Qualitative Study Nursing Essay

Research is defined by Parahoo (2006, p. 472) as “the study of phenomena by the rigorous and systematic collection and analysis of data”. Nursing research is necessary as up-to-date knowledge is vital for appropriate nursing and midwifery decision making. In order to improve upon health outcomes and provide effective care, research should inform best practice and provide an evidence base with which to underpin nursing care.

The two studies to be analysed in this assignment are, ‘Finalyear student nurses’ perceptions of role transition’ (Doody et al. 2012) and ‘Surviving, not thriving: a qualitative study of newly qualified midwives’ experience of their transition to practice’ (Fenwick et al. , 2012). Both these papers explore the perceptions and understanding of the transition from student to practitioner. Doody et al. (2012) explore student nurses perceptions of the upcoming transition while Fenwick et al. (2012) conduct their research with qualified members of staff. Although both studies have similar aims they use two contrasting research methodologies to answer their research questions.

Doody et al. (2012) conduct a quantitative survey among final year nursing students, while Fenwick et al. (2012) use a qualitative approach (one to one interviews) to explore the transition from student to midwife. Doody et al. (2012) and Fenwick et al. (2012) demonstrate different sampling methodologies in their respective studies, this essay will focus on this aspect of their studies, exploring sample selection, and how sampling affected the generalisability of the study and consent issues around sampling.

A sample is a subset of a given population (Parahoo, 2006). There are many different approaches to obtaining a research sample; Walker (1985, cited by Parahoo, 2006, p. 261) states that “the rigorous sampling procedures used in quantitative research are inappropriate to the nature and scale of qualitative work”. The studies by Doody et al. , (2012) and Fenwick et al (2012) demonstrate two contrasting sampling approaches. Doody et al’s. , (2012) study is a quantitative study exploring final year nursing students’ perception of role transition.

One of the main concerns with a quantitative study is how representative the study is or how generalisability can be established. Generalisability is achieved through the use of an adequate and appropriately representative sample. The type of sample used by Doody et al. , (2012) is a convenience sample. A convenience sample is a non-probability (that is to say, a non-random) sample that is convenient for the researcher. One advantage of using a convenience sample is that the participants are readily available, it is also a time and cost effective method of sampling.

Newell and Burnard (2011) state however, that convenience sampling is the weakest form of sampling as the similarity between the sample and the population can be limited as it is not randomised. In order to increase their validity Doody et al. , (2012) could have incorporated elements of quota sampling and followed that with a convenience sample. A quota sample is also a non-probability sample wherein a stratum is identified. A stratum is a subset of the population usually sharing a common characteristic.

Once a quota sample has been acquired, a convenience sample is usually used to select a required number of participants from each stratum (Parahoo, 2006). In the discussion section, of this study the researchers stated that students from different disciplines had contrasting views, the use of a quota sample would have given Doody et al. (2012) the opportunity to gain a deeper insight into these contrasting views, and perhaps improved the generalisability and validity of their results. Fenwick et al. , (2012) like Doody et al. (2012), also used a convenience sample.

However in contrast to Doody et al. (2012), Fenwick et al. , (2012) demonstrate elements of purposive sampling, as the researchers purposively identified participants before obtaining a convenience sample. Fenwick et al. , (2012) selected their sample from the graduates of 2007 and 2008 who had participated in an earlier study (MidTREC study). From this selection the convenience sample individuals were purposively selected to ensure that there were similar numbers of Graduate Diploma in Midwifery students and Bachelor of Midwifery students.

A purposive sample is usually made up of participants who are able to offer insight into a given topic. A purposive sample is more selective than a convenience sample and is not designed to be representative of a larger population. Fenwick et al. , (2012) aimed to gain an insight into the phenomena under investigation and therefore used purposive sampling. Fenwick et al. (2012) ensured that the participants were able to offer information on the topic under study, consequently increasing the validity of their findings.

According to Parahoo (2006) there are four factors that strengthen the generalisability of a study’s results: the size of the sample, the sampling method, the study setting and the response rate. Doody et al. (2012) attempted to recruit a whole cohort of final year nursing students as their sample, by attending a lecture that all students would attend Doody et al (2012) also emailed the students not present, ensuring all students were potentially in the sample.

With a response rate of 84% Doody et al. 2012) maximised the study’s external validity and, therefore, the generalisability of results. In contrast to the quantitative study of Doody et al. (2012), in Fenwick et al’s. (2012) qualitative study, generalisation was different (Parahoo, 2006). The aim of a qualitative study is not necessarily to be generalisable but rather to provide a deep insight into the issue under study. This can be seen as a limitation as the evidence generated cannot always be applicable to the practice of others.

However, this lack of generalisation does not mean that the findings of qualitative studies are not of value, by providing sufficiently descriptive information; researchers can promote the transferability of their study (Polit and Beck, 2014). Goetz and LeCompte (1984, cited by Parahoo 2006, p. 276) suggest that “the components of a study… must be sufficiently well described and defined in order for other researchers to use the results of the study as a basis for comparison”. The transferability of a qualitative study is akin to the generalisation of a quantitative study.

Transferability is the extent to which the findings of a qualitative study can be applicable to different settings. By ensuring the transferability of a study, researchers can increase the validity and reliability of their findings (Polit and Beck, 2014). By using the Lincoln and Guba’s (1985, cited by Polit and Beck, 2014, p. 322) Framework of Quality Criteria, researchers can establish the trustworthiness of their study. This framework is similar to the criteria used to establish generalisability in quantitative studies.

The criterion for trustworthiness contains four components: credibility, dependability, confirmability, and transferability. By fulfilling this criterion Fenwick et al. (2012) can ensure the validity and reliability of their study. Perhaps the most important aspect of any research is the extent to which the ethical aspects of the research have been considered. Fundamental to ethical research is respect for the autonomy of research participants. Autonomy refers to the right of an individual to make decisions about those things that affect them.

In the context of research, participants should have the opportunity to make an informed decision about whether to participant in research or not. For consent to be valid it should be informed, it should be voluntary and the person giving consent should have the capacity to give that consent (Beauchamp and Childress, 2012). Doody et al. (2012) and Fenwick et al. (2012) describe the process of gaining consent from participants in different ways. Doody et al. (2012) stated that consent was implied through the act of returning the questionnaire while Fenwick et al. 2012) stated that all participants agreed to participate in their study but did not explicitly state how consent was obtained.

Using implied consent with questionnaires is completely acceptable (Czaja and Blair, 2005, cited by Gerrish and Lacey, 2010). However, there have been issues expressed when using students as research participants. The students can be considered vulnerable in such circumstances of power differential, as it can affect their decision on whether to participate and, furthermore, the outcome of the study (Gerrish and Lacey, 2010).

Doody et al (2012) went to some lengths to ensure they achieved maximal response rate for their survey but did not state that students were free decline to participate in their survey. One of the principles of ethical research is to non-malfeasance or to do no harm (Beauchamp and Childress, 2012). If there was any coercion of students to participate in this survey, even subtle coercion, Doody et al (2012) would be in breach of this principle. With qualitative research, a risk to the participants’ autonomy is the potential for identification.

Due to the small sample size and the use of quotes to illustrate views put the participants at risk (Parahoo, 2006). Richards and Schwartz (2002, cited by Parahoo, 2006, p. 114) recommend various strategies to reduce the risks that come with qualitative research – they state that “considering obtaining consent as a process” and “ensuring confidentiality” as vital. It is not clear from Fenwick et al. (2012) what measures they took to ensure participant autonomy was ensured. It is clear that while both qualitative and quantitative research use different methodologies, sampling is of vital importance to both.

Both Doody et al. (2012) and Fenwick et al. (2012) had different but similar issues that arose from their sampling approach. For example, both addressed issues of generalisability and transferability to ensure that the results from their respective studies were valid and reliable. The importance of ensuring an ethical approach to sampling, particularly around autonomy and consent, were also apparent in both studies. Both these studies, although demonstrating different methodologies are examples of valid and reliable research that can be used by nurses and midwives to ensure that they provide evidence-based practice.