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Uh Well, good afternoon, everyone. Um and welcome to this session on getting started in choosing methodologies as part of the incubator for clinical education research. Um Welcome to everyone and whether you've been to one of these sessions or not, um It's really great that you could join us today. Um I'm just gonna start with a little bit of background of what the session I is about and then I'll be handing over to my colleague, Amy who will be um starting the session and telling us all about how to choose a methodology. So these, these um webinars are part of um a program of offerings um that we give as part of the incubator. It's funded by the N A hr with intention to try and get more clinic, clinicians involved in educational research. This is very much a getting started series. Um So it's particularly good for, for those of you who may be doing your first project first ideas or even just thinking about getting involved. Everyone else is welcome. And we've certainly had people at different stages of their career uh joining us. Um But just to say that um the incubator does run some other programs for kind of mid stage and for supervisors as well. So do have a look at the website for the incubator for clinic education research. We'll, we'll put the link in the chat box uh at some stage as well. So you could see the other things that we offer. So this is series, as I said very much for, for starters and for, for beginners. Um this is, I think the fourth session that we've ran this year um this academic year. Um So if you want to look back again on the, the website um through Medal, how you logged in um the the other sessions are there and you can look at the recordings or the slides and then there's a series of other things still coming up. Um So we always meet on the third uh Wednesday, lunch time of the month um and the other sessions. So, for example, in January, we'll be looking at running interviews and focus groups, er and then February and March the sessions on analysis, both qualitative and quantitative analysis. Um So do sign up for those as well. Uh through um through medal means we can't see you and you can't speak um whilst we're doing the, the, the presentation. Um but the idea for today will Amy will be doing a presentation and you can certainly put questions up in the chat box while she's doing that. Um That'll be for about, for about half the time and then for the second half, we'll be going into breakout rooms, breakout sessions and during those sessions, you definitely can speak and can see each other. And we very much encourage you at that point to unmute yourself and put your videos on. Um and there will be some time to talk in small groups and then there'll be time to come back at the end where we'll talk again. Um II will pass over to Amy to um find out more about methodologies. Thank you very much, Hill, welcome everyone to this session. My name is Amy Wong. I'm associate professor in medical education, working in Norwich Medical School at the University of East Anglia. I'm also a member of the advisory group and training works stream of the NIH R incubator for clinical education research. So my background is education and I'm an educationalist, but I have experience working in medical and health profession, education, both in Australia and in the UK in the last 15 years. And my research interest is in faculty development, assessment and feedback and interprofessional education. So, welcome to this session. Choosing methodology. Methodology is a huge topic. So the aim for the next half an hour is to demystify the process. There are a lot of big words we use in methodologies, but actually, we don't really need to use those big words and then we are trying to see, have an understanding of what that, what is mean by choosing methodology and provide you with six questions as a starting point to think about what kind of methodology that you would use for your research study. So this is an overview of the session. So first of all, we're going to explore the differences between methodology and methods and then we are going to discuss why we need to choose an appropriate methodology for a research project. And then we'll be introducing the six step approach to guide the choice of an appropriate methodology. And then at the end, we'll have a breakout room discussion to give you an opportunity to apply the six step approach in a research project of your own or with the example that I'm going to give it to you and thank you everyone for putting their brief introduction. Um Just have a quick look. We've got um clinic, academic teacher in radiology, uh radiography. Um We've got nursing, um we've got advanced practice. So we've got a huge range of health professionals here with us. So first of all, I would like to know anyone would like to have a go and put that in your chat board. What are the differences between methodology and methods? Don't worry, I didn't know about that when I first started doing research. So having it a go what is methodology and what are the differences between methodology and methods? I'll give you a few moments to think about that. And if you can put it in the chart. That would be great. Yes, NASA say that methodology is broader and can include multiple methods. Thank you, Katie methodology is the philosophical underpinning. Great, a very good starting point. Thank you for participating in the chat. Really appreciate a bit of an interaction although I can't see you, but it's good that we can communicate through the chat. So please use the chat function. Yeah. And methods is the actual tool used to collect data, right? And methodology is the overarching concept explaining why certain methods are chosen. Exactly. Yes, you've got a ball path of what is what are the differences between methods and methodology. OK. Let's go to the next slide. So as some of you mentioned method is a specific techniques or procedures that we use in data collection and analysis. For example, we use a questionnaire to collect data. OK? We are interested in how are we going to collect and analyze data when we talk about methods? So it's a practical application in research. So it's a specific way of collect data. But on the other hand, some of you should have mentioned that methodology is the principles and theory underlying a research approach that we have chosen. So for example, if we want to understand the participants experiences or perception, we will use a qualitative approach. However, if we want to observe a phenomenon in a targeted sample in an objective manner and collect data and communicate the findings through numbers and statistics, then we'll adopt a quantitative approach. So methodology is the why we choose to use a certain methods? OK. So method is a to how we collect data and methodology is the reason why we choose using a particular methods. So why do we need to choose an appropriate methodology for research study? So first of all, and it's really important that we need to choose a robust methodology to justify the reason of why we use a quantitative qualitative or mixed method study. So for example, if we want to explore the changes in medical students or health professional students confidence in clinical skills after their first clinical placement, if the focus is is on what is the extent of the change whether the change is significant or not, then we will adopt a quantitative approach. However, if the focus is on exploring the reason for the change in students confidence, then we probably would adopt a qualitative approach. So with the appropriate methodology is actually informs how we collect data informs our methods. So as briefly mentioned before, so quantitative approach, we can use a questionnaire to ask the student preimpose to raise their confidence in clinical skills before and after the placement. But if we are interested in the reason for changes, then we can conduct interviews to explore the reason and it's also guide you how to interpret the data because they are very different interpreting quantitative data usually by statistical analysis and QQ qualitative data, usually we use thematic analysis. But the most important bit that I think that we need to bear in mind, whatever we choose to methodology must align with your research question. Whether your research question is one to find out what is the extent of changes or want to explore or develop a deeper understanding of a certain topic. Now, I'm going to introduce a six step approach to guide the choice of choosing an appropriate methodology for your research project. So first of all, what is your research paradigm? What is the appropriate approach? How many methods, how many tools will you be used? What sort of data will be collected? And the reason why why you collect quantitative qualitative or mixed? What are, what is your methodological strategies and how often would you collect data? So we're going through each questions, you come across some big words, but don't be scared of the big words, we'll explain it in an everyday language so that it is understandable um to everyone. So this is a flow diagram and then it is a very good step to step by step approach to think about how to choose your methodology. So definitely it is not an exhaustive list. These are some common paradigms or approaches or methodological strategies that usually is used in clinical education research. So let's crack on and have a look at the first question. What is your research paradigm before we actually jump to the research paradigm. There are three different things that are actually impacting on our choice of research paradigm. The first one is axiology again, don't scare off the big words. So a axiology is actually related to the values. So what would be the value of doing research to you? So my value of doing research is I really value ethical and equality and diversity and inclusion. And then I need to think about how I might go about being doing research that is ethical and including the voice of the, of those that who are underrepresented. And I love doing research is that doing research is actually a way of reflecting my own value as a researcher. So you have two questions to think about in terms of axiology. Why is this research study worth your time and effort? We are all very busy people but why doing this particular research study and project? The second one is about what are your motivation? What motivates you to complete this research project? OK. So first one is about your value as the researcher. Second one, ontology, what is out there to know? So we talk about axiology is about value ontology is about your belief, your ontological assumption as the researcher about the nature of the reality, sorry, it is a bit abstract, but the reality that referring here is the social world, either the academic and clinical context that you're working in. So generally, there are two position of this onto ontological assumption. The first one, what we call is realistic position, there's only one verifiable reality. And on the flip side, the relativist position is that you believe that there are multiple constructed reality that exist. So give you an example. So for simulation based education, improve students ability to perform surgical procedures. So if your ontological assumption is realist, realist, which means that you only believe that there is only one verifiable reality, then the researcher will, will look at some measurable and consistent impact on the skill acquisition of the students because of the stimulation based education. And the researcher believe that improvement happened regardless of the student experience, interpretation or application. So this is one side of the belief, this is the realist position. The flip side, the relative position is that there isn't a single objective truth about the impact of simulation based education on student performance. It does vary from individual based on their background, their context and their experience. So this is a relative position any questions so far. So if you have any questions, I know that you can't speak to me, please put it on the chat and I'll try to pick it up in my presentation as well. So we talk about axiology, we talk about value ontology, we talk about the belief um as a researcher and the first one is, is so what and how can we know about it is our own reflection on how you define knowledge, the nature of knowledge. So three key questions to think about is OK, try that word again is three key questions. Sorry. First one, what do you think is counted as knowledge? OK. The second one is what constitute as knowledge. And the third question is how you design your research project to obtain this knowledge. OK. So your value, your belief and how you perceive the nature of the knowledge will have a direct impact on the methodology that you choose or your stance for the research paradigm. So let's have a look of three common research paradigm that we usually seen in clinical education research. So the first one is po visit. So if you as a researcher adopt a pouchy paradigm, you place yourself in an objective or what we call realist position, you see the reality, the social world that you're working in is fixed and measurable. And by observing you, you you would devise knowledge by collecting empirical data. So empirical data, by observation is your is logical assumption and actually you're being neutral, you, you would adopt a neutral position similar to the referee, you will observe and analyze the data without taking size, which may impact on the findings. So this is very much as a pacifist research paradigm. Yeah, the second one is pragmatist. So if you place yourself as a or if you choose as a pa pragmatist as your research paradigm, you place yourself in a more flexible position. You see that there are multiple ways of solving or developing knowledge of a specific issues and generate useful outcomes. So your axiology, you value, you value your practical outcome, practical implications that derived from your research study. And the last one is interpret paradigm. So in an interpret paradigm, you place yourself in a real in a what we call. Remember we talk about realist and reist position. So the reality of the social world is actually constructed by individuals around you based on their experiences. And what you aim to do in your research project is to develop a deeper understanding or in your research, to develop a deeper understanding and value a what we call a participatory relationship with your participants. So you as a researcher will be actively involved in the research project to core knowledge with the participants to understand the issue. So there are distinct differences between research paradigm and these are the three that we usually we seen in doing um clinical education research. So this is all step one. What is your research paradigm? And I saw a question on the chat, we probably um we'll talk about it um at the end of the presentation is that OK, so let's go to step two, step two is what is the appropriate approach? Again, there are very common approach, deductive, inductive, or abductive. So the first one is deductive, it's really about testing existing theory. So we start off with a hypothesis and then we collect empirical data through observation and then we use the data collected to measure or test a theory or concepts. And that and deductive approach aligned very much with the positivist research paradigm. The inductive approach is usually ideal for explorer exploratory research exploring an issue. We begins rather from instead of the hypothesis, we begins with observations and through observations of the data, we develop pattern and ending up with developing new theories. And this inductive um approach aligns very much with the pragmatist research paradigm. The last one is adaptive is involve both the observation and theory and create a new theoretical understanding based on the existing theory. So neither deduction or induction alone is sufficient to do this. So we usually use this approach to explain some complex phenomena. So this is step 23 common approaches deductive, inductive and adopt and adaptive. So let's go to step three. When you design your research study, you need to think about how many methods are you going to use? So are you going to use one single focus method? So for example, are you only using a questionnaire or are you using interviews um with your participants or using a multiple methods, multiple tools to address different parts of your research questions of the different elements of a phenomena. So for example, you can use interviews to address one part of your question and you can use questionnaire to address other part of your question. But these different part, if we what you use multi methods, these different parts are separate, they are not linked to each other. And this is the main difference between a multi and a mixed methods. So what what you use mixed method, you will combine interview datas and questionnaire data. So you you would use qualitative approach to collect data through interviews or use quantitative approach to collect quantitative data through a questionnaire. But one will inform the other. So for example, if you do a survey, first, the quantitative data that you obtain from your survey will inform the interview data that you use. Sorry, the interview questions that we use in the interview. So one part, the qualitative part will inform the quantitative part or the quantitative part will inform the qualitative part. So the data it integrates to create a comprehensive understanding of a specific issue. So after we think about, after we thought about how many methods will be used, then we need to think about what sort of data will be collected. We talk a little bit about that um in and and in the previous slide qualitative or quantitative. So very very general qualitative is related to text words that we've collected. And the purpose is really to develop a deeper understanding to explore particular issues and use the data to in in in interpret a specific phenomena. The re is to reuse qualitative data to address the research question of how something happened or why something happens. We usually collect qualitative data through interviews or focus groups and we identified the patterns and themes through the collected data and used the inductive approach to build theories based on the data. On the other hand, quantitative data very roughly is about numbers. Um The purpose is to measure or quantify variables and usually to answer the question to what extent does X impact on why? To what extent the students go on stimulation, stimulation based learning impact their confidence um rating. What is the relationship between A and B? And we usually collect data through surveys, standardized testing, structured observation. And we use descriptive um statistics or statistical analysis. And we usually adopt a deductive approach to test the hypothesis against the data to either confirm or reject the hypothesis. So, so far we talk about step one, your research paradigm. Step two. What is your appropriate approach, deductive, inductive or adductive. Step three. How many methods will we use? And step four, what sort of data will be collected? Now, I'm going to pass on to hill to talk about, to talk a little bit about quantitative research. Thanks. Uh Thanks Amy. Um Now there there is a whole other session on excuse me, quantitative analysis and research coming up in March. But we thought we better include just um a a mention or, or refer to the fact that obviously quantitative methods can be used and often are in clinical education research. Um I forgot to introduce myself and when I started, I always forget something. So I'm glad it was only that. Um But I'm a GP and Professor of General Practice Education Research at Newcastle University and Amy, if you could just forward the slide, um then we can um just wanted to, to mention now, I know that many of us um particularly those of us who are clinicians, our background will have been more in biomedical research. Um And we may even have been involved in quantitative um work before. When you've been listening to Amy, you're probably thinking, oh yes, you know, certainly our background um often is in positivist research, very deductive, we're testing hypothesis. Um It's all about numbers. Um And so sometimes we don't talk about that quite as much as because that's something that many of us are familiar with and actually trying to get our heads around other paradigm uh is the, the, the challenge but want to just reinforce that sometimes research can be very, very helpful in clinic clinical education as it is in other types of research. And as Amy's already mentioned, it's very much a, a systematic attempt um to look at define measure or test particularly hypotheses through various different means. Um And often it will be surveys of some sort, rarely do RCT S in clinical education. Um It would be nice to um but it's just difficult pragmatically um to actually be able to um put people into control groups, et cetera and to balance for other confounder in education, which is much easier to do if you're just gonna give a drug to someone. But giving a teaching session to someone is much more complex and nuanced than that. Um But these are the, some of the ways that we could, we could use. I just wanna give you one real life example um of a study that I was involved in LA a few years ago where it was really important to use quantitative methods. Um And Amy just goes on a slide. Thank you. Um It was um in my field of er GP education. Um And what we wanted to do was to look at whether um if students had more time spent in the GP context as an undergraduate, were they more likely to become GPS in the future? And this was very much very important politically and socially to, to know the answer. So we looked at every medical school at the time uh and worked out approximately how much time students spent in GP as an undergraduate. Er and then looked at the proportion of graduates who went into different, into GP training. It had to be, it was a proxy, it had to be straight after their F foundation doctors cos that was the only data that we had um and used a log logistic regression model and found that there was a correlation it accounted for about 15% of the variation across medical schools. And that data is being used by ourselves and by medi many medical schools across the across the country to support um more time for students in general practice. I will pass you back to Amy. Thank you very much Hill. So let's go to have a look at step five, the methodological strategies. Now, here is we, these are the five key or common methodological strategies we use in qualitative clinical education research. So the first one is phonology, so we'd really the key is focused on the participants live experiences to develop an understanding of the meaning constructed by them on a particular issue. OK. So usually it will involve in depth interviews but with a small sample, the next one is case studies and we have s we can have single case study in a single setting or a multiple case study across institutions. And we use case study both for the purpose of descriptive analysis or we can do an exploratory or explanatory research. So the ground theory ground theory, the key in here is based on direct participants experiences and their perspective. We used these direct experiences and perspective to create a new the theoretical framework to explain a particular situation. Usually is rather long research process because it will in involve iterative data collection and data analysis to construct this new theoretical framework or new theoretical theory. And then Ann Gray Ann gray. The focus in here is a very in depth understanding of a complex social and cultural phenomenon. OK. And it's also us it is when we use an Gray because we need to develop that very in depth understanding and the researcher is directly immerse and interact with the participants. So we need to use a extensive period of time because it will contains multiple data collection methods. So interviews, we do surveys, we do documents reviews because we need to have that direct immersion and interaction between the researcher and the participants. And the last one is general qualitative inquiry. It is a quite a flexible data collection strategies. And the aim is to explore and develop an initial understanding of the participant experience, perceptions and interpretations of a specific topic. OK. So Feminone, the first one will look at the participant lift experience. OK? It doesn't necessarily lead to create a new theoretical framework as in the Granted theory. So the aim of the Granted Theory is based on the direct participants experiences and perspective to create a new theoretical framework. OK? You do not necessarily generate a theory with immunology. OK. And these strategies doesn't necessarily mean to be mutually exclusive. You can use the a couple of methodological strategies in your research study, but don't make it too complex. And you need to justify the reason why of choosing a particular methodology. OK. And the last step we talk about is how often will you collect data. So if you're doing a cross sectional study, you'll collect data at a s single point in time. If you do a longitudinal study, you will collect data repeatedly over time with the same cohort or different cohort of participants as based on your research design of your study. So cross sessional study, one data collection point, longitudinal study, multiple data collection point. OK. So the next things we've got about, I think we've got about we're actually in pretty good timing. So the next activities is we're going to break our room discussion and we talk about these six steps approach of choosing an appropriate methodology for research study. So I would like you to go into a small uh small group discussion and talk about how you would apply this six step. You can use an example of your research study that you are doing or you're thinking of doing or if you haven't had one, you can think about this research question. How and to what extent does interprofessional education impact collaboration, skills among health professional students? Wel Welcome back everyone. Um I think we have all the groups now back on, back on the main stage as it's called. Um Certainly um a couple of groups I was popping into um certainly had productive discussions. II hope that was helpful for everyone. Um And if it has been a good session, um then it means that you will leave with as many questions as you came with, but question, hopefully helpful questions that, um are a step forward from where you were before or questions like what on earth is critical realism. I'll go and read up about it. Um So we're hoping that there's things for you to take away and think about, um, just to round up now. Um, if there are any, um, I think there are one or two questions already in the chat box that um we'll cover now. But if there are any questions that came up from the breakout rooms, um that you, um, that you like us to cover just in the last couple of minutes, we realize people will have to leave, but we're happy to keep talking until the questions run out. Um Then add it to the chat box. Um Just practically, um, or the, the recording from today in the slides will be on the med website. Um So the same place where you logged in, um if you click on there, then this session and the other sessions um will be there. So, um, feel free to encourage you to have a look at those. Um And also whilst we're talking, I'll put on a couple of links to future sessions, uh and also to um the clinical incubator for other things that we offer training wise. Um But over to you Amy, maybe to cover the one or two questions that we, we've, we've had. Yeah, so I've got a questions about the differences between critical realism. Um And what are the differences between critical realism to relativism? So it is a rather complex um questions but um very briefly, critical realism is a combination of a realist and a relativist research paradigm. And they've got three main um perception is that there is a real reality out there, the actual reality, the actual social world and the empirical, how we use data to explain this real and actual social world. So this is a short answer, but happy to continue talking Thomas um after we finish the session and then um yeah, any more questions that you can put on the chart? I think there's a question about um difference between phenomenology and grounded theory. Yeah, I've talked about briefly during the presentation. So um the ethnology, no, hang on. Um We'll just go back to slide there. The Feminone is to lift experiences. But if, if a researcher use Feminone, um the researcher doesn't necessarily want to create a new theoretical model as well. But if a researcher specifically use grounded theory, the aim is to to create this new theoretical model based on the direct participants experiences. And um briefly mentioned that um researchers can use a combination of these methodological strategies in their research study but try not to make it too complex and then always explain the rationale for choosing a particular strategies. And thanks very much, Amy. Thank you, everyone.