Lecture 2 RMHS – research perspectives
The purpose of health science/research is finding an objective, generalizable truth. In
contrast to social sciences, where no generalizable truth is aimed.
Epistemology: what does it mean to know?
Positivism (objectivism): presenting facts as truth, knowledge can be formulated in laws, it’s
generalizable. Reality can be observed as something out there, external, waiting to be found.
- Single reality (dominant mode in natural sciences)
- Value free
- Measure and predict
- Quantitative
- Newton: uncover the natural laws of how the world functions
- Discovers truth
- Time analogy: time can seem slower
Interpretivism (constructivism): Truth and meaning are constructed by the
person/researcher (subjects) interpretation of the world (object). An interpretivist
approaches to research acknowledge that any truth is socially constructed and this socially
constructed truth is largely based on the interpretations of the researcher and his/her
participants.
- Constructs reality/truths (social sciences)
- Observations are value bound
- To deeply understand
- Time and context bound hypothesis/generalization
- Qualitative
- As human beings our own presence as researchers influences what we are trying to
measure
- Researchers inherently view the world through their frame of reference.
- Multiple realities (are experienced), and meaning is not stable. (alternative for
studying social reality – social sciences)
For instance time: positivism as measure so 10 days waiting list, but interpretivism as how
people experience those 10 day (for some people it’s a short time, time flies, but for some
it’s too long).
So think, are we constructing something or is it a generalizable truth.
Research methodologies: deductive and inductive
- Believes, also those about truths, are leaps of faith, but not all leaps of faith are
equal.
- They are based on collection and interpretation of anecdotes [data]
- We always collect and interpret anecdotes
- We check/test if our interpretations are correct
- The extent to which we can reduce anecdotes to fragments that can be made
distinguishable and have limited variability determines how we can analyze these
,Methodology: the rigorous collection and analysis of anecdotes
Example: Nr of drinks you can have before having a hangover: easy to say/judge Was it
worth it: difficult to say/judge
How do I abstract data from the world?
Inductive: Inductive approaches aim at collecting empirical data far less structured and let
meaning arise from this data. They intend to contribute to the development of new theory,
although these theories are often bound to the context where they emerged.
- Analyze data from emerging patterns: theory unstructured
- So, we start with data, see a pattern and end with theory.
- “Thick” description
- Ends with hypotheses and grounded theory
- Emergence and portrayal Researcher as instrument
- Seeks for (contextual) theory.
- You are open to whatever comes in, you see/observe, start to look for patterns and
end with hypothesis.
- Observation→pattern→hypothesis→ theory (unstructured)
Deductive: Deductive approaches are often very structured – researchers collect and
analyse data using clearly defined units/properties (variables). Thereby aiming at verifying or
falsifying theory / hypothesis.
- You start with a theory from deduction
- Begins with hypotheses and theories
- Manipulation and control
- Uses formal instruments to measure it, because you know where to look for
- Experimentation/survey/structured interviews
- Seeks for/the goal is confirmation/rejection
- Looks at your data with clear units of analysis structured
- Theory: conceptual framework
- Hardly any research is deductive: you will always look beyond the framework you
have
- Theory→ hypothesis→ observation → conformation/rejection
However, in reality is mostly mixed.
Inductive and deductive support each other: cycle
- Inductive: qualitative
- Deductive: quantitative
Questions:
1. Am I searching for an objective truth
2. Do you think the real world cannot be measured in this way, and you believe that the
understanding of underlaying mechanism (in your study context) is more important than
generalizing
,Research methodology
Get acquainted with different research methodologies:
(Quasi) experimental
- Manipulate the independent variable to determine effect on the dependent variable
- Determine causality
- Reproducing the laboratory experiment with highly structured methods (das
- experiment)
- RCT: Randomly assign participants to groups, comparable groups; control and
intervention
- When we have to use existing groups, it’s the Quasi experiment: not able to
randomize people. The weakest Quasi will be that there is no comparative control at
all and you have to look at the same group pre and post.
- Generation of hypothesis
- Clear indicators to determine outcome
- Aim to generalize from the experiment
- Associated with positivism/deductive approaches
- Complex intervention in normal day setting, such as RCT
Analytical survey
- Observational studies
- To explore and test proportions / associations / predictors between variables
- Test theories in the field, explore/determine associations/predictors
- Structured questions/units and limited options for respondents. Structured questions
lead to control of variables
- Limited options for respondents
- Generalization from sample
- Highly deductive
- Aim to generalize
- Question why certain data is in a dataset
Phenomological studies
- Aims for contextual description and analysis of ‘phenomena’. They do not aim for
generalization.
- Phenomenology holds that any attempt to understand social reality has to be
grounded in people’s experiences of that social reality
- Emphasizes inductive logic
- Seeks the opinions and subjective accounts and interpretations of participants
- Relies on qualitative analysis of data
- Is not so much concerned with generalizations to larger populations
- Producing thick descriptions of peoples experiences, Seek subjective accounts and
interpretation of participants.
- Much less structured: prior to start less knowledge (“how does a patient experiences
something)
(participatory) action research
- Research that aims to change practice in real life
- Collaborations between researchers and practitioners and users (e.g. patients,
community members) (To change practice)
- Iterative designs An iterative approach is one where the content of the discussion,
, stimulus, or sometimes even the methodology is adapted over the course of the
research program. Iterative we call Cyclic design, because change is not shaped in
one day, often different fases.
- Mixed methods
- Understanding of perspectives in order to determine change AND (often) measuring
the change. It really focuses on change.
- Deductive and inductive reasoning. Very qualitative in the beginning to understand
the problem, to confirm the problem maybe a survey or questionnaire, maybe also a
Quasi experiment.
- Development of clinical guidelines: produced by patients, nurses and doctors, thus
Participations.
- Research objectives: research is not only classified by the perspective or
methodology, but also by its objectives
Think about the advantages or disadvantages
In summary: Research methods
- Experimental and quasi-experimental research (associated with positivism and
deductive approach)
- Action research: change within an organization (highly deductive)
- Analytical surveys: test a theory in the field through exploring the association
between variables.
- Phenomenological research: inductive collection, thick descriptions, peoples
experiences. (constructivism)
- Cross-sectional studies often use surveys
- Case study: mixed methods, can be inductive or deductive
Studies gesorteerd op purpose:
- Exploratory studies: seek to explore what is happening
- Descriptive studies: provide picture of a phenomenon
- Explanatory studies: correlative in nature, discovering relationships between
variables.
Research objective:
The research objective is ….(a)…. by …. (b)…
a) External objective: contribution of your research project to solution of the problem/
what results can be expected
b) Internal objective: the way in which this will be done/the insights, information,
knowledge needed = very similar to your research question
(or ….(b)…. in order to …. (a)…)
Example: the objective was to assess the acceptability of impregnated school uniforms.
Research agenda / priorities in a world of EBM
Evidence based medicine triad: Individual, clinical expertise, Patients values and
expectations Best available clinical evident Aiming on Improved patient outcomes
The purpose of health science/research is finding an objective, generalizable truth. In
contrast to social sciences, where no generalizable truth is aimed.
Epistemology: what does it mean to know?
Positivism (objectivism): presenting facts as truth, knowledge can be formulated in laws, it’s
generalizable. Reality can be observed as something out there, external, waiting to be found.
- Single reality (dominant mode in natural sciences)
- Value free
- Measure and predict
- Quantitative
- Newton: uncover the natural laws of how the world functions
- Discovers truth
- Time analogy: time can seem slower
Interpretivism (constructivism): Truth and meaning are constructed by the
person/researcher (subjects) interpretation of the world (object). An interpretivist
approaches to research acknowledge that any truth is socially constructed and this socially
constructed truth is largely based on the interpretations of the researcher and his/her
participants.
- Constructs reality/truths (social sciences)
- Observations are value bound
- To deeply understand
- Time and context bound hypothesis/generalization
- Qualitative
- As human beings our own presence as researchers influences what we are trying to
measure
- Researchers inherently view the world through their frame of reference.
- Multiple realities (are experienced), and meaning is not stable. (alternative for
studying social reality – social sciences)
For instance time: positivism as measure so 10 days waiting list, but interpretivism as how
people experience those 10 day (for some people it’s a short time, time flies, but for some
it’s too long).
So think, are we constructing something or is it a generalizable truth.
Research methodologies: deductive and inductive
- Believes, also those about truths, are leaps of faith, but not all leaps of faith are
equal.
- They are based on collection and interpretation of anecdotes [data]
- We always collect and interpret anecdotes
- We check/test if our interpretations are correct
- The extent to which we can reduce anecdotes to fragments that can be made
distinguishable and have limited variability determines how we can analyze these
,Methodology: the rigorous collection and analysis of anecdotes
Example: Nr of drinks you can have before having a hangover: easy to say/judge Was it
worth it: difficult to say/judge
How do I abstract data from the world?
Inductive: Inductive approaches aim at collecting empirical data far less structured and let
meaning arise from this data. They intend to contribute to the development of new theory,
although these theories are often bound to the context where they emerged.
- Analyze data from emerging patterns: theory unstructured
- So, we start with data, see a pattern and end with theory.
- “Thick” description
- Ends with hypotheses and grounded theory
- Emergence and portrayal Researcher as instrument
- Seeks for (contextual) theory.
- You are open to whatever comes in, you see/observe, start to look for patterns and
end with hypothesis.
- Observation→pattern→hypothesis→ theory (unstructured)
Deductive: Deductive approaches are often very structured – researchers collect and
analyse data using clearly defined units/properties (variables). Thereby aiming at verifying or
falsifying theory / hypothesis.
- You start with a theory from deduction
- Begins with hypotheses and theories
- Manipulation and control
- Uses formal instruments to measure it, because you know where to look for
- Experimentation/survey/structured interviews
- Seeks for/the goal is confirmation/rejection
- Looks at your data with clear units of analysis structured
- Theory: conceptual framework
- Hardly any research is deductive: you will always look beyond the framework you
have
- Theory→ hypothesis→ observation → conformation/rejection
However, in reality is mostly mixed.
Inductive and deductive support each other: cycle
- Inductive: qualitative
- Deductive: quantitative
Questions:
1. Am I searching for an objective truth
2. Do you think the real world cannot be measured in this way, and you believe that the
understanding of underlaying mechanism (in your study context) is more important than
generalizing
,Research methodology
Get acquainted with different research methodologies:
(Quasi) experimental
- Manipulate the independent variable to determine effect on the dependent variable
- Determine causality
- Reproducing the laboratory experiment with highly structured methods (das
- experiment)
- RCT: Randomly assign participants to groups, comparable groups; control and
intervention
- When we have to use existing groups, it’s the Quasi experiment: not able to
randomize people. The weakest Quasi will be that there is no comparative control at
all and you have to look at the same group pre and post.
- Generation of hypothesis
- Clear indicators to determine outcome
- Aim to generalize from the experiment
- Associated with positivism/deductive approaches
- Complex intervention in normal day setting, such as RCT
Analytical survey
- Observational studies
- To explore and test proportions / associations / predictors between variables
- Test theories in the field, explore/determine associations/predictors
- Structured questions/units and limited options for respondents. Structured questions
lead to control of variables
- Limited options for respondents
- Generalization from sample
- Highly deductive
- Aim to generalize
- Question why certain data is in a dataset
Phenomological studies
- Aims for contextual description and analysis of ‘phenomena’. They do not aim for
generalization.
- Phenomenology holds that any attempt to understand social reality has to be
grounded in people’s experiences of that social reality
- Emphasizes inductive logic
- Seeks the opinions and subjective accounts and interpretations of participants
- Relies on qualitative analysis of data
- Is not so much concerned with generalizations to larger populations
- Producing thick descriptions of peoples experiences, Seek subjective accounts and
interpretation of participants.
- Much less structured: prior to start less knowledge (“how does a patient experiences
something)
(participatory) action research
- Research that aims to change practice in real life
- Collaborations between researchers and practitioners and users (e.g. patients,
community members) (To change practice)
- Iterative designs An iterative approach is one where the content of the discussion,
, stimulus, or sometimes even the methodology is adapted over the course of the
research program. Iterative we call Cyclic design, because change is not shaped in
one day, often different fases.
- Mixed methods
- Understanding of perspectives in order to determine change AND (often) measuring
the change. It really focuses on change.
- Deductive and inductive reasoning. Very qualitative in the beginning to understand
the problem, to confirm the problem maybe a survey or questionnaire, maybe also a
Quasi experiment.
- Development of clinical guidelines: produced by patients, nurses and doctors, thus
Participations.
- Research objectives: research is not only classified by the perspective or
methodology, but also by its objectives
Think about the advantages or disadvantages
In summary: Research methods
- Experimental and quasi-experimental research (associated with positivism and
deductive approach)
- Action research: change within an organization (highly deductive)
- Analytical surveys: test a theory in the field through exploring the association
between variables.
- Phenomenological research: inductive collection, thick descriptions, peoples
experiences. (constructivism)
- Cross-sectional studies often use surveys
- Case study: mixed methods, can be inductive or deductive
Studies gesorteerd op purpose:
- Exploratory studies: seek to explore what is happening
- Descriptive studies: provide picture of a phenomenon
- Explanatory studies: correlative in nature, discovering relationships between
variables.
Research objective:
The research objective is ….(a)…. by …. (b)…
a) External objective: contribution of your research project to solution of the problem/
what results can be expected
b) Internal objective: the way in which this will be done/the insights, information,
knowledge needed = very similar to your research question
(or ….(b)…. in order to …. (a)…)
Example: the objective was to assess the acceptability of impregnated school uniforms.
Research agenda / priorities in a world of EBM
Evidence based medicine triad: Individual, clinical expertise, Patients values and
expectations Best available clinical evident Aiming on Improved patient outcomes
