Issue no.1, November 2004
Remodeling Grounded Theory
By Barney G. Glaser Ph.D., Hon. Ph.D. with the assistance of Judith Holton Abstract This paper outlines my concerns with Qualitative Data Analysis’ (QDA) numerous remodelings of Grounded Theory (GT) and the subsequent eroding impact. I cite several examples of the erosion and summarize essential elements of classic GT methodology. It is hoped that the article will clarify my concerns with the continuing enthusiasm but misunderstood embrace of GT by QDA methodologists and serve as a preliminary guide to novice researchers who wish to explore the fundamental principles of GT. Introduction The difference between the particularistic, routine, normative data we all garner in our everyday lives and scientific data is that the latter is produced by a methodology. This is what makes it scientific. This may sound trite, but it is just the beginning of many complex issues.Whatever methodology may be chosen to make an ensuing research scientific has many implicit and explicit problems. It implies a certain type of data collection, the pacing and timing for data collection, a type of analysis and a specific type of research product. In the case of qualitative data, the explicit goal is description. The clear issue articulated in much of the literature regarding qualitative data analysis (QDA) methodology is the accuracy, truth, trustworthiness or objectivity of the data. This worrisome accuracy of the data focuses on its subjectivity, its interpretative nature, its plausibility, the data voice and its constructivism. Achieving accuracy is always worrisome with a QDA methodology. These are a few of the problems of description. Other QDA problems include pacing of data collection, the volume of data, the procedure and rigor of data analysis, generalizability of the unit findings, the framing of the ensuing analysis and the product. These issues and others are debated at length in the qualitative research literature.Worrisome accuracy of qualitative data description continually concerns qualitative researchers and their audiences. I have addressed these problems at length in “The Grounded Theory Perspective: Conceptualization Contrasted with Description” (Glaser, 2001). In this paper I will take up the conceptual perspective of classic Grounded Theory (GT). (In some of the research literature, classic GT methodology has also been termed Glaserian GT although I personally prefer the term “classic” as recognition of the methodology’s origins.) The conceptual nature of classic GT renders it abstract of time, place and people. While grounded in data, the conceptual hypotheses of GT do not entail the problems of accuracy that plague QDA methods. The mixing of QDA and GT methodologies has the effect of downgrading and eroding the GT goal of conceptual theory. The result is a default remodeling of classic GT into just another QDA method with all its descriptive baggage. Given the ascending focus on QDA by sheer dint of the number of researchers engaged in qualitative analysis labeled as GT, the apparent merger between the two methodologies results in default remodeling to QDA canons and techniques. Conceptual requirements of GT methodology are easily lost in QDA problems of accuracy, type data, constructivism, participant voice, data collection rigor according to positivistic representative requirements, however couched in a flexibility of approach (see Lowe, 1997). The result is a blocking of classic GT methodology and the loss of its power to transcend the strictures of worrisome accuracy – the prime concern of QDA methods to produce conceptual theory that explains fundamental social patterns within the substantive focus of inquiry. I will address some, but not all, of the myriad of remodeling blocks to classic...Pluralistic dialoguing: A theory of interdisciplinary teamworking
By Antoinette McCallin, Ph.D., M.A. (hons), B.A., RGON Abstract The aim of this emerging grounded theory study was to discover the main concerns of health professionals working in interdisciplinary teams, and to explain the processes team members used to continually resolve practice problems. Data collected from forty-four participants from seven disciplines in two teaching hospitals in New Zealand, included eighty hours each of interviewing and participant observation. In this paper the theory of pluralistic dialoguing is presented. It is argued that interdisciplinary work is possible when the team replaces the discipline focus with a client-focused care and thinks differently about service delivery. Thinking cooperatively requires individual team members to dialogue with colleagues, thereby deconstructing traditional ways of thinking and reconstructing new approaches to interdisciplinary practice. Although dialoguing was an informal process occurring within clinical spaces, as the effects of health reform and restructuring intensify teams also need to establish formal dialogue groups to facilitate team practice development and support team learning in the continually changing fast-paced practice context. Introduction Over the past decade the interdisciplinary team has received mixed reviews. While the interdisciplinary team is generally seen as a means to change professional practice and foster interprofessional collaboration (Leathard, 2003; Sullivan, 1998) it is also viewed as a means to promote clinical improvement in care and the outcomes of care, thereby improving public health and quality service provision (Lax & Galvin, 2002; Manion, Lorimer & Leander, 1996). As the care needs of clients have changed health care organisations have challenged traditional models of service delivery and endorsed the interdisciplinary team as a new model of practice that will supposedly reduce costs and improve the quality of care (Dodge, 2003). Interdisciplinary teams are usually expected to provide efficient, effective integrated care in restructuring health organisations (De Back, 1999). While team effectiveness is important (Millward & Jeffries, 2001; Schofield & Amodeo, 1999) integrating the disciplines in practice is much more challenging. This suggests that the process of teamworking has received less attention despite the fact that no one discipline can provide integrated care for clients with multiple needs, which often crosses many disciplinary boundaries (Gillam & Irvine, 2000). The interdisciplinary team is defined as one in which clinicians from various disciplines such as medicine, nursing, occupational therapy, physiotherapy, and social work cooperate with each other, sharing leadership, assessment, goal setting, problem-solving and decision making so that care is coordinated and client outcomes optimised. While the assumption that clinicians from different disciplines will automatically integrate care effectively is a worthy goal the reality may be somewhat different (Long, 2001; Masterton, 2002) suggesting that interdisciplinary team members may lack understanding of what is involved (O’Connell, 2001). Too often interdisciplinary teamwork seemingly evolves from trial and error learning. Indeed, Long (2001) observes that while there is longstanding general support for interdisciplinary work many variables limit implementation in less-than-ideal environments. Long though urges colleagues to concentrate on the successes. In this paper one of the successes, some of the findings from an investigation into interdisciplinary teamwork in the acute care hospital are presented (McCallin 1999a, McCallin 1999b). The theory of pluralistic dialoguing is introduced and hopefully offers insights into interdisciplinary teamworking explaining how health professionals from different disciplines support colleagues as they put aside disciplinary differences, thinking through and learning new ways of working cooperatively for the common good of the client. Discussion begins with a brief outline of the research topic, the approach and the findings of the research. Next, the meaning of pluralistic...Grounded action: Achieving optimal and sustainable change
By Odis E. Simmons, Ph.D. & Toni A. Gregory, Ed. D. Abstract Grounded action is the application and extension of grounded theory for the purpose of designing and implementing practical actions such as interventions, program designs, action models, social and organizational policies, and change initiatives. Grounded action is grounded theory with an added action component in which actions are systematically derived from a systematically derived explanatory grounded theory. Actions are grounded in the grounded theory in the same way that grounded theories are grounded in data. Grounded action was designed by the authors to address complex, multi-dimensional organizational and social problems and issues. The Roots of Grounded Action: The Real World Context of Grounded Theory Grounded theory is a primarily inductive research method that was developed in the mid-1960’s, by Barney Glaser and Anselm Strauss (1967). As they pointed out, before their discovery of grounded theory, methods of social research focused mainly on how to deductively verify logically elaborated theories. They suggested it was equally important to have a method by which theories could be systematically generated, or “discovered,” directly from data. After their original collaboration, Glaser’s and Strauss’ views of what constituted grounded theory diverged. Because Glaser’s developments in grounded theory are more suitable for practical applications, grounded action is rooted in grounded theory as articulated by Glaser. A rigorous, inductive approach to theory development that provides a “controllable theoretical foothold” (Glaser & Strauss, 1965, p. 268) and gets at what is really going on in action scenes and contexts is a crucial tool for developing effective, sustainable solutions to social and organizational problems. Grounded theory fits this bill. As Glaser (1998) notes: …fields with high impact dependent variables, variables that deal with learning, pain or profit, began looking for a methodology that gave them answers that fit, worked were relevant and easily modifiable to constantly changing situations…A methodology was needed that could get through and beyond conjecture and preconception to exactly the underlying process of what is going on so that professionals and laymen alike could intervene with confidence to help resolve the participants’ main concerns. (pp. 4-5). In grounded theory, getting at what is really going on in an action scene/context is ensured by continually asking: What is actually happening in the data? What is the basic social psychological problem(s) faced by the participants in the action scene? What is the basic social psychological process or social structural process that processes the problem to make life viable in the action scene? (Glaser 1978, p.57) In contrast, actions deduced from logically elaborated theories that are not grounded in what is really going on in context are unlikely to fit the needs of the context for which they were designed. Many years of experience show that actions based on ungrounded ideas more often than not fail to provide meaningful long-term outcomes. The power of grounded theories in real world contexts has been apparent since the method evolved out of a study of death and dying in hospitals, conducted by Glaser and Strauss in the mid 1960’s. Their grounded theories of “awareness contexts” (Glaser and Strauss, 1964) and the “death trajectory” process (Glaser and Strauss, 1968, 1970) that emerged from this study had important implications for improving the way in which health care professionals manage the personal care and organizational aspects of dying patients and their families. One of the earliest grounded studies is Pape’s (1964) study of high job turnover amongst young nurses. Pape discovered that, although it...A Grounded Theory of Moral Reckoning in Nursing
By Alvita K. Nathaniel, DSN, APRN, BC Abstract Moral distress is a pervasive problem in nursing, contributing to nurses’ emotional and physical health problems, loss of nurses’ ethical integrity, dissatisfaction with the work of nursing, and loss of nurses from the workforce. The purpose of this research was twofold: 1) to further elucidate the experiences and consequences of professional nurses’ moral distress and 2) to formulate a logical, systematic, and explanatory theory of moral distress and its consequences. METHOD: This Glaserian grounded theory study utilized volunteer and purposive sampling to recruit 21 registered nurses. Analysis of the data resulted in an original substantive theory of moral reckoning in nursing, which reaches further than the concept of moral distress, identifying a critical juncture in nurses’ lives and better explaining a process that affects nurses and the health care that they deliver. Results: Moral reckoning in nursing consists of a three-stage process. After a novice period, the nurse experiences a Stage of Ease in which there is comfort in the workplace and congruence of internal and external values. Unexpectedly, a situational bind occurs in which the nurse’s core beliefs come into irreconcilable conflict with social norms. This forces the nurse out of the Stage of Ease into the Stage of Resolution, in which the nurse either gives up or makes a stand. The nurse then moves into the Stage of Reflection in which beliefs, values, and actions are iteratively examined. The nurse tries to make sense of experiences through remembering, telling the story, examining conflicts, and living with the consequences. Implications: In today’s complex health care system, nurses find themselves faced with morally troubling situations which if not resolved can lead to serious consequences for nurses, patients, and the health care system as a whole. This study sets the stage for further investigation on the human consequences of moral distress. Further, since moral reckoning impacts health, nurse leaders are challenged to identify opportunities to facilitate successful moral reckoning in the workplace through encouraging nurses to tell their stories, examine conflicts, and participate as partners in moral decision making. Significance The investigator’s curiosity was initially piqued by stories about nurses’ experiences with moral distress in the workplace. Moral distress is the pain or anguish affecting the mind, body, or relationships resulting from a patient care situation in which the nurse is aware of a moral problem, acknowledges moral responsibility, and makes a moral judgment about the correct action; yet, as a result of real or perceived constraints, participates, either by act or omission, in a manner perceived by the nurse to be morally wrong (Jameton, 1984; Wilkinson, 1987-88; Nathaniel, 2003). According to extant literature, situations involving moral distress may be the most difficult problems facing nurses, resulting in unfavorable outcomes for both nurses and patients. Because of moral distress, nurses experience physical and psychological problems, sometimes for many years (Kelly, 1998; Wilkinson, 1987-88; Perkin, Young, Freier, Allen & Orr, 1997; Fenton, 1988; Davies, et al., 1996; Krishnasamy, 1999; Anderson, 1990). Reports of the number of nurses who experience moral distress vary. Redman & Fry reported that at least one-third of nurses in their study (n = 470) experienced moral distress (2000). Nearly fifty percent of nurses in another study (n = 760) reported that they had acted against their consciences in providing care to the terminally ill (Solomon, et al., 1993). Between 43 and 50 percent of nurses leave their units or leave nursing altogether after experiencing moral distress (Wilkinson, 1987-1988; Millette,...SOLUTIONING
By Maria de Hoyos Guajardo, Ph.D. Candidate, M.Sc., B.Eng. ABSTRACT The theory that is presented below aims to conceptualise how a group of undergraduate students tackle non-routine mathematical problems during a problem-solving course. The aim of the course is to allow students to experience mathematics as a creative process and to reflect on their own experience. During the course, students are required to produce a written ‘rubric’ of their work, i.e., to document their thoughts as they occur as well as their emotions during the process. These ‘rubrics’ were used as the main source of data. Students’ problem-solving processes can be explained as a three-stage process that has been called ‘solutioning’. This process is presented in the six sections below. The first three refer to a common area of concern that can be called ‘generating knowledge’. In this way, generating knowledge also includes issues related to ‘key ideas’ and ‘gaining understanding’. The third and the fourth sections refer to ‘generating’ and ‘validating a solution’, respectively. Finally, once solutions are generated and validated, students usually try to improve them further before presenting them as final results. Thus, the last section deals with ‘improving a solution’. Although not all students go through all of the stages, it may be said that ‘solutioning’ considers students’ main concerns as they tackle non-routine mathematical problems. GENERATING KNOWLEDGE An important activity in students’ problem-solving process is to generate knowledge about the situation; i.e., to generate relevant data and information and to gain understanding. This is usually conducted at the start of the process, particularly if students know little or nothing about the situation. For this reason, generating knowledge and understanding seems a good place to start the discussion on students’ problem solving processes. However, it must be made clear that the need to generate knowledge will continue to emerge throughout the process and that students respond to this need in ways that will be discussed in this section. A common strategy that students use as they try to generate information and understanding is to reduce the complexity of the situation that they are dealing with. By reducing complexity, students “start at the beginning” and focus on intentionally simplified or even trivial versions of the situation. Students’ aim behind reducing complexity is to start gathering the information and understanding that will allow them to eventually move on to more sophisticated cases. Reducing complexity may help students gain access to complex situations by reducing them to simpler, more manageable ones. Numbers which can be expressed as a single prime to a power may be a good place to start…(Oscar, Liouville, p. 2) Right, let’s think about this. Start simple and work my way up…(Hillary, Steps, p. 1) Students generate information and gain understanding about the situation in many ways. Thus, it is hypothesised that the only limit for students as they try to generate useful information and understanding might be the one imposed by their own creativity and mathematical abilities. The following is a brief list of the types of activities that students conduct for this purpose. The list is not extensive and other activities may be included from further research: • A common way in which students generate information and understanding is by ‘specialising’, i.e., by looking at particular aspects of the situation. When students specialise, they focus on isolated aspects of the situation and thus on simplified versions of the problem. For this reason, it may be said that specialising is intrinsically about reducing complexity....