session 2 Flashcards
define research?
the systemic search for information & new
knowledge to solve a problem”.
why research is important?
It produces evidence and
informs actions that can provide wider benefit to a society.
Social research
Is research method used by the researchers to learn
about people and societies so that they can produce services to meet
various needs of the people.
importance of social research
researchers to learnabout people and societies so that they can produce services to meet
various needs of the people
insights from this research can guide the design of healthcare delivery practices and interventions that acknowledge and adapt to
social, cultural, and economic barriers;.
what the social sciences approaches emphasize?
social, structural, and organizational
factors that influence the kinds of care available, access to that care, and quality of care.
Importance of social research methods
1-Policies and practices are based on social science research.
2-You have a responsibility as a doctor to be able to access, appraise and
use this research.
3- Need to integrate and critically evaluate multiple resources (Tomorrow ‘s
Doctors)
what are the methods of the social researches?
Two main groups of methods:
1-Quantitative
2-Qualitative
Quantitative research deal with ————
with numerical variables analyzing and
correlating them with
other variables according to specific hypothesis to
draw a conclusion
whats the designs of the quantities researches?
Experimental study designs (e.g. RCTs) – Cohort studies – Case-control studies -Cross-sectional surveys - Official statistics -Other national surveys: -Local and regional surveys
does Questionnaires is quantitive or qualitative methods?
Methods for quantitative research
importance of the Questionnaires?
– Measurement of exposure to risk factors e.g. effect of lifestyle and dietary
factors on cancer.
– Knowledge and attitudes e.g. family planning.
– Satisfaction e.g. with health services.
Published questionnaires may have been tested for ?
validity and reliability.
Principles for Questionnaire design
1- Questionnaires should be:
- Valid and realibe
2-Measure things consistently
3-Differences in results come from differences between participants, not from inconsistencies in how items are understood or in how responses are interpreted.
Types of questions in methods
Mainly closed questions: as
Yes/No
Strongly agree/agree/neither disagree…
Numeric scales
Symbols
Self-completed on paper
– Administered
- Telephone, interviewer, internet..
Can have open-ended questions.
Often free text box at end of questionnaire
what’s the method of research in qualitative researches
systematic collection, organization, and analysis of textual material derived
from talk or observation
,
what qualitative studies emphasize on?
the importance of
understanding, from the viewpoint of the people involved, how individuals
and groups interpret, experience and make sense of social phenomena
useful study for assessment of quality and improve it ?
qualtititve studies particularly useful for quality assessment and for
unpacking some of the complex issues inherent to quality improvemen
what we concern about it in the qualitative studies
– Making sense of phenomena in terms of meanings people bring to them.
–Need to listen to what people have to say, understand their perspective.
– Emphasizes meaning, experience and views of respondents.
– Analysis emphasizes the researcher ‘s interpretation, not measurement.
– Can also provide insights into people ‘s behavior (subject to caveats)
the qualitative research methods ?
– Observation and ethnography
– Interviews
– Focus groups
– Documents
what is mean by the Ethnography and observation methods?
Studying human behavior in its natural context
– Observe what people actually do, rather than relying on their expressed
views.
Two forms: of observatiion studies
Participant observation – (usually) covert
– Non-participant observation – overt
whats the importance of the observation studies ?
The systematic observation of organizational settings, team behavior
useful in studying quality issues as it allows researchers to uncover everyday behavior rather than only relying on
interview accounts.
useful in uncovering what really happens in particular healthcare settings
how the observational methods allow a to understand and assess the behaviors of inviduals
access to the behavior of which individuals themselves may provide biased accounts, or
indeed be unaware.
Interviews method
Individual face to face interviews may be either semi-structured or in-depth.
types of interviews methods in qualtitive studies
- Semi-structured interview
- in-depth interview
difference between a semi-structural interview and depth interview?
Semi-structured interviews are typically based on a flexible topic guide
that provides a loose structure of open-ended questions to explore
experiences and attitudes.
In-depth interviews provide an opportunity to obtain more detail about an
issue or experience, and are especially useful for exploring experiences of
care
In order to ensure that
really detailed information is gathered, interview methods require?
experienced researches
with the necessary sensitivity and ability t oestablish rapport with respondents,
use topic guides flexibly and followup questions and responses.
focus group
Focus groups are similar in structure to face to face interviews but they use
the interaction of a group of, typically, 6–8 people to generate data.
“exploration group”
different healthcare providers who have direct contact with a particular health problem review and discuss
some material such as audio or video taped cases or interviews in order to
develop an interpretative explanation
quality circle
This convenes a small group of healthcare providers and patients who meet at regular times for a determined period to formulate hypotheses or
action points to improve quality in health ca
challenges in focus group
Not so useful for individual experience
· May encourage people to participate
· Some topics may be too sensitive ‘for focus groups
· Deviant views may be inhibited
· Not the easy option
· Can be difficult to arrange
· Have to consider membership of group – e.g. consultants and health
care assistants
· Need fairly homogenous group
· Good facilitator is needed – managing group dynamics is not easy!
Documentary and media analysi
it is the independent historical type and provides independent evidence and Useful for subjects difficult to investigate.
· Can analyze television, newspaper and media stories
-
documentary and media method good for?
Understanding the perspective of those in a situation
– Accessing information not revealed by quantitative approaches
– Explaining relationships between variables
documentary and media method less good for?
Finding consistent relationships between variables.
– Generalizability
how choose the best method and study type ?
1-Topic under investigation and research question.
2- Research team ‘s preferences/expertise.
3- Time and money available.
4-Funders and/or audience
evidence- based -medicine
The standard definition Evidence-based practice involves the integration of individual clinical expertise with the best available external clinical evidence
from systematic researches.
Previously practices influenced (too much) by:
- Professional opinion
- Clinical fashion
- Historical practice and precedent
- Organizational and social culture
evidence-based medicine depend on the two important things?
systematic review and meta- analysis
how the systematic review help clinician?
Systematic reviews Useful to clinicians because by appraising and
integrating findings, they offer both quality control and increased
certainty.
Where do you find the evidence?
Medical journals , cocharan collabration
Critiques of the evidence-based practice movement?
· Practical criticisms: around the possibility of evidence-based
practice
· Philosophical criticisms: around the desirability of evidence-based
practice
Practical criticisms of the evidnec based medicine
May be an impossible task to create and maintain systematic reviews
across all specialties
May be challenging and expensive to disseminate and implement
findings.
Lots of methodological arguments about meta-analyses and
systematic reviews
RCTs are seen as the gold standard but not always feasible or even
necessary/desirable
Choice of outcomes often very biomedical
Certain groups (e.g. BME) may not be well served by the evidence base.
Philosophical criticisms:
Does not align with (most) doctors’ modes of reasoning
Aggregate, population-level outcomes don ‘t mean that an
intervention will work for an individual
Potential of EBM to create unreflective rule followers out of professionals.
legitimizing rationing, with
potential to undermine trust in the doctor- patient relationship
Problems in getting evidence into practice:
Evidence exists, but doctors don ‘t knows about
Doctors know about the evidence but don ‘t use it – Why not?
Habit? Organizational culture? Professional judgment
Organizational systems cannot support innovation
Commissioning decisions reflect different priorities – E.g. what if
patients say they want something else.
Resources not available to implement change
