Table 2

Methods, rationale for decision and challenges undertaking ethnographical research

Being an insiderAdopting an overt insider researcher approach facilitated opportunities to collect data during direct care provision and observe practitioners’ interactions with patients.
As an insider, discussions following the period of observation were illuminating as practitioners explained their actions, which added depth to the data when analysing the observed practice.
Although adopting an insider approach strengthened the relationship between the researcher and participants, challenges arose when boundaries became blurred. For example, when one participant sought advise in relation to the observed practice, the researcher had to step back and re-state the boundaries of the relationship.
An insider researcher is often an experienced practitioner in the field of enquiry, in this instance occupational therapy practice, therefore Manindar being reflexive and cognisant of preconceived perceptions about practice was essential to ensure the validity of the findings.
Data collectionA participant-as-observer approach to data collection enabled a natural engagement between the researcher and participants’ real world context.
Interjections and questions, as appropriate to the situation, facilitated developing a rapport with participants and ensured the purpose of the research was clear, adding depth to the data collected.
Postobservation discussions and semistructured follow-up interviews allowed participants to articulate their views about the observed practice.
Field notes and reflective accounts were analysed as part of the data.
Data saturation can be problematic in ethnographic studies; pragmatically, data collection often ends when time and resources have been exhausted resulting in withdrawing from the field.2 4
The presence of the researcher can influence the participants’ behaviour, changing the way they practice during the observations, known as observer effect or observer expectancy effect.16 Tensions can arise if the researcher perceives the participant is adopting certain behaviours—for example, to add prominence to a specific aspect of practice. Postobservation discussions and semistructured follow-up interviews can be used to clarify and explore observations in the field. In addition, detailed field notes, combined with the reflexive approach of the researcher, strengthened the validity of the findings.
Data analysisUsing the framework approach in a structured and systematic way, to analyse data across multiple sources, was central to the rigour of data analysis. In addition, data analysis was an iterative process, which in addition to constantly revisiting the data included working with other researchers. Presenting preliminary findings at professional conferences, where assumptions were challenged, strengthened the data analysis.The large amount of unstructured data required a transparent and structured approach to data analysis. The well documented audit trail, meticulous recording of decisions about emerging categories and themes strengthened the reliability of the findings.