1. Critical Appraisal of Qualitative Research Jenny Tancock, Clinical Librarian, FGH jenny.tancock@mbht.nhs.uk 01229 491297 Alison Harry, R+D Co-ordinator, RLI alison.harry@mbht.nhs.uk 01524 516485

2. Learning Objectives By the end of this workshop you will: Understand why critical appraisal is useful Understand the principles of critically appraising a qualitative study Have used some tools available to aid critical appraisal Be confident in recognising qualitative research methods

3. 1. decide how trustworthy a piece of research is (validity) 2.determine what it is telling us (results) 3. weigh up how useful the research will be (relevance) Critical appraisal helps the reader of qualitative research…

4. “Understanding the complex world of lived experience from the point of view of those who live it.” Jones R. Why do qualitative research? BMJ 1995; 311:2 it is concerned with seeing the world through the eyes of the person being studied What is qualitative research?

5. Why use qualitative research ? views of individuals/groups : increase knowledge in a poorly understood area challenge assumptions and practices act as a precursor to quantitative research generate new ideas

6. Qualitative or quantitative? How many parents would consult their general practitioner when their child has a mild temperature? Why do parents worry so much about their children’s temperature? What proportion of smokers have tried to give up? What stops people giving up smoking? Trisha Greenhalgh ‘How to read a paper’

7. Qualitative research methodologies phenomenology ethnography grounded theory e.g.

8. 1.research question 2.sampling process 3.data collection 4.data analysis Components of qualitative research:

9. are the aims of the research clear? is a qualitative methodology appropriate? qualitative research addresses the ‘what’ ‘how’ ‘why’ questions - what is happening? - how does it happen? - why does it happen? 1. Research Question

10. The sample consists of individuals who have experiences relevant to the area being researched. Knowing how they were selected is important in establishing transferability. methods of sampling: purposive theoretical the sample size can be determined by: data analysis saturation size of ‘expert’ group pragmatism 2. Sampling Process

11. 3. Data Collection Methods are determined by the nature of the research question posed observation - looking at non verbal/verbal behaviour by notes, audio/video interviews - unstructured or semi-structured text - diaries, case notes, letters focus groups - semi-structured or unstructured Are the methods used suitable for the question? Is it clear how the data were collected? Is it clear where the data were collected? Has the researcher considered ethical issues?

12. Reflexivity types of interview questions asked venue area being studied meaning given to data researcher

13. Ethics consent confidentiality professional responsibility reporting Need to consider:

14. Aim is to give understanding to participants’ experiences interpretations are made by the researcher/s from participants’ descriptions or from observations e.g. thematic analysis - researcher/s reads the transcribed data, re-reads it and codes it into themes/categories Is the method of analysis clear? Does it use all of the data? Would another researcher make a similar interpretation? Are alternative interpretations explored? Respondent validation? 4. Data Analysis

15. “…it was too constricting, I felt pressurized into taking the medication for a longer time than I thought necessary” “… I felt I ought to see it through because it might help me, but I’m not sure I really believed it would” “…it seemed like a good idea at the time, to stop feeling off colour all the time, but I also felt guilty if I ever missed a dose and then I thought what the hell”

16. Triangulation Methods interviews observations text questionnaire Sample group patients professionals carers

17.  Is there a clear statement of the aims of the study ?  Is a qualitative research design appropriate ?  How and why have participants been selected ? Is the process described and justified?  How were the data collected? Are the setting and methods described adequately and any modifications discussed? Questions to apply to qualitative studies:

18. Consider your appraisal of the paper: how useful is the paper to you? The value of research

19. http://www.phru.nhs.uk/Pages/PHD/resources.htm Critical Appraisal Skills Programme making sense of evidence Critical appraisal of qualitativeresearch Critical appraisal of qualitative research