Negotiated interactive observation: Doing fieldwork in hospital settings

Abstract

In this paper I discuss the possibilities and limitations of the ethnographer participating in the different on-going activities and events in highly specialised healthcare systems. The concept of participant observation is based on a number of assumptions, particularly that the ethnographer will become one of 'them' to be able to follow the steps belonging to the accepted ethnographic research practice of doing fieldwork. The character of fieldwork in highly specialised healthcare systems does not fit well with this assumption. I suggest that we need to rethink the concept of participant observation and I propose negotiated interactive observation as a more appropriate way to describe ethnographic fieldwork in a setting such as the hospital or the clinic.

Frontline health worker motivation in the provision of maternal and neonatal health care in Ghana

“…Also her continued reference to her superior in the actual interview on issues of administrative decisions on worker motivation, revealed her belief that I was spying on hospital management issues for the GHS regional authority. Based on this account I agree with Wind's (2008) …”

“…The ethnographer's identity can be influenced by various social and contextual processes within and beyond the research environment. Consequently, the individual can have multiple identities, and so can negotiate her identity by choosing to play down on some aspects, while emphasising others -depending on the time and space (Eriksen 2004;Narayan 1993;Wind 2008). Similarly anthropologists have had to negotiate between multiple identities of 'insider' and 'outsider' positions during research (Chege 2015;Merriam et al 2001;Narayan 1993;Tsuda 1998;Wind 2008).…”

“…Having to constantly negotiate my identity and position in the research field relates well with Wind's (2008) experience of having to daily negotiate her position as a participant observer, in order to observe on-going activities and events in her study of how rheumatoid arthritis people manage chronic diseases in two Danish health facilities.…”

“…Ethnographers have assumed various identities in the field of research depending on the aim of the study (Long et al 2008;Mulemi 2010;Van der Geest and Finkler 2004;Wind 2008). Since this study aimed at understanding frontline health worker motivation, having no medical background, I chose the identity of a research student.…”

“…Research participants' decision to cooperate in the research process is informed by their perceived identity of the ethnographer, which influences the level of trust between the two parties (Coumans 2011;Mullings 1999;Narayan 1993;Rosaldo 1989;Tsuda 1998;Wind 2008;Zaman 2008). So increasingly, as more anthropologists study their own societies their identity as natives and its influence on the research process come into question (Davies 2008;Wind 2008). Narayan (1993) contests the status of a 'native', questioning: 'how native is a native anthropologist?'…”