The SRQR guidelines for writing qualitative research articles

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Use SRQR to confidently describe qualitative research so that others can find, understand, and use your work.

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Full Title: Standards for Reporting Qualitative Research

Authors: Bridget O’Brien, Ilene Harris, Thomas Beckman, Darcy Reed, David Cook

DOI: 10.1234/equator/1010101    Version: 1.1

Translations: 🇫🇷 French

Recommendations to help describe your work clearly

Your research will be used by people from different disciplines and backgrounds for decades to come. Reporting guidelines list the information you should describe so that everyone can understand, replicate, and synthesise your work.

Reporting guidelines make writing research easier, and transparent research leads to better patient outcomes.

Easier writing

Following guidance makes writing easier and quicker.

Smoother publishing

Many journals require completed reporting checklists at submission.

Maximum impact

From nobel prizes to null results, articles have more impact when everyone can use them.

How to use this guideline

  1. Read the full guidance below.
  2. Write your manuscript. Use a template if you like.
  3. Cite this guideline in your manuscript.
  4. Complete a checklist and include it with your journal submission.
“Reporting guidelines help me draft manuscripts and develop as a researcher. I use them when teaching and hope that my students continue to use them.” Manuel Silva - Researcher

Reporting guidelines do not prescribe order nor structure. You should include items in the article body whenever possible but some items can be reported in tables, figures, or supplementary materials if necessary (see FAQs).

Additional resources:

Guidance

Approx. 16 min read

Is this the right guideline for you?

Use this guideline for writing qualitative research articles. You can use it when describing all kinds of qualitative approaches, methods, and designs.

You can also use this guideline for:

  • writing proposals or protocols (use the items within the Introduction and Method sections).
  • reviewing the reporting of an article, but not for appraising its quality.

Do not use this guidance for:

  • writing a qualitative evidence synthesis, use ENTREQ instead.
  • appraising the quality of qualitative research, use an appraisal tool like CASP-Qual instead.

Related reporting guidelines:

  • JARS Qual for writing qualitative, psychology manuscripts
  • ENTREQ for writing qualitative evidence syntheses
  • For writing studies involving interviews or focus groups, you can use this guideline or COREQ.

For appraising research consider:

Title & Abstract

1. Title

Describe the nature and topic of the study.

Identify the study as qualitative or indicate the approach or data collection methods.

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Why readers need this information

This allows readers to quickly identify the type of study. Your title will be indexed by search tools so descriptive words will make it easier for others to discover.

Examples

Residents learning from a narrative experience with dying patients: a qualitative study.

Medical students’ perceptions of the factors influencing their academic performance: an exploratory interview study with high-achieving and re-sitting medical students.

Undergraduate rural medical education program development: focus group consultation with the NRHA Rural Medical Educators Group.

Training and Resources

See this article for advice on writing titles that are interesting and descriptive.

The EQUATOR Network provides training for writing effective manuscript titles as part of their publication school.

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2. Abstract

“Informative key words in the title and abstract make manuscripts easier to find.”Lorna Ellis - Evidence Synthesiser

Summarise key elements of the study including:

  • background about the problem or phenomenon of interest

  • description of the study purpose or research question

  • methods, including the approach or perspective (e.g., general inductive, grounded theory), context (setting, time period), sample (number and key characteristics of participants, events, documents), data collection strategies (e g., observation, interview, focus group) and data analysis techniques

  • description of main findings (e.g., themes or inferences) related to the study purpose and/or research question

  • study implications

Information presented in the abstract should be consistent with the information presented in the full text.

Use the format of your intended journal (see ).

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Why readers need this information

A reader should be able to read the abstract independent of the manuscript and get a sense of the background, purpose, methods, main results and implications that will be described in greater detail in the manuscript.

Your abstract will be indexed by search tools so descriptive words will make it easier for others to discover.

Example

Purpose: Although academic centers rely on assessments from medical trainees regarding the effectiveness of their faculty as teachers, little is known about how trainees conceptualize and approach their role as assessors of their clinical supervisors
Method: In 2010, using a constructivist grounded theory approach, five focus group interviews were conducted with 19 residents from an internal medicine residency program. A constant comparative analysis of emergent themes was conducted.
Results: Residents viewed clinical teaching assessment (CTA) as a time-consuming task with little reward. They reported struggling throughout the academic year to meet their CTA obligations and described several shortcut strategies they used to reduce their burden. Rather than conceptualizing their assessments as a conduit for both formative and summative feedback, residents perceived CTA as useful for the surveillance of clinical supervisors at the extremes of the spectrum of teaching effectiveness. They put the most effort, including the crafting of written comments, into the CTAs of these outliers. Trainees desired greater transparency in the CTA process and were sceptical regarding the anonymity and perceived validity of their faculty appraisals.
Conclusions: Individual and system-based factors conspire to influence postgraduate medical trainees’ motivation for generating high-quality appraisals of clinical teaching. Academic centers need to address these factors if they want to maximize the usefulness of these assessments.

Use the format of your intended journal

Some journals require abstracts to have subheadings, others don’t. In some cases the journal’s structured abstract format aligns more with positivist paradigms and quantitative approaches than with qualitative traditions, so translation may be necessary. For example, what might be labelled “Findings” in many qualitative research traditions could be reported as “Results” in the abstract. Similarly, “Design” might be labelled as “Approach” or “Methodology” for a qualitative study.

Training and Resources

The EQUATOR Network provides training for writing effective manuscript abstracts as part of their publication school.

See this article from the London School of Economics for general abstract writing tips.

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Introduction

3. Problem Formulation

“When the problem is described clearly I find it much easier to understand why a study was done, even if its from a different subject area, country, or decade.”Nkinda Akaro - Researcher

Describe the theoretical and/or practical issues or concerns that make the study necessary, including:

  • an overview of what is known about the problem

  • gaps in current knowledge (the problem statement)

  • the scope of the research problem or phenomena addressed in the study (what will and will not be included)

  • theoretical and/or empirical work directly relevant to the problem or phenomena studied

  • the need for a qualitative approach.1

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Why readers need this information

This information provides context for the research question or study purpose and situates the study in relation to other work in the field.

Example

Regulatory focus theory may therefore offer insight into the variability in responses to feedback, but how well do these experimental findings translate to real clinical situations in which the reality of responsiveness to feedback seems frustratingly complex? …. In order to better elaborate a theory to account for this variability in learner response to feedback, the present study was undertaken. We aimed, in this study, to determine how readily clinical learning events could be classified as activating a promotion or a prevention focus, and to explore, through a careful analysis of doctors’ descriptions of their feedback experiences, the predictive value of regulatory focus theory in the context of real clinical learning situations.

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4. Purpose or research question

“A clear purpose frames the article.” Rahilah Zayn - Researcher

Include a statement of study intent. This can be framed as one or more research questions, purposes, goals, or objectives.2

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Why readers need this information

By clearly stating the purpose of the study, authors set readers’ expectations for the methods, findings and discussion sections of the manuscript.

Example

The purposes of this study were to investigate how medical students recognize, respond to and utilise feedback, and to determine whether there are maturational differences in understandings of the role of feedback across academic years in medical school.

Training and Resources

See this article for advice on writing qualitative research questions.

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Methods

5. Qualitative approach and research paradigm

Describe your qualitative approach, your guiding theory (if appropriate), and identify the research paradigm.3

“I like it when authors describe terms in their own words as well as using the proper terms.”Rahilah Zayn - Researcher

Explain why the selected approach is appropriate for the research question.

Provide references to theories or traditions that guide the use of the approach as needed.

“I hadn’t heard the term ‘approach’ before writing-up my study. I realise now that I did have an approach and that it might be different to other researcher’s approaches, so I need to describe things that I felt were obvious.”Tim Westland - Researcher

If you don’t know what your approach or paradigm was, or you don’t think you had one, it’s OK to reflect on this after collecting data and you should still report it. Read this list to see what best describes your work.

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Why readers need this information

Identifying the research paradigm helps readers understand whether the researcher assumes that there is a single, objective reality (positivist or post-positivist) and has thus designed the study to describe this reality or whether the researcher assumes multiple, subjective realities and designed the study to describe these multiple realities, with no attempt to merge or reconcile these realities (constructivist/interpretivist). The paradigm has implications for the study design, approach, methods, and techniques to ensure rigour and trustworthiness.

Since the research paradigm does not necessarily dictate particular approaches or methods, the approach should also be clearly defined. Stating the approach provides readers the opportunity to evaluate the fidelity of the research approach to the research question(s) and consider the rationale for modifications and deviations from the selected approach. Qualitative research also includes an array of methods that can be used across paradigms and approaches. (See also Item 10).

Examples

The study was performed from a constructivist point of view using an interpretative phenomenological epistemology. Based on the notion that social phenomena are constructed by the communal making of meaning about the underlying phenomena, we aimed to construct insightful accounts of lead consultants’ approaches to educational change, rather than to identify the ‘true’ nature of these approaches. Because the management of change by lead consultants is an under-researched area, we conducted an exploratory qualitative study…

Given the relative dearth of explanatory theories about factors affecting medical students’ emotional reactions, we chose to develop one by applying methods associated with grounded theory, specifically constant comparative analysis, to qualitative data obtained from learning logs and interviews. Our approach was constructivist, deliberately using researchers’ own experiences and acquired knowledge to enhance theoretical sensitivity and enrich theory development.

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6. Researcher characteristics and reflexivity

Describe how roles and identities of research team members influence choice of research approach, data collection, and data analysis.4

“Coming from quantitative research it felt strange to include such personal descriptions of the team. But I came to realise why it was useful to others, and that peer reviewers would expect it.” Tim Westland - Researcher

Describe the perspectives, assumptions, prior knowledge, preliminary hypotheses, and/or motives (the “stance”) of the members of the research team.

Describe the researchers’ relationships to participants in the study and what decisions were made in light of these relationships.5

If your research was observational (e.g., ethnography), describe the role of the researcher along a spectrum from passive observer (no involvement in the activity studied) to participant-observer (ranging from some limited involvement in the activity to full involvement).

There is no expectation that the study could be precisely replicated; these characteristics and perspectives of the researcher should not be mentioned in the limitation section. (See also Item 14: Data Analysis)

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Why readers need this information

In positivist and post-positivist paradigms, personal characteristics and perspectives of researchers might be viewed as biases that limit the credibility of study findings, while in constructivist or interpretivist paradigms the characteristics and perspectives of the researchers are important contextual factors that are an accepted part of the study design, data collection, and data analysis. These characteristics and perspectives may explain how the researcher(s) obtained access to the site or participants included in the study or may add valuable insight during data analysis.

Examples

Reflexivity was maintained by the research team through the analysis and writing by recording, discussing and challenging established assumptions. In addition both EH and SV kept reflexive diaries.

The first author conducted all interviews and discussion groups. Her own medical undergraduate training took place between 1995 and 2000. She was not known to the participants of this research prior to undertaking the study and deliberately did not undertake any clinical or teaching activities locally alongside this research. Whilst it was useful to ‘know’ (from her own background) what the students were talking about medically (and in terms of detecting items of significance), as a researcher she made conscious efforts not to accept potentially common assumptions at face value.

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7. Context

Describe the setting/site(s) in which the study was conducted, the reason(s) why the setting/site(s) was selected, and the salient cultural, political, historical, economic and/or other external factors that influence the study.

“When synthesising evidence, context helps me work out how and why different studies and findings fit together (or don’t)”Lorna Ellis - Evidence Synthesiser

Additional context may be reported with findings (i.e., the Results section) to add evidence for interpretations and to enhance discussion of transferability.

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Why readers need this information

This helps readers interpret the meaning and significance of the study findings by situating them in social, cultural, temporal and other relevant contexts.

Example

We conducted the study among hospital-based clinical teachers of students in years 4 to 6 of a six-year undergraduate medical program at Maastricht University Medical School. Years 4 to 6 are devoted to clerkships in the academic hospital and affiliated regional hospitals. Rotations differ in duration depending on the type of rotation and the discipline, and the sequence of rotations differs among students. During rotations, students spend time in the wards, the outpatient clinics, and the accident and emergency department. Clerkships in years 4 and 5 last between 4 and 10 weeks (“regular clerkship”), whereas students in year 6 undertake an 18-week “senior clerkship” in a discipline of their choice.

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8. Sampling strategy

Describe how and why research participants, sites, documents/artifacts, and/or events were selected for inclusion in (and, if appropriate, exclusion from) the study, along with a justification for this strategy.

Describe the sampling strategy rather than simply labeling it (e.g., “purposive” or “snowball”), since such labels do not have a universally accepted definition and, more importantly, procedures tend to be study- specific.

Describe how you established the final sample size:

  • If you used a flexible sampling strategy, then explain the criteria used to decide when no further sampling was necessary.

  • If data collection ended once saturation or sufficiency had been reached, then describe the specific criteria used to define saturation or sufficiency.

Describe procedures used to recruit participants, including:

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Why readers need this information

This information helps readers understand the source of data / findings so they can consider the boundaries of the study and the relevance to their own context. It also gives readers insight into the researchers’ decisions, which can be important for critical appraisal.

Examples

As students’ perceptions were previously shown to be related to gender, age, prior experience and place of attachment,[REF] we purposely selected respondents with different backgrounds. This sampling strategy led to the diversity of gender, age, prior patient experience and place of attachment shown in Table 1.

Purposive sampling was directed towards achieving maximum variation in age and specialty, using a snowball approach (‘a non-probabilistic form of sampling in which persons initially chosen for the sample are used as informants to locate other persons having necessary characteristics making them eligible for the sample’).[REF ]

Potential participants were all medical students in Years 1 and 2 at the University of Toronto in 2004. Following research ethics board approval, recruitment was conducted via e-mail to class listservs. Participant responses were sent directly to the research assistant, who was unknown to participants, so that the principal investigators did not know who did or did not participate. This process was engaged to protect participants’ anonymity and to avoid any impression of coercion because the lead researcher (SG) was involved in the administration of the undergraduate curriculum at the time. Sample size was estimated to be sufficient based on the principle of theoretical saturation [REF] and our previous experience with this methodology (i.e., with a relatively homogeneous population, we expected to reach saturation with approximately 15 interviews per group). There were no exclusion criteria and we accepted the first 15 students from each class who volunteered.

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9. Ethical issues pertaining to human subjects

Report approval for the study from an appropriate institutional review board for research associated with human subjects.

If you did not receive ethical approval, describe why.

Describe procedures used to protect participants, including:

  • data collection (e.g., recruitment and informed consent)

  • analysis (e.g., data security and integrity)

  • and reporting of findings (e.g., anonymization of excerpts).

If you provided compensation or offered incentives to facilitate participation, describe this too.

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Why readers need this information

Journals will require an ethical approval statement.

Qualitative research often involves interaction between researchers and research participants. Correspondingly, researchers should ensure that participants are fully aware of their participation in a research study, the risks and benefits associated with the study, the steps and precautions the researchers will take to minimize risks, such as loss of privacy and confidentiality, and how the researchers plan to use the data.

Examples

Ethical approval was granted by the University of Otago and student participants were invited to attend each focus group discussion by the university representatives of New Zealand Medical Students Association (NZMSA). Usually, a key concern when collecting data from students is that students may feel vulnerable when sharing their experiences with academic staff during a focus group discussion. However, this potential harm was removed as each group discussion was facilitated by a fellow student, the discussions were transcribed by a professional transcribing service, and only the primary researchers [Names] had access to the raw data.

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10. Data collection methods

Describe data collection methods and design in detail, and justify them in relation to the research question(s), paradigm, approach, and other methods.6

If data collection and analysis was iterative:

  • describe the iterative process

  • if changes occurred during the research process, describe how and why study procedures changed in response to evolving study findings.

Identify the study period.

Describe important characteristics of the individuals conducting interviews, observations or focus groups, and methods used to train these individuals.

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Why readers need this information

The study period helps readers place the study in temporal context and identify factors not mentioned by the authors that might affect findings, interpretation, and implications. (See Item 8 for ending data collection.)

Describing researcher characteristics clarifies the relationship between the individuals involved in data collection and the participants in the research and also explains what efforts were made to ensure consistency in the data collection process (See Items 6 and 15.)

Examples

Further, it was decided that group interviews, also known as focus group discussions would be the best means of data collection. This is a method of data collection that enables group members to feed off each other’s ideas and an effective moderator will maintain group focus whilst at the same time permitting flexibility in the direction those aspects of the discussion might take. [REF]

Adjustments to the interview protocol were made according to early experience and information participants had provided (i.e. redundant questions were eliminated; questions were reworded to improve flow and clarity; additional probes were included).

Faculty staff were then interviewed individually by a trained study investigator in a 15-minute, semi-structured interview. This sequence was repeated with other video encounters. Table 2 presents examples of interview questions. Each faculty member was interviewed by at least three interviewers over their various interviews. Interviewers were chosen based on their experience in interviewing. All were trained during a half-day meeting to interpret and deliver the interview guide in the same manner in order to elicit information of a consistent type.

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11. Data collection instruments and technologies

Describe all data collection instruments, including their development, and if/how they changed over the course of the study. Cite relevant literatures, theories or conceptual frameworks as appropriate. Consider sharing the data collection instrument(s) or a detailed description of them in the article body, supplementary material, or published elsewhere.

“I publish my materials on the OSF and then describe and cite them in my articles.”Tim Westland - Researcher

Describe the use of equipment for audio or video recording, reproduction of paper documents or computer files, or other processes in data collection.

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Why readers need this information

Describing instruments and equipment helps readers understand the full context in which data collection occurred and how this context might have affected data collection (e.g., the influence of recording devices on participants’ behaviors; the nature of inferences drawn from live vs. recorded events).

Examples

To facilitate the discussion and to maintain consistency over different sets of discussions, key trigger questions were devised prior to the discussion. The opening trigger question was: ‘Thinking back to some of your best clinical learning placements in 4th and 5th year. What was it about those clinical placements that provided good opportunities for learning?’

Interviews included discussion of the expectations, processes and consequences of AEE [authentic early experiences]. The interview schedule was derived following identification of questions that could not be fully answered in a systematic review of previous empirical or theoretical literature. It comprised a sequence of topic areas including experiences in action, and areas of frustration in Medical Education such as the learning of content knowledge, achieving functional knowledge, and transfer of knowledge.[REF]… Interested readers can request a copy of the schedules from the corresponding author. Interviews lasted between 20 and 90 min. and discussion groups between 60 and 90 min. All interviews and discussion groups were conducted in private rooms at the participant’s workplace—the medical school for students and faculty, and individual places of work for workplace supervisors (except for one who chose to be interviewed at the medical school). All data were audio-recorded, and transcribed verbatim.

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12. Units of study

Describe the number of participants, documents, or events included in the study (the units of study).

Describe characteristics of the participants, documents or events that are relevant to the study purpose and research question(s).7

Include the dates or timeframe for participation.

If the actual sample differs from the target sample, describe:

  • the difference,

  • why these differences may have occurred,

  • how this might affect the findings.

If the degree of participation varied among individuals, describe:

  • the different levels of participation,

  • the reasons for these differences (i.e., the researchers’ choice or the participants’ preferences),

  • and how these different levels of participation were taken into account in the analysis.

This information could appear in the Methods section as part of the description of the sample, or at the beginning of the Results section to provide context for the findings presented.

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How does this item differ to Sampling (Item 8)?

The sampling item (Item 8) describes the target or ideal participants, documents, or events selected for the study. By contrast, this item focuses on description of the actual participants, documents or events included in the study.

Why readers need this information

This helps readers know whose experiences and perspective are and are not included.

Example

Of the 70 Mindful Communication program participants, 46 met the eligibility requirements to participate in the in-depth interviews. We randomly chose and then contacted 22 participants, of whom 20 agreed to be interviewed within six months of completing the program: 15 in person and 5 by telephone. Two declined for lack of time. On reaching saturation after 20 interviews, no further attempts to contact the remaining 24 participants were made.

There were 31 nursing handovers covering 137 patients, and 21 resident handovers covering 101 patients included in this study.

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13. Data processing

Describe the ways in which data are prepared for analysis and managed throughout the analysis process. These activities might include transcription, coding, data entry, and organization of data. (See footnote for audio or visual recordings8).

Describe the processes used to organize, compile, and categorize data (e.g., field notes, transcripts, documents, photographs, artifacts) for analysis.

If you used transcripts, describe procedures used to check accuracy.

Describe procedures used to maintain data security and protect the privacy of participants, as specified in the human subjects protocols (see footnote on anonymisation9 as an example).

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Why readers need this information

This information helps readers know what decisions the researchers made and why so the reader can 1) consider the relevance to their context and the resonance with their own experience or observations (or lack of resonance and why that might be) and 2) evaluate or critically appraise the manuscript.

Examples

Interviews were anonymised and each participant was given a code number.

The interviewers and another member of the research team (H.B.) reviewed transcripts for accuracy.

We collected data throughout the admission process through direct observation, audio- recording, and chart extraction. We audio-recorded, transcribed, and anonymized both the overnight and morning case review discussions. We also observed the morning case review discussions in person and collected field notes. For each case review discussion, we copied the admission notes from the patient’s record and de-identified all data.

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14. Data analysis

Describe your analytic process as transparently as possible.10

If you used an approach that has a well-defined process for data analysis (e.g., grounded theory, discourse analysis, phenomenography):

  • cite the guiding literature

  • describe your processes in sufficient detail so readers can judge the extent to which your processes align with the guiding approach.

  • If you modified or deviated from the guiding approach, explain and justify these modifications.

Specify the unit of analysis.11

Explain the rationale underlying different decisions made throughout the data analysis process to provide as much transparency as possible.12

If observations that contrast or deviate from identified concepts or themes were important to your analysis, describe how these discrepancies were handled during the analysis.

If you drew upon a theoretical perspective or framework during analysis, describe theoretical or other influences on your analysis scheme or categories if they exist. If you identified a theoretical perspective or framework early in the conception of the study or after reviewing some or all of their data, consider referring to these as “sensitizing concepts” to acknowledge that the approach is inductive, but with influence from relevant theory, models, or organizational schemes. Alternatively, explain that themes were developed from the data with no external influences.

Describe which members of the research team are involved in data analysis and what perspective(s) they bring to the analysis.

If software was used to assist with data analysis13, describe how it was used. Simply stating that software was used is insufficient.

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Why readers need this information

Techniques used for data analysis will depend on the paradigm, approach, and/or data collection methods selected by the researchers. Correspondingly, authors should be as transparent as possible about the analytic process so that readers can follow the logic of inquiry from the research question(s) to the analysis and findings.

Examples

…we brought sensitizing concepts to the analysis while we conducted an open, inductive analysis.[REF]In this case the sensitizing concepts arose, a priori to analysis, from a framework derived from the literature [REF] (as described above), in which participants’ motivations to act are based on principles of professionalism, internal affect, or potential implications of their actions.[REF]

Through an iterative process of listening, discussing, and relistening, the team identified and consensually validated emerging themes[REF] and appended segments of dialogue supporting the proposed themes. Recruitment stopped when saturation was reached (no new themes were identified). The team systematically reviewed the themes and sorted them into content domains. The team used an analytic matrix to identify patterns and connections amongst the domains. Two of us not involved in the qualitative coding process (R.E., M.K.) audited the analytic matrix, choice of quotes, and thematic analysis.

The analysis started after the first interview. All data were analyzed with the aid of the audio- coding facility of the NVivo 8: QSR International Pty Ltd, Doncaster, Vic, Australia programme. First, [name] and [name] coded independently from one another, making sure to stay semantically close to the participants’ wording. Then we discussed these open codes and defined axial codes.[REF] New insights about the impact of CST were written down in memos.

Videotapes were analysed using immersion/crystallisation methods of qualitative data analysis.[REF] With no pre-existing framework developed in advance for analysis, an inductive approach was used to discover patterns of NVB in the data. A team of six researchers met weekly for 18 months to view videos together. Using a consensus-building approach based on a combination of field notes, ‘opportunistic’ interviews with the participants, and repeated viewing of the same material, sometimes many months apart, we eventually achieved consensus on verbal, non-verbal, and physical themes and patterns observed in the data. Finally, as a test of ‘goodness-of-fit,’ we carefully reviewed the videotapes for any ‘deviant’ cases that did not fit the categories we had developed.

All transcripts were coded thematically by four of the five authors, who met regularly to identify areas of convergence until full agreement was reached. One of the interviewers (P.M.) maintained an audit trail to track the team’s developing thinking. A process of dialectical empiricism[REF] was used to categorise the emergent themes into more abstract concepts…

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15. Techniques to enhance trustworthiness

Describe methods used to ensure trustworthiness and credibility throughout the data collection and analysis process. (See footnote on commonly used techniques14).

Explain your choice of techniques and why these are appropriate for the particular study.

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Why readers need this information

This information helps readers know what decisions the researchers made and why so the reader can 1) consider the relevance to their context and the resonance with their own experience or observations (or lack of resonance and why that might be) and 2) evaluate or critically appraise the manuscript.

Examples

Member checking

Member checks [REF] with an external TBL expert (R.L.) supported the validity of these analyses.

Triangulation of data types and data sources

The interview data were triangulated with the data of 11 student and supervisor focus groups of a previous study, and more specifically, with those data that concern in particular the influence of CST [Communication Skills Training] on the development of patient-centredness…. Triangulation with the focus group data allowed us to broaden the in-depth information from the interviews in the analysis and to ‘share and compare’ this with information from students and doctors with varying levels of CST (no, limited, full programme) and from two universities (Universities of Antwerp and Ghent). Moreover, this enabled us to better explore the evolution over time, given that the focus groups included participants at different stages of their study: before clerkships (year 4, undergraduate), during clerkships (year 6, undergraduate), after clerkships (year 7, undergraduate) and postgraduate (general practice trainees, and supervising specialists and GPs; Table 1).

Finally, as a test of ‘goodness-of-fit’, we carefully reviewed the videotapes for any ‘deviant’ cases that did not fit the categories we had developed.

Triangulation of Researchers + Audit trail

To ensure rigor and increase authenticity in our methodology, we used two kinds of triangulation—investigator triangulation and data triangulation.[REF] We sought analytical rigor using an audit trail and multiple coders; our coding team included an experienced clinician (M.G.) as well as a nonclinician with expertise in medical communication and team dynamics (L.L.).

Training and resources

See Lincoln and Guba’s Evaluative Criteria for trustworthiness.

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Results

16. Synthesis and interpretation

Describe the main analytic findings.15

In most cases, report a synthesis of the data along with specific quotes, examples, or illustrations derived from the data.

“I like when authors use words like ‘many’, ‘few’, or ‘all’ to describe frequency.”Nkinda Akaro - Researcher

Consider describing frequency, variety, representativeness, counter-examples, concrete details, contextualization, conditions, and qualifications related to the findings.

Frequency counts play a limited role in qualitative research, and need not be reported unless they play a meaningful role in interpretation of the data.

If your findings include integration with prior literature or theory and/or the development of a theory, model or meta-narrative, consider using tables and figures to communicate these findings.

Items 16 and 18 can be reported in Results or Discussion sections.16

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Why readers need this information

This information helps readers know what decisions the researchers made and why so the reader can 1) consider the relevance to their context and the resonance with their own experience or observations (or lack of resonance and why that might be) and 2) evaluate or critically appraise the manuscript.

Examples

We identified four patterns of NVB (non-verbal behavior) that relate to handover quality and have dubbed them: (1) joint focus of attention; (2) ‘the poker hand’; (3) parallel play; and (4) kerbside consultation. Each pattern constitutes a ‘transfix,’ or systematic way of participating non-verbally in the care transfer process. And, although there are variations in each pattern, we have been able to code virtually every handover we have observed in nursing, medicine and surgery into one of these four categories.

Because our participants came from similar educational backgrounds, had studied medicine as their tertiary course, were embedded in the culture of medicine, and were associated in meaningful ways with a single medical school, we approached their transcripts with the assumption that they belonged to a loosely formed discourse community. Although their graduation dates ranged over a period of 50 years and their collective sphere of practice included 10 different specialty areas, there were many similarities in their experiences of enculturation during and after medical school.

Their three major (often overlapping) areas of concern were epistemic (acquiring knowledge and skill), interpersonal (relating to patients, families, colleagues and administrators) and personal (achieving work–life balance). In each of these areas, medical enculturation was achieved by two overlapping processes, ‘absorption’ and ‘assimilation’, each of which may have distinct implications for postgraduate medical education.

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Provide evidence (e.g., quotes, field notes, text excerpts, photographs) to substantiate the more general and abstract concepts or inferences they present as findings.17

“I love seeing evidence like this because it really brings results to life.” Nkinda Akaro - Researcher

You could report this evidence in a table or figure, incorporated into a narrative description of findings, as a stand-alone narrative, or in text blocks embedded in the manuscript text. If you are constrained by word limits or media limitations (e.g.. video), consider sharing data via an appendix, supplemental material, or web-based repository.

Discussion

18. Integration with prior work, implications, transferability, and contribution(s) to the field

Describe how the findings and conclusions connect to, support, elaborate on, or challenge previous findings, experiences, theory, or a guiding paradigm or approach.18

Describe how the findings contribute to or advance the field.

Describe any implications of the work, such transferability or generalizability.

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Why readers need this information

The short summary reminds readers of the main findings and may help them assess whether the subsequent interpretation and implications formulated by the authors are supported by the findings.

Examples

This study contributes to the understanding and discussion of the complexity of involving patients in healthcare education. It shows that integrating patient-led teaching into initiatives that are partly faculty-led influences the way in which students perceive learning from and with PIs. What is not known, however, is whether perceptions are also affected by type of health profession and the students’ different orientation towards logics of care and science, and issues of authority and power relations.

For complete examples of Discussions, see:

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19. Limitations

Describe problems or gaps in their efforts to ensure trustworthiness and the potential implications.19

“Authors should never feel nervous to report limitations. In fact, thoughtful discussion of limitations is a hallmark of good research!”Charles Ruggle - Editor

Describe how the chosen paradigm, approach, and methods will influence the situations to which the findings may reasonably apply.20 (See also Item 18.)

Describe how specific decisions or events in the conduct of the study strengthen or weaken the rigor of the findings.

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Why readers need this information

All research has limitations. Discussing them will help readers consider the relevance to their context and the resonance with their own experience or observations (or lack of resonance and why that might be). If you don’t address limitations, editors and peer reviewers may ask you about them which will delay publication.

Example

The study has several limitations. One is that the focus group interview method reveals students’ perceptions rather than their actual behaviors. Observations of the patient-led teaching encounter may have illuminated an understanding of the relationship between patient instructors and medical students. Another limitation is that the PI-led teaching is optional rather than mandatory, which may have influenced students’ attitudes in a positive direction. Moreover, students who are eager to take on extra-curricular activities may not be representative of the whole population. That only 23 out of 39 students signed up for this study might also have influenced results if the missing group of students represented other perceptions than those present in the focus groups. However the received data from the focus groups were rich in information and diverse perceptions were present. Another limitation is the overrepresentation of women over men in our sample. Even though women are also overrepresented in medical school this might potentially have influenced results, but gender differences in perceptions were nevertheless not identified in the data.

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Other

20. Conflicts of interest

“Authors shouldn’t feel nervous reporting conflicts of interest. They are very common and rarely influence our decision to publish.”Charles Ruggle - Editor

Describe any real or potential conflicts of interest that might have influenced or could appear to have influenced the research.

Describe:

  • how these conflicts were managed in the conduct of the study,

  • the potential impact on study findings and/or conclusions.

Some aspects may be mentioned as part of reflexivity (see Item 6).

Why readers need this information

“Many factors, including professional and personal relationships and activities, can influence the design, conduct, and reporting of the clinical science that informs health care decision. The potential for conflict of interest exists when these relationships and activities may bias judgment (1). Many stakeholders— editors, peer reviewers, clinicians, educators, policymakers, patients, and the public—rely on the disclosure of authors’ relationships and activities to inform their assessments. Trust in the transparency, consistency, and completeness of these disclosures is essential.” - ICMJE

21. Funding

Describe any sources of funding and other support for the study.

Describe the role of funders in data collection, data analysis, and reporting if applicable.

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How to cite

For attribution, please cite this guideline as:

Bridget O’Brien, Ilene Harris, Thomas Beckman, Darcy Reed, and David Cook. 2023. “The SRQR Guidelines for Writing Qualitative Research Articles version 1.1.” The EQUATOR Network Guideline Dissemination Platform. https://doi.org/10.1234/equator/1010101.

You can use your reference manager to save citation information for this webpage, or copy the BibTeX below.

FAQs

Who made this guideline?

Bridget O’Brien, PhD has been a faculty member in the Department of Medicine, Division of General Internal Medicine, since 2008. She is a professor of medicine and an education scientist in the Office of Medical Education’s Center for Faculty Educators. As co-director of the Teaching Scholars Program and the UCSF-University of Utrecht Health Professions Education doctoral program she teaches and mentors faculty and learners interested in education research and scholarship. At the San Francisco VA, she directs the Advanced Fellowship in Health Professions Education Evaluation and Research. In 2015 she was selected as one of five national Macy Faculty Scholars supported by the Josiah Macy Jr. Foundation and in 2021 she was selected as a KIPRIME Fellow at the Karolinska Instituet. She is a deputy editor for the journal Academic Medicine.

Dr. Ilene Harris, deceased, was professor and head, Department of Medical Education, University of Illinois at Chicago College of Medicine, Chicago, Illinois.

Dr. Thomas Beckman is professor of medicine and medical education, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota.

Dr. Darcy Reed is associate professor of medicine and medical education, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota.

Dr. David Cook is associate director, Mayo Clinic Online Learning, research chair, Mayo Multidisciplinary Simulation Center, and professor of medicine and medical education, Mayo Clinic College of Medicine, Rochester, Minnesota.

How was this guideline made?

The developers synthesised 40 sets of recommendations previously proposed by experts in qualitative methods. You can read about their development process here.

Does SRQR prescribe structure?

No. This reporting guideline does not prescribe a rigid format or standardized content. Consider each item and prioritize elements that are most relevant to your study, findings, context, and readers.

You may prefer to report an item in a different order, section, or in a table or figure. If you feel confident that an item is less important to your study, you could report it in an appendix or supplement. If you think an item is not applicable, state why. You don’t need to write your article in the order the items are presented.

Where can I get general writing training?

The EQUATOR Network provides in-person training for writing research articles.

AuthorAID have resources, an online course, and mentoring to help authors.

Research paradigm

The set of beliefs and assumptions that guide the research process. These commonly include positivist, post-positivist, constructivist or interpretivist, and critical theory. Qualitative research generally draws from a post-positivist or constructivist/interpretivist paradigm.”

Instruments
Data collection instruments include (but are not limited to) interview or focus group guides, observational protocols and prompts for field notes, and data extraction or coding protocols for selection and analysis of documents, photographs, videos, or other artifacts”
Bias
A term drawn from quantitative research, bias technically means a systematic error, where a particular research finding deviates from a ‘true’ finding. This might come about through errors in the manner of interviewing, or by errors in sampling. In qualitative research this is a problematic concept, since by definition the qualitative researcher is part of the process, and all researchers are different. This human factor has been said to be both the greatest strength and the greatest weakness of qualitative method. What can be done in commercial qualitative research, however, is to minimise obvious and avoidable sources of bias, for example by not confining all the fieldwork to one social group or geographic location, by taking steps to recognise the personal views of the researcher, (using techniques such as bracketing), and by working in teams.
Sampling strategy

Several sampling strategies are commonly used in qualitative research, although most fall under the umbrella of purposeful (or purposive) sampling.

Purposeful sampling means that participants, documents, or events are selected for their relevance to the research question, based on guiding theory or experiences and assumptions of the researchers. Over the course of the research process, researchers may determine that additional or different participants, documents, or events should be included to address the research question.

Other sampling techniques, such as theoretical sampling (seeking examples of theoretical constructs), snowball sampling (using study participants to identify additional participants who meet study criteria), and convenience sampling (including any volunteers with no or minimal criteria for inclusion) may be appropriate depending on the question and approach, so long as the authors provide explanation and justification.

Approach
A qualitative “approach” is a general way of thinking about conducting qualitative research. It describes, either explicitly or implicitly, the purpose of the qualitative research, the role of the researcher(s), the stages of research, and the method of data analysis. Commonly used approaches include ethnography, grounded theory, case study, phenomenology, and narrative research.
Data collection methods
Data collection methods include (but are not limited to) interviews, focus groups, observations (direct or indirect via video), and review of written text, photographs, and other documents or materials.
Iterative
Qualitative research often occurs as an iterative process, meaning that researchers begin data analysis before they complete data collection. The data collection and analysis process may occur in phases or stages. As part of an iterative collection-analysis process, researchers will often alter their data collection methods to explore their preliminary impressions in greater depth and/or actively pursue confirming and disconfirming perspectives.
Study period
The start and end dates for data collection and analysis.
Ethnography

The scientific description of peoples and cultures with their customs, habits, and mutual differences.

Read more

Grounded theory

A method consisting of a set of systematic, but flexible, guidelines for conducting inductive qualitative inquiry aimed toward theory construction. This method focuses squarely on the analytic phases of research, although both data collection and analysis inform and shape each other and are conducted in tandem.

Read more

Degree of participation

For example, if some participants were observed and interviewed and others only interviewed, or if some participants completed multiple interviews and others completed a single interview, these variations should be explained.

Unit of analysis

In qualitative research, the unit of analysis is not necessarily the same as the unit of sampling (e.g., individual participants or events). Instead, some approaches use specific events as the unit of analysis, such as mentions of a particular topic or experience, or observations of a particular behavior or phenomenon, while others use groups rather than individual group participants. This specification has implications for how the data are organized and analyzed as well as the inferences drawn from the data.

Reflexivity

Reflexivity refers to intentional, systematic consideration of the potential or actual effects of the researcher(s) on all aspects of the study process.

Transferability

The transferability of a research finding is the extent to which it can be applied in other contexts and studies. It is thus equivalent to or a replacement for the terms generalizability and external validity.

Generalizability

The appropriate scope for generalization of the findings beyond the study (e.g., to other settings, populations, time periods, circumstances)

Analytic findings

Analytic findings may include interpretations, inferences, narratives, themes, and models.

Frequency counts

The frequency of specific themes or codes.

Footnotes

  1. Justifications for a qualitative approach include to elucidate poorly defined or previously unexplored constructs, to generate theories or to develop causal explanations connecting processes and outcomes, to understand phenomena as they naturally occur and the role of context, to explore problems involving high complexity, to gain insight into participants’ perspectives when such insight is lacking)↩︎

  2. Qualitative studies often explore “how” and “why” questions related to a social or human problems or phenomenon, and they are designed to enhance readers’ understanding of a problem or phenomenon.↩︎

  3. Qualitative research includes an array of approaches and methodologies, both general (e.g., qualitative content analysis, general inductive approach) and specific (e.g., ethnography, grounded theory, phenomenography).↩︎

  4. Relevant personal characteristics might include cultural background, occupation, experience, training, position/ power dynamics, gender, race/ethnicity, and sponsoring institution.↩︎

  5. For example, were any members of the research team part of the sample of potential participants in the study? Do any members of the team teach, supervise, or have any authority over participants in the study? If so, how do these characteristics influence choices about their roles in data collection and analysis?↩︎

  6. Researchers may choose to use information from multiple sources, contexts, and/or time points depending on their approach and research question(s). (See Item 11 for triangulation.)↩︎

  7. For participants, characteristics might include age, race, ethnicity, gender, profession, institution, year of training, or relationship to the researcher and/or other participants in the study. For documents, this might include the source, intended audience, date, or type of document. For events, this might include the location, date(s), length, characteristics of attendees or participants in the event, or mood or emotional climate.↩︎

  8. Details might include indication of verbatim transcription of dialogue, additional notes to capture non- verbal information (especially for group interviews or focus groups), and annotations to indicate vocal inflections and utterances, as appropriate for the analytic approach.↩︎

  9. If data are anonymized, the authors should explain how and at what point in the process this occurred. Authors may choose to use anonymous labels or identifiers to represent quotes or excerpts from unique participants, documents or events, in order to reflect the variety of sources from which such data were derived.↩︎

  10. E.g., characterize the processes and decisions made for initial classification or segmentation of data, pattern identification and description, and/or development of in-depth interpretations.↩︎

  11. In qualitative research, the unit of analysis is not necessarily the same as the unit of sampling (e.g., individual participants or events). Instead, some approaches use specific events as the unit of analysis, such as mentions of a particular topic or experience, or observations of a particular behavior or phenomenon, while others use groups rather than individual group participants. This specification has implications for how the data are organized and analyzed as well as the inferences drawn from the data.↩︎

  12. In some approaches researchers use memoing or bracketing to make their reflections, interpretations, and links among passages explicit and more transparent to others.↩︎

  13. e.g., used to apply codes after the final coding scheme was developed; to extract coded passages for further synthesis and identification of themes; or to identify passages with key words↩︎

  14. Techniques to enhance trustworthiness will depend on the paradigm, approach, and/or methods used. Commonly used techniques include: member checking; triangulation of data sources, methods, and/or researchers; creation of an explicit audit trail; and immersion in the site of data collection for an extended period of time (especially for research in which an observer’s presence is likely to disrupt the phenomenon under investigation). Member checking involves sharing findings, such as descriptions of key phenomena, themes, or an explanatory model, with participants and asking them to verify the accuracy or resonance with their perspectives. Triangulation involves using more than one data source, method, or researcher to add diverse perspectives on the findings of the study and, in some approaches, to test the transferability or generalizability of a model. An audit trail involves careful documentation of all decisions made throughout the study, from initial conceptualization to study design, sampling, analysis, and reporting, to provide transparency and to enable an external researcher to review all the steps involved in the study.↩︎

  15. The nature of these findings and how they are reported will depend on the approach and methodology selected and thus should be in alignment with the approach and methods.↩︎

  16. In qualitative research the distinction between results and discussion tends to blur because analysis often involves interpretation, inference, and synthesis. Although most journals require separate sections for Results and Discussion, many elements of Items 16 and 18 could reasonably be reported in either section. As such, we defer to authors and editors to determine where to report these essential elements.↩︎

  17. Evidence is typically de-identified to protect the privacy of study participants, settings, and/or institutions.↩︎

  18. The discussion provides authors an opportunity to elaborate on their findings in relation to their research question(s) and study purpose(s); connect their findings to prior empirical work, theories, and/or frameworks; and discuss implications.↩︎

  19. Whereas you should describe techniques used to ensure trustworthiness in the Methods section of the manuscript, this section is about the gaps that you didn’t or couldn’t cover. For example, if you intended to interview individuals with certain characteristics, or who might offer different perspectives, but were unsuccessful in recruiting any willing participants, explain this issue and describe possible consequences for transferability. (See also Item 18.)↩︎

  20. All research paradigms and approaches have strengths and weaknesses.↩︎

Citation

BibTeX citation:
@misc{o'brien2023,
  author = {O’Brien, Bridget and Harris, Ilene and Beckman, Thomas and
    Reed, Darcy and Cook, David},
  title = {The {SRQR} Guidelines for Writing Qualitative Research
    Articles Version 1.1},
  version = {1.1},
  date = {},
  doi = {10.1234/equator/1010101},
  langid = {en}
}
For attribution, please cite this work as:
O’Brien, Bridget, Ilene Harris, Thomas Beckman, Darcy Reed, and David Cook. n.d. “The SRQR Guidelines for Writing Qualitative Research Articles Version 1.1.” The EQUATOR Network Guideline Dissemination Platform. https://doi.org/10.1234/equator/1010101.