Demystifying Research for Medical and Healthcare Students. John L. AndersonЧитать онлайн книгу.
scale, with 10 gradations, or 10 levels. They assigned the name of ‘dols’ to these levels. Other researchers were not able to reproduce the results of Hardy, Wolff and Goodell, and the device and the approach were abandoned … In 1945, Time magazine reported that Cleveland's Dr. Lorand Julius Bela Gluzek had developed a dolorimeter that measured pain in grams. Dr. Gluzek claimed that his dolorimeter was 97% accurate.
Sounds a bit far‐fetched to me! Some of the approaches to develop ‘pain‐ometers’ were bizarre and reminded me of the experiments in Nazi Germany (I deal with these in Chapter 18).
In the 1970s, pain was initially ‘measured’ as ‘mild, moderate or severe’. Then people began to tinker with it to make it more sophisticated. They introduced 10‐point scales, some of which are accompanied by faces smiling to crying. (See Figure 1.1.)
FIGURE 1.1 The 10‐point pain scale (Harvard Men’s Health Watch, 2018).
Source: Image: © EgudinKa/Getty Images.
Can you imagine, one patient says to another:
P1:
How're you feeling today?
P2:
Not great – I've got a grade 8 pain!
P1:
Gee, I'm sorry to hear that! What axis are you measuring it on?
Those who believe that there is only one reality and that this reality exists independently of our knowledge of it are called positivists. Those who believe that all reality is subjective are called relativists or interpretivists. To me it does not make sense to say, ‘I believe that all of “reality” is subjective’, any more that it makes sense to me to say ‘I believe that all of reality is objective’. But, I acknowledge that other people have different views. For me, life is too short to bother with them. And that's all I want to say about that.
Epistemology
Epistemology is the study of what constitutes ‘knowledge’. It is concerned with defining the nature of what knowledge is and how we know things. So, the epistemologist will be concerned about different views on knowledge, beliefs, truth, justification, and internalism/externalism. (Don't even ask!)
In relation to research methods, if you hold a positivist belief (note my use of the term ‘belief’) then you are likely to want to have proof for your knowledge in the form of things you can see, touch, and get confirmation from others that they see and touch them too. You are likely then to favour methods which measure things and count things and to use statistics to analyse your data. One criticism is that they reduce everything to a number:
Nrs:
What's your depression like today?
Ptnt:
It's a seven.
Nrs:
Oh my, that's bad, I'd better get you some more pills!
If you hold an interpretivist belief, then you will not search for absolute proof for your knowledge, because you don't think that that exists. Therefore, you will be inclined to use inductive methods and qualitative approaches, because you recognise the subjectivity of your unique location in time (history) and society (class, gender, race, culture, etc.). You won't try to measure pain, or depression just by numbers. You might say ask questions like:
Nrs:
Can you describe your pain to me?
A third paradigm (way of thinking) is a pragmatist belief. This accepts aspects of both positivist and interpretivist beliefs and can adapt to the most realistic means of addressing an issue using either positivist or interpretivist approaches.
Methodology
Methodology refers to the broad approach which we take to guide our collection of data. The three main categories are quantitative (numbers), qualitative (no numbers), and mixed‐methods (whatever you want).
Methods
Methods refers to the actual means of collecting your data – for example by measurements, surveys, interviews, questionnaires, focus groups, and so on.
They are linked, and I have tried to show a relatively simple way of thinking about it in Table 1.1. (I was inspired By Salma Patel's 2015 model which I have adapted here.)
To Sum Up
The main distinctions we tend to make in research are about:
positivist vs interpretivist
quantitative vs qualitative
hypothetico‐deductive vs hypothetico‐inductive.
And if you bear those distinctions in mind, you'll get by!
Final Word
Research can exist outside of our knowledge of ontology and epistemology. Don't fret too much over these complex ideas. As you might end up debating whether it is positivist or relativist to decide how to count the number of angels you can get on a pinhead …
TABLE 1.1 Ontology, epistemology. Theoretical perspective, methodology, and methods.
Source: Adapted from Patel (2015).
| Research Paradigm | Ontology | Epistemology | Theoretical Perspective | Methodology | Methods |
|---|---|---|---|---|---|
| Positivist | There is a single reality | Reality can be measured using the best scientific methods | Positivism | Quantitative methods – experimental and observational hypothetico‐deductive | Sampling, measuring Numbers and statistics |
| Interpretivist | No single reality. Reality depends on the researcher's location in time and society | Everything is subject to interpretation. We need to discover how people experience their worlds | Interpretivism | Qualitative methods: phenomenology ethnography grounded theory Etc. Hypothetico‐inductive | Participant observation Interviews Focus groups Etc. |
| Pragmatism | Reality is constantly being re‐negotiated and interpreted | You can choose the best method for solving the problem | Pragmatism | Mixed methods |
Any methods which |