introduction to research and healthcare study designs, a focus on Qualitative research and the qualitative data analysis. Presented by Clinical Pharmacists Ahmed Nouri, PharmD

1. RESEARCH &
STUDY DESIGNS
A H M E D N O U R I , P H A R M D, M S C ( C L I N I C A L P H A R M A C Y )
U N I V E R S I T I S A I N S M A L AY S I A

2. OUTLINES
• I N T R O D U C T I O N
• T Y P E S O F R E S E A R C H
• Quantitative
• Qualitative
• C L A S S I F I C AT I O N S O F S T U D Y D E S I G N
• L E V E L O F E V I D E N C E
• Q U A L I TAT I V E R E S E A R C H
• Definition
• Differences
• Types
• S A M P L I N G I N Q U A L I TAT I V E R E S E A R C H
• D ATA C O L L E C T I O N I N Q U A L I TAT I V E R E S E A R C H
• D ATA A N A LY S I S I N Q U A L I TAT I V E R E S E A R C H

3. INTRODUCTION
• Research is a scientific way of answering questions and testing hypothesis in order to
generate new knowledge or validate existing knowledge
• Why do pharmacist need to know about research?
– Basic pharmaceutical sciences, (Development and testing of new dosage forms or medication-
administration modalities)
– Clinical research, (Efficacy, safety, and pharmacokinetics of drugs)
– Pharmacy practice (research addressing various issues such as the evaluation of new and
existing services, workload measurement, pharmacoeconomics, and quality management)
• The Canadian Pharmacists Association (CPhA) defines pharmacy practice research as a
component of health services research that focuses on the assessment and evaluation of
pharmacy practice.
• I hear, I forget I see, I remember I do , I understand

4. ELEMENTS OF RESEARCH PROTOCOL
Results and
Conclusions
FINER
• Feasible
• Interesting
• Novel
• Ethical
• Relevant
Study
Design
Researc
h
Questio
n
Sampling
Data
Collection
Data
Analysis
1. Quantitative
2. Qualitative

5. TYPE OF STUDY DESIGNS
• Dependent on questions/hypothesis to be answered
– aims and objectives of your study
–Qualitative
–Quantitative
–Mixed methodology

6. QUANTITATIVE RESEARCH
• Systematic scientific investigation of interventional data or data
collected through polls, questionnaires, and surveys by applying
statistical, mathematical, or numerical analysis.
• Scientist more comfortable with quantitative research
• Quantitative research focuses on gathering numerical data and
generalizing it across groups of people or to explain a particular
phenomenon.
• Answer questions
– How often? To what extent? How much? How many

7. RESEARCH DESIGN CLASSIFICATION
Study purpose
• Descriptive
• Analytical
Time orientation
• Prospective
• Retrospective
Experimental setting
• Interventional
• Observational

8. EXPERIMENTAL STUDIES
1. Observational studies 2. Interventional studies
A. Case Report
B. Case Series
C. Case-control studies (retrospective)
D. Cohort studies
E. Cross-sectional studies, surveys
(prevalence)
A. Controlled trials
1. Parallel or concurrent controls
a. Randomized
b. Not randomized
2. Sequential controls
a. Crossover
B. Studies with no control

11. LEVEL OF
EVIDENCE

12. QUALITATIVE
RESEARCH Outlines
• Definition
• Differences
• Types
• Sampling
• Interview process
• Handling data
• Data analysis

13. • Qualitative research involves investigating participants' opinions, behaviors and
experiences from the informants' points of view.
• Qualitative methods aim to make sense of, or interpret, phenomena in terms of
the meanings people bring to them
• Qualitative research is concerned with finding the answers to questions which begin
with: why? how? in what way?
• It is concerned with the social aspects of our world and seeks to answer questions
about:
• Why people behave the way they do
• How opinions and attitudes are formed
• How people are affected by the events that go on around them
• How and why cultures have developed in the way they have
• The differences between social groups
DEFENITION

14. "There's no such thing as
qualitative data.
Everything is either 1 or 0"
- Fred Kerlinger
"All research ultimately has
a qualitative grounding"
- Donald Campbell
QUALITATIVE VS QUANTITATIVE

15. QUANTITATIVE VS QUALITATIVE
Qualitative Quantitative
Purpose describe a situation, gain insight to
practice
measure magnitude-How widespread is a
practice
Data In-depth explanatory data from a small
sample in the form of words, pictures or
objects
data from large representative sample
in the form of numbers and statistics
Analysis Draws out patterns from concepts and
insights
Tests hypotheses, uses data to support
conclusion
Sampling Theoretical Statistical
Expected
outcome
Usually not predefined, emergent research
question
Identified in advance
Tools Depend on interactive interviews,
observations
Structured data collection instruments
Results Produce results that give meaning,
experience and views
Produce results that generalize, compare
and summarize

16. QUALITATIVE STUDY DESIGNS
Study design Description
Ethnography Study of the story and culture of a group usually to develop cultural awareness
& sensitivity
Grounded
theory
Developing a new theory about a phenomenon-theory grounded on data.
Case study
In-depth investigation of a single or small number of units at certain time. E.g.
Evaluation of s service
Phenomenology Study of individual’s lived experiences of events.

17. • Phenomenology literally means the study of phenomena.
• Phenomena may be events, situations, experiences or concepts. We are surrounded by
many phenomena, which we are aware of but not fully understand.
• Back Pain
• Types of people who experience back pain and the apparent causes.
• Compare the effectiveness of one analgesic against another.
• But what is it actually like to live with back pain? What are the effects on peoples’ lives?
What problems does it cause?
• Phenomenological research begins with the that there is a gap in our understanding and
that clarification or illumination will be of benefit.
• Phenomenological research will not necessarily provide definitive explanations but it does
raise awareness and increases insight.
PHENOMENOLOGY

18. DATA COLLECTION
• Direct interaction with individuals on a one to one basis or in a group setting
• The main methods of collecting qualitative data are:
1. Individual interviews
2. Focus groups
3. Observation

19. FOCUS INTERVIEWS
• Collect information from groups of people rather than
from a series of individuals.
• Focus groups can be useful to obtain certain types of information
or when circumstances would make it difficult to collect
information using other methods to data collection
• If limited resources prevent more than a small number of
interviews being undertaken.
• Group interaction among participants has the potential for greater
insights to be developed.

20. ONE-TO-ONE INTERVIEWS
1. Unstructured interviews
• The interviewer goes into the interview with the aim of discussing a limited
number of topics, sometimes as few as one or two
• Interviewer wants to find out about a specific topic but has no structure or
preconceived plan or expectation as to how they will deal with the topic.
2. Structured interviews
• A tightly structured schedule of questions is used, very much like a
• The interviewer asking each respondent the same questions in the same way.
3. Semi-structured interviews
• Series of open ended questions based on the topic areas the researcher wants
cover.
• The interviewer can interact, elaborate, ask more, change the wording and
of questions according to the interviews.

21. TIPS FOR INTERVIEWERS
1. Interview in a comfortable place.
2. Introduce yourself and your research
3. Keep it short and simple, Don’t use jargon.
4. Be respectful
5. Take care of your appearance and look.
6. Never begin an interview cold.
7. Remember your purpose and keep directing the interview to your aim.
8. Present a natural front-be relaxed, affirmative, and as natural as you can.
9. Demonstrate aware hearing, and feel with the interviewee
10. Don’t be satisfied with monosyllabic answers, encourage them to talk
11. Practice, practice, and practice some more
*Adapted from: Berg B. Qualitative research methods for the social
sciences,5th ed. Boston: Allyn and Bacon; 2004. pp 110–11.

22. SAMPLING IN QUALITATIVE RESEARCH
• Generate a sample which allows understanding the social process
• Samples are usually smaller than with quantitative studies and are often locally based
• The one that adequately answers the research question-until new categories, themes or
explanations stop emerging from the data. (Saturation point)
• Sampling techniques in qualitative research
1. Convenience sampling
2. Purposive sampling-selection of the most productive sample to answer the
research question
3. Quota sampling
4. Snowball sampling

23. EXAMPLES
• "How many parents would consult their general practitioner when their child has a
mild temperature?"
• "What proportion of smokers have tried to give up?"
• clearly need answering through quantitative methods.
• "Why do parents worry so much about their children's temperature?"
• "What stops people giving up smoking?"
• cannot and should not be answered by leaping in and measuring the first aspect
of the problem that we (the outsiders) think might be important.

24. HANDLING DATA
IN QUALITATIVE
RESEARCH

25. STAGES OF HANDLING DATA
• Transcription
• Translation
Data
Preparation
• Data cleaning
• Read, Read, Read, Read
• Coding
• Labelling
Data
Reduction • Easy to readers
• Diagrams and
tables
Data
Presentation
• Interpretations
and mapping
verification and
conclusions

26. TRANSCRIBING
• Transcribing is the procedure for producing a written version of the interview.
• It is a full "script" of the interview
• Transcribing is a time consuming process.
• The estimated ratio of time required for transcribing interviews is about 5:1.
• It also produces a lot of written text as one interview can run to up to 20 pages
• If the transcriber is unfamiliar with the terminology or language contained in the
interviews this can lead to mistakes or prolong the transcribing time

27. QUALITATIVE DATA ANALYSIS (QDA)
• QDA is the range of processes and procedures where by we move from the qualitative data
that have been collected into some form of explanation, understanding or interpretation
of the people and situations we are investigating.
• Working with data, organizing it, breaking it into manageable units, synthesizing it,
searching for patterns, discovering what is important and what is to be learned, and
deciding what you will tell others
1. Content Analysis
2. Narrative Analysis
3. Discourse analysis
4. Framework Analysis
5. Grounded Theory

28. CONTENT ANALYSIS
• Content analysis involves coding and classifying data.
• Some authors refer to this as categorizing or indexing.
• To identify from the transcripts the extracts of data that are informative in some way
and to sort out the important messages hidden in the mass of each interview

29. FAMILIARIZATION : READING : STEP 1
1. Browse through all transcripts, as a whole.
2. Make notes about your impressions.
3. Read the transcripts again, one by one.
4. Read very carefully, line by line.

30. LABELLING AND CODING : STEP 2
• Coding: is organizing raw data into categories (sentences, words, phrases)
• make transcriptions into more meaningful elements,
• Breaking data down into smaller parts, line by line
• In qualitative research you start with very broad idea, you do interviews, and from
content of that you need to determine any pattern that emerge, any similarities
patients have said, or themes that may come out from interviews, to become more
specific.

31. LABELLING AND CODING : STEP 2
Open Coding
• Labels can be about actions, activities, concepts, differences, opinions, processes, or
whatever you think is relevant.
• You might decide that something is relevant to code because:
– It is repeated in several places.
– It surprises you;
– The interviewee explicitly states that it is important.
– You have read about something similar in reports, e.g. scientific articles.
– It reminds you of a theory or a concept.
– Other reason that you think is relevant.
• Do not hesitate to code plenty of phenomena. You can have lots of codes, even
hundreds

32. FROM CODING TO THEMES: STEP 3
• Decide which codes are the most important, and create categories by bringing several
codes together
1. Go through all the codes created in the previous step. Read them, with a pen in your
hand.
2. You can create new codes by combining two or more codes.
3. You do not have to use all the codes that you created in the previous step.
4. Keep the codes that you think are important and similar and group them together
5. Create categories. (i.e. Themes)
6. The categories do not have to be of the same type. They can be about objects,
processes, differences, or whatever.
7. Compared to the previous steps, the work is more organized now.
8. Data is being conceptualized

33. INTERPRETATION : STEP 4
• Searching for patterns, associations, concepts and explanations in the data.
• Label categories and decide which are the most relevant and how they are connected
to each other
• The categories and the connections are the main result of the study.
• It is new knowledge about the world, from the perspective of the participants in the
study.

34. DATA PRESENTATION
• After we came to make sense of our data, we need to find a suitable ways to present it
• it has to be accessible and easy to readers to understand the connections (Diagrams
and tables)
• Themes are the main findings of the study
• Evidence are presented at direct quotations from respondents

35. DATA PRESENTATION
1. Network diagram
Shows hierarchical relationships between different ideas.
central theme, then sub-categorize it, then subcategorize further.
2. Venn Diagrams
Shows the relationships or overlapping relationships of various components
3. Radial/spider diagram
Shows central theme, how each item or topic links to central item
4. Cycle diagram
If there is a process , shows stages of a process as continuous cycle,
how each stage affects the next
.
. . .
.

36. I: “WHY YOU DON’T PLAY FOOTBALL?”
P1: “my father doesn’t like sports”
P3: “none of my friends like to play”
P2: “my parents fear I will hurt myself”
P4: “no point, all you see are male stars on
TV”
P5: “I like to play, but I don’t find it
entertaining to play alone”
Dad
Parents
Friends
TV
Stereotype
Gender
Friends
Place
Family
Media
Friends

38. • SUMMARY
1. The anatomy of research is the set of tangible
elements that make up the study plan:
• Research question
• Design
• Study subjects
• Measurement approaches.
2. The physiology of research is how the study works.
3. The increased interest in qualitative research in recent
years warrants a basic understanding of this paradigm
on the part of all technology education researchers
4. Quantitative answers the question how much? To
what extent?
Qualitative answers the questions why? How come?
5. Quantitative research aims to generalize the results,
hence, large sample size required.
Qualitative aims to give an insight into certain
phenomena, no need for large sample size.
SUMMARY

39. THANK YOU..
Q U E S T I O N S ?
A H M E D N O U R I , P H A R M D
M A S T E R O F S C I E N C E ( C L I N I C A L P H A R M A C Y )