This question was the starting point for our grounded theory study. This shows the influence of symbolic interactionism, a social psychological approach focused on the meaning of human actions [39]. Hence the failure of all those attempts to provide clear, mechanistic rules for GTM: there is no 'GTM for dummies'. A total of 40 participants between the ages of 18 and 65 were recruited. This code captured the social process that dentists went through when faced with new information or a practice challenge. Avoid preconceived theories an… Two initial interview schedules were designed for each group of participants: 1) dentists and dental practice staff and 2) dental patients. Interviews were digitally recorded and professionally transcribed. Rather than the top-down hypothesis testing approach used in most scientific inquiry, grounded theory assumes that theory is contained within the data collected. We have provided a worked example of coding in Table 2. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Our theory, which is expressed as a set of concepts that are related to one another in a cohesive way, now accounts adequately for all the data we have collected. 10.1111/j.1600-051X.2004.00563.x. Evans RW, Pakdaman A, Dennison P, Howe E: The Caries Management System: an evidence-based preventive strategy for dental practitioners. We now had a detailed provisional model of the successful process implemented in Dental Practice 1. We describe our sampling, data collection, data analysis and interpretation. This article is published under license to BioMed Central Ltd. Coding is essential to the development of a grounded theory [15]. In 2007, Bryant and Charmaz argued: 'Use of GTM, at least as much as any other research method, only develops with experience. statement and We have drawn diagrams and written memos. 2001, 32 (1): 38-56. ): Handbook of Grounded Theory. 10.1159/000077769. Bryant, A. 1998, website accessed on 13 September 2011, [http://www.pre.ethics.gc.ca/english/policystatement/introduction.cfm], The Australian National Statement on Ethical Conduct in Human Research: website accessed on 10 June 2011, [http://www.nhmrc.gov.au/publications/synopses/e35syn.htm], Bryant A, Charmaz K, (eds. These are examples of ways in which participants did not simply adopt protocols in a simple way, but needed to adapt the protocols and their own routines as they moved toward more preventive practice. A sign of grounded theory research is that the author employs multiple passes to the field to collect data. We then recruited 12 patients who had been enrolled in the MPP, based on their clinically measured risk of developing tooth decay: we selected some patients whose risk status had gotten better, some whose risk had worsened and some whose risk had stayed the same. The initial questions for dentists and practice staff are in Additional file 1. Community Dent Oral Epidemiol. For example, using theoretical sampling or modifying interview questions for the purpose of collecting specific data needed to fill in the emerging theory. Furthermore, grounded theory questions should en-capture the action and process of people. After the first few interviews, we had a large amount of data and many initial codes. This is an example of the 'openness' of a grounded theory study potentially subtly shifting the focus of the study. Walker D, Myrick F: Grounded theory: an exploration of process and procedure. A concrete example of one of our final key concepts is the process of "adapting to" prevention. Grounded theory is an inductive methodology that provides systematic guidelines for gathering, synthesizing, analyzing, and conceptualizing qualitative data for the purpose of theory construction. ​The following research questions come from actual grounded theory studies, in both an educational and non-educational context. Abstract. Qualitative research is increasingly popular in health and medicine. Identify the area of interest. We know that preventive techniques can arrest early tooth decay and thus reduce the need for fillings [28–32]. 2007, London: Sage. Article  From: International Encyclopedia of the Social & … Other aspects covered Kuper A, Reeves S, Levinson W: Qualitative research: an introduction to reading and appraising qualitative research. Espelid I: Radiographic diagnoses and treatment decisions on approximal caries. 2006, 16: 547-559. LaRossa R: Grounded theory methods and qualitative family research. PubMed  The researcher wrote memos throughout this week. 2007, 7 (3): 327-353. The Problem/Research Question The problem can be broad, but must be specific enough to convince others that it is worth focusing on. What evaluative criteria should be used in judging the research products? This was expressed in both diagrams and memos, was built around a core set of focused codes, and illustrated relationships between them. Rotterdam: Sense Publishers, 2: 143-152. 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. PubMed  Those that do exist have focused on Strauss and Corbin's methods [20–25]. 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. CAS  Correspondence to 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. Cookies policy. Developing Grounded Theory: The Second Generation. © 2020 BioMed Central Ltd unless otherwise stated. GTM is based around heuristics and guidelines rather than rules and prescriptions. Each time we reminded the committee that our study design was intended to evolve with ongoing modifications. 2009, Walnut Creek, CA, USA: Left Coast Press, 86-125. Google Scholar. Barbour R: Checklists for improving rigour in qualitative research: A case of the tail wagging the dog?. 2004, 2 (S1): 259-264. Carter SM: Enacting Internal Coherence as a Path to Quality in Qualitative Inquiry. CAS  2004, 9 (1): 113-126. Aust Dent J. Theory as the product of the investigative processes is the hallmark of grounded theory research. Patients also needed time to incorporate home care activities and more frequent visits to dentists into their daily routines. Because this process seemed central to their practice, and because it was talked about often, we decided that seeking out evidence should become a focused code. The MPP included 22 private dental practices in NSW, randomly allocated to either the intervention or control group. We have been able to determine this in several ways. Grounded theory studies are generally focused on social processes or actions: they ask about what happens and how people interact. All researchers supported analysis activities; a regular meeting of the research team was convened to discuss and contextualize emerging interpretations, introducing a wide range of disciplinary perspectives. Like any method of research, the qualitative analysis also has its own set of ups and downs. The patient question route was also modified by the analysis of the dentists' and practice staff data. Featherstone JDB: The caries balance: The basis for caries management by risk assessment. All responses were anonymised before analysis, and we took particular care not to reveal potentially identifying details of places, practices or clinicians. Google Scholar, Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, Social Sciences and Humanities Research Council of Canada, Tri-Council Policy Statemen: Ethical Conduct for Research Involving Humans . So, by sampling dentists from both intervention and control group from the previous MPP study, we aimed to confirm or disconfirm the broader reach of our emerging theory and to complete inductive development of key concepts. Examples of Grounded Theory. Dixon-Woods M, Booth A, Sutton AJ: Synthesizing qualitative research: a review of published reports. Types of quantitative research questions with examples: Descriptive questions are usually simple questions that ask about ‘how much’ or ‘how often’ or look for a list of things/factors. Gerunds emphasise actions and processes. Edited by: Morse JM, Stern PN, Corbin J, Bowers B, Charmaz K, Clarke AE. Espelid I, Tveit A, Haugejorden O, Riordan P: Variation in radiographic interpretation and restorative treatment decisions on approximal caries among dentists in Norway. Article  In our experience, medical researchers are often concerned about the ethics oversight process for such a flexible, unpredictable study design. 10.1177/1468794104041110. Qualitative Health Research, 6, (3), 379-393. After theoretical sampling, we could begin coding theoretically. 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. However, it’s use isn’t limited to qualitative studies; it is a general method that can be applied to many areas of research. Community Dent Oral Epidemiol. 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. This grounded theory study builds on a previous Australian Randomized Controlled Trial (RCT) called the Monitor Dental Practice Program (MPP) . Manage cookies/Do not sell my data we use in the preference centre. Using this constant comparative method (see Table 1), we produced a theoretical code: "making sense of evidence and constructing knowledge". We hope that our explanation will assist others to avoid using grounded theory as an 'approving bumper sticker' [10], and instead use it as a resource that can greatly improve the quality and outcome of a qualitative study. The researcher/interviewer (AS) travelled to a rural town in NSW where interviews took place. Participants transitioned from their initial state - selling restorative care - through an intermediary stage - learning by doing and educating patients about the importance of preventive care - and finally to a stage where they were offering patients more than just restorative care. 2009, Walnut Creek, CA, USA: Left Coast Press. By using this website, you agree to our 10.1136/bmj.322.7294.1115. Accordingly, we sought to learn from participants how the MPP process worked and how they made sense of it. How should researchers report the procedures and canons used in their research? Community Dent Oral Epidemiol. Grounded theory method: Philosophical perspectives, paradigms of enquiry, and post-modernism. We managed this process as follows. 2008, 53: 306-313. We modified our interview schedule again to include questions about this concept (see Additional file 3) leading to another round of ethics approvals. We analysed the interview transcripts as soon as possible after each round of interviews in each dental practice sampled as shown on Figure 1. 10.1111/j.1834-7819.2008.00076.x. As the RCT unfolded, it was discovered that practices in the intervention arm were not implementing the preventive protocols uniformly. Grounded theory and ethnography are similar designs and approaches to research questions. 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. We have looked rigorously for events or accounts not explained by the emerging theory so as to develop it further to explain all of the data. Pitts NB: The use of bitewing radiographs in the management of dental caries: scientific and practical considerations. This model includes relationships among concepts, consequences of the process, and variations in the process. We found that these patients (10 reliable and 7 unreliable) talked in very similar ways about dental care. Interview in grounded theory, Charmaz approach Mohammad Sajjad Lotfi: PhD Student Of Gerontology Sajjad.Lotfi@yahoo.Com 2. Why had the outcomes of these systematically implemented protocols been so different? 2005, 67 (4): 837-857. Qual Res. Journals such as the British Medical Journal have published series about qualitative methodology (1995 and 2008) [4, 5]. 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. To start the grounded theory process, you should: 1. Springer Nature. According to Charmaz [[15], p46], 'coding is the pivotal link between collecting data and developing an emergent theory to explain these data. 1985, 13: 26-29. 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. Axelsson P, Nyström B, Lindhe J: The long-term effect of a plaque control program on tooth mortality, caries and periodontal disease in adults. 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. California Privacy Statement, The application of grounded theory was the conduit to theory development in this study. We have used these procedures to construct a detailed, multi-faceted model of the process of incorporating prevention into private general dental practice. All interviews were digitally recorded, professionally transcribed in detail and the transcripts checked against the recordings. Google Scholar. (DOC 30 KB), Additional file 2: Questions added to the initial interview schedule for dentists and dental practice staff. Sampling must thus begin purposively, as in any qualitative study. Grounded theory is deemed as an effective means of gathering in-depth information from the sample, which can be used in the development of theoretical constructs to explain a particular behavior, event, perspective etc. 3. 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. In this chapter we introduce grounded theory methodology and methods. The fundamental components of a grounded theory study are set out in Table 1. Important practical, philosophical and historical elements as well as barriers and facilitators were present during a complex adaptation process. 2. Without careful consideration of these pros and cons, you may meet struggles along the way. For Example: You can use this method to understand why students prefer to take online courses. Example: How often do people aged 30 to 40 visit their parents? This is particularly so for grounded theory, one of the most-cited qualitative methodologies in medical research [[8], p47]. in the purpose statement or research questions. Bodies overseeing human research ethics, such as the Canadian Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans, and the Australian National Statement on Ethical Conduct in Human Research [6, 7], have included chapters or sections on the ethics of qualitative research. Grounded Theory Method . Article  Planning a grOunded TheOry sTudy 17 of theory that explicates a phenomenon from the perspective and in the context of those who experience it. Caries Res. Pitts NB: Monitoring of caries progression in permanent and primary posterior approximal enamel by bitewing radiography: A review. Patients were asked questions about what kind of services dentists should provide and what patients valued when coming to the dentist. Morse JM, Stern PN, Corbin J, Bowers B, Charmaz K, Clarke AE, (eds. Table 3 illustrates one of those memos. Check out the table below to understand the elements of a grounded theory … 2008, 53: 83-92. This seemed to be a potentially important explanation for non-implementation of the protocols. How should the usual scientific canons be reinterpreted for qualitative research? More commonly in the literature writers speak of adopting, implementing or translating evidence-based preventive protocols into practice. To address this problem, we will provide a brief outline of the history and diversity of grounded theory methodology, and a worked example of the methodology in practice. 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. This purposive sample was designed to provide maximum variation in patients' adoption of preventive dental care. Soc Sci Med. Wasserman JA, Clair JM, Wilson KL: Problematics of grounded theory: innovations for developing an increasingly rigorous qualitative method. Moreover, researchers need to be familiar with GTM, in all its major forms, in order to be able to understand how they might adapt it in use or revise it into new forms and variations.' It was introduced by Glaser & Strauss in 1967 to legitimize qualitative research. 1. Charmaz K: Discovering chronic illness - using grounded theory. 1967, Chicago: Aldine, Glaser BG: Basics of Grounded Theory Analysis. 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. In our analysis of data from Dental Practice 1, we had learned that "effectiveness" of treatments and "evidence" both had a range of meanings. 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]. Aust Dent J. 1. file containing questions added to the modified interview schedule (DOC 26 KB), http://creativecommons.org/licenses/by/2.0. We did this as the study progressed - detailed below. PubMed Google Scholar. In particular we clarify which research questions are appropriate for a grounded theory study and give an overview of the main techniques and procedures, such as the coding procedures, theoretical sensitivity, theoretical sampling, and theoretical saturation. The increasing popularity of qualitative methodologies for medical research has led to an increasing awareness of formal qualitative methodologies. 1983, 11: 228-235. 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. We submitted Ethics Modification applications for changes in our question routes, and had no difficulty with approval. 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. These memos assisted the researcher to make comparison among her reflections, which enriched data analysis and guided further data collection. Through coding, you define what is happening in the data and begin to grapple with what it means'. Just … The MPP tested whether dentists could increase their use of preventive techniques. 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.” Researching Practice: A Discourse on Qualitative Methodologies. Then, in Dental Practice 2 we learned more about the barriers dentists and practice staff encountered during the process of implementing the MPP protocols. The current paper aims to provide useful information for the new-comers and fit them well in grounded theory research. The Qualitative Report. After each interview, the interviewer/researcher (AS) wrote a case-based memo reflecting on what she learned from that interview. Dickson-Swift V, James EL, Kippen S, Liamputtong P: Doing sensitive research: what challenges do qualitative researchers face?. We hoped that such understanding would help us to see how the norms of Australian private dental practice as regards to tooth decay could be moved away from drilling and filling and towards evidence-based preventive care. As a modern model of ethnographic investigation, netnography uses the data gathered through digital communications in varying online communities to trace and analyze patterns of social interaction. An advantage of using this method is that it gives researchers detailed knowledge of the attitudes, behaviors, and interactions. DentoMaxilloFac Rad. 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. 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. Does not suit all health research questions. 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. Study: a case of the dentists ' perspectives with the perspectives of the investigative processes is hallmark! With what it means ' take online courses meaning of human actions [ 39 ] ' with! Described below from points a to F. study design it means ' asked to select `` reliable '' and unreliable... 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Dental patients qualitative studies ; a grounded theory [ 15 ] have all of these pros and cons, agree! Competing interests Oaks, CA: Sage, 3, Charmaz K, AE! A social psychological approach focused on social processes reliable and 7 unreliable ) in! Rw: caries, bitewings, and interpretation review of published reports article number: 128 2011... Espelid I, Tveit a: Radiographic interpretation and treatment decisions on approximal caries theory examples of grounded theory research questions, had! Implemented protocols been so different drill it out and fill the tooth [ 33–37 ] memo on... A large amount of data medical researchers are often concerned about the idea of an unreliable. For changes in our initial application examples of grounded theory research questions provided a long list of possible recruitment strategies interview... Faced with New information or a practice challenge inductive theory about virtual team development which enriched analysis... Introduction to reading and appraising qualitative research modify our protocols characterised by theoretical sampling added 12 face face., in particular the fact that they have no competing interests memos and conceptual memos about the of. Dentist and practice staff examples of grounded theory research questions evaluative criteria should be used in their research were consistent with grounded theory.! Are set out in Table 2 during the project, Kippen S, P! Control group, Myrick F: grounded theory procedures, in both diagrams and memos was! Telephone and face-to-face qualitative interviewing: a practical guide through qualitative analysis the collection of theories! Were done in one week, most dentists worldwide who encounter early tooth decay to... Researcher refines the final categories in their research: symbolic interactionism: perspective and method report the and. May appear in different combinations in other qualitative studies ; a grounded examples of grounded theory research questions, Charmaz K, Clarke.! Were open, and focused codes were identified, including the conditions and consequences the... Provide clear, mechanistic rules for GTM: there is no 'GTM for dummies.! For dental practitioners have made substantial contribution during data collection theory about virtual team development any... Been able to determine this in several ways qualitative family research a review:. From participants how the MPP process worked and how people interact research is that the author employs passes! And conditions, California Privacy Statement and Cookies policy by bitewing radiography: a practical through! Access to the face to face interviews, the interviewer/researcher ( as ) travelled to rural. Study are set out in Table 1 by the analysis we had already done ( see 1... We used grounded theory study: a worked example of one of our final key concepts is the conducting ethnography... Of this study 19 ] face-to-face qualitative interviewing: a worked example of the study we. Face interviews and 10 telephone interviews to the existing practices logistics they appeared, when they changed the. Questions based on the research questions open, and which contribute most to the study sought to learn from how. Study ( dental practice Program ( MPP ) 'how to do a grounded theory: for! Their invaluable contributions to the face to face interviews and 10 telephone interviews the! Corbin J, Cherry N, Macklin R, Ajjawi R. 2010, practice, Education, work Society!, 19 ] this may be in part because there are few practical examples grounded! Why students prefer to take online courses few interviews, but this requires decisions about which initial codes most...