motorbike that some cannot afford. Thus, women lost the service due to inadequate service access.” (P-06, 30-year-old provider, male, 2 years of experience in the PMTCT unit)

In almost all facilities, PMTCT service was not given on weekends and holidays, despite women's interest in being served at these times. When ARV drugs were stocked out at their homes, they did not get the drugs if facilities were not providing services on weekends and holidays. When appointment date was passed, they lost care due to fear of health workers’ reactions.

Lack of confidentiality

Despite maintaining ethical principles to retain women in care, breaches of confidentiality by HCWs were one of the reasons for LTFU by women. Women were afraid of meeting someone they knew or that their privacy would not be respected. As a result, they lost from PMTCT care.

“I don’t want to visit the facility. All my information was distributed to the community by a HCW who counselled me at the antenatal clinic.” (W-09, 25-year-old woman, married, daily labourer)

Reasons for resumption after LTFU

Healthcare workers' commitment to searching for lost women, partners’ encouragement, and women’s health status were key reasons for resuming women's Option B plus services after LTFU.

Healthcare workers’ commitment

The majority of lost women resumed Option B plus care after LTFU when healthcare workers called them via phone or conducted home visits for those who could not be reached by phone call.

“We went to a woman’s home, who started ART during delivery and lost for four months, travelling about 90 kilometers. She just cried when she saw us. She said, 'As long as you sacrificed your time traveling such a long distance to return me and save my life, I will never disappear from care today onward.' Then, she returned immediately and was linked to the ART unit after completing her PMTCT program.” (P-13, 32-year-old provider, male, 5 years of experience in the PMTCT unit) “We have an appointment date registry for every woman. We waited for them for seven days after they failed to arrive on the scheduled appointment date. From the 8th day onward, we called them via phone if it was available and functional. If we didn't find them via phone, we conducted home visits and returned them to care.” (P-02, 24-year-old provider, female, 3 years of experience in the PMTCT unit)

Partner encouragement

Women who got their partners' encouragement did not drop out of PMTCT care. Besides, most women returned to care and restarted their ARV drugs due to partner encouragement.

“I did not disclose my HIV status to my husband, which was diagnosed during the antenatal period. I lost my care after the delivery of a male baby. When my husband knew my status, rather than disagreeing, he encouraged me to resume the care to live healthily and to prevent the transmission of HIV to our baby. This was why I resumed care after LTFU.” (W-14, 28-year-old woman, divorced, daily labourer)

Women’s health status

Some women returned to Option B plus care on their own when they felt sick and wanted to stay healthy.

“When I felt healthy, I was away from care for about eight months. Later on, when I sought medical care for the illness, doctors gave me medicine and linked me to this unit (the PMTCT unit). I returned because of sickness.” (W-06, 29-year-old woman, married, daily labourer)

This qualitative study assessed the reasons why women left the service and why they resumed care after LTFU. The study aimed to enhance program implementation by providing insights into reasons for LTFU and facilitators for resumption from women's, health professionals', and MSG members' perspectives. We found that financial problems, partner violence, lack of support, HIV-related stigma and discrimination, lack of awareness, religious belief, shortage of drug supply, poor access to health services, and fear of confidentiality breaches by healthcare providers were major reasons for LTFU from PMTCT care. Healthcare workers’ commitment, partner encouragement, and feeling sick made women resume PMTCT care after LTFU.

In this study, fear of partner violence and divorce were identified as major reasons that made women discontinue the PMTCT service. Men are the primary decision-makers regarding healthcare service utilization, and the lack of male involvement in the continuity of PMTCT care decreases maternal health service utilization, including PMTCT services 41 , 42 . In addition, economic dependence on men threatened women not to adhere to clinic appointments without their partner’s willingness due to fear of violence and divorce 28 . Thus, strengthening couple counselling and testing 13 , male involvement in maternal health services, and women empowerment strategies like promoting education, property ownership, and authority sharing to reach decisions on health service utilization were crucial to retaining women in PMTCT care. Besides, legal authorities and community and religious leaders should be involved in preventing domestic violence and raising awareness about the negative effects of divorce on child health.

Financial constraints to cover daily expenses were major reasons expressed by women for LTFU from PMTCT care. Consistent with other studies, this study revealed that a lack of money to cover transportation costs resulted in poor adherence to ART and subsequent loss of PMTCT care 27 , 29 , 43 . As evidenced by other studies, lack of food resulting from financial problems was a major reason for LTFU in the study area 30 . As a result, women prefer death to living with hunger due to food scarcity, which led them to LTFU. Besides, women of poor economic status spent more time on jobs to get money to cover day-to-day expenses than thinking of appointment dates. Thus, governments and organizations working on HIV prevention programs should strengthen economic empowerment programs like arranging loans to start businesses and creating job opportunities for women living with HIV.

Despite continuous information dissemination via different media, fear of stigma and discrimination was a frequently reported reason for LTFU among women in PMTCT care. Consistent with other studies conducted in Ethiopia and other African countries, our study identified that fear of stigma and discrimination by partners, family, and community members are significant risk factors for LTFU 27 , 28 , 29 , 31 . As a result, women did not usually disclose their HIV status to their partners 28 , 32 so that they could not get financial and psychological support. This highlights the need to intensify interventions by different stakeholders to reduce HIV-related stigma and discrimination in the study area. Women's associations, community-based organizations, and religious, community, and political leaders should continuously work on advocacy and awareness creation to combat HIV-related stigma and discrimination.

Our study revealed that a lack of support for women made them discontinue life-saving ARV drugs. In developing countries like Ethiopia, most women living with HIV have low socio-economic status to run their lives, and thus they need support. However, as claimed by the majority of study participants, the government and organizations working on HIV programs were decreasing support from time to time. This was in line with qualitative studies such that lack of support by family members or partners 27 was identified as a barrier to adherence to and retention in PMTCT care 27 , 28 , 29 , 30 , 32 . Organizations working on HIV programs need to design strategies so that poor women get support from partners, family members, the community, religious leaders, and the government to stay in PMTCT care. Moreover, some women thought incentives and support must be given to retain them in Option B plus care. Thus, HCWs should inform women during counselling sessions that they should not link getting PMTCT care to incentives or support.

Women infected with HIV want to be healthy and have HIV-free infants, which could be achieved by proper utilization of recommended therapy as per the protocol 27 , 43 . However, women’s religious beliefs were found to interfere with adherence to the recommended treatment protocol, made them LTFU, and refused resumption after LTFU. Although religious belief did not oppose the use of ARV drugs at any time, women did not take the medicine when they went to Holy Water and prayer. As evidenced by previous studies, lost women perceived that they were cured of the disease with the help of God and refused to resume PMTCT care 27 , 30 . This finding suggests the need for sustained community sensitization about HIV and its treatment, engaging religious leaders. They need to inform women on ART that taking ARV drugs does not contradict religious preaching, and they should not discontinue the drug at any religious engagement.

Once on ART, women should not regress from care and treatment due to problems related to the facility. Unlike the study conducted in Malawi, which reported a shortage of drugs as not a cause of LTFU 29 , in the study area there was a shortage of drugs and supplies to give appropriate care to women and their infants and to retain them in care. They did not get all services related to HIV free of charge and were requested to pay for them, including the cotrimoxazole syrup given to their infants. The finding was consistent with the study conducted in Malawi, where the irregular availability of cotrimoxazole syrup was mentioned as a risk factor for LTFU 32 .

On some occasions, there may also be a shortage of ARV prophylaxis (Nevirapine and Zidovudine syrups) at some facilities for their infants that they couldn’t get from private pharmacies. Services related to PMTCT care were expected to be free of charge for mothers and their infants throughout the care. Ensuring an adequate supply of prophylactic and therapeutic drugs should be considered to prevent the MTCT of HIV and control the spread of the disease among communities via appropriate resource allocation. Facilities should have an adequate supply of ARV prophylaxis and should not request that women pay for diagnostic services. Besides, they always need to provide cotrimoxazole syrup free of charge for HIV-exposed infants.

Lack of awareness of a continuum of PMTCT care among women is a major challenge to retaining them in care. Women who experienced malpractice against standard care practice and had misconceptions about the disease were at higher risk for LTFU. Those women who forgot to take ARV drugs due to different reasons (maybe due to poor counselling) did not get the benefits of ART. Improved counselling and appropriate patient-provider interaction increase women’s engagement in care and reduce the risk of LTFU 28 , 44 . Thus, proper counselling on adherence, malpractice, and misconceptions should be strengthened by healthcare providers in PMTCT units to create optimal awareness for retention.

Maintaining clients’ confidentiality is the backbone of achieving HIV-related treatment goals. However, some women disappear from PMTCT care due to a lack of confidentiality by HCWs delivering the service. Although not large, women claimed a lack of privacy during counselling, and disclosing their HIV status in the community was practiced by some healthcare professionals. The finding was consistent with the study conducted in developing countries, including Ethiopia, where lack of privacy and fear regarding breaches of confidentiality by healthcare workers were identified as risk factors for LTFU 31 , 32 , 44 . Thus, HCWs should deliver appropriate counselling services and maintain clients’ confidentiality to develop trust among women.

The validity of the findings of this study was strengthened by the triangulating data collected from women, MSG members, and HCWs delivering PMTCT service. Besides, the study included women from the community who had already been lost from care during the study, which minimized the risk of recall bias. However, we recognized the following limitations. First, the study did not explore the husband’s perspective to validate the findings from women and HCWs. Second, the study may have different reasons for LTFU for women who were unreached or unwilling to participate compared to those who agreed to be interviewed. Thus, further studies are advised to include the husband’s perception to validate their concern and to address all women who have lost care.

Conclusions

Financial constraints to cover transportation costs, fear of partner divorce and violence, HIV-related stigma and discrimination, lack of psychological support, religious belief, shortage of drug supply, inadequate service access, and breach of confidentiality by HCWs were major reasons for women’s lost. Healthcare workers’ commitment to searching for lost women, partners’ encouragement to resume care, and women’s desire to live healthily were explored as reasons for resumption after LTFU. Women empowerment, partner engagement, involving community and religious leaders, awareness creation on the effect of HIV-related stigma and discrimination for the community, and service delivery as per the protocol were of vital importance to retain women on care and resume care after LTFU. Besides, HCWs should address false beliefs related to the disease during counseling sessions to retain women in care.

Data availability

All data generated or analysed during this study are included in this article and its Supplementary Information files.

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The authors acknowledge the staff of the South Ethiopia and Central Ethiopia Regional Health Bureaus for their technical and logistic support. Moreover, the authors sincerely thank the research assistants who translated and transcribed the interview. The authors would also like to thank the study participants who were involved in the study.

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Understanding disciplinary perspectives: a framework to develop skills for interdisciplinary research collaborations of medical experts and engineers

• Sophie van Baalen   ORCID: orcid.org/0000-0002-1592-3276 1 , 2 &
• Mieke Boon   ORCID: orcid.org/0000-0003-2492-2854 1  

BMC Medical Education volume  24 , Article number:  1000 ( 2024 ) Cite this article

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Health professionals need to be prepared for interdisciplinary research collaborations aimed at the development and implementation of medical technology. Expertise is highly domain-specific, and learned by being immersed in professional practice. Therefore, the approaches and results from one domain are not easily understood by experts from another domain. Interdisciplinary collaboration in medical research faces not only institutional, but also cognitive and epistemological barriers. This is one of the reasons why interdisciplinary and interprofessional research collaborations are so difficult. To explain the cognitive and epistemological barriers, we introduce the concept of disciplinary perspectives . Making explicit the disciplinary perspectives of experts participating in interdisciplinary collaborations helps to clarify the specific approach of each expert, thereby improving mutual understanding.

We developed a framework for making disciplinary perspectives of experts participating in an interdisciplinary research collaboration explicit. The applicability of the framework has been tested in an interdisciplinary medical research project aimed at the development and implementation of diffusion MRI for the diagnosis of kidney cancer, where the framework was applied to analyse and articulate the disciplinary perspectives of the experts involved.

We propose a general framework, in the form of a series of questions, based on new insights from the philosophy of science into the epistemology of interdisciplinary research. We explain these philosophical underpinnings in order to clarify the cognitive and epistemological barriers of interdisciplinary research collaborations. In addition, we present a detailed example of the use of the framework in a concrete interdisciplinary research project aimed at developing a diagnostic technology. This case study demonstrates the applicability of the framework in interdisciplinary research projects.

Interdisciplinary research collaborations can be facilitated by a better understanding of how an expert’s disciplinary perspectives enables and guides their specific approach to a problem. Implicit disciplinary perspectives can and should be made explicit in a systematic manner, for which we propose a framework that can be used by disciplinary experts participating in interdisciplinary research project. Furthermore, we suggest that educators can explore how the framework and philosophical underpinning can be implemented in HPE to support the development of students’ interdisciplinary expertise.

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Expertise is highly domain-specific, and learned by being immersed in professional practice [ 1 ]. However, today’s rapidly evolving health care systems require clinicians who are capable of meeting complex challenges [ 2 ], which often requires interdisciplinary and interprofessional collaborations between experts from distinct disciplines. Footnote 1 With the increasingly central role of innovative medical technologies in many medical specialties [ 3 ], health professionals will presumable participate in interdisciplinary and interprofessional research collaborations. But interprofessional and interdisciplinary research collaborations are notoriously difficult (e.g., [ 4 , 5 , 6 , 7 ]). Boon et al. (2019) argue that the complexity of current medical practices requires interdisciplinary expertise , which is an extension of adaptive expertise [ 8 ]. Interdisciplinary expertise involves the ability to understand the role of disciplinary perspectives .

In this paper, we combine insights from the philosophy of science on disciplinary perspectives and practice experience from an interdisciplinary medical research project aimed at the development and implementation of diffusion MRI for the diagnosis of kidney cancer. Based on these insights and practice experience, we propose a framework for mitigating cognitive and epistemological barriers caused by different disciplinary perspectives. In addition, we present a detailed example of the use of the framework to analyse and explain the experts’ disciplinary perspectives in the aforementioned interdisciplinary research project aimed at developing a diagnostic technology. This case study demonstrates the use of the framework in interdisciplinary research projects. The framework can be used by health professionals to facilitate their interdisciplinary research projects, by analysing and explaining their disciplinary perspectives.

Interdisciplinary research

To address the barriers to interdisciplinary research, various authors have developed analytical frameworks to guide the research process and help disciplinary experts understand what it takes to execute projects together with experts from other disciplines [ 9 , 10 , 11 , 12 ]. Menken et al. (2016), for example, provide a method for interdisciplinary research that is much similar to the traditional empirical cycle, including steps such as “identify problem or topic,” “formulate preliminary research questions,” “data collection” and “draw conclusions” [ 11 ]. Other frameworks describe which steps need to be taken in the interdisciplinary research process . In the literature on team science , several authors also aim to provide a better understanding of the process of interdisciplinary research. For example, Hasan et al. (2023) focuses on the ‘micro’ layers of the team science ecosystem proposed by Stokols et al. (2019) – the layer of individual team members collaborating in interdisciplinary research projects [ 13 , 14 ]. From their analysis of an online collaborations between early academics from different fields, they provide insights into common issues in interdisciplinary research and methods for dealing with them. By applying their framework from the start of the interdisciplinary research process, they argue, interdisciplinary capture [ 15 ] can be avoided.

Although the aforementioned frameworks provide valuable guidance on the process of interdisciplinary collaboration, they do not address the deeper cognitive and epistemological challenges of interdisciplinary research collaboration [ 5 , 16 ], which is the objective of our contribution. A crucial assumption in current frameworks seems to be that interdisciplinary research collaboration is learned by doing, and that the integration of different disciplines will automatically follow. Footnote 2 In our view, however, the integration of different disciplines is both crucial and one of the most challenging aspects of interdisciplinary research collaboration. In previous work we have argued that the inherent cognitive and epistemological (knowledge-theoretical) challenges of integration have been neglected by most authors providing models for interdisciplinary research [ 8 ]. In this paper, our focus is therefore on challenges of using and producing knowledge in interdisciplinary research collaborations that aim at solving complex real-world problems. Examples are collaborations between distinct medical specialists in the diagnosis and treatment of a specific patient (e.g., an oncologist and radiologist), but also collaborations between medical experts and biomedical engineers aimed at innovative medical technology for clinical uses. In this paper, we focus on inter disciplinary research projects, in which two or more academic fields are integrated to solve real-world problems, and not on trans disciplinary projects in which one or more academic fields are integrated with expertise from outside of academia such as policy-making or practice. Footnote 3

The challenge of interdisciplinary research collaborations aimed at solving a shared problem is that each expert is guided by his/her own disciplinary perspective. However, the results produced by experts from different disciplines, although internally coherent, are not mutually coherent, so that they are not easily integrated. Furthermore, approaches and results understood within a contributing disciplinary perspective are not easily understood by experts specialised in other disciplinary perspectives, even though each expert aims to contribute to the same problem.

In short, the way in which experts use and produce knowledge is guided by the disciplinary perspective typical of their own practice. But experts are often unaware of having a disciplinary perspective. We argue that this is an obstacle to participating in interdisciplinary research collaborations focused on using and producing knowledge for complex problem-solving . Moreover, disciplinary perspectives are often considered impenetrable —as they are acquired by doing — which makes dealing with the disciplinary perspective of other experts a difficult learning objective. In this paper, we defend that disciplinary perspectives can be made explicit in a systematic manner, and that their role in ‘how experts in a specific discipline use and produce knowledge’ can thus be made understandable for experts and students in both their own and other disciplines.

To this end, we have developed a framework, based on new insights in the philosophy of science and on practice experience of interdisciplinary research collaboration aimed at the development of a medical technology, which can be used by experts in a particular discipline to analyse different elements of their discipline and, together with collaborators, to analyse the same elements from other disciplines. We believe that this systematic approach to understanding disciplinary perspectives will facilitate interdisciplinary research collaborations between experts from different fields. It will create awareness of one’s own disciplinary perspective and the ability to understand the disciplinary perspective of other experts at a sufficient level. Our framework thus aims to alleviate the challenge of integration in a collaborative research project by providing a tool for analysing disciplinary perspectives . We suggest that the concrete descriptions of disciplinary perspectives that result from the application of the framework, clarify the approaches of experts in a multi-disciplinary team. It thus enables effective communication through improved understanding of how each discipline contributes. Once researchers sufficiently understand each other’s discipline, they will be able to construct so-called conceptual models that integrate content relevant to the problems at hand. Footnote 4

Education in interdisciplinary research

In addition to professionals using our framework to facilitate collaboration in interdisciplinary research projects, we suggest that this framework can also be implemented in medical education. It can be used to teach students what it means to have a disciplinary perspective, and to explicate the role of disciplinary perspectives of disciplinary experts participating in an interdisciplinary research collaboration. We have implemented this framework in an innovative, challenge-based educational design that explicitly aims to support and promote the development of interdisciplinary research skills [ 22 ]. Research into the intended learning objectives has not yet been completed, but our initial findings indicate that the proposed framework effectively supports students in their ability to develop crucial skills for conducting interdisciplinary research projects. We suggest therefore that the framework can also be implemented in HPE as a scaffold for teaching and learning metacognitive skills needed in interdisciplinary research collaborations, for example between medical experts and engineers.

Research has shown that interprofessional education courses for healthcare students can have a positive effect on the knowledge, skills and attitudes required for interprofessional collaboration, but that organising such interventions is challenging [ 23 , 24 ]. In the HPE literature, it is generally assumed that the limitations of interprofessional and interdisciplinary teamwork are due to problems of communication, collaboration and cooperation [ 25 , 26 ], which are linked to barriers and enablers at institutional, organizational, infrastructural, professional and individual levels (e.g., [ 27 , 28 ]). Therefore, interprofessional and interdisciplinary collaborations are discussed extensively in the HPE literature – our focus is challenges of interdisciplinary research collaboration.

The ability to use and produce knowledge and methods in solving (novel) problems is covered in the HPE literature by the notion of adaptive expertise , which encompasses clinical reasoning, integrating basic and clinical sciences, and the transfer of previously learned knowledge, concepts and methods to solve new problems in another context (e.g., [ 1 , 29 , 30 , 31 , 32 , 33 , 34 ]). In previous work, we introduced the concept of interdisciplinary expertise, which expands on the notion of adaptive expertise by including the ability to understand, analyse and communicate disciplinary perspectives [ 8 ]. In this paper, we address the challenge posed by how this ability to understand, analyse and communicate disciplinary perspectives can be learned. The framework that we propose can be implemented in HPE to function as a tool to scaffold metacognitive skills of health professions students, facilitating the development of interdisciplinary expertise.

Aims and contributions of this paper

Our first objective is to show that interdisciplinary collaboration in (medical) research faces not only institutional, but also cognitive and epistemological barriers. Therefore, we first provide a theoretical explanation of the concept of ‘disciplinary perspective’ as developed in the philosophy of science, in order to make it plausible that the cognitive barriers experienced by experts in interdisciplinary collaboration are the result of different disciplinary perspectives on a problem and its solution.

Our second objective is to provide a systematic approach to improve interdisciplinary research, for which we propose a framework, in the form of a series of questions, based on new insights from the philosophy of science into the epistemology of interdisciplinary research. We provide a detailed explanation of the application of the proposed framework in an interdisciplinary medical research project to illustrate its applicability in a multidisciplinary research collaborations, by showing that the different disciplinary perspectives that inform researchers and technicians within a multidisciplinary research team can be made transparent in a systematic way.

In short, our intended contribution is (i) to explain cognitive and epistemological barriers by introducing the concept of disciplinary perspectives in medical research collaborations, (ii) to offer a framework that enables the mitigation of these barriers within interdisciplinary research projects that are caused by different disciplinary perspectives, and (iii) to illustrate the applicability of this framework by a concrete case of an interdisciplinary research collaboration in a medical-technical research setting.

We developed a framework for making disciplinary perspectives of experts participating in an interdisciplinary research collaboration explicit, by combining insights from the philosophy of science with practical experience from a medical research project. Philosophy of science provided the theoretical basis for our concept of disciplinary perspectives. Our detailed case-description stems from an interdisciplinary medical research project to develop and implement a new imaging tool for the diagnosis of kidney cancer, in which the first author participated. We then applied the framework to analyze and articulate the disciplinary perspectives of experts involved in this interdisciplinary medical research project.

The usefulness and applicability of the proposed framework was tested by the first author who, in her role as PI, was able to use it successfully in coordinating an interdisciplinary research project aimed at developing a biomedical technology for clinical practice [ 35 , 36 ]. Below, we illustrate how the framework was systematically applied to this specific case, providing initial evidence of its applicability. However, to test whether the proposed framework reduces the cognitive and epistemological barriers caused by different disciplinary perspectives, experts need to be trained in its use. We suggest that training in the use of this framework requires, among other things, some insight into the philosophical underpinnings of the concept of ‘disciplinary perspective’. Our explanation of the so-called epistemology of disciplinary perspectives in this paper aims to provide such insight.

Developing a framework for analysing and articulating a disciplinary perspective

The framework proposed here is based on insights about disciplinary perspectives in the philosophy of science. These insights concern an epistemology (a theory of knowledge) of scientific disciplines. In other words, the framework is based on an account of the knowledge-theoretical (epistemic) and pragmatic aspects that guide the production of knowledge and scientific understanding by a discipline [ 21 ].

The epistemology of scientific disciplines developed in our previous work is based on the philosophical work of Thomas Kuhn [ 37 ]. Building on his seminal ideas, we understand disciplinary perspectives as analysable in terms of a coherent set of epistemic and pragmatic aspects related to the way in which experts trained in the discipline (and who have thus, albeit implicitly, acquired the disciplinary perspective) apply and produce knowledge [ 38 ]. In our approach, the epistemic and pragmatic aspects that generally characterize a discipline, are made explicit through a set of questions that form the basis of the proposed framework (see Table 1 , and the first column of Table  2 ). The disciplinary perspective can thus be revealed through this framework. In turn, when used in educational settings, this framework can be used to foster interdisciplinary expertise by acting as a scaffold for teaching and learning metacognitive skills for interdisciplinary research collaborations. Footnote 5

The general aspects indicated by italics in each question in Table 1 are interdependent, so that analysis using this framework results in a coherent description of the disciplinary perspective in terms of these aspects. The framework can be used by experts in an interdisciplinary research project not only to make explicit their disciplinary perspective in a general sense, but to also to specify in a systematic way how these aspects relate to the interdisciplinary research problem from their disciplinary discipline (see Table  2 , which contains both the general and problem-specific descriptions for each aspect per discipline). In our view, this approach is productive in overcoming the cognitive and epistemological barriers. It thus contributes to productive interdisciplinary collaboration.

Applying the framework in an interdisciplinary medical research project

To test the applicability of this framework, we applied it to an interdisciplinary medical research project. The interdisciplinary medical research project aimed at developing a new clinical imaging tool, namely, diffusion magnetic resonance imaging (i.e., diffusion MRI) to characterize the micro-structural makeup of kidney tumours, running from early 2014 to mid-2018. The first author was involved in this project as a principle investigator (PI). As an interdisciplinary expert with a background in technical medicine , which combines medical training with technological expertise [ 41 ], she coordinated and integrated contributions from experts with medical and engineering backgrounds. In her role as PI, she applied the proposed framework to analyse and articulate the disciplinary perspectives of other experts involved in the medical research project.

The aim of the interdisciplinary medical research project was to develop a new imaging tool for the characterization of renal tumours, i.e., diffusion MRI. Diffusion MRI allows for visualization and quantification of water diffusion without administration of exogenous contrast materials and is, therefore, a promising technique for imaging kidney tumours. In earlier studies, several parameters derived from diffusion MRI studies were found to differentiate between different tumour types in the kidney [ 42 , 43 , 44 ]. Existing imaging methods in clinical practice can detect the size and location of kidney tumours, but the tumour type and malignancy can only be determined histologically after surgery. The purpose of the medical research project was to assess whether more advanced parameters that can be obtained from diffusion MRI [ 35 , 45 ] can differentiate between malignant and benign kidney tumours [ 36 ]. Being able to make this distinction could potentially prevent unnecessary surgery in patients with non-malignant tumours.

The interdisciplinary medical research project needed to bring together expertise (knowledge and skills) from different professionals, academic researchers as well as clinicians. Therefore, the research team consisted of a physicist, a biomedical engineer, a radiologist, a urologist and the principle investigator. The complex, interdisciplinary research object can be thought of as a system that encompasses several elements: the MRI-machine, the software necessary to produce images, the patient with a (suspected) kidney tumour, and the wider practice of care in which the clinical tool should function. In developing the clinical tool, these elements must be considered interrelated, whereas usually each expert focuses on one of these elements.

The PI utilized the framework to coordinate and integrate the contributions from different experts in the following manner. Throughout the project, she had meetings with each of the team members, where she probed them to explain their specific expertise in regard of the research object, as well as their expert contribution to the development of the imaging tool. Her approach in these meetings was guided by the general questions of the framework (Table 1 ). In this manner, she succeeded in getting a clear insight in aspects of each discipline relevant to the research object, and also in the specific contribution that needed to be made by each expert (as illustrated in Table  2 below). The level of understanding gained by this approach enabled her to, firstly, facilitate interdisciplinary team meetings in which disciplinary interpretations and questions from the experts about the target system could be aligned, and secondly, integrate their contributions towards the development of the new imaging tool [ 36 ].

In the presented approach, the framework was exclusively used by the PI, enabling her to acquire relevant information and understanding about the contributions of the disciplines involved. The other team members in the medical research project were not explicitly involved in applying the framework, nor in articulating their own disciplinary perspective or that of others. Hence, the resulting articulation of the disciplinary perspectives and of the contributions per discipline to the research object (in Table  2 ) is crafted by the PI. The level of understanding of the role of each discipline that the PI has acquired thereby appears to be sufficient to enable her coordinating task in this complex medical research project. Our suggestion for other research and educational practices, though, is that clinicians (as well as) other medical experts can develop this metacognitive skill by using the scaffold (in Table  1 ) in order to participate more effectively in these kinds of complex medical research projects.

In the results  section we will first present our explanation and justification of the idea that disciplinary perspectives determine the specific approaches of experts (who have been trained in a specific discipline in using and producing knowledge) when faced with a complex problem. In this explanation and justification, we will use insights from the philosophy of science. Next, we will explain and illustrate the systematic use of the proposed framework (Table 1 ) by showing the results of applying it to the interdisciplinary medical research project.

The insights from philosophy of science on which the proposed framework for the explication of disciplinary perspectives is rooted in insights of the philosophers Immanuel Kant (1794–1804) and Thomas Kuhn (1922–1996). Their important epistemological insight was that ‘objective’ knowledge of reality does not arise from some kind of imprint in the mind, such as on a photographic plate, but is partly formed by the concepts and theories that scientists hold. These concepts and theories therefore shape the way they perceive the world and produce knowledge about reality. This philosophical insight provides an important explanation for the cognitive and epistemological barriers between disciplines. After all, scientific experts learn these concepts and theories by being trained within a certain discipline. In this way, they develop a disciplinary perspective that determines their view and understanding of reality. Based on this philosophical insight, we can imagine how these barriers can be bridged, namely by developing the metacognitive ability to think about their own cognition and how their scientific view of reality is shaped by their specific disciplinary perspective. In order to facilitate this ability, we develop a framework that can be used as a metacognitive scaffold. Finally, we apply this framework to an example interdisciplinary medical-technical research project, to illustrate it’s use in practice.

Insights from the philosophy of science: disciplinary perspectives

Boon et al. (2019) refer to the notion of disciplinary perspectives and their indelible role in how experts approach problems —in particular, the ways in which experts use and produce knowledge in regard of the problem they aim to solve— and provide a philosophical account of this notion based on so-called constructivist (Kantian) epistemology (i.e., knowledge-theory, [ 38 , 46 ]). On a Kantian view, ‘the world does not speak for itself,’ i.e., knowledge of (aspects of) the external world is not acquired passively on the basis of impressions in the mind (physically) caused by the external world (e.g., similar to how pictures of the world are physically imprinted on a photographic plate). Instead, the way in which people produce and use knowledge results from an interaction between the external world, the human senses and the human cognitive system. Crucially, neither our concepts nor our perceptions stem from passive impressions. Instead, ‘pre-given’ concepts ‘in the mind’ are needed in order to be able to perceive something at all and thus to produce knowledge about reality. Conversely, according to Kant, the imaginative (i.e. creative) capacity of the mind is then able to generate new concepts and to draw new connections of which the adequacy and usability must be tested against our experiences of reality. When new concepts (invented by the creative capacity of the human mind) have been tested against experience, they allow us to see new things in the external world, which we would not see without those concepts. This theoretical insight by Kant is crucial to get past naïve conceptions of knowledge, in particular, by understanding the indelible role of concepts in generating knowledge from observations and experiences.

This philosophical insight already makes it clear, for instance, that ‘descriptions of facts’ in a research project involve discipline-specific concepts, making these descriptions not easy to understand for someone who is not trained in that discipline. After Kant, this role of concepts has been expanded to the role of perspectives . For, Kuhn [ 37 ] created awareness that the human mind plays ‘unconsciously’ and ‘unintentionally’ a much greater role in the way scientific knowledge is created than usually assumed in the view that scientific knowledge is objective . Kuhn has introduced the concept of scientific paradigm to indicate in what sense the mind contributes. His idea was revolutionary because the notion of true and objective knowledge, which is the aim of science, became deeply problematic, as knowledge is only true and objective within the scientific paradigm, whereas it may even be meaningless in another.

Our notion of disciplinary perspectives is in many respects comparable to Kuhn’s idea of scientific paradigm, and is certainly indebted to Kuhn’s invention, particularly, with regard to the idea that it is a more or less coherent, usually implicit ‘background picture’ or ‘conceptual framework,’ which constitutes an inherent part of the cognitive system of an expert, and which forms the basis from which an expert thinks, sees and investigates in a scientific or professional practice. Furthermore, the scientific paradigm is not ‘innate,’ nor individually acquired, but maintained and transferred in scientific or professional practices, usually by being immersed in it. The same can be said about disciplinary perspectives. Yet, there are also important differences.

First, Kuhn believed that the paradigm is so deeply rooted in the cognitive structure of individual scientists, and, moreover, is embedded in how the scientific community functions, that it takes a scientific revolution and a new generation of scientists to shift into another paradigm, which is called a paradigm-shift (sometimes explained as a Gestalt-switch ). Kuhn’s belief suggests that humans lack the capacity to reflect on their own paradigm. Footnote 6 Conversely, we argue that humans can develop the metacognitive ability to perform this kind of reflection by which the structure and content of the paradigm or disciplinary perspective is made explicit. We take this as an important part of interdisciplinary expertise . Our suggestion, however, should not be confused with the idea that we can think without any paradigm or disciplinary perspective – we can’t, but we can explicate its workings (and adapt it), which is what we will illustrate in the case-description below.

Second, Kuhn’s focus was science , i.e., the production of objectively true scientific knowledge, in particular, theories. Instead, our focus is on experts trained in specific disciplines, who use and produce knowledge with regard to (practical) problems that have to be solved. Nonetheless, the Kuhnean insight explains why knowledge generated in distinct disciplines often cannot be combined in a straightforward manner (e.g., as in a jigsaw puzzle), which is due to the fact that knowledge is only fully meaningful and understandable relative to the disciplinary perspective in which it has been produced.

Our notion of disciplinary perspectives is similar to Kuhn’s idea of paradigm (which he specified later on as disciplinary matrices ) in the sense that a paradigm functions as a perspective or a conceptual framework , i.e., a background picture within which a scientific or professional practice of a specific discipline is embedded and which guides and enables this practice. But instead of considering them as replacing each other in a serial historical order as Kuhn did, we assume that disciplinary perspectives co-exist, that is, exist in parallel instead of serial. This view on disciplinary perspectives can be elaborated somewhat further by harking back to Ludwik Fleck [ 47 ], a microbiologist, who already in the 1930s developed a historical philosophy and sociology of science that is very similar to Kuhn’s (also see [ 48 ]). Footnote 7 Similar to and deeply affected by Kant, Fleck draws a close connection between human knowledge (e.g., facts) and cognition. Hence, Fleck disputes that facts are descriptions of things in reality discovered through properly passive observation of aspects in reality – which is why, according to Fleck, facts are invented , not discovered . Similar to Kuhn, Fleck expands on Kant by also including the role of the community in which scientists and experts are trained. Instead of paradigms , however, Fleck uses the terms thought styles and thought collectives to describe how experts in a certain professional or academic community adopt similar ways of perceiving and thinking that differ between disciplines: “The expert [trained in the discipline] is already a specially moulded individual who can no longer escape the bonds of tradition and of the collective; otherwise he would not be an expert” ([ 47 ], p. 54). But while Kuhn strove to explain radical changes in science, Fleck’s focus is on ‘normal science,’ that is, on communities ( thought collectives each having their own thought style ) that co-exist and gradually, rather than radically, change, which is closer to our take on disciplines. Importantly, according to Fleck, the community guides which problems members of that communities find relevant and how they approach these problems. Translated to our vocabulary, in scientific and professional practices, experts trained in different disciplines each have different disciplinary perspective, by means of which they recognize different aspects and problems of the same so-called research object , which they approach in accordance with their own discipline.

We propose that disciplinary perspectives can be analysed and made explicit, which we consider a crucial metacognitive skill of interdisciplinary experts. Our proposal for the framework to analyse disciplinary perspectives (in Table 1 ) takes its cue in Kuhn’s notion of disciplinary matrices. Kuhn’s original notion presents a matrix by which historians and philosophers can analyse the paradigm in hindsight, specifying aspects such as the metaphysical background beliefs and basic concepts, core theories, epistemic values, and methods, which all play a role in how knowledge is generated (also see [ 8 , 50 ]). Our framework includes some of these aspects, but also adds others, thereby generating a scaffold that facilitates interdisciplinary collaborations aimed at applying and producing knowledge for complex problem-solving in professional research practices aimed at ‘real-world’ practices, such as medical research practice. Below, we will illustrate the application of this framework in a concrete case.

Interdisciplinary research project: diffusion MRI for the diagnosis of kidney tumour

We will illustrate the applicability of the proposed framework (Table 1 ) for the analysis of disciplinary perspectives using the example of a research project that aims to develop a new clinical imaging tool, namely, diffusion MRI to characterize the microstructure of renal tumours. In our analysis, we focus on experts from four different disciplines: (I) clinical practice, (II) medical biology, (III) MRI physics, and (IV) signal and image processing. As indicated in the methods section, the complex, interdisciplinary research object that these experts have to deal with concerns a system consisting of the MRI-machine, the software necessary to produce images, and the patient with a (suspected) renal tumour, including the broader care practice in which the clinical tool should function.

In the following paragraphs we will first present a general explanation of the four disciplines involved in the project, and next, illustrate how the proposed framework can be applied to analyse and articulate each disciplinary perspective as well as the specific contribution of each discipline to the research object (in Table  2 ). It is not our intention to provide comprehensive descriptions of the fields that are involved, but rather to provide insight into how the fields differ from each other across the elements of our framework. In addition, we do not believe that all (disciplinary) experts only adhere to one disciplinary perspective. For example, clinicians usually combine both a clinical and biomedical perspective to fit together a complete picture of a patient for clinical decision-making concerning diagnosis and treatment [ 51 , 52 , 53 ]. Moreover, MRI engineers will usually need to combine insights from MRI physics and signal processing.

I. Clinical practice concerning patients with renal tumours

Clinical practice concerns the patient with a renal tumour. This practice differs from the other disciplines in our example, because it is not primarily a scientific discipline. Nonetheless, to develop a diagnostic tool, the disciplinary perspective of clinicians specialized in patients with kidney tumours is crucial, for example, to determine the conditions that the technology needs to meet in order to be useful for their clinical practice. The knowledge-base of clinical experts is rooted in biomedical sciences, which means that clinical experts often understand their patient’s signs and symptoms from a biomedical perspective (i.e., in terms of tumour formation of healthy renal physiology). Yet, clinicians will usually focus on their patient’s clinical presentation and possible diagnostic and clinical pathways. In clinical practice, several kidney tumour types are distinguished, each with its own histological presentation (visible under the microscope), tumour growth rate and chance of metastases. Unfortunately, all kidney tumour types, including non-malignant types, appear the same on standard imaging modalities, namely, as solid lesions. When the tumour is not metastasized, treatment consists of surgery removing the whole kidney or the part of the kidney that contains the tumour (i.e., ‘radical’ or ‘partial’ nephrectomy). If surgery is not possible, other treatments include chemotherapy or radiation. After surgery, a pathologist examines the tumour tissue to determine the tumour type. Occasionally, the pathologist concludes that the removed tumour was non-malignant, which is a situation that may be prevented if diffusion MRI can be used to distinguish between malignant and non-malignant tumours prior to surgery.

II. Medical biology

In biology, the structure and working of the body is studied at several levels, from the interaction of proteins and other macromolecules within cells to the functioning of organs. In the case at hand, the organ of interest is the kidney. Functions of the kidneys are excretion of waste materials, control of blood pressure via hormone excretion, balancing the body fluid, acid-base balance and balancing salts by excretion or resorption of ions. Understanding these functions requires insights into the anatomy, tissue architecture and physiology of the kidneys. The main functional structures of the kidney are: (1) the nephron, consisting of a tuft of capillaries (the glomerulus) surrounded by membranes that are shaped like a cup (Bowman’s capsule), responsible for the first filtration of water and small ions, and (2) the renal tubule that is responsible for more specific resorption and excretion of ions and water. The arrangement of small tubes that fan from the centre towards the outside (or cortex) of the kidneys allows maintaining variation in concentrations of ions, which helps to regulate resorption and excretion. The contribution of medical biology to the development of the diagnostic tool is important because knowledge about kidneys such as just sketched provides an understanding of the properties (i.e., microstructural of physiological properties) by which different tumour types can be distinguished from each other, which is crucial to interpreting the novel diagnostic imaging technology.

III. MRI physics & diffusion MRI

Magnetic resonance imaging is based on the physics of magnetism and the interaction of tissue components with radio magnetic fields. The main component of the human body that clinical MRI machines are sensitive to is (the amount of) water molecules or, more specifically, hydrogen nuclei (protons). These protons can be thought of as rotating or spinning , producing (tiny) magnetic fields. By placing tissue in a relatively strong magnetic field (usually 1.5 or 3 Tesla emitted by a large coil that surrounds the body), the tiny magnetic fields of protons (in the water-phase of the tissue) will align themselves with the direction of the strong magnetic field. By then applying a series of radiofrequency pulses, protons will be pushed out of balance and rotate back to their original state, causing a magnetic flux that causes a change in voltage which is picked up by receiver coils in the MRI machine. The rate with which protons return to their original state, the relaxation time, is influenced by the makeup of their environment, and will, therefore, differ for different tissues, resulting in image contrasts between tissues. To be able to form images of the signal, magnetic field gradients are applied, spatially varying the field which enables to differentiate between signals from different locations. Computer software using mathematical formulas ‘translate’ the signal into a series of images.

Diffusion MRI is a subfield of MR imaging, that is based on a contrast between ‘diffusion rates’ of water molecules in different tissues. Diffusion is based on the random (‘Brownian’) motion of water molecules in tissue. This motion is restricted by tissue components such as membranes and macromolecules and therefore water molecules move (or ‘diffuse’) at different rates in different tissues, depending on the microstructure of tissues. To measure this, additional magnetic field gradients are applied, which results in a signal attenuation proportional to the diffusion rate, as water molecules move (‘or diffuse’) out of their original voxel due to diffusion.

The method for acquiring diffusion-weighted images with an MRI machine (i.e., the ‘acquisition sequence’ of applying radiofrequency pulses and switching gradients on and off) is designed to gain sensitivity to the water molecules diffusing from their original location. The measured diffusion coefficient is considered to be related to microstructural properties of the tissue, namely the density of tissue structures such as macromolecules and membranes that restrict water diffusion. Together with other diffusion parameters that can be obtained by fitting the signal to other functions or ‘models’, the diffusion coefficient can be used to characterise and distinguish between different (tumour) tissue types, which is the aim of this new imaging tool.

IV. Signal and image processing

The signal acquired by MRI machines undergoes many processing steps before they appear as images on the screen. Some of these steps are performed automatically by the MRI system while others require standardized operations in the software package supplied by the manufacturer, and yet other, more advanced, manipulations are performed in custom-made programs or software packages developed for specific research purposes. In the field of diffusion MRI, software packages that perform the most common fitting procedures are available but often custom-made algorithms are required. The reason for this is that diffusion MRI is originally developed for brain imaging, while investigating its feasibility in other organs has started more recently and only makes up a small part of the field. New applications generate new challenges. For example, unlike the brain, kidneys (and other abdominal organs) move up and down as a consequence of breathing. Therefore, specific algorithms manipulating the scan to correct for this respiratory motion are required for diffusion MRI of the kidneys. Furthermore, as tissue structure and physiology in the kidneys differ from that in the brain, existing models need to be adjusted to that of the kidney.

In this paper, we have argued that interdisciplinary collaboration is difficult because of the role of experts’ disciplinary perspective, which shapes their view and approach to a problem and creates cognitive and epistemological barriers when collaborating with other disciplines. To overcome these barriers, disciplinary experts involved in interdisciplinary research projects need to be able to explicate their own disciplinary perspective. This ability is part of what is known as interdisciplinary expertise [ 8 ]. We defend that interdisciplinary expertise begins with creating awareness of the role of disciplinary perspectives in how experts view a problem, interpret it, formulate questions and develop solutions.

Analytical frameworks to guide interdisciplinary research processes previously developed by other authors typically focus on the process of interdisciplinary collaboration [ 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. The approach we propose here contributes to this literature by addressing the deeper cognitive and epistemological challenges of interdisciplinary research collaboration on the role of the disciplinary perspective as an inherent part of one’s expertise [ 5 , 16 ]. Several authors have already used the concept of ‘disciplinary perspectives’ to point out the challenges of interdisciplinary research (e.g., [ 9 , 15 ]). Our contribution to this literature is the idea, based on philosophical insights into the epistemology of interdisciplinary research, that disciplinary perspectives can be made explicit, and next, to provide an analytical framework with which disciplinary perspectives within an interdisciplinary research context can be systematically described (as in Table 1 ) with the aim of facilitating interdisciplinary communication within such research projects.

Our further contribution is that we have applied this framework to a concrete case, thereby demonstrating that disciplinary perspectives within a concrete interdisciplinary research project can actually be analyzed and explicated in terms of a coherent set of elements that make up the proposed framework. The result of this analysis (in Table  2 ) shows a coherent description of the discipline in question per column, with an explanation per aspect of what this aspect means for the interdisciplinary research project. It can also be seen that the horizontal comparison (in Table  2 ) results in very different descriptions per aspect for each discipline. We believe that this example demonstrates that it is possible to explain the nature of a specific discipline in a way that is accessible to experts from other disciplines. We do not claim, therefore, that this table is an exhaustive description of the four disciplines involved. Instead, our aim is to show that the approach outlined in this table reduces cognitive and epistemological barriers in interdisciplinary research by enabling communication about the content and nature of the disciplines involved.

We suggest that educators can explore how the framework and philosophical underpinning can be implemented in HPE to support the development of students’ interdisciplinary expertise. Much has been written, especially in the engineering education literature, about the importance of interdisciplinarity and how to teach it. A recent systematic review article shows that the focus of education aimed at interdisciplinarity is on so-called soft skills such as communication and teamwork. Project-based learning is often used to teach the necessary skills, but without specific support to promote these skills [ 7 ]. In our literature review on education for interdisciplinarity [ 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 ], we did not find any authors who specifically address the cognitive and epistemological barriers to interdisciplinary collaboration as described in our article. One possible reason for this is that current epistemological views on the application of science in real-world problem-solving contexts, such as the research project presented here, do not recognise the inherent cognitive and epistemological barriers philosophically explained in this article [ 78 ]. The novelty of our approach is therefore our emphasis on the epistemological and cognitive barriers between disciplines that result from the ineradicable role of disciplinary perspectives in the discipline-bound way in which researchers frame and interpret the common problem. This makes interdisciplinary communication and integration particularly difficult. Specific scaffolds are needed to overcome these barriers. The framework proposed here, which systematically makes the disciplinary perspective explicit, aims to be such a scaffold. We therefore argue that much more attention should be paid to this specific challenge of interdisciplinary collaboration in academic HPE education. This requires both an in-depth philosophical explanation that offers a new view of scientific knowledge that makes clear why interdisciplinary research is difficult, and learning how to make disciplinary perspectives explicit, for which the proposed framework provides a metacognitive scaffold.

We have implemented this framework in a newly designed minor programme that uses challenge-based learning and aims to develop interdisciplinary research skills. In this minor, small groups of students from different disciplines work on the (interdisciplinary) analysis and solution of a complex real-world problem. A number of other scaffolds focused on the overarching learning objective have been included in the educational design, which means that the framework proposed here cannot be tested in isolation. Although our research into whether this new educational design achieves the intended learning goal is not yet complete, our initial experience of using the framework is positive. Students, guided by the teacher, are able to use the framework in their interdisciplinary communication - first in a general sense to get to know each other’s disciplines and then within their research project. This implies that the framework is useful in education aimed at learning to conduct interdisciplinary research.

This example, where the framework has been implemented in education aimed at developing interdisciplinary research skills, also shows that although it was developed in the context of a medical-technical research project, it is in fact very general and well suited for any interdisciplinary research.

A critical comment should be made regarding our preliminary evidence of the framework’s usefulness. The first author, who was PI of the interdisciplinary medical research project, in which she applied this framework in her role as coordinator, was also involved in the development of the framework [ 35 , 36 ]. She, therefore has a detailed insight into the theoretical underpinnings of the framework in relation to its intended application. The lack of such a theoretical background may make it more difficult to apply the framework in interdisciplinary research. Footnote 8 Which is why we have provided an extensive elaboration of these underpinnings in this paper.

Further research should address the question of whether this scaffold can facilitate interdisciplinary collaboration between disciplinary experts.

Further research is also needed to systematically analyse the value of this framework in HPE education. This starts with the question of what type of educational design it can be successfully implemented in. Other important questions are: Can interdisciplinary expertise be acquired without knowledge of the other discipline (e.g., biomedical engineering)? In other words, how much education in other disciplines should HPE provide to prepare experts to participate in specific interdisciplinary collaborations?

Furthermore, we emphasize that in addition to learning to use this framework as a metacognitive scaffold to gain a deeper understanding of the epistemological and cognitive barriers, students also need to develop other skills necessary for interdisciplinary research collaboration and working in interdisciplinary teams. The frameworks discussed in our introduction that analyse and guide the interdisciplinary research process provide insights into these skills (e.g. [ 9 , 10 , 11 , 12 ] and [ 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 ]).

We suggest that the article as a whole can be used in such educational settings to achieve several goals, provided that students are guided and coached by educators. First, to foster student’s understanding of the epistemological challenges of interdisciplinary collaboration and to recognize that these challenges are usually underestimated and not addressed in most approaches. Second, by providing insights into the epistemological challenges by outlining the philosophical underpinnings, students will be made aware of having a disciplinary perspective and how it guides their work. Finally, by providing a framework that can be used to analyse these disciplinary perspectives and by providing an example from the case description. When successful, this approach encourages students to developing transferrable skills that can be used in research projects beyond the initial educational project.

Conclusions

Interdisciplinary research collaborations can be facilitated by a better understanding of how an expert’s disciplinary perspectives enables and guides their specific approach to a problem. Implicit disciplinary perspectives can and should be made explicit in a systematic manner, for which we propose a framework that can be used by disciplinary experts participating in interdisciplinary research projects. With this framework, and its philosophical underpinning, we contribute to a fundamental aspect of interdisciplinary collaborations.

Availability of data and materials

All data generated or analysed during this study are included in this published.

In this article, we use ‘disciplines,’ ‘fields’ and ‘specialisms’ interchangeably.

Bridle (2013), Klein (1990), Newell (2007) and Szostak (2002) provide activities that are important for interdisciplinary collaborations, such as communication, negotiation and evaluating assumptions. In order to be able to perform such activities, students need to develop the appropriate skills [ 9 , 17 , 18 , 19 ].

Roux et al. (2017) provide a clear characterization of transdisciplinary research: “A key aim of transdisciplinary research is for actors from science, policy and practice to co-evolve their understanding of a social–ecological issue, reconcile their diverse perspectives and co-produce appropriate knowledge to serve a common purpose.” ([ 20 ], p. 1).

Boon (2020, 2023) explains the notion of conceptual modelling in application oriented research [ 21 , 22 ].

i.e., a framework that enables us to think analytically and systematically about our cognitive processes when we use and produce knowledge [ 39 , 40 ].

Yet, we recognize that this belief was plausible in Kuhn’s era, where the idea that humans (including scientists) are inevitably and indelibly guided by paradigms and perspectives was revolutionary and devastating with regard to the rational view of man. But nowadays we have become familiar with this idea, which offers an opening for the metacognitive abilities that we suggest.

To scholars in HPE, we recommend the entry on Ludwik Fleck in the Stanford Encyclopedia of Philosophy [ 49 ].

The point made here touches on a more fundamental issue that is beyond the scope of this article. Namely, that resistance of students, but also of teachers, to the described approach may have to do with more traditional epistemological beliefs about science that do not fit well with the way scientific research works in practice [ 78 , 79 ]. The philosophical underpinnings of the proposed framework explained in this article suggest alternative epistemological beliefs that are more appropriate for interdisciplinary research aimed at (complex) ‘real-world’ problems.

Abbreviations

Health professions education

Magnetic Resonance Imaging

Principle investigator

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Acknowledgements

We are very grateful to three anonymous reviewers who have provided valuable feedback and suggestions that have helped us improve the paper.

This work is financed by an Aspasia grant (409.40216) of the Dutch National Science Foundation (NWO) for the project Philosophy of Science for the Engineering Sciences , and by the work package Interdisciplinary Engineering Education at the 4TU-CEE (Centre Engineering Education https://www.4tu.nl/cee/en/ ) in The Netherlands.

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SvB and MB have co-authored the manuscript and have contributed equally to the article.

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Mieke Boon (PhD) graduated in chemical engineering (cum laude) and is a full professor in philosophy of science in practice . Her research aims at a philosophy of science for the engineering sciences , addressing topics such as methodology, technological instruments, scientific modeling, paradigms of science, interdisciplinarity, and science teaching. Sophie van Baalen (PhD) graduated in technical medicine and in philosophy of science technology and society , both cum laude. She recently finished her PhD project in which she aimed to understand epistemological aspects of technical medicine from a philosophy of science perspective, such as evidence-based medicine, expertise, interdisciplinarity and technological instruments.

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van Baalen, S., Boon, M. Understanding disciplinary perspectives: a framework to develop skills for interdisciplinary research collaborations of medical experts and engineers. BMC Med Educ 24 , 1000 (2024). https://doi.org/10.1186/s12909-024-05913-1

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Received : 14 July 2023

Accepted : 14 August 2024

Published : 13 September 2024

DOI : https://doi.org/10.1186/s12909-024-05913-1

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