Skip to 0 minutes and 18 secondsAt this point, it’s worth thinking about how our philosophical assumptions fit with real-life clinical problems so we can relate this back to healthcare research. At the beginning of the course, we asked you to think about a piece of research that has informed everyday practice in your work area within healthcare. At the end of the whole module, we’ll be asking you to write up a proposal for a real-life piece of research. So, it will help to start thinking early on about how to create a research question. Research questions tend to start off quite big and then get smaller based on the number of factors.
Skip to 0 minutes and 50 secondsSome of these factors are practical like, what time do I have to do this, or who’s going to pay for the research, even if it’s just giving me time off from my other duties to get this done. Other factors that affect the question are more related to how we think, or whether the question is realistic, or whether we need to think about tackling part of the big problem and breaking it down into smaller, more management bites. As the old saying goes, eating the elephant involves knowing where to start and having a plan, not that we advocate eating elephants obviously. If you get the research question right, the rest should fall into place.
Skip to 1 minute and 31 secondsWe’ll look shortly at the research process which involves looking in detail at how you answer your question, but everything hangs on what exactly is your question.
Skip to 1 minute and 42 secondsSo, let’s take a simple question that’s healthcare related and see how we can refine it a bit. If you work in an outpatient or community clinic, for example, it’s unlikely that everyone turns up for their appointment and this leads to some inefficiency in how the clinic runs. If you offer long appointments for therapies for example or have expensive equipment lying around unused, this is not good use of time, and it ends up with patients waiting longer than they need to be seen. So, your initial question might be, how do I improve attendance rates at my clinic? This is an example of a big question that needs breaking down, because it’s not very precise.
Skip to 2 minutes and 23 secondsYou may already have some ideas that you want to test. This implies a positivist approach, but there are certain factors which affect attendance and you want to test those ideas. Your question now becomes which of these factors are most important in improving attendance at my clinic. You can test this with a survey of some sort and get an answer than can be expressed in numbers. So, this is a quantitative approach. Your numerical data then gives you an idea of which factors you can work on in order to improve attendance. Your research has worked in a positivist way, assuming there are some definite factors at work here and you can quantify which ones are most important to work on.
Skip to 3 minutes and 7 secondsAlternatively, you may not know what is causing your low attendance rate and want to ask people to get some ideas. This allows a more interpretivist approach, where you open to what people say and then you can work on your improvement plan as a result. Now we are looking at a different way of asking the questions, one which will get a variety of different answers expressed in words rather than numbers, so this is a qualitative approach. Your question now is more open, what factors do my patients and service users think are important in encouraging attendance at this clinic?
Skip to 3 minutes and 44 secondsOften this will be conducted by using individual interviews or focus groups to find out what people have to say, and the answers may surprise you, but this will be a good thing because then we’re learning new things, maybe factors we hadn’t considered as clinicians and can then act on those new ideas, which may be more effective than our own original thoughts on the subject. Of course, your question might need a bit of both, and then you’re going to have to think about either using a mixed methods approach or doing the research in stages. We’ll cover the nuts and bolts of how to do this in coming weeks.
Skip to 4 minutes and 20 secondsIn summary then, you’ll need to start thinking about breaking down your big question into one which is actually achievable with the resources you have available, or come up with a plan for a big piece of research that will attract funding. For our purposes, it’s probably best to focus on a small piece of work which is achievable, so breaking down your ideas into smaller chunks. In the next section, we’ll be looking at some tools to help you do that and then we’ll be asking you to think of a piece of practice based work relevant to you to illustrate this.
Creating research questions
In this audio Dr Laurence Baldwin describes how to create a research question using the example of patient appointment attendance.
Research questions tend to start rather broad and are narrowed down by practical factors, such as how much time is available to conduct the research and other factors like how we think and how realistic the question is.
During the process of creating the research question, it is important to test it to make sure it does what you are asking of it.
Once the question has been refined, your approach should be quite clear. It is then possible to think about and decide how to answer the question: will it be via surveys, interviews etc.? This will determine the type of data that will be produced.
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