How Can Video-Reflexive Ethnographers Anticipate Positive Impact on Healthcare Practice?

Abstract

Evidence suggests that studies aiming to improve healthcare practice should be flexible and prioritise patient, family and clinician engagement. Video-reflexive ethnography (VRE), a form of qualitative research often employed in healthcare settings, is well-suited to these aims. VRE supplements ethnographic techniques with video-recordings of in situ practices, allowing practitioners to reflect on taken-for-granted practices. Its prioritisation of collaboration, affective entanglement, theory-driven analysis and flexibility – aligned with participatory and post-qualitative inquiry (PQI) – can facilitate reflexivity among researchers and participants for local practice improvement. Yet paradoxically, flexibility can hinder the predictability of impact, and demonstrating likely impact is crucial to securing research funding. This article offers practical advice to qualitative researchers facing this methodological challenge. Using three exemplars, we examine how differing onto-epistemological groundings, conceptualisations of participant engagement and researcher positionings affect the timing, predictability, scalability and transferability of each study’s impact. We show how prioritising affective engagement, flexible goals and collaboration can enable local healthcare practice improvement; prioritising theory generation via consultation can lead to traditional, more transferable, forms of impact. We share insights for researchers seeking to improve healthcare using methods inspired by PQI such as VRE. While predicting impact is fraught, optimising conditions for impactful VRE research can be accomplished by: foregrounding epistemology; prioritising affective engagement; aligning research and stakeholder goals; assessing timing and organisational readiness; and considering researcher and participant positioning.

A catalyst for change: Developing a collaborative reflexive ethnographic approach to research with hospital doctors during the COVID-19 pandemic

“…The goals of publicly-funded research align with policy and practice change and improvement ( Olson and Dadich, 2022 ); this research project is no different. However, MIME facilitated change long before the formal policy-informing stage of the research project; change has been driven not just from the findings, but from the very research process itself.…”

“…At the same time, contemporary ethnographers have for many years been wrestling with the conceptualisation of ‘impact’ in their work, particularly under evolving funding frameworks. New ethical debates and dilemmas have arisen in the nexus between the imperative to effect real-world change – often dictated by funders and policymakers – and the ethics of honouring the contextualised human emotions, experiences, influences and challenges of the ethnographic participants directly impacted by both the research and subsequent changes ( Bergerum et al, 2020 ; Naumann et al, 2020 ; Olson and Dadich, 2022 ).…”

Quality of life beyond measure: Advanced cancer patients, wellbeing and medicinal cannabis

“…Guided by critiques of the rigidity of traditional qualitative methods as ‘methodological fetishism’ (Olson & Dadich, 2022 ), and calls to foreground theory, in the latter stages of analysis, we supplemented thematic analysis with post‐qualitative practices of thinking with theory (Mazzei, 2021 ). We drew on Sointu ( 2006 ) and Coffey’s ( 2022 ) Deleuzo–Guattarian theorisations to counter the segmented understandings of wellbeing employed in standardised RCT measurements and foreground appreciation of wellbeing as embodied, relational, socially inscribed, structurally mediated and discursively shaped.…”