Hot Topics: Researcher skills – 5 key learning points about Reflexive Thematic Analysis

This blog is written for BMERG by one of our committee members Dr Grace Pearson. Grace is Bristol Medical School graduate and a current Clinical Research Fellow in Population Health Sciences. Her research interests are in undergraduate medical education, specifically curriculum development and evaluation and geriatrics education.  

Grace shares her experience and tips after attending a workshop hosted by BMERG and the School of Policy Studies on ‘Reflexive Thematic Analysis’ from the expert Qualitative researcher, Professor Virginia Braun from the University of Auckland. 

Image of a galaxy Photo by Bryan Goff on Unsplash
Image of buckets Photo by Sixteen Miles Out on Unsplash

At medical school, future doctors are taught to detect patterns in history and examination to reach a diagnosis. Moving into medical research, this scientific pattern-recognition continues in quantitative data analysis and interpretation. As a result, approaching mixed methods studies or pure qualitative research can be daunting for those of us in medical and other scientific fields – it certainly was for me.  

There are several core aspects of qualitative data analysis that I’ve never truly got to grips with, despite attending multiple training courses… Therefore, getting the chance to learn directly from a world-leading expert was an opportunity not to be missed.  

I went into this workshop wanting to learn how to analyse or ‘code’ my data and develop my themes. I came away with a much wider appreciation of the importance of exploring context, embracing subjectivity, finding latent meaning, and conceptualising what Prof Braun called ‘galaxy’ themes rather than ‘buckets’. Let me explain a bit more.  

When we first look at qualitative data during analysis, certain things can jump out at us as topics. We may think these may start to look like our themes, but if we are not careful, they can end up looking like our original questions and, because everything we connect to a particular topic ends up together ‘in a bucket’ so to speak, may have lots of conflicting ideas within them.  

Conversely, true themes are more like a galaxy with a clear core, a ‘central organizing concept’ holding together all the ideas which although may be different, just like stars and planets are in a galaxy, they remain inherently linked. 

Here are my 5 key learning points from Professor Braun’s fantastic reflexive thematic analysis (RTA) workshop, which I hope might help others to approach their own qualitative data analysis in a reassuringly robust way:  

  • Scientifically Descriptive vs Artfully Interpretive analysis: Descriptive describes and summarises the data in an ‘experiential’ or ‘realist’ manner. Interpretive tells a story, locating the data within a wider context and presents an argument in a ‘critical’ or ‘constructionist’ way. Approaches to thematic analysis (TA), range from ‘scientifically descriptive’ deductive methods such as coding reliability, to ‘artfully interpretive’ inductive methods such as reflexive TA. 
  • Small q vs Big Q: Descriptive analysis suits ‘Small q’ research questions that seek to explore or describe peoples’ experiences, understandings, or perceptions – their ‘individual reality’. Interpretive analysis suits ‘Big Q’ research questions that seek to explore the ‘wider context’, for instance influencing factors, representations, and constructions.  
  • Context and Subjectivity: Analysis occurs in the intersecting space between the researcher(s), the data, and the research question. Subjectivity is present in all 3, as all are influenced by sociocultural, disciplinary, and scholarly context – as a result, analysis is situated in context, which must be clearly communicated.  
  • Coding: codes are ‘units of analytic interest’, the smallest unit of analysis capturing a single analytic idea or facet. These can be semantic (explicit) or latent (implicit) – descriptive analysis generally uses more semantic codes, whilst interpretive analysis uses both. Codes are not ontologically ‘real’, they exist only for the researcher(s) to foster engagement with the data – they need to capture the meaning of the data along with the researchers’ interpretation, orientated towards answering the research question.   
  • Themes: a theme is a construction that captures shared or repeated meaning in the data around a ‘central organising concept’. Themes are conceptual, therefore semantic-level data may seem disparate, but it is unified by latent meaning representing diverse manifestations of the core concept (like a galaxy).  Themes sit in the analytic narrative – they must tell a story of how the data is meaningful and answers the research question.   

Some examples of recommended resources for getting started using reflexive thematic analysis 

  • https://www.thematicanalysis.net/  
  • Braun, V, & Clarke, V. (2013). Successful qualitative research: A practical guide for beginners. SAGE. 
  • Braun, V, & Clarke, V. (2022). Thematic analysis: A practical guide. SAGE. 
  • Braun, V, & Clarke, V. (2021). Can I use TA? Should I use TA? Should I not use TA? Comparing reflexive thematic analysis and other pattern-based qualitative analytic approaches. Counselling and Psychotherapy Research, 21(1), 37-47. https://doi.org/https://doi.org/10.1002/capr.12360 
  • Braun, V, & Clarke, V. (2021). One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qualitative Research in Psychology, 18(3), 328-352. https://doi.org/10.1080/14780887.2020.1769238 

More about Professor Braun https://profiles.auckland.ac.nz/v-braun

Virginia “Ginny” Braun is a New Zealand psychology academic specialising critical psychology of health and gender. She is internationally recognised for expertise in qualitative methodologies, and particularly the now widely utilised method of (reflexive) thematic analysis – developed in collaboration with Victoria Clarke (UWE).

Building Community: Networking Opportunities through joining a MedEd association

Sarah Allsop

Joining one of the many Medical Education Associations can be a great way of meeting like minded people in the discipline and building collaborations. In this blog Sarah Allsop highlights a few of the available networks you can join.

Photo by Roman Kraft on Unsplash

Networking and national work can be a fantastic opportunity of medical educators to learn, develop and share their ideas with increased reach and impact. One of the ways of doing this is by joining one of the Medical Education Associations. For the UK, three of the main associations working in Medical Education are listed below, but there are many associations around the world:

  • The Association for the Study of Medical Education (ASME)
  • The Association for Medical Education in Europe (AMEE)
  • The Academy of Medical Educators (AoME)

To start with you may simply want to join an association, to get linked in with their publications, discounts to their events or to undertaking training or accreditation. Each association offers a slightly different emphasis so it is worth having a look at their websites to consider which might be the best fit for you and your work, and of course you can join as many associations as you want. There are often discounted memberships for students and those in low-income situations aiming to make joining more inclusive.

Once you are a member, there are also calls to be involved in the committees which can further help to facilitate work on policies and strategic aspects of medical education. Watch out for these calls via social media and on association websites. We will also post about opportunities we spot right here on the BMERG blog too, so subscribe to get the latest news direct to your inbox, and follow us on twitter @BristolUniBMERG.

Which are your favourite #MedEd Associations to be part of? Add your thoughts in the comments section below!

Launching Bristol Medical School Educator and Researcher Profiles

As part of our objective to ‘Innovate and Inspire’, this page is dedicated to showcasing not only the work of these individuals, but also a bit about their journey and their top tips for working in the discipline.

We will be adding a new profile every month to our educator and researcher profiles page, and our first profile spotlight is….

Annie Noble-Denny

Annie is the Director of BMERG, which she conceptualised as part of her vision to build the infrastructure needed to enhance the educational research portfolio at Bristol Medical School. She is the currently the School Education Director for Bristol Medical School and the Programme Director for the Teaching and Learning for Healthcare Professional Programmes (bristol.ac.uk/tlhp). 

 


If you want to nominate someone from Bristol Medical School to feature on these pages contact us at brms-bmerg@bristol.ac.uk.


Publishing in Medical Education: List of Journals

Sarah Allsop

 

This blog is shared by Sarah Allsop as a place to start for those wanting to find out about where to publish medical education innovation and research.

  

Photo by Aaron Burden on Unsplash

Whether you have been working on a fantastic educational innovation or have undertaking a great piece of education research, the likelihood is you will want to share this with the wider medical education community. But, where so you publish it and how do you find out which journals publish medical education research?

Fortunately, Professor Doctor Olle ten Cate has produced an open access list of journals where it is possible to publish medical education research. Version 4 of this list (released in August 2022) comes complete with links to the journal websites and includes those related not only to medical education, but across the health professions and those written in languages other than English.

Access this really helpful list at: JOURNAL OPTIONS TO PUBLISH HEALTH PROFESSIONS EDUCATION

To cite this dataset: ten Cate, Olle (2022), “JOURNAL OPTIONS TO PUBLISH HEALTH PROFESSIONS EDUCATION ARTICLES”, University Medical Centre Utrecht, V1, doi: 10.17632/rf29ym3bpw.1

Hot Topics: Researcher skills – Creating your database search strategy

This blog is kindly written for BMERG by one of our amazing subject librarians, Richard Kielb. Richard takes us through some top tips around searching databases whilst undertaking your research, and some tips for breaking down the process.

Books on shelves
Photo by Paul Melki on Unsplash

When it comes to research, different search strategies are needed dependent on the nature and context of your work. Sometimes you may just need a book or a few relevant articles on a subject, and in this situation a quick search of your local library catalogue can often be sufficient. For more detailed research, it is likely to be more important to be able to carry out a comprehensive review of the literature, and this will usually require an advanced search using bibliographic databases.

So what is a bibliographic database? A database will allow you to search across very large numbers of academic sources simultaneously. Most of these sources will be academic journals, but some databases will include book chapters, conference proceedings, systematic reviews etc.

Different subjects will be supported by particular databases, so it will be important to identify the ones that are most relevant for you. Medical education would be a good example of a topic which would cross over more than one subject, so you would need to consider searching in databases recommended for both Medicine and Education as well as others with a multi-disciplinary focus.

Which databases you choose to use will depend very much on the topic you are researching and also what resources you have access to as an individual or a member of an institution. Many databases are not free to access and can be extremely expensive, but they are often provided by library services in organisations such as Universities and in the NHS.

Although the various databases have search interfaces that look quite different, the basic principles listed below will generally apply to all of them. Some of the functionality and ‘wildcard’ symbols etc might be slightly different, but there are usually help pages and guides available that will help indicate how it all works.

There are four basic stages to the database searching process:

  • Break your question down to its main concepts
  • Decide on the relevant search terms
  • Combine your search terms
  • Review your results

Breaking your question down to its main concepts

For clinical questions you may have come across the PICO formula to identify your concepts, and you can consider doing something similar for your medical-education topic. The social science framework called SPICE can be useful:

S – Setting Where does the research happen?
P – Population Who is your research focused on? Is your population defined by age, gender, ethnicity etc?
I – Intervention What are you investigating? Is it the use of technology or participation in a particular educational programme?
C – Comparator Are you comparing anything with your main intervention?
E – Evaluation Appraising the value, validity, or effectiveness of the intervention.

As with PICO you do not necessarily need to have a concept for every SPICE element.

Decide on the relevant search terms

Next you will need to consider what terms to search in relation to all of the different concepts. Include likely variations in terms in order to carry out a comprehensive review and to avoid missing any papers which are relevant to your topic. It will be important to factor in all synonyms, related terminology and any variations in spelling (particularly UK/US).

Keyword searching, also known as free-text searching, is where you will look for exact matches for your search terms in the titles and abstracts of journal articles. It is also useful to include searches in any controlled vocabulary offered by your chosen database, for example resources like Medline, ERIC and Cinahl offer ‘Subject Headings’, which make it easier to locate papers on a specific subject. Each article listed in the database is assigned a number of Subject Headings which represent what topics it covers. The advantage of this is that all of the articles on the same subject will be given the same subject heading, independent of the terminology used by the individual authors.

Combine your search terms

The Boolean search operators (OR, AND, NOT) can be used to combine your searches effectively.

  • Use OR to combine searches about the same concept – synonyms, related terms, variant spellings (e.g. Vitamin C OR ascorbic acid). This will broaden your search.
  • Use AND to combine searches about different concepts (e.g. caffeine AND asthma). This will narrow your search.
  • Use NOT to exclude terms from your search. This can be useful if you are retrieving some irrelevant content but use an element of caution as this can also remove useful material that may have mentioned the excluded term.

Review your results

Critically appraise your results (are they relevant to your research topic?) and decide if you need to make any changes to your search strategy. When you have run your search, you will often find that you either have more or fewer results than you were expecting.

  • Too many? Look for ways to make your search more specific. Can you add concepts? Are there valid ways to limit your results (publication date range, age group, language etc)?
  • Too few? Look for ways to make your search more general. Are there any terms that could be removed? Would broader search terms be useful?

Setting ‘limits’ can also be helpful as many of the databases will provide a series of in-built limits and filters, so it can be useful to investigate the options available.

Remember that your local Librarian will be more than happy to answer any questions you might have about using bibliographic databases and finding information more generally! At the University of Bristol you can find your subject specific librarian at: www.bris.ac.uk/library/subject-support/

Building Community: BMERG is on Twitter

You can now follow Bristol Medical Education Research Group on Twitter!

twitter logo

Whilst there are of course many different social media platforms that offer ways of collaborating and learning, you will find on twitter most of the big medical education associations and publishers, along with many educators and researchers who share practice ideas through their content. So for now at least, twitter remains a great platform for connecting with the rest of the Medical Education community.

BMERG will also be regularly sharing news and events from Bristol through its new twitter account, as well as highlighting the work of other colleagues from around the world with ideas on best practice in Medical Education. Follow us at @BristolUniBMERG

Not sure who to follow?

If you are new to twitter, here is a list of a few great medical education feeds to get you started:

  1. Teaching and Learning for Health Professionals, Bristol @TLHPBristol
  2. Incubator for Clinical Education Research @ClinEdResearch
  3. Association for the Study of Medical Education @asmeofficial
  4. Developing Medical Educators Group (DMEG) @DevMedEd
  5. The International Network for Health Workforce Education @INHWE_Network
  6. The Academy of Medical Educators @MedicalEducator
  7. International Association For Health Professions Education @AMEE_community
  8. International Association of Medical Science Educators @iamse

Which other great medical educators, researchers, associations and organisations would you add to the list? Add your ideas in the comments below.

Publication Call: Submit to the Inspire Student Research Journal!

This publication call is one for all the Medicine, Dentistry, Veterinary and Biological Sciences students out there who are looking to publish their work.

INSPIRE posters about publication submission calls 2023

The Inspire Student Research Journal is written, peer reviewed and edited by students.  The journal is a great opportunity to experience science publishing and have your name in print. This year’s editorial team are looking for Med, Vet, Dentistry and Biomedical articles for the 2023 issues. These could be: research papers from your course; opinion pieces; reviews; features on intercalation, events or electives; cover art; creative writing and more…

They are also creating a special edition on One Health – the concept of human, animal and planetary health being interlinked. It is up to you how to interpret the theme, for example whether it’s the impact of single use plastics or antibiotic resistance and factory farming to cross species infectious diseases or food system failures.

Deadline for the Autumn issue: 12 June

Deadline for the One Health special: 11 September

If you are a Medicine, Veterinary or Dentistry student and would like to act as a peer reviewer then please send us your details.

Read back issues and find out how to submit/get involved at: inspirestudentjournal.co.uk

BMERG News: BMERG wins Award from ASME

BMERG has won an Award from the Association for the Study of Medical Education (ASME) to launch the work of the group across the next academic year

Flyer of winners of ASME Educator Development Awards from ASME 2022

We are thrilled to announce that the BMERG team have won an Educator Development Award from the Association of Medical Education (ASME).

These sought after awards are aimed to provide funding to support educator development. We look forward to sharing more about how this funding will support us to build and develop the community of practice to support excellence in Medical Education Research at Bristol in the coming months.

Read more about the awards at: Recipients of the 2022 round of EDC Educator Development Awards Announced

BMERG News: BMERG goes live on the Bristol Medical School Webpage

As part of the work of the new BMERG group, one of our missions is to maximise the visibility of the work of researchers and innovators in Medical Education here at the University of Bristol Medical School.

Part of this was the creation of this blog – we are glad you’re here and don’t forget to click subscribe to get regular updates and news if you haven’t done already! We also wanted to give medical education research a space on the University webpages alongside our highly successful and established clinical research institutes.

The BMERG webpage is now live on the Bristol Medical School webpage under the research tab. From here you can directly access links to the BMERG blog, the events pages and find out about our mission and objectives. You will also find links to the profiles and research of individuals undertaking medical education work and research here at Bristol (via the University research information PURE system).

We are very grateful to Mike Cameron, an independent digital education consultant, and Clare Tremlett and her team from the Senior Executive team at Bristol Medical School for supporting the BMERG team to launch the new page on the Bristol Medical School Website.

Take a look at: www.bristol.ac.uk/medical-school/research/medical-education-research/

BMERG News: The Inaugural BMERG Committee Steering Group

The work of the new BMERG group is being overseen by a steering group from across Bristol Medical School. This group of passionate individuals will be working behind the scenes to create a programme of exciting new events and support opportunities for those involved in Medical Education Research both at Bristol and beyond.

Committee members join for one year with the option to stay on for a further year. Expressions of interest are welcomed throughout the year from both academics and professional service staff.

BMERG Committee 2022-23

Annie Noble-Denny
Sarah Allsop
Steve Jennings
Sharon Usher
Andrew Blythe
Claire Hudson
Santi Rodriguez
David Rogers
Liang-Fong Wong
Sally Dowling
David Hettle
Fiona Holmes
Grace Pearson

Through collaboration we aim to be able to better share practice, learn together, and showcase our fantastic and innovative Medical Education work as well as building the culture for publishing and disseminating work more widely.