Journal Notes: Avoiding the Pitfalls of Qualitative Research – A Conversation with JGME Associate Editor Rachel Gottlieb-Smith, MD
What is qualitative research, and what do the editors at The Journal of Graduate Medical Education (JGME) wish authors knew about it? In its August issue, JGME published the second editorial in a two-part series entitled, “Common Pitfalls to Avoid in Qualitative Submissions to JGME.” While the first editorial presents advice for each section of a qualitative research article, from introduction to conclusion, the second attempts to help authors steer clear of some common traps when conducting this type of work.
Qualitative research can be an excellent way to explore some of the phenomena that many in the graduate medical education (GME) community seek to better understand, such as how professional identity, resilience, and learning relationships are experienced. While quantitative research relies on the kind of measurable numerical data that most associate with traditional research, qualitative methods use descriptive data, often obtained through interviews or discussion groups, to gain deeper insights into participants’ experiences and perceptions.
JGME Associate Editor Rachel Gottlieb-Smith, MD co-authored both editorials with Deputy Editor Lalena M. Yarris, MD, Associate Editor Dorene Balmer, PhD, and Editor-in-Chief Gail Sullivan, MD. As a child neurologist, Dr. Gottlieb-Smith is well-versed in quantitative research and data, but her interests as an educator led her to questions around career choice, exploring how medical students progress through their education, and why some choose the field of neurology. To understand more fully how and why that career choice happens, she employed qualitative methods to learn more from students’ own experiences and perspectives.
Dr. Gottlieb-Smith learned about the unique challenges of qualitative research through her own experience and through good mentorship, particularly working with Dr. Balmer. “As I was starting, I didn’t have a great understanding of how to approach the project,” she recalls. “[Dr. Balmer] helped me see that I needed to have a strong conceptual framework to guide the study. I needed to know how I was contributing to conversations that were already happening, what theories I could apply, and how those theories could structure my thought process and interview guides.”
She notes that researchers are often unaware of how many paradigms and worldviews there are in approaching this kind of work. “I grew up and trained in a very positivist mentality, where there is one reality and one truth. But qualitative research often uses a constructivist paradigm, where individuals and communities can co-construct meaning and their own understanding of reality,” she recounts. “So asking myself which paradigm I was sitting in helped me to ask better research questions.”
Because qualitative research often lives in this constructivist worldview, there are some who believe that it’s not possible to assess rigor and quality. After all, if you are co-constructing reality, could you just be making things up? On the contrary, the editors at JGME want to dispel that notion. As Dr. Gottlieb-Smith argues, “There are ways of doing quality control. It is important to carefully explain the process of how you obtained and analyzed the data. You can keep detailed notes on the data collection and analysis, called an audit trail. Member checking, going back to participants to confirm the study accurately reflects their opinions, is another example. We need to stay true to what the participants are telling us about their experiences, and we need quality control there to prove it.”
Many of the pitfalls in this work stem from not properly describing the framework or paradigm used and not aligning that framework with the study’s methods. “If you’re using a constructivist paradigm, then you don’t want to set yourself up with a question that is answered with a yes or no,” she explains. “Also, there are some terms that get used often in qualitative research that sound jargony, and some authors might include them believing they will help the paper get published. ‘Grounded theory’ is an example. There are different types of grounded theory, and it’s not always clear that the authors chose methods that align with their theory. So, it’s important that the authors all understand what those terms mean so they can accurately describe them in the work.”
The editors at JGME find great value in qualitative research when it’s done well. Their hope is that authors considering a qualitative study will take advantage of these editorials, as well as other articles on this topic, to help set themselves up for success. To learn even more, check out the articles on qualitative research on the Resources for Authors page and let us know at jgme@acgme.org what you think.
Journal Notes blogger Kevin Gladish is a staff editor for the Journal of Graduate Medical Education. He’s been at the ACGME since 2016, and is also a performer, writer, and storyteller.