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FOCUS: CONDUCTING QUALITATIVE RESEARCH Conducting Case Study Research SUZANNE CAMPBELL 1 LEARNING OBJECTIVES have a better prognosis than others? A quantitative 1. Describe when the case study approach is the most research method would not provide the data needed to appropriate qualitative research method. respond to those questions. Therefore, we should 2. Outline the components of a case study research consider conducting a qualitative research method. method. 3. Discuss data coding and analysis and how categories As previously identified, there are five approaches to and themes are developed. qualitative research methods: narrative inquiry, Downloaded from 4. Identify considerations for reporting the findings of phenomenological, grounded theory, ethnographic and 2 case study research. case study research. It is vital that the researcher consider the research questions and research design so INDEX TERMS: Case study research, qualitative the appropriate qualitative research method is selected. research methods, data coding, data validation Qualitative research methods are used in psychology, sociology, philosophy, political science, medicine, social http://hwmaint.clsjournal.ascls.org/ Clin Lab Sci 2015;28(3):201 science, anthropology, government, business and education.1,3,4,5 Let us explore in more detail the case CM study research method. Suzanne Campbell, PhD, MLS(ASCP) , Seward County Community College/Area Technical School, Liberal, KS Case study research is an “…intensive study of a single case where the purpose of that study is… to shed light Address for Correspondence: Suzanne Campbell, on a larger class of cases.”4 Being of an exploratory CM nature, case study research results in hypothesis PhD, MLS(ASCP) , STEM Project Director, Medical Laboratory Technician Program Coordinator, Seward generation versus hypothesis testing. The findings County Community College/Area Technical School, provide a deep scope of proposition through on August 19 2022 Liberal, KS 67901, 620-417-1403, suzanne.campbell@ concentrated data. Evidence from case study research 4 sccc.edu supports a firm causal effect. INTRODUCTION Purpose As medical laboratory professionals, we compare patient In case study research, the researcher can expect “… results to reference ranges and determine the clinical [an] intensive analysis and descriptions of a single unit 5 significance of the findings. Those numbers indicate or system bounded by space and time.” The purpose of whether a patient is healthy or will be diagnosed with a conducting case study research is to provide “… in- disease process. Even after the diagnosis, the numbers depth understanding of situations and meaning for still have meaning as they reflect the outcome of the those involved.”5 Case study research is defined as the treatment. The result of the analytical process provides study of a “case” – a single individual, a situation, an the healthcare team vital information regarding organization, or a phenomenon. The study is conducted diagnosis and treatment. Because of the nature of our in the natural setting and is bounded by time and 3 profession, quantitative research may be more readily space. When conducting qualitative research, “the accepted. We incorporate the results of quantitative researcher is the primary instrument for data collection research when we consider the likelihood of developing and analysis.”5 the disease, treatment success/failure rate, and prognosis. However, do we ever consider “how” the The five different applications of the case study research patient reacts to the diagnosis or “why” some patients method include “to explain the presumed causal links in 201 VOL 28, NO 3 SUMMER 2015 CLINICAL LABORATORY SCIENCE FOCUS: CONDUCTING QUALITATIVE RESEARCH real-life interventions; to describe an intervention and able to note the weaknesses and strengths of the 5 the real-life context; to illustrate certain topics using a previous work. Additionally, the literature review assists descriptive mode; to explore situations in which in determining the method of reporting the findings of intervention has no clear set of outcomes; and to the study. My literature review revealed that most conduct a meta-evaluation.”1 Furthermore, as indicated higher education administrators were men. However, if with case study design, “The interest is in process rather a woman held the position of a higher education than outcomes, in context rather than a specific administrator, particularly of a college of allied health, variable, in discovery rather than confirmation. Insights their academic background was nursing. The lack of gleaned from case studies can directly influence policy, information regarding women clinical laboratory practice, and future research.”6 scientists who held positions as higher education administrators supported the need for the case study When designing case study research, one must consider research. the knowledge and skill of the researcher, a well-defined research question, the information that is available in The case is defined as an individual, organization, event Downloaded from the literature, the identified case, the data collection or entity. It is important that the researcher identifies protocols, the data coding and analysis strategies, and the characteristics of the case to be studied. The the method of reporting the findings. The process is of participants constitute a purposive sample as they must an exploratory nature where data codes are used to meet characteristics identified by the researcher. In case develop categories which are then used to formulate study research, the case number is often less than 12 http://hwmaint.clsjournal.ascls.org/ 4 themes. The themes are considered findings and are and may even be a single case. The eight participants of 1,3,7 used to answer the research questions. my study were female clinical laboratory scientists who held the position of a higher education administrator I utilized the case study research method to investigate and resided in the Midwest region of the United States. and document career paths of women clinical laboratory scientists that have transitioned from the clinical setting Data Collection to the higher education arena and held an Yin (2014) identifies six sources of evidence: administrative position at the dean’s level. The findings documents, archival records, interviews, direct identified the experiences, training, obstacles, and observation, participant observation, and physical opportunities that directed and influenced the career artifacts. However, interviews, observations and 8 documents are the most common sources of on August 19 2022 paths of these women. 3 information. When conducting interviews in case study A case study researcher is committed to spending design, asking “how” and “why” questions provide the extended periods of time in the natural setting. Data opportunity for participants to tell their story in their 1 coding and analysis also require extensive time on task own words. After explaining the purpose of the and knowledge of the complex coding process. research and obtaining consent from the participant, the Cognitive skills identified as necessary for case study interviews can be conducted. A semi-structured research include induction, deduction, synthesis, interview protocol with probes and follow up questions evaluation, and logical and critical thinking.7 Being was developed. The researcher becomes a listener in the organized, possessing perseverance, dealing with interview process and acts to reduce any researcher bias. ambiguity, being flexible and creative, utilizing Audio recorded documentation of the interview results rigorously ethical standards, and having an extensive in a verbatim transcript. Examples of additional vocabulary are skills best suited for the data coding documents included participant curriculum vitas and 7 demographic information. Field notes written by the process. Because case study research does not have well- defined guidelines, the researcher must contend with researcher provide a source of additional data noting 3 10 the evolving and changing procedures. observations of the setting and the participant. Observations of the university, the participant’s office A thorough review of the existing literature assists the and my first impression of the location were included in researcher in defining the research question. The my field notes written the day of the interview. researcher identifies the known and unknown and is VOL 28, NO 3 SUMMER 2015 CLINICAL LABORATORY SCIENCE 202 FOCUS: CONDUCTING QUALITATIVE RESEARCH Data Analysis phrases resulted in 80 pages of data. To group the data, Ten open-ended questions were used for the semi- I needed a visual display so the information was formal interview format. The verbatim transcripts from transferred to four large poster boards. After further eight participants resulted in hundreds of pages of synthesis of the data, a total of 33 codes were identified. narrative. “Coding is just one way of analyzing As the codes were assembled and reassembled, axial 7 coding occurred as categories began to emerge around a qualitative data, not the way.” Coding of the data can 2 be performed manually or with the assistance of core phenomenon. Nine categories were noted. After computer software. I elected to code the data using the completing the selective coding process, the final manual method. The format of the transcripts included research themes were developed from the categories. a wide right margin for my written codes and notes. The data collection and analysis strategies resulted in Reading the transcripts multiple times and reflecting on three major themes. See Figure 1. To ensure high the meaning of the statements resulted in reduction of quality data analysis, consider the following attention to the data and identification of key words and phrases. “A all data – don’t ignore parts or pieces, address all code in qualitative inquiry is most often a word or short plausible rival interpretations, focus on the most Downloaded from phrase that symbolically assigns a summative, salient, significant aspect of the case study, and use one’s prior, essence-capturing, and/or evocative attribute for a expert knowledge as the data is considered.9 portion of language-based or visual data.”7 This is often referred to as the open coding process.2 Coding is the Data Validation “critical link” between data collection and the While it is difficult to generalize findings from a http://hwmaint.clsjournal.ascls.org/ explanation of the meaning.7 qualitative research project, the researcher must ensure the validity of the data analysis. Strategies to validate the In my study, gathering and sorting of key words and study include triangulation, member-checks, rich-thick Getting to the Right The Right Navigational The Right Place Place at the Right Skills are Required Comes With a Price Time The Clinical Don’t Wait for The Price on August 19 2022 Laboratory Opportunity to Knock Women Pay Professors in Communication is Gender Higher the Key Considerations Education Higher The Right Place Education Requires a Administration Balancing Act The Road Block to the Right Place Has a Crack Figure 1. CLS to Higher Education Administrator Research Themes and Categories 203 VOL 28, NO 3 SUMMER 2015 CLINICAL LABORATORY SCIENCE FOCUS: CONDUCTING QUALITATIVE RESEARCH descriptions, clarification of researcher bias, evaluation I don’t think I can be the best advocate for people if of negative/discrepant information, and an external I don’t understand their programs or their 3,6 positions… hear their concerns. I also think that auditor. The validation methods that I selected included member-checks, rich-thick descriptions, an when you’re at the dean’s level or associate dean external audit and awareness of bias. The transcripts and really even at the chair level, you need to hear were returned to the participants for review and the concerns of the people under you. Even if you additional information needed for clarification. I used don’t agree on the outcome or agree with rich-thick descriptions to report findings in such a everything, it is important that you hear that. I manner that allowed the reader to be present in the think to communicate means to be able to not only 2 be articulate in talk but to have very good listening setting. An experienced external auditor was employed to review the IRB approval letter, all correspondence skills. with the participants, the informed consent form, the transcript verification form, interview transcripts, Limitations 3 One of the challenges of conducting case study research Downloaded from coding key and a draft of the findings. My researcher 2 bias was fully disclosed and monitored so as not to is the identification of the case. The researcher must influence data interpretation. make decisions related to the definition of the bounded study and the size of the purposive sample population. Data Results Most case study designs consist of a small sample Once the themes have emerged, the researcher must population, thus limiting the ability to generalize the http://hwmaint.clsjournal.ascls.org/ consider how best to articulate the findings and who findings to a larger population. Because the researcher is will compose the audience. A few examples of ways to a vital component of case study research, researcher bias disseminate the findings include an oral presentation to must be recognized and handled in an ethical manner. a doctoral dissertation committee or at a professional conference, a publication in a scholarly journal, or even CONCLUSION 5 a theatrical performance. For most researchers, the Case study research is one method of conducting written format is the selected method. However, for qualitative research. The case is defined as an individual, some, writing up the findings can be as challenging as an organization, or an entity and is bounded by time conducting the case study. It may help to consider this and space. The researcher is the primary instrument in as a composition versus a written report. Additionally, case study methods; therefore researcher bias should be beginning to draft the composition with the “when” recognized and minimized as much as possible. Case on August 19 2022 and “how” sections even before the data collection and study data is collected via observations, interviews and 9 documents. In this example, semi-structured interview analysis is completed may be helpful. During the initial steps of the research design, it is helpful to be thinking questions with probes and follow up questions were of how best to distribute the findings of the study. The designed to allow the participants to tell their story such researcher should be aware that case study reports tend that the role of the researcher was as a listener. The to have a larger number of audiences than other forms interviews were audio recorded and transcribed to of research because the findings can be presented in provide a verbatim transcript of the interview. After the multiple ways. field notes and transcripts were reviewed multiple times, key words and phrases were noted. From this Finally, it is important that the findings of the case information, codes, categories and themes were study research be a significant contribution to developed and reported as findings to support the knowledge or practice, must be complete, must consider research questions. alternative perspectives and must be composed in an engaging manner.9 REFERENCES To do so, my research findings were reported using rich-thick description including 1. Yin, R. 2003 Case study research: design and methods. quotations of the participants when appropriate. An Thousand Oaks, CA: SAGE Publications, Inc. example of listening as a communication key was 2. Creswell, J. 2013. Qualitative inquiry and research design. expressed by one participant in these words: Thousand Oaks, CA: SAGE Publications, Inc. 3. Creswell, J. 2003. Research design: qualitative, quantitative, and mixed methods approaches. Thousand Oaks, CA: SAGE VOL 28, NO 3 SUMMER 2015 CLINICAL LABORATORY SCIENCE 204
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