BMC Medical Research Methodology To start the grounded theory process, you should: 1. Qualitative and quantitative data generation techniques can be used in a grounded theory study. 10.1177/1468794107078517. 2008, Thousand Oaks, CA: Sage, 3, Charmaz K: Constructing Grounded Theory: A Practical Guide through Qualitative Analysis. 2009, 9: 355-381. Furthermore, grounded theory questions should en-capture the action and process of people. 1969, Berkley: University of California Press. We aimed to understand how the protocols had been implemented, including the conditions and consequences of variation in the process. Riordan P, Espelid I, Tveit A: Radiographic interpretation and treatment decisions among dental therapists and dentists in Western Australia. Unfortunately, most dentists worldwide who encounter early tooth decay continue to drill it out and fill the tooth [33–37]. 10.1159/000077769. Hence the failure of all those attempts to provide clear, mechanistic rules for GTM: there is no 'GTM for dummies'. Abstract . 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. All participants seemed to be revealing deeply held perspectives shared in the dental profession, whether or not they were providing dental care as outlined in the MPP protocols. Coding is essential to the development of a grounded theory [15]. As the RCT unfolded, it was discovered that practices in the intervention arm were not implementing the preventive protocols uniformly. This theoretical code will be the focus of a future paper. Figure 1 illustrates the steps taken during the project that will be described below from points A to F. Study design. Pitts NB: Monitoring of caries progression in permanent and primary posterior approximal enamel by bitewing radiography: A review. Rather than the top-down hypothesis testing approach used in most scientific inquiry, grounded theory assumes that theory is contained within the data collected. Grounded theory is a well-known methodology employed in many research studies. Grounded theory is a research methodology that results in the production of a theory that explains patterns in data, and that predicts what social scientists might expect to find in similar data sets. Community Dent Oral Epidemiol. 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. 1986, 14: 265-270. 10.1111/j.1600-0528.1983.tb01883.x. Detailed analysis records were kept; which made it possible to write this explanatory paper. Grounded theory studies are generally focused on social processes or actions: they ask about what happens and how people interact. Data Base Adv Inf Sy. 2008, 337: a288-10.1136/bmj.a288. Interviews were digitally recorded and professionally transcribed. Cookies policy. California Privacy Statement, Soc Sci Med. Throughout the study, we wrote extensive case-based memos and conceptual memos. Google Scholar. As in any ethical study, we ensured that participation was voluntary, that participants could withdraw at any time, and that confidentiality was protected. Oral Health Prev Dent. 2008, 53: 340-348. A concrete example of one of our final key concepts is the process of "adapting to" prevention. 2004, 2 (S1): 259-264. Grounded theory involves the application of inductive reasoning.The methodology contrasts with the hypothetico-deductive model … The MPP tested whether dentists could increase their use of preventive techniques. Our initial research questions were: What was the process of implementing (or not-implementing) the protocols (from the perspective of dentists, practice staff, and patients)? 1983, 11: 228-235. Just … How to do a grounded theory study: a worked example of a study of dental practices. 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. 1995, 311: 182-, CAS  Application for adults. PubMed Google Scholar. At the end of our data collection and analysis from Dental Practice 1, we had developed a tentative model of the process of implementing the protocols, from the perspective of dentists, dental practice staff and patients. Evans RW, Pakdaman A, Dennison P, Howe E: The Caries Management System: an evidence-based preventive strategy for dental practitioners. What evaluative criteria should be used in judging the research products? 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. Patients also needed time to incorporate home care activities and more frequent visits to dentists into their daily routines. Writing case-based memos right after each interview while being in the field allowed the researcher/interviewer to capture initial ideas and make comparisons between participants' accounts. Interview in grounded theory, Charmaz approach Mohammad Sajjad Lotfi: PhD Student Of Gerontology Sajjad.Lotfi@yahoo.Com 2. Qual Res. 3. 2001, 32 (1): 38-56. Grounded theory methodology assisted us to develop a detailed model of the process of adapting preventive protocols into dental practice, and to analyse variation in this process in different dental practices. Google Scholar. 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. For example, using theoretical sampling or modifying interview questions for the purpose of collecting specific data needed to fill in the emerging theory. Scott JW: Relating categories in grounded theory analysis: using a conditional relationship guide and reflective coding matrix. CAS  2007, London: Sage. Then, in Dental Practice 2 we learned more about the barriers dentists and practice staff encountered during the process of implementing the MPP protocols. Crafting and Conducting Intensive Interviews • In the following, one of my research assistants interviewed a middle- aged woman, Carla, about having a life-threatening illness. Interviews were semi-structured and based loosely on the research questions. We asked research questions that were open, and focused on social processes. Grounded Theory after the Postmodern Turn. The MPP included 22 private dental practices in NSW, randomly allocated to either the intervention or control group. 2006, 16: 547-559. et al. Then during a return visit, patient interviews were completed, again with memo-writing during the data-collection period. 2008, 53: 83-92. Dentist and practice staff interviews were done in one week. 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. Grounded theory researchers begin with a question, or series of questions about a particular research scenario. This paper provides a detailed explanation of how a study evolved using grounded theory methodology (GTM), one of the most commonly used methodologies in qualitative health and medical research [[8], p47]. The use of the constant comparative method enabled the analysis to produce not just a description but a model, in which more abstract concepts were related and a social process was explained. Planning a grOunded TheOry sTudy 17 of theory that explicates a phenomenon from the perspective and in the context of those who experience it. Cite this article. Qualitative Health Research, 6, (3), 379-393. Identify the area of interest. We submitted Ethics Modification applications for changes in our question routes, and had no difficulty with approval. How should the usual scientific canons be reinterpreted for qualitative research? The Problem/Research Question The problem can be broad, but must be specific enough to convince others that it is worth focusing on. Qual Health Res. At this point, we decided to theoretically sample dental practices from the non-intervention arm of the MPP study. In the intervention arm, dentists were provided with a set of evidence-based preventive protocols to apply [38]; control practices provided usual care. 2007, 7 (3): 375-422. 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. This seemed to be a potentially important explanation for non-implementation of the protocols. The intent was to explore nurse manager, educator, preceptor, and new … 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. BMJ. The increasing popularity of qualitative methodologies for medical research has led to an increasing awareness of formal qualitative methodologies. 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. This article is published under license to BioMed Central Ltd. All interviews were digitally recorded, professionally transcribed in detail and the transcripts checked against the recordings. Featherstone JDB: The caries balance: The basis for caries management by risk assessment. 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. 2004, 38: 294-304. By using this website, you agree to our 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. Sampling must thus begin purposively, as in any qualitative study. 2004, 4 (1): 107-18. 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. 2. 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. Below are the links to the authors’ original submitted files for images. Those that do exist have focused on Strauss and Corbin's methods [20–25]. This is an example of the 'openness' of a grounded theory study potentially subtly shifting the focus of the study. Bowers B, Schatzman L: Dimensional Analysis. Grounded theory studies are characterised by theoretical sampling, but this requires some data to be collected and analysed. We also returned to Practice 1 to ask participants about the idea of an "unreliable" patient. According to Charmaz [[15], p46], 'coding is the pivotal link between collecting data and developing an emergent theory to explain these data. Furthermore, grounded theory questions should en-capture the action and process of people. 2008, 53: 306-313. However, it’s use isn’t limited to qualitative studies; it is a general method that can be applied to many areas of research. We know that preventive techniques can arrest early tooth decay and thus reduce the need for fillings [28–32]. Kendall J: Axial coding and the grounded theory controversy. Sarker S, Lau F, Sahay S: Using an adapted grounded theory approach for inductive theory about virtual team development. Aust Dent J. Examples of Purpose Statement and Research Question for Grounded Theory(Mapping the Process: An Exemplar of Process and Challenge in Grounded TheoryAnalysis)• Article discuss theoretical considerations and use a visual model to illustrate how theyapplied grounded theory … This model includes relationships among concepts, consequences of the process, and variations in the process. 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. Important practical, philosophical and historical elements as well as barriers and facilitators were present during a complex adaptation process. Table 4 illustrates a conceptual memo. Google Scholar, Glaser BG, Strauss AL: The Discovery of Grounded Theory: Strategies for Qualitative Research. 1998, website accessed on 13 September 2011, [], The Australian National Statement on Ethical Conduct in Human Research: website accessed on 10 June 2011, [], Bryant A, Charmaz K, (eds. Carter SM: Enacting Internal Coherence as a Path to Quality in Qualitative Inquiry. 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]. Dentists were asked to select "reliable" and "unreliable" patients to be interviewed. 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. Grounded Theory. The research location was remote from the researcher's office, thus data collection was divided into two episodes to allow for intermittent data analysis. Abstract. 1999, 21 (6): 743-757. [[8], p17]. Does not suit all health research questions. After theoretical sampling, we could begin coding theoretically. volume 11, Article number: 128 (2011) BMJ. The patients' interview schedule and theoretical sampling followed similar procedures. 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 question was the starting point for our grounded theory study. These components may appear in different combinations in other qualitative studies; a grounded theory study should have all of these. GTM is based around heuristics and guidelines rather than rules and prescriptions. In the remainder of this paper, we will show how each of the characteristics of grounded theory methodology worked in our study of dental practices. Aust Dent J. Developing Grounded Theory: The Second Generation. Simply put, netnography is online ethnography research, that is, it is the conducting of ethnography research via the internet. We wanted to answer a practical social problem: how do dentists persist in drilling and filling early stages of tooth decay, when they could be applying preventive care? The theory is “grounded” in actual data, which means the analysis and development of theories happens after you have collected the data. Pitts NB: The use of bitewing radiographs in the management of dental caries: scientific and practical considerations. We wanted to compare dentists' perspectives with the perspectives of the patients themselves. 1. Having the opportunity to contact participants after interviews to clarify concepts and to interview some participants more than once contributed to the refinement of theoretical concepts, thus forming part of theoretical sampling. This allowed the process of theoretical sampling to occur. 3. CAS  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. How should researchers report the procedures and canons used in their research? Aust Dent J. PubMed  We found that these patients (10 reliable and 7 unreliable) talked in very similar ways about dental care. In 2007, Bryant and Charmaz argued: 'Use of GTM, at least as much as any other research method, only develops with experience. 1. Grounded theory is the methodology most-often cited by authors of qualitative studies in medicine, but it has been suggested that many 'grounded theory' studies are not concordant with the methodology. Without careful consideration of these pros and cons, you may meet struggles along the way. 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. 10.1177/1049732305285972. 10.1177/1468794107078515. PubMed  BMC Med Res Methodol 11, 128 (2011). Community Dent Oral Epidemiol. Emergence vs Forcing. Theoretical sampling added 12 face to face interviews and 10 telephone interviews to the data. 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. 2. The researcher then took a month for data analysis in which coding and memo-writing occurred. This was a purposive sampling strategy, to give us the best possible access to the process of successfully implementing the protocols. We managed this process as follows. Article  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. Kuper A, Reeves S, Levinson W: Qualitative research: an introduction to reading and appraising qualitative research. LaRossa R: Grounded theory methods and qualitative family research. 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]. ): Handbook of Grounded Theory. There are a number of important assurances of quality in keeping with grounded theory procedures and general principles of qualitative research.