August 2012: "Complexity" through Qualitative Research

Representing complexity well: A story about teamwork, with implications for how we teach collaboration, Lingard L, McDougall A, Levstik M, Chandok N, Spafford MM, Schryer C. Medical Education, 2012; 46: 869-877.  

This Medical Education article is like the star pupil in a class of education research examples. To begin, it’s a rigorous qualitative study with a textbook application of a theoretical framework. Data includes standardized field notes of focused observations and transcripts from semi-structured interviews. Observations were conducted with “a ‘marginal participant role’…which enabled the study group to focus on observing interactions while allowing for informal discussions with team members.” (p. 871) Analysis was iterative and inductive, from a grounded theory approach utilizing open coding. Validity was achieved through member-checking and triangulation.

This article is also well written. Flip to the results section and you’ll read a story portraying the themes identified through analysis. This style of results presentation helps contextualize both the application of results and the theoretical framework for the reader.   

Finally, the article also highlights some meaningful content. The complexity that each of you may experience on patient care teams is not unique to your situations. In fact, complexity is an attribute ingrained in interprofessional collaboration (IPC), and the authors of this article argue that research examining IPC not only must consider such complexity but must also investigate such complexity directly. The authors argue that, although we all agree that IPC and interprofessional education are valuable, they are “in constant tension with other relevant motives, such as appropriate resource allocation and trainee education.” Competition among relevant objectives helps define the complexity of health care teamwork, and, unfortunately, the authors uncover that “IPC and IPE models do not sufficiently reflect this complexity.” (p. 876).

Bottom Line:

Interested in qualitative research?

Read this article for an example of rigorous methodology and creative display of results.

Interested in improving the collaboration among members of your patient care team?

Read this article for some insight into the complexity of interprofessional collaboration. Creative solutions to address such complexity will be successful only if we truly understand the underlying problems.