In-Depth Interviews: Techniques and Best Practices
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In-Depth Interviews: Techniques and Best Practices A workshop in conjunction with the ACEHP Annual Conference Friday, January 17, 2014 4:15pm-6:15pm Wendy Turell, DrPH, CCMEP President Contextive Research LLC wendy@contextiveresearch. com Alexandra Howson MA, PhD, CCMEP Owner Thistle Editorial, LLC [email protected] m
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Slides from a 2-hour facilitated workshop presented at the Alliance for Continuing Education in the Health Professions
Transcript of In-Depth Interviews: Techniques and Best Practices
In-Depth Interviews: Techniques and Best Practices
A workshop in conjunction with the ACEHP Annual Conference
Friday, January 17, 20144:15pm-6:15pm
Wendy Turell, DrPH, CCMEPPresidentContextive Research [email protected]
Alexandra Howson MA, PhD, CCMEPOwnerThistle Editorial, [email protected]
OverviewLearning Objectives: After participating, learners will be able to:
• Develop, pilot, and administer an interview guide for an IDI series
• Demonstrate optimal interviewer skills and techniques to encourage full feedback from interviewees
The qualitative approach
Search for objective, universal truths using standardized data gathering techniques
Naturalistic/interpret-ative approach
Focus on how people perceive their worlds and interpret experience
Data: What vs WhyQuantitative Data:A 37% drop-off was observed in adherence to post surgery medication regimens
Qualitative Data“After their bypass surgery, when they have seen God and all that, they listen, but after they are out of the hospital and they are going through rehab and they are fine, that period of after the bypass, they are invincible.”
Relevance to CEHP
Needs assessment
Formative evaluation
Outcomes evaluation
Why Interview?• It’s good to talk
o Provides depth + context to other data
• Lopsided conversation• Relies on interaction
What Defines an Interview?
A tool to direct or guide a conversation between 2 or more people towards a particular outcome.
Frey and Oishi (1995:01) define Interview as “a purposeful conversation in which one person asks prepared questions (interviewer) and another answers them (respondent).”
Examples: • Journalistic• Clinical• Research• Occupational
Activity 1: Core Components of Interviews
• What went well in this interview?
• What did not work?
Alexandra Howson
moving from rationale and relevance to what an interview is to set up discussion of its core components/elements in next section of the workshop - leads into activity 1 = interview critique
Debrief
Interview Planning
Components of an Interview
• Opening/building rapport
• Language (word choices) and tone
• Body language
• Empathy
• Questions that will elicit deep response
The Interview Guide
• Keeps you on track
• Ensures material/research question coverage
• Establishes sequence
Question Order
sensitive
more serious
Small chat/ice-breaker
conversation
Types of Questions
Question Types• Open ended, neutral, sensitive, clear to
respondent
Patton, MQ. How to use qualitative methods in evaluation. London: Sage, 1987.
1. Main questions2. Probes3. Various follow up questions
Wendy Turell
AH has a q type grid
Main/Introducing
• “Tell me about….?”
• “Do you remember an occasion when…?”
• “What happened when you...?”
Prompts + Probes• Extensions of main question
• Aimed to encourage respondents to share more information and touch on areas they did not initially address
• May reflect statements or use vocabulary of respondent
“You mention patients come into visits with opinions from these ads. How does that impact the interaction?”
“Could you say something more about that?”
“Can you give a more detailed description of what happened?”
“Do you have further examples of this?”
Specifying
• “What did you think at that point?”
• “What did you actually do when you realized he had this side effect?”
• “How did your colleagues react when you started the new program?”
Direct/Indirect
Direct Indirect“In what ways do you
implement these guidelines post
diagnosis? “
“How do you believe other physicians view
these guidelines?”
“Describe ways in which you support your
patients’ adherence efforts”
“What do you think are the reasons behind your
patients’ lack of adherence?”
AH: I made the examples more CME specific. Do these still fit as good examples of direct/indirect questions in your opinion?
Interpreting “When you use the term ‘uncontrolled’ disease, are you referring mainly to A1Cs?”
“So do you mean that the patients have literacy challenges?”
“Is it correct to say that you are typically unable to chose your ideal treatment due to these barriers?”
“Does the expression ‘trying to keep up’ describe what you have just expressed?”
More about Questions• Use vocabulary of respondent• Appropriate tone• (make sure order/sequence is in deck
somewhere)• What open ended q looks like• Language that may invoke defensiveness• Leading questions
Time to Craft Some Questions
Activity 2: Your Mission…• As CME Director of Main Street Community Hospital,
you and your team have been asked to interview 20 recently discharged patients who received joint replacement surgery. The hospital administration would like to learn about patient satisfaction during their stay as part of an education program designed to reduce readmission rates.
• Develop 5-7 questions that will help hospital leadership better understand more about “patient satisfaction”.
Activity Debrief
Interview Presence
Face-to-face ‘live’
WHAT ARE YOU REALLY SAYING?
Telephone
Pros + cons
Optional Webcam-
enabled images
Text based chat &
audio capable
Online: Virtual Interview Room
Skype video call
Activity 3: Revisit Your Questions
• As CME Director of Main Street Community Hospital, you and your team have been asked to interview 20 recently discharged patients who received joint replacement surgery. The hospital administration would like to learn about patient satisfaction during their stay as part of an education program designed to reduce readmission rates.
• Develop 5-7 questions that will help hospital leadership better understand more about “patient satisfaction”.
Administering an interview
Interviewer Behavior• Active Listening – Be ‘in the moment’
o Patience, okay with silence
• Encourage respondento Give appropriate verbal and non-verbal feedback
• Stay neutralo Avoid presenting your perspective (bias interview)o Avoid counseling, teaching
• Reflectingo Paraphrase/reflect back
Capturing Informationo Audio Recording
• Digital RecorderoConference linesoPhone apps (e.g., italk)
• Video recording• Pen and paper notetaking
Activity 4: Interviewing with partners
• 1:1 pairing• Practice using revised questions• Chose one partner to share information on
experience
REMEMBER:Active ListeningReflect back to respondentStay neutral
Interview Disadvantages
• Time intensive
• Bias (researcher + interviewee)
• Skill requires practice!
• Lack of generalization
Subjects
• Recruitment• Screening
o participants/inclusion criterion
• Subject preparationoWhat to expecto Institutional Review Boards (IRBs)o Informed Consent
Questions?
Follow-up Questions?Contact Us
Wendy Turell, DrPH, CCMEPPresidentContextive Research [email protected]
Alexandra Howson MA, PhD, CCMEPOwnerThistle Editorial, [email protected]
Resources
Software Resources: Coding & Organization
• Free (QDA Miner Lite)o http://provalisresearch.com/products/qualitative-data-analysis-software
/freeware/
• Low Cost: dedoose ($10 per month)o http://www.dedoose.com/
• Bells and Whistles software: Nvivo or Atlas Tio http://www.qsrinternational.com/products_nvivo.aspxo http://www.atlasti.com/index.html
Resources Cont.• Hopkins Open Coursework: http://ocw.jhsph.edu/• Qualitative course materials:
o http://ocw.jhsph.edu/index.cfm/go/viewCourse/course/qualitativedataanalysis/coursePage/index/
• Online Qual. Textbook: http://onlineqda.hud.ac.uk/Introduction/index.php
Resources Cont.• Cater JK. SKYPE: a cost-effective method for
qualitative research. Rehab, Counselors + Educators Journal. 20011;4:
• Cohen DJ, Crabtree BF. Evaluative criteria for qualitative research in health care: controversies and recommendations. Ann Fam Med. 2008;6:331-339.
• Curry L, Nembhard IM, Bradley EH. Qualitative and
mixed methods provide unique contributions to outcomes research. Circulation. 2009. 119:1442-1452.
Appendix
Conversation vs. InterviewConversation Interview
Respondent Friend/Acquaintance
Recruited respondent
Who provides Questions/Answers
Generally equal questions/answers among participants
Lopsided
Tone Share true feelings, reactions to what you hear
Maintain objective tone, non judgmental, non reactionary
Focus Typical focus on immediate outcome (e.g.: how was the game?)
Process, cause/consequences, context, search for patterns
Depth Most often a range of issues, not always deep
Narrow range of issues, greater depth
Qualitative Research
Quantitative Research
Type of Questions
Probing “below the surface”; immediate follow up & adjustment
Limited probing; pre-determined questions NOT adjusted
Sample Size Small Any size including large
Information per respondent
Much Varies; Limited to answer choices
AdministrationRequires skilled researcher
Fewer specialist skills required
Type of Analysis
Follows structured steps; subjective and interpretative
Statistical; objective
Type of ResearchExploratory, descriptive Descriptive or Causal
Wendy Turell
appendix
Wendy Turell
add later, at end; maybe focus on Q&A style for first part of deck
White Board Exercise example
Which drug class do you prefer to use in patients who fail on oral monotherapy?
DPP4 Inhibitors
SGLT2 inhibitors
