However the limitations associated with the sampling, validity, reliability and bias seem to raise concerns among scholars about the reliance on it as a tool of qualitative investigation. After each interview, the interviewer/researcher (AS) wrote a case-based memo reflecting on what she learned from that interview. We developed our coding systems individually and through team meetings and discussions. Coding occurs in stages. After our initial data collection and analysis, we used theoretical sampling (see Table 1) to determine who to sample next and what questions to ask during interviews. 1991, 19: 268-271. The decision to include phone interviews due to participants' preference worked very well in this study. In this chapter we introduce grounded theory methodology and methods. Barbour R: Checklists for improving rigour in qualitative research: A case of the tail wagging the dog?. Abstract . https://doi.org/10.1186/1471-2288-11-128, DOI: https://doi.org/10.1186/1471-2288-11-128. Article  Check out the table below to understand the elements of a grounded theory … Grounded theory is: a research method that will enable you to:; develop a theory which; offers an explanation about; the main concern of the population of your substantive area and; how that concern is resolved or processed. Article  We developed a detailed model of the process of adapting preventive protocols into dental practice, and analysed the variation in this process in different dental practices. In these memos, we made comparisons between data, cases and codes in order to find similarities and differences, and raised questions to be answered in continuing interviews. Below are the links to the authors’ original submitted files for images. In recent decades, qualitative researchers in health and medicine have founded specialist journals, such as Qualitative Health Research, established 1991, and specialist conferences such as the Qualitative Health Research conference of the International Institute for Qualitative Methodology, established 1994, and the Global Congress for Qualitative Health Research, established 2011 [1–3]. PubMed Google Scholar. Gerunds emphasise actions and processes. Many authors label their work 'grounded theory' but do not follow the basics of the methodology [10, 11]. Qualitative methodologies are increasingly popular in medical research. 10.1177/1468794107078515. Interview in grounded theory, Charmaz approach Mohammad Sajjad Lotfi: PhD Student Of Gerontology Sajjad.Lotfi@yahoo.Com 2. Table 3 illustrates one of those memos. Article  10.1177/1049732305285972. A well-refined theory (and categories) consists of saturation and zigzagging back and forth between data collection and analysis to build the categories and theory. Patients were asked questions about what kind of services dentists should provide and what patients valued when coming to the dentist. Grounded theory studies are generally focused on social processes or actions: they ask about what happens and how people interact. BMJ. We also learned that new technologies - in particular digital x-rays and intra-oral cameras - had been unexpectedly important to the process of implementing the protocols. For this reason, we added new questions for the interviews in Dental Practice 2 to directly investigate "effectiveness", "evidence" and how dentists took up new technologies in their practice. PubMed  PubMed Central  This may be in part because there are few practical examples of grounded theory in use in the literature. Walker D, Myrick F: Grounded theory: an exploration of process and procedure. As the RCT unfolded, it was discovered that practices in the intervention arm were not implementing the preventive protocols uniformly. 10.1111/j.1834-7819.2007.00004.x. 1967, Chicago: Aldine, Glaser BG: Basics of Grounded Theory Analysis. In initial coding, the researcher generates as many ideas as possible inductively from early data. The initial 18 participants (one dentist, five dental assistants and 12 patients) from Dental Practice 1 were interviewed in places convenient to them such as the dental practice, community centres or the participant's home. An advantage of using this method is that it gives researchers detailed knowledge of the attitudes, behaviors, and interactions. In our initial application we provided a long list of possible recruitment strategies and interview questions, as suggested by Charmaz [15]. Time was needed to allow dentists and practice staff to go through this process of slowly adapting their practices to this new way of working. By employing grounded theory methodology rigorously, medical researchers can better design and justify their methods, and produce high-quality findings that will be more useful to patients, professionals and the research community. 2001, 32 (1): 38-56. After a few interviews, the interviewer/researcher also began making and recording comparisons among these memos. Through our analysis, we concluded that what was required was 'adapting to' those protocols in practice. We did this as the study progressed - detailed below. The MPP protocols used in the RCT guided dentists to systematically apply preventive techniques to prevent new tooth decay and to arrest early stages of tooth decay in their patients, therefore reducing the need for drilling and filling. The grounded theory method was the appropriate method to examine popular perceptions of party leaders during the 2010 election campaign as it let us systematically uncover patterns and codes through a process of successive coding; we could analyse the … Grounded theory method: Philosophical perspectives, paradigms of enquiry, and post-modernism. Asking questions of the data: memo writing in the grounded theory tradition. Sarker S, Lau F, Sahay S: Using an adapted grounded theory approach for inductive theory about virtual team development. volume 11, Article number: 128 (2011) We indicated that we would make future applications to modify our protocols. If your desire is to perform a qualitative study, it will probably be a lot easier to develop your research question if you first become familiar with some of qualitative research’s basic … Coding is essential to the development of a grounded theory [15]. Community Dent Oral Epidemiol. Even some of their methodological considerations are alike, particularly in that both grounded theory and ethnography use observation as the primary tool of data collection (Najafi, … The intent was to explore nurse manager, educator, preceptor, and new … In this paper we provide a worked example of a grounded theory project. et al. This purposive sample was designed to provide maximum variation in patients' adoption of preventive dental care. Interviews were digitally recorded and professionally transcribed. Sampling must thus begin purposively, as in any qualitative study. Qual Res. 2008, Thousand Oaks, CA: Sage, 3, Charmaz K: Constructing Grounded Theory: A Practical Guide through Qualitative Analysis. BMC Medical Research Methodology As we have become increasingly certain about our central focused codes, we have re-examined the data to find all available insights regarding those codes. We have used these procedures to construct a detailed, multi-faceted model of the process of incorporating prevention into private general dental practice. Transferring evidence-based preventive protocols into these dental practices entailed a slow process of adapting the evidence to the existing practices logistics. 10.1136/bmj.322.7294.1115. We explain how these steps were consistent with grounded theory methodology, and show how they related to one another. To start the grounded theory process, you should: 1. There has been some discussion in the literature about what characteristics a grounded theory study must have to be legitimately referred to as 'grounded theory' [18]. Grounded theory and ethnography are similar designs and approaches to research questions. We analysed the interview transcripts as soon as possible after each round of interviews in each dental practice sampled as shown on Figure 1. In theoretical coding, the researcher refines the final categories in their theory and relates them to one another. 1999, 21 (6): 743-757. Featherstone JDB: The caries balance: The basis for caries management by risk assessment. With permission of the ethics committee; we sent letters to the participants in the MPP, inviting them to participate in a further qualitative study. It is important to keep in mind that grounded theory research questions seek to understand, and make explicit, the social processes and implicit belief systems that underlie behaviour in the phenomena under observation (Moghaddam 2006; McLeod, 2011). 1983, 11: 228-235. Types three and four are Kathy Charmaz's 'Constructivist Grounded Theory' [15] and Adele Clarke's postmodern Situational Analysis [16]: Charmaz and Clarke were both students of Anselm Strauss. Because our aim was to understand the process of implementing the protocols, including the conditions and consequences of variation in the process, we needed to understand how implementation might fail. At time of writing, we have reached theoretical saturation (see Table 1). When practicing this popular social science method, a researcher begins with a set of data, either quantitative or qualitative, then identifies patterns, trends, and relationships among the data. This included a group of codes that captured how dentists sought out evidence when they were exposed to a complex clinical case, a new product or technique. Our aim is to provide a model for practice, to connect medical researchers with a useful methodology, and to increase the quality of 'grounded theory' research published in the medical literature. The fundamental components of a grounded theory study are set out in Table 1. Tan PL, Evans RW, Morgan MV: Caries, bitewings, and treatment decisions. Simply put, netnography is online ethnography research, that is, it is the conducting of ethnography research via the internet. All authors have made substantial contributions to conception and design of this study. (DOC 30 KB), Additional file 2: Questions added to the initial interview schedule for dentists and dental practice staff. This grounded theory study builds on a previous Australian Randomized Controlled Trial (RCT) called the Monitor Dental Practice Program (MPP) [27]. 10.1111/j.1600-0528.1991.tb00165.x. file containing questions added to the initial interview schedule (DOC 26 KB), Additional file 3: Questions added to the modified interview schedule for dentists and dental practice staff. We used grounded theory methodology to investigate social processes in private dental practices in New South Wales (NSW), Australia. For this reason, we theoretically sampled participants from Dental Practice 2, where uptake of the MPP protocols had been very limited according to data from the RCT trial. More commonly in the literature writers speak of adopting, implementing or translating evidence-based preventive protocols into practice. Aust Dent J. Grounded theory studies are characterised by theoretical sampling, but this requires some data to be collected and analysed. ): Handbook of Grounded Theory. Kuper A, Reeves S, Levinson W: Qualitative research: an introduction to reading and appraising qualitative research. 2008, 337: a288-10.1136/bmj.a288. LaRossa R: Grounded theory methods and qualitative family research. In focused coding, the researcher pursues a selected set of central codes throughout the entire dataset and the study. Edited by: Higgs J, Cherry N, Macklin R, Ajjawi R. 2010, Practice, Education, Work and Society Series. This model includes relationships among concepts, consequences of the process, and variations in the process. We have presented the developing theory to specialist dental audiences and to the participants, and have found that it was accepted by and resonated with these audiences. Against this background, the chapter Rather than the top-down hypothesis testing approach used in most scientific inquiry, grounded theory assumes that theory is contained within the data collected. This code captured the social process that dentists went through when faced with new information or a practice challenge. We know that preventive techniques can arrest early tooth decay and thus reduce the need for fillings [28–32]. We confirmed and enriched our understanding of dentists' processes for adopting technology and producing knowledge, dealing with complex cases and we further clarified the concept of evidence. Figure 1 illustrates the steps taken during the project that will be described below from points A to F. Study design. Initial ethics approval was obtained from the Human Research Ethics Committee at the University of Sydney. California Privacy Statement, From: International Encyclopedia of the Social & … Evans RW, Pakdaman A, Dennison P, Howe E: The Caries Management System: an evidence-based preventive strategy for dental practitioners. Then, we selected the practice in which the most dramatic results had been achieved in the MPP study (Dental Practice 1). Researching Practice: A Discourse on Qualitative Methodologies. Privacy CAS  The initial questions for dentists and practice staff are in Additional file 1. Soc Sci Med. Our detailed explanation of our experience in this grounded theory study is intended to provide, vicariously, the kind of 'experience' that might help other qualitative researchers in medicine and health to apply and benefit from grounded theory methodology in their studies. We wanted to compare dentists' perspectives with the perspectives of the patients themselves. The MPP included 22 private dental practices in NSW, randomly allocated to either the intervention or control group. The patients' interview schedule and theoretical sampling followed similar procedures. Each time we reminded the committee that our study design was intended to evolve with ongoing modifications. We know that preventive techniques can arrest early tooth decay and thus reduce the need for fillings [28–32]. Google Scholar. Each modification was approved without difficulty. Caries Res. 2005, Thousand Oaks, CA: Sage. 2006, 16: 547-559. Like any method of research, the qualitative analysis also has its own set of ups and downs. 1992, Mill Valley CA, USA: Sociology Press, Corbin J, Strauss AL: Basics of qualitative research. 2. We have been able to determine this in several ways. The inductive approach to social science research known as grounded theory represents a bottom-up method in which theory emerges from a process of data collection, coding and analysis. Morse JM, Stern PN, Corbin J, Bowers B, Charmaz K, Clarke AE, (eds. 3. The fifth, emerging variant is 'Dimensional Analysis' [17] which is being developed from the work of Leonard Schaztman, who was a colleague of Strauss and Glaser in the 1960s and 1970s. We will describe how the interview questions for dentists and dental practice staff evolved, and how we selected new participants to allow development of our substantive theory. In our analysis of data from Dental Practice 1, we had learned that "effectiveness" of treatments and "evidence" both had a range of meanings. J Clin Periodontol. This was a purposive sampling strategy, to give us the best possible access to the process of successfully implementing the protocols. 2009, Walnut Creek, CA, USA: Left Coast Press, 86-125. 2008, 53: 306-313. Kendall J: Axial coding and the grounded theory controversy. This question was the starting point for our grounded theory study. Espelid I, Tveit A, Haugejorden O, Riordan P: Variation in radiographic interpretation and restorative treatment decisions on approximal caries among dentists in Norway. Grounded theory studies begin with open questions, and researchers presume that they may know little about the meanings that drive the actions of their participants. How should the usual scientific canons be reinterpreted for qualitative research? Why had the outcomes of these systematically implemented protocols been so different? 2. Data Base Adv Inf Sy. Cookies policy. & Charmaz, K. (2007). One hour in-depth interviews were conducted. 1969, Berkley: University of California Press. Grounded Theory Method . Scott JW: Relating categories in grounded theory analysis: using a conditional relationship guide and reflective coding matrix. Research Questions and Hypotheses • Explore a process (e.g., case study) • Describe the experiences (e.g., phenomenology) • Report the stories (e.g., narrative research) Use these more exploratory verbs that are nondirectional rather than directional words that suggest quantitative research, such as “affect,” “influence,” “impact,” “determine,” “cause,” and “relate.” As noted, there are few examples of 'how to do' grounded theory in the literature [18, 19]. Qualitative Research Questions: Qualitative research questions are the central elements of study as they develop a theoretical framework for the research study.They are more advantageous than quantitative studies because they provide a richer view of the subject. Carter SM: Enacting Internal Coherence as a Path to Quality in Qualitative Inquiry. They contained the interviewer's impressions about the participants' experiences, and the interviewer's reactions; they were also used to systematically question some of our pre-existing ideas in relation to what had been said in the interview. As we know from previous chapters, science is knowledge represented as a collection of “theories” derived using the scientific method. We thank dentists, dental practice staff and patients for their invaluable contributions to the study. Some dental practices underwent a slow process of adapting evidence-based guidance to their existing practice logistics. Charmaz K: Discovering chronic illness - using grounded theory. Emergence vs Forcing. Qualitative and quantitative data generation techniques can be used in a grounded theory study. Aust Dent J. 2009, Walnut Creek, CA, USA: Left Coast Press. 2007, London: Sage. Dentist and practice staff interviews were done in one week. Qual Health Res. 10.1111/j.1600-0528.1985.tb00414.x. In the intervention arm, dentists were provided with a set of evidence-based preventive protocols to apply [38]; control practices provided usual care. ​The key when designing a grounded theory research question, is to keep it "broad, open-ended and action oriented" (McLeod, 2011, p.120). Charmaz's method, like Glaser's method [13], captures actions or processes by using gerunds as codes (verbs ending in 'ing'); Charmaz also emphasises coding quickly, and keeping the codes as similar to the data as possible. 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