How to do a grounded theory study: a worked example of a study of dental practices

Abstract

BackgroundQualitative methodologies are increasingly popular in medical research. 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. In this paper we provide a worked example of a grounded theory project. 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.MethodsWe documented a worked example of using grounded theory methodology in practice.ResultsWe describe our sampling, data collection, data analysis and interpretation. We explain how these steps were consistent with grounded theory methodology, and show how they related to one another. 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.ConclusionsBy 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.

Using qualitative and mixed methodologies to explore hierarchy in the operating room

“…[3][4][5] Parmi les diverses méthodologies qualitatives, la méthodologie dite de la théorie à base empirique est désormais la plus populaire dans la recherche en soins de santé, en partie en raison de son emphase sur la génération de théorie basée sur les données empiriques et de ses processus méthodologiques spécifiés. [3][4][5] La recherche quantitative et la recherche qualitative cherchent toutes deux à représenter les phénomènes de façon précise, mais elles abordent cet objectif à partir de différents cadres épistémologiques et avec différents buts et procédés méthodologiques. 6,7 La recherche quantitative se fonde sur un paradigme ou une vision du monde « positiviste », paradigme selon lequel il existe une véritable réalité objective qui peut être découverte grâce à un examen scientifique rigoureux dans des environnements contrôlés de façon à prévenir toute interférence due à un biais.…”

“…[3][4][5] Of the various qualitative methodologies, the grounded theory methodology has gained the most popularity in healthcare research, due in part to its focus on generating theory from the empirical data and its specified methodological procedures. [3][4][5] While both quantitative and qualitative research aim to represent phenomena accurately, they approach this task from different epistemological frameworks, purposes, and methodological procedures. 6,7 Quantitative research is based on a ''positivist'' paradigm or worldview that holds that there is a true objective reality that can be discovered through rigorous scientific inquiry in settings that are controlled to prevent interference from biases.…”

“…Final sample size is determined when analysis reaches ''saturation'', i.e., the point at which further analysis of incoming data no longer produces any new insights or findings to the emergent theory. 3,4,6,8 Qualitative research has been critiqued as being too subjective, non-generalizable, and lacking in transparency and rigour. 7 It has been accepted that quantitative and qualitative research should have different criteria for rigour given their different paradigms, purposes, and methodologies, but the actual criteria have been vigorously debated.…”

“…4,5 Since that seminal publication, grounded theory has evolved into a number of different approaches or ''schools''. [3][4][5] Despite the different schools, there are a number of common elements that define grounded theory methodology. These include: an inductive approach to the data with an initial broad and open coding of words and phrases with descriptors; purposeful theoretical sampling; iterative data gathering and analysis wherein data are analyzed shortly after collection; constant comparison of current and prior data; secondary or axial coding that merges codes under larger conceptual categories (which generates memos in order to develop an evolving understanding of the relationships amongst the concepts); and production of a substantive theory from the culmination of this process.…”

“…These include: an inductive approach to the data with an initial broad and open coding of words and phrases with descriptors; purposeful theoretical sampling; iterative data gathering and analysis wherein data are analyzed shortly after collection; constant comparison of current and prior data; secondary or axial coding that merges codes under larger conceptual categories (which generates memos in order to develop an evolving understanding of the relationships amongst the concepts); and production of a substantive theory from the culmination of this process. [3][4][5]8 Kennedy and Lingard 8 distinguish between grounded theory research, which uses all the aforementioned elements, and studies that use the grounded theory approach to analysis. Bould et al's study 1 would fall into the latter category, as the qualitative phase is part of a mixed methods study, and sampling was neither iterative nor purposeful.…”