Abstract
This article contributes to the discussion of the value of utilizing mixed methodological approaches to conduct nursing research. To this end, the author of this article proposes creating a mixed-methods program of research over time, where both quantitative and qualitative data are collected and analyzed simultaneously, rather than focusing efforts on designing singular mixed-methods studies. A mixed-methods program of research would allow for the best of both worlds: precision through focus on one method at a time, and the benefits of creating a robust understanding of a phenomenon over the trajectory of one’s career through examination from various methodological approaches.
As nurse scholars, the core of our pursuit is that of veracity, communicating the truth of a phenomenon or health concern of interest. Research endeavors allow for us to meaningfully examine and contribute to our collective search for truth through innovative and varying methodological approaches. The very definition of research is that of “systematic inquiry that uses disciplined methods to answer questions or solve problems … [with the] ultimate goal of develop[ing] and expand[ing] knowledge” (Polit & Beck, 2017, p. 3) to benefit the profession and clients. Although those within the profession can agree that we are in search of truth, approaches to this ultimate goal vary greatly from one methodology to another.
Traditional thought leads us to believe that in education and in practice, one’s best work comes from tireless study within one specific methodological approach. Researchers who ascribe to quantitative purity insist that methods should be objective and devoid of context (Johnson & Onwuegbuzie, 2004; Nagel, 1986). Qualitative purists, such as constructivists and interpretivists, reject this rigidity all together citing the importance of context and the lived-experience of research subjects (Johnson & Onwuegbuzie, 2004; Nagel, 1986). Although both quantitative and qualitative approaches to research have unique merits, most researchers are educated to uniquely align themselves and their scholarly perspective with one school of thought, maintaining this allegiance through the course of their careers and indoctrinating students and mentees of their own into this prescribed approach to research.
Benefits and Shortcomings of Quantitative Research Methodologies
Each branch of methodology carries unique value in our search for truth to further nursing science. Quantitative research receives its name from its goal of discovery and analysis of quantifiable, numerical data using a number of statistical techniques (Carr, 1994). It is characterized by systematic and methodological processes placing value on the concepts of rationality, objectivity, precision, and control (Koch & Harrington, 1998; Streubert & Carpenter, 1999; Walker, 2005). Foundational to the strength of quantitative nursing research methods is this concept of control (Walker, 2005). Systematic control of research processes and procedures helps to minimize chances of erroneous conclusions (Burns & Grove, 1999; Hicks, 1998). “Control may be exerted in several ways, including: random sampling, inclusion/exclusion criteria, use of a comparison group, subject matching across groups, manipulation of the independent variable, blinding procedures, the use of precise measuring tools and the application of standardized statistical tests in the final analysis of data” (Walker, 2005, p.574). The intention behind exerting this level of control is to be able to confirm that the study findings are attributable to the effects of the experiment (Duffy, 1985).
This level of control in quantitative research is not always congruent with the humanistic philosophy espoused for nursing practice (Clark, 1998; Munhall, 1982; Playle, 1995), and there are many aspects of patient care that are not measurable or amenable to manipulation (Corner, 1991; Parahoo, 1997; Walker, 2005). Furthermore, one may argue that by stripping research of its context and exerting too much control, quantitative research methodologies render human experiences as being unimportant and relegate human beings to being only passive reactors (Cormack, 1991).
Benefits and Shortcomings of Qualitative Research Methodologies
The beauty of qualitative methodology is that it is our way of illuminating “evocative, true-to-life, and meaningful portraits, stories, and landscapes of human experience” (Sandelowski, 1993, p. 1). Qualitative research is defined as “the investigation of phenomena, typically in an in-depth and holistic fashion, through the collection of rich narrative materials using a flexible research design” (Polit & Beck, 2017, p. 11). The strength of qualitative research is in its flexibility and its creation of a more holistic understanding of people and the worlds in which they live. Such an understanding cannot be created through rigid approaches (Duffy, 1986). However, there are also commonly noted weaknesses of qualitative methodology that include its lack of generalizability, replicability, and the possible effect of the researchers’ presence on the people they are studying and how the relationship that develops between the researcher and participants may actually distort findings (Carr, 1994; Polit & Beck, 2017).
What About Mixed-Methods Approaches to Research?
As scholars in a practice-oriented discipline, our goal should be to explore the possibilities that can come from examining phenomena from every methodological approach that may help us to “achieve the ‘fuller knowing’ that advances knowledge and influences practice” (Sandelowski, 1993, p. 3). As both quantitative and qualitative methods are invaluable in our pursuit of nursing knowledge, mixed methodology has grown in its popularity. Interestingly enough, “for every strength there appears to be a corresponding weakness in both quantitative and qualitative research” methods (Carr, 1994). To this end, it may be appropriate to utilize methodology of the other paradigm to address the weaknesses in one’s previous quantitative or qualitative study design. Encouraging students, colleagues, and ourselves to choose just one methodology narrows our research perspective and deprives us of the benefits inherent in each unique methodological approach (Duffy, 1986).
Mixed-methods research most generally speaks to the concurrent collection and analysis of both quantitative and qualitative data to answer separate but related research questions about singular phenomena of interest (Polit & Beck, 2017). According to some members of our community of scholars, mixed-methods research is envisioned as a third and distinct research paradigm, rather than a mere combining of quantitative and qualitative paradigms (Johnson & Onwuegbuzie, 2004). In traditional mixed-methods approaches, results of both quantitative and qualitative efforts are analyzed and reported concurrently to formulate a comprehensive discussion of study results.
Perhaps designing and conducting singular mixed-methods studies is not the most ideal approach to mixed-methods research. Perhaps our larger goal should be to develop mixed-methods programs of research over the trajectory of our careers. Since each paradigmatic approach, quantitative and qualitative, takes significant effort to plan and implement, singular focus on one methodological approach in each study may be most appropriate. This practice of focusing on a singular method at a time while committing to the utilization of multiple methodologies over the trajectory of one’s career may yield the most successful results. One should begin with the methodological approach appropriate to answering the first research question on the phenomenon, as posed by empirical research to date, and then build upon the preliminary research findings to examine the phenomenon from other methodological perspectives in a stepwise progression. Each methodological approach used to study the singular phenomenon of interest will undoubtedly uncover new discoveries. As each methodology yields new insights and greater perspective on phenomena of interest, our greatest comprehension of the complexity of real-world issues should come from utilizing multiple methods of study over time.
Envisioning a Mixed-Methods Program of Research
As nurse scholars, we work to better the lives of patients, including individuals, family units, groups/communities, and populations. No matter the phenomena of interest, there are ways in which work can be extended to larger or smaller populations. Similarly, there are ways to incorporate qualitative methodology for those who preliminarily focus on quantitative methods and ways for qualitative researchers to incorporate quantitative methods into their work as well. Figure 1 presents a multilevel model of patient populations of interest and methodological approaches that could be utilized to examine phenomena of interest in these patient populations. Note that this figure is meant to be illustrative, rather than exhaustive.
Methodological Approaches to Mixed Methods Research.
Individual-Level Methodological Approaches
Examining phenomena of interest at the individual level over the trajectory of one’s program of research may encompass any number of approaches, including qualitative methods such as interviews, participant observation, case study design, and reflexive journaling. Employing quantitative methods such as collection of biophysical measurements may enrich the data and understanding as well.
Family-Level Methodological Approaches
Research methodologies appropriate for implementation with families may include qualitative methods such as interviewing, reflexive journaling, or participant observation. At the same time, quantitative biophysical measurements may also be of value in this unit of analysis.
Group/Community-Level Methodological Approaches
Nursing research at the aggregate level with groups or communities of interest may take many forms. Qualitative methods appropriate for this level include focus group discussion, photo, voice, and reflexive journaling. Quantitative methods for group work may include survey methodology, instruments, and biophysical measurements.
Population-Level Methodological Approaches
Population-level nursing research generally relies on quantitative methods such as survey methodology, instruments, service provider/facility data, government surveillance data, or biophysical measurements. Although qualitative methods may not seem directly applicable to the study of populations, it may be appropriate to continue such work on a phenomenon of interest that first began with qualitative methods at the group/community level. Next, such work could be expanded to a population-level study employing quantitative methods to further elucidate one’s topic of interest.
Conclusions
Nursing research is in need of methods that reflect the multidimensionality and complexities that are inherent in nursing practice (Benner, Tanner, & Chelsa, 1996). This is the exact intention behind developing a mixed-methods program of research. Furthermore, using both quantitative and qualitative approaches over time would encourage collaboration within academic and practice departments as well as transdisciplinary research across units. Proliferation of mixed-methods research also allows for more meaningful dialogue between those traditionally placed into quantitative and qualitative camps.
In the end, developing a mixed-methods program of research yields a greater understanding of one another within our community of scholars, a larger audience for our research endeavors, a more robust perspective of the phenomena of interest, and ultimately, a more perfect understanding of the truth.
Footnotes
Declaration of Conflicting Interests
The author declared no potential conflicts of interest with respect to the authorship and/or publication of this review.
Funding
The author received no financial support for the authorship and/or publication of this review.