Qualitative &

Mixed-Methods
Research
Sohail Bajammal, MBChB, MSc, FRCS(C), PhD(c)
Assistant Professor of Orthopaedics, Faculty of Medicine
Vice Dean, Academic Development, Faculty of Dentistry
Umm Al-Qura University, Makkah, Saudi Arabia
ssbajammal@uqu.edu.sa
Quantitative Qualitative

Numbers Words
Mixed- Actions
Methods Reactions
Not everything that can be
counted counts,
and
not everything that counts
can be counted.
Albert Einstein
 EBM
Research Patients’
Evidence Preferences

Clinical
Expertise

Clinical
Context
Haynes et al. BMJ 2002;324:1350
 Everyday
• New Patient
– QUALITATIVE  quantitative

• Follow-up Patient
– QUANTITATIVE  qualitative
 Questions
• How do trauma patients with
quadriplegia in the Western region –
Saudi Arabia rehabilitate?

• What are the important aspects of

quality of life for Saudi patients?

• What are the barriers to conduct RCTs in

Saudi Arabia?
 Learning Outcomes
By the end of the lecture, you will be able to:

• Identify:
– What is qualitative research? characteristics?
– When to use it?

• Identify:
– What is mixed-methods research? types?
– When to use it?
Qualitative Research
 Types of Research Questions
• Quantitative: (cause, determine, relate, influence)
– Does A cause/correlate with B?
– Which is better A or B in terms of diagnosis, treatment,
or prognosis?

• Qualitative: (discover, understand, explore,

describe)
– What?
– How?
– Why?
 Quantitative Qualitative
Research Closed-ended questions Open-ended questions
Pre-defined approaches Emerging approaches
Methods Numeric data Text or image data
• Test theories • Generate theories
• Variables to study • Collect participants meanings
Features • Use standards of • Study the context
reliability & validity • Bring personal values
• Unbiased approaches • Validate accuracy of data
• Statistical procedures • Create an agenda for reform

Creswell J. Research Design. 2009

 Characteristics of Qualitative
• Natural settings
• Researcher as key instrument
• Multiple sources of data: interviews, observations,
documents
• Inductive data analysis
• Participants’ meanings
• Emergent design
• Theoretical lens: sampling, saturation, integrating
• Interpretive
• Holistic account
Creswell J. Research Design. 2009
 When to use qualitative?
1. Investigate complex phenomena that are difficult to
measure quantitatively

2. Generate data necessary for a comprehensive

understanding of a problem

3. Gain insights into potential causal mechanisms

4. Develop quantitative measurement instruments

5. Study special populations (those traditionally

underrepresented in research, low literacy)
Curry et al, Circulation 2009
Investigate complex phenomena that are
difficult to measure quantitatively
Generate data necessary for a comprehensive
understanding of a problem
Common Strategies (Approaches)
of Qualitative Research

• Ethnography Culture-sharing behavior

of groups
• Phenomenology
Individuals
• Narrative research
• Case studies Explore processes,
• Grounded theory activities, events
 Data Collection Methods
• Observation  field notes

• Interviews  transcripts
– One-on-one: in-depth, open-ended
– Focus group

• Documents  content analysis

• Audio-visual materials  analysis

Qualitative Data Analysis

Data Collection

Data Analysis
Qualitative Data Analysis
Raw Data (transcripts, field notes, images)

Organizing data for analysis

Reading through all data

Coding the data  Themes

Integrating themes, diagramming 

Interpreting
Data
 Computer-Aided Qualitative Analysis

• ATLAS.ti
• NVivo
• MAXqda
NVivo
NVivo
www.researchsupport.com.au
 “Validity” Strategies
• Rationale for choosing an approach
• Triangulation of methods
• Interviewers training
• Member checking
• Rich, thick description
• Reflectivity
• Peer debriefing  Cross-coding
• Documentation  External auditor
Mixed-Methods
What is mixed-methods research?

Combining
qualitative & quantitative research

1960s
 Aspects in Mixed-Methods

• Timing: sequentially or concurrently

• Emphasis: qualitative, quantitative, or both

• Mixing: integrating, connecting, or embedding

1. Sequential Explanatory

QUAN qual

Creswell J. Research Design. 2009

2. Sequential Exploratory

QUAL quan

Creswell J. Research Design. 2009

3. Concurrent Triangulation
QUAN QUAL
QUAN QUAL
Data Collection Data Collection

QUAN QUAL
Data Analysis Data Analysis
Data Results
Compared
Creswell J. Research Design. 2009
4. Concurrent Embedded

qual

QUAN

Creswell J. Research Design. 2009

Lewin et al, BMJ 2009
Publishing
Resources
 Books
• Research Design: Qualitative, Quantitative,
and Mixed Methods Approaches. John
Creswell. 3rd Edition. 2009. SAGE Publications.
Articles
 People
• Look around in your university:
– Nursing
– Medical Educationalist
– Psychology
– Sociology
– Medical Geography
 Questions
• How do Saudi patients with quadriplegia
in the Western region rehabilitate?

• What are the important aspects of

quality of life for Saudi patients?

• What are the barriers to conduct RCTs in

Saudi Arabia?
 Summary
• Patients talk, act & react  not numbers

• Qualitative is helpful when nothing or little is

known about a condition or environment

• GOOD qualitative research needs lots of work

• Be pragmatic

ssbajammal@uqu.edu.sa