Qualitative approaches to research in psychology and the social sciences are increasingly used. The variety of approaches incorporates different epistemologies, theoretical traditions and practices with associated analysis techniques spanning a range of theoretical and empirical frameworks. Despite the increase in mixed method approaches it is unusual for qualitative methods to be used in combination with each other. The Pluralism in Qualitative Research project (PQR) was developed in order to investigate the benefits and creative tensions of integrating diverse qualitative approaches. Among other objectives it seeks to interrogate the contributions and impact of researchers and methods on data analysis. The article presents our pluralistic analysis of a single semi-structured interview transcript. Analyses were carried out by different researchers using grounded theory, Foucauldian discourse analysis, interpretative phenomenological analysis and narrative analysis. We discuss the variation and agreement in the analysis of the data. The implications of the findings on the conduct, writing and presentation of qualitative research are discussed.K E Y W O R D S : mixed methods, pluralism, qualitative research, rigour, subjectivity, transparencyPluralism in qualitative research: the impact of different researchers and qualitative approaches on the analysis of qualitative data This article builds on the first author's previous work (Frost, 2006(Frost, , 2009) on exploring the use of within-method pluralistic approaches to qualitative research. We present findings from a study that was developed to explore acrossmethod pluralistic approaches to qualitative research, the Pluralism in Qualitative Research (PQR) study. The study employed four data analysts to use one of four widely used qualitative analysis techniques to analyse one semistructured interview transcript. The four qualitative analysis methods employed were grounded theory (GT), interpretative phenomenological analysis (IPA), Foucauldian discourse analysis (FDA) and narrative analysis (NA). These were chosen because they reflect four of the more commonly used approaches to qualitative research in the social sciences and are the particular areas of analysis specialized in at several of the institutions from which the research assistants were recruited. One purpose of our study was to explore what meanings could be made from the same data analysed by four different people using four different analytical lenses. To examine this in detail we also studied the researcher impact on the data analysis and our findings in this area are presented in this article.Before introducing the study in more detail we develop the concept of pluralism in qualitative research and briefly outline the four approaches that were used in the study. Pluralism in qualitative researchQualitative research encompasses a wide range of approaches and also encompasses the mixing of those approaches (e.g. Dicks et al., 2006;Moran-Ellis et al., 2006). There is a range of advice about which metho...

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BackgroundThe demographics of doctors working in the UK are changing. The United Kingdom (UK) has voted to leave the European Union (EU) and there is heightened political discourse around the world about the impact of migration on healthcare services. Previous work suggests that foreign trained doctors perform worse than UK graduates in postgraduate medical examinations. We analysed the prevalence by country of primary medical qualification of doctors who were required to take an assessment by the General Medical Council (GMC) because of performance concerns.MethodsThis was a retrospective cohort analysis of data routinely collected by the GMC. We compared doctors who had a GMC performance assessment between 1996 and 2013 with the medical register in the same period. The outcome measures were numbers experiencing performance assessments by country or region of medical qualification.ResultsThe rate of performance assessment varied significantly by place of medical qualification and by year; χ 2(17) = 188, p < 0.0001, pseudo-R2 = 15%. Doctors who trained outside of the UK, including those trained in the European Economic Area (EEA), were more likely to have a performance assessment than UK trained doctors, with the exception of South African trained doctors.ConclusionsThe rate of performance assessment varies significantly by place of medical qualification. This is the first study to explore the risk of performance assessment by individual places of medical qualification. While concern has largely focused on the competence of non-EEA, International Medical Graduates, we discuss implications for how to ensure European trained doctors are fit to practise before their medical licence in the UK is granted. Further research is needed to investigate whether these country effects hold true when controlling for factors like doctors’ sex, age, length of time working in the UK, and English language skills. This will allow evidence-based decisions to be made around the regulatory environment the UK should adopt once it leaves the EU. Patients should be reassured that the vast majority of all doctors working in the UK are competent.

ObjectivesThe aim of the study was to explore what components of the General Medical Council’s (GMC) Quality Assurance Framework work, for whom, in what circumstances and how?SettingUK undergraduate and postgraduate medical education and training.ParticipantsWe conducted interviews with a stratified sample of 36 individuals. This included those who had direct experiences, as well as those with external insights, representing local, national and international organisations within and outside medicine.InterventionThe GMC quality assure education to protect patient and public safety utilising complex intervention components including meeting standards, institutional visits and monitoring performance. However, the context in which these are implemented matters. We undertook an innovative realist evaluation to test an initial programme theory. Data were analysed using framework analysis.ResultsAcross components of the intervention, we identified key mechanisms, including transparent reporting to promote quality improvement; dialogical feedback; partnership working facilitating interactions between regulators and providers, and role clarity in conducting proportionate interventions appropriate to risk. The GMC’s framework was commended for being comprehensive and enabling a broad understanding of an organisation’s performance. Unintended consequences included confusion over roles and boundaries in different contexts which often undermined effectiveness.ConclusionsThis realist evaluation substantiates the literature and reveals deeper understandings about quality assuring medical education. While standardised approaches are implemented, interventions need to be contextually proportionate. Routine communication is beneficial to verify data, share concerns and check risk; however, ongoing partnership working can foster assurance. The study provides a modified programme theory to explicate how education providers and regulators can work more effectively together to uphold education quality, and ultimately protect public safety. The findings have influenced the GMC’s approach to quality assurance which impacts on all medical students and doctors in training.