Abstract
Novice researchers must be trained to be ethical practitioners. This means more than just knowing how to gain ethics approval and being familiar with the codes of ethics. Rather, researchers need to develop their ethical awareness, perception, and judgment, and their capabilities to reflect and act when actually in the field, which we refer to as “situated research ethics.” We employ the concept of “formation” as a useful pedagogical frame accentuating the importance of integrating knowledge, research skills, and ethical capabilities in research practice. We suggest that a narrative approach is consistent with formation, and is useful in research ethics training. This approach uses storytelling and engaging with stories to enable the development of ethical know-how in research. We conclude the article by focusing on the benefits and limitations of this approach.
In training students in qualitative health research our aim is for them to become knowledgeable, skilled, and ethical practitioners. All three aspects are important; however, the focus of qualitative research training is often limited to skills acquisition and research methods. A more considered approach would also include the epistemology of research and an examination of the theoretical knowledge underpinning qualitative research. Our interest is on how to train novice researchers to act ethically in the field. We want to extend the current focus on research ethics training beyond gaining ethics approval from an ethics committee, or knowing a code of ethics. Although we do not dispute the value of procedural ethics, we want our novice qualitative health researchers to also develop “ethical know-how”; this comprises knowledge in research ethics, a set of ethical skills and capabilities, and also an ethical sensitivity of the local and contextual when actually in the field. We refer to this as “situated research ethics.”
As we go on to discuss, the focus of situated research ethics is on the particular rather than at the level of universal principles. Ethical questions in qualitative research might not necessarily comprise life-or-death dilemmas, but rather might be “ethically important moments” (Guillemin & Gillam, 2004, p. 262). For example, how, as a researcher, do you respond when a participant asks you a question about your personal life after you have spent an hour with them asking personal details about their private life; or how do you reply to a participant who asks you if the interview can be conducted in your home rather than theirs; or how do you respond to a funding body that wants access to your participants’ names and contact details? These are everyday, but nonetheless ethically significant, moments that occur in the conduct of research. The ethical questions in qualitative research might not have immediate visibility; however, as Brinkmann (2010) reminded us, less visibility does not mean less importance, but instead, calls for mindful and responsible research practice.
Our scope here is on qualitative health research. This is our own area of research and our experience base as educators of novice researchers. We justify our interest in qualitative health research for its often-heightened ethical stakes, for example when undertaking research about someone’s illness or collecting sensitive health information. Qualitative health researchers need to be aware of and appropriately educated to deal with often highly charged ethical situations as they arise in practice. Ethics committees or codes of ethics are not very useful when one is in the field and an ethical issue arises; there is a need to respond, often immediately.
As educators of qualitative health researchers, we believe that there are limited resources to guide us in training for ethical research practice. Much of the training focuses on the successful completion of human research ethics review applications, which might extend to knowledge of national or institutional codes of research conduct. When it comes to situated research ethics we believe there is a gap. To address this gap, we draw on the concept of “formation” proposed by the Carnegie Foundation for the Advancement of Teaching (2011). This concept has been used to develop approaches to the professional education of clergy, engineers, lawyers, nurses, and physicians. We suggest that this concept is also useful for the education of researchers. The idea of formation refers to a kind of education leading to an integration of knowledge and moral virtue. The concept of professional formation reminds us that the education of researchers is a complex process; it requires more than the development of intellectual expertise, and also needs to encompass the development of character and habits of thinking, feeling, and acting. This could be thought of as developing practical wisdom, or what Aristotle referred to as phronesis (Irwin, 1985).
Formation requires developing capabilities of reflection and awareness while building on students’ existing capacities and experiences; what is being formed is a sense of professional identity (Walker, Golde, Jones, Bueschel, & Hutchings, 2008). In our discussion of formation, we refer to training. The term training is often interpreted to mean low-level, mechanical learning, and could be seen as a contradiction to our argument. However, we purposely use training for two reasons; first, the concept of formation as proposed by the Carnegie Foundation (2011) is based on a particular understanding of training and integrated learning; and second, we use training, where appropriate, to emphasize our focus on practice and situated learning.
We propose that the concept of formation provides us with a useful pedagogical frame in educating novice researchers in situated research ethics practice. However, as educators we are still faced with how to move from the conceptual level to actually educate novice qualitative health researchers to conduct ethical research in practice. This is where we turn to a narrative approach. We have used this successfully in the ethical training of health care practitioners, and suggest that it could be similarly applicable to qualitative research training. A narrative approach is a useful learning strategy that encourages students to reflect on their own experience and that of others. Equipped with the appropriate skills with which to engage with the narrative, we suggest that this can enable novice researchers to develop the ethical capabilities we think are necessary in situated research ethics practice.
In support of our argument we make three points. First, we argue that training qualitative health researchers in ethics must address situated research ethics as well as the importance of ethics review and codes of ethics. Second, we propose that the concept of formation is a useful pedagogical frame to develop this training. Third, we suggest the use of a narrative approach to provide a learning strategy to inform situated research ethics training. We suggest that using a narrative approach in the classroom enables students to explore what they would do in the field when faced with ethical issues. In the process of telling and engaging with stories, students are able to develop a burgeoning sense of professional identity as researchers.
Situated Research Ethics and Qualitative Research
The term situated ethics has recently been adopted by a number of authors in the research context (Calvey, 2009; Danaher & Danaher, 2008; Heggen & Guillemin, in press; Piper & Simons, 2005; Simons & Usher, 2000). With situated research ethics the focus is placed on the local and the specific rather than at the level of universal principles. A situated ethics approach takes into account a temporal and spatial context; it is concerned with these participants, in this place, at this time, with these concerns. Teaching and learning research ethics from a situated perspective is related to Lave and Wenger’s (1991) radical and important rethinking of learning. Lave and Wenger argued for a conception of learning not based on receiving factual knowledge, but rather being about social engagement and interaction.
In our use of situated research ethics, we focus on qualitative health research practice, which is often characterized as uncertain and ambiguous, where the ethical way to proceed is not always obvious. For instance, gaining a participant’s signature on a consent form at the beginning of the interview might be perceived as satisfying the requirements of the ethics committee and institutional codes of ethics. However, if, in the process of the participant signing the consent form, it is clear that the participant had not actually read the project information or indicated that they had understood the risks and benefits of the research, had informed consent actually been achieved? We argue that a signed consent form does not necessarily equate to informed consent; but what does the researcher do in this situation? We argue that with ethical challenges such as this, researchers need to apply discretionary practical judgment from a situated perspective.
Situated research ethics specifies that a researcher’s ethical practice should be addressed with a mindful attentiveness to the local and the particular without an overreliance on universal principles. Brinkmann’s (2007) view is that the qualitative researcher’s prime duty is to live up to what the Danish philosopher and theologian, Knut Ejler Løgstrup, called the ethical demand; namely “to handle with care those aspects of the other person’s life that are in their hands” (Brinkmann, 2007, p. 132). To meet this demand requires ethical capabilities grounded in the situatedness of research, rather than on universal rules and codes of ethics. As with the example cited, a signed consent form did not necessarily mean that informed consent had been achieved. We are not suggesting that ethical guidelines are not useful; we agree that they serve as helpful “rules of thumb.” However, there are no specific rules for every ethical instance, and to try and specify recommendations for every possibility is not achievable or desired.
The Framework of Formation
Learning to become a qualitative health researcher involves the mastering of doing research in complex and sometimes unpredictable situations. The researcher must constantly weigh up what is ethically at stake while still aiming to achieve the goal of research, which is to produce new knowledge. In training researchers we are aiming to produce researchers who have the capacity to integrate knowledge with methodological skills and ethical know-how. The goal of integrating analytical insights with practical and ethical judgment and action requires certain pedagogical approaches. We suggest that the concept of formation provides a useful frame to achieve this goal.
The concept of formation in education has its origins in studies of the professions undertaken by the Carnegie Foundation. The Preparation for the Professions Program is a 10-year series of comparative studies of education across the professions, with publication of reports on the education of clergy (Foster, Dahill, Golemon, & Tolentino, 2005), engineers (Sheppard, Macatangay, Colby, & Sullivan, 2008), lawyers (Sullivan, Colby, Wegner, Bond, & Shulman, 2007), nurses (Benner, Sutphen, Leonard, & Day, 2010), and physicians (Cooke, Irby, & O’Brien, 2010), and in doctoral education (Walker et al., 2008). These researchers have used the concept of formation to study how professionals “learn to balance technical, intellectual and moral equations” (Shulman, 2004, p. xv). Every field of professional education studied by the Carnegie Foundation concluded that the most “overlooked aspect of professional preparation was the formation of a professional identity with a moral and ethical core of service and responsibility around which the habits of mind and of practice could be organized” (Schulman, 2004, p. ix). Formation refers to an evolving experience by which a person is prepared for a particular task or is made capable of functioning in a particular role. By using the notion of formation, we signal a constitutive and transactional view on the training of researchers.
Sullivan (2005) explained the status of formation and apprenticeship in professional education as having a long history of contrasting conceptions of knowledge and traditions of education. Sullivan suggested that ignoring the concept of formation stemmed from “the contemporary academy’s preference for analytic-paradigmatic over narrative-practical education” (2005, p. 220). Walker et al. (2008), in their study of doctoral education, proposed three principles for student formation; first, the development of increasing independence and responsibility; second, integration of learning across different contexts and arenas; and third, collaboration with peers and educators. These principles are useful when considering the education of novice researchers in situated research ethics. We are striving to produce researchers who are independent in their ability to conduct qualitative health research. Furthermore, we want researchers who are aware of their ethical responsibilities and obligations, and can fulfill them. In training ethical researchers, there needs to be learning that integrates knowledge, research skills, and ethical capabilities. A notion of situated research ethics accentuates the importance of this integration in the situatedness of the research.
Formation involves the close integration of three types of learning: knowledge, skills, and ethical capabilities. In relation to qualitative research training, the first type, knowledge or cognitive learning, is linked to the conventional favoring of analytical reasoning and argument in research. The second type of learning refers to how to conduct research; this involves both the overt learning of different methods (e.g., how to develop interview schedules) and tacit learning, such as how to establish rapport with your participants or how to respectfully close an interview. The third type of learning involves students learning the ethics of qualitative research practice through acquisition of practical wisdom, or phronesis. This presupposes more than consulting a set of rules or a code of ethics, but requires developing a professional virtue, including phronesis.
The Carnegie (Carnegie Foundation, 2011) studies of education for the professions emphasized that although the student’s educational experience might focus on one type of learning or might emphasize one over the others, integrated learning and development across all three is necessary (Benner et al., 2010). Although we agree that these three types of learning do not function independently of one another in qualitative research, our emphasis in this article is on the development of ethical practice, in an effort to address what we believe is a gap in the current training of qualitative researchers. We have suggested that the concept of formation offers a useful pedagogical frame for the education of novice qualitative researchers in situated research ethics; however, we are still left with the question of how to educate students. We need a relevant and accessible learning strategy to enable this integrated learning approach and provide an empirical base.
The Narrative Approach
We propose the use of a narrative approach as a useful learning strategy for educating qualitative health researchers in situated research ethics so as to develop practical ethical wisdom. The outcome of this approach is increased capacity for critical reflection in relation to ethical practice, and increased awareness of its importance. A narrative approach is consistent with the notion of formation. As Sullivan noted, education is first and foremost meant to be a reflective training of insight, and “its chief tools are use of narratives, cases, questioning, and dialogue” (2005, p. 220).
There is a strong tradition of using narratives in health care training, particularly in medical schools that include medical humanities in their curriculum. The narrative approach to health care ethics education involves the use of stories, either personal stories or from relevant literature, to encourage ethical awareness, reflection, and the acquisition of humane values. We have successfully used an adapted narrative approach for teaching health ethics (Guillemin & Gillam, 2006, 2007; Guillemin, McDougall, & Gillam, 2009), and suggest that it might be similarly useful for research ethics education.
An obvious question is, Why narratives? 1 We concur with the point made by many scholars in this area that narratives help us make sense of our lives (Hunter, 1996; Montello, 1995; Schafer, 1981). We tell, listen to, and engage with narratives not just for the sake of it, but rather this process helps us to make sense of ourselves and our life experiences. Narratives are now extensively used in research; some recent examples of this include Hopfer & Clippard (2011); Hall (2011); De Haene, Grietens, and Verschueren (2010); and Holloway and Freshwater (2007). We extend this to situated research ethics and propose that a narrative approach can assist in the formation of ethical know-how or practical wisdom with novice researchers. In a narrative approach to teaching research ethics, the central component of the teaching method is telling and reflecting on personal narratives about experiences in the research setting. The narratives need to involve ethical issues, notably issues encountered in everyday research practice. Our experience in using narratives in teaching highlights their dialogic nature; there is engagement between a storyteller and a listener. Moreover, one story invariably leads to another, and another. This process of getting caught up in the storytelling means that learning is experiential and often ongoing.
In discussing our proposal for a narrative approach, we first outline the kinds of stories that might be useful in research ethics training. Second, we discuss the process of storytelling, using examples from our teaching practice. Third, we examine how to engage with stories to enable the development of ethical know-how, and finally, we examine the potential outcomes of this approach.
The Source of Stories
In using a narrative approach for situated research ethics training it is important that the story reflects the situatedness of qualitative research practice. The story should be about a real-life ethical issue in research practice involving ethically important moments; being “real” prepares student researchers for future research practice. From our experience it is often these everyday ethical issues that leave researchers feeling troubled and uncertain as to how to act. The story should be open to interpretation, without an obvious right or wrong way to proceed. This uncertainty provides rich grounds for ethical exploration and development.
We appreciate that for some students starting out in research, their research experience base might be limited. In these situations we have relied on stories from our own experiences, or have used existing stories from the qualitative research literature. An important resource in teaching has been to invite more advanced students who have had some research experience to come and share their stories. An example of this from our teaching was a more advanced doctoral student telling the story of a participant in a longitudinal study whom she had interviewed a number of times. The participant was due to undergo surgery and asked the researcher if she would visit her in hospital after the surgery. This example of an ethically important moment served to clearly illustrate situated research ethics. Involving more advanced students had the added benefit of peer learning, wherein the storyteller provided both the story and her reflection on the ethical issue she encountered. Another example involved asking students to tell stories of being a covert participant observer in a public setting, such as observing people’s shopping behavior; their reflections on covertly observing and note taking of other people’s behavior provided fascinating accounts of ethical issues in the field. Students benefited from the skills gained in these exercises, but of greater relevance here, it enabled them to gain valuable experience of how to deal with ethical issues when undertaking research.
The Process of Storytelling
In using a narrative approach, we suggest that it is important that the stories should be told in the first-person voice. A narrative told in the first person ensures that researchers focus on their own experiences, reflections, uncertainties, and doubts. In qualitative research, the researcher’s subjectivity plays an important role in the construction of knowledge. Using a narrative approach with first-person narratives is consistent with this, while at the same time shaping ethical consciousness. This emphasizes the subjectivity of situated research ethics and counteracts the objective case-study approach often used in educating health care professionals. The medical case study is often written in a dispassionate voice; for example, “Mr. K was a 44-year-old laborer who was diagnosed with diabetes.” The absence of the first-person voice in these kinds of case studies means that the storyteller is absent and does not take ownership of the story; moreover, the detached case study often makes it difficult to recognize the ethical significance within the story. In contrast, a story told in the first person invites us to engage with it, both intellectually and emotionally; for example, “I had cared for Mr. K, a 44-year-old laborer, in the five years since he had first been diagnosed with diabetes.” The use of the first person encourages us to join in the meaning-making process. On a practical note, we have used both verbal and written stories. Although verbal stories presented the advantage of seeming more immediate and engaging, written stories lent themselves much more to in-depth interrogation. We have found that both forms work, but the choice is largely dependent on the educational context and setting.
Engaging With Stories
Having outlined what we believe are important features of the story and the process of storytelling, we turn to some suggestions for promoting engagement with the stories. In our previous work with educating health care practitioners, we found it helpful to use the questions presented in Table 1 as triggers for ethical engagement These questions were not designed to be used as a checklist or strict template; rather, we offer them as interpretive triggers. The questions do not have to be considered in any particular order, nor will they be useful for all narratives. The point here is not the questions themselves, but where they lead to. Using these questions to interrogate the stories of situated research ethics offers the potential for ethical reflection and engagement. They serve to develop ethical know-how. The questions were adapted from a number of sources (Frank, 2010; Jones, 1999; Nelson, 2002; Zoloth & Charon, 2002); in particular, we borrowed from Nelson in thinking of these as naming questions, sideways-looking questions, and forward-looking questions. Guillemin & Gillam (2006) offered a detailed discussion of the questions and how they can be used to promote ethical engagement.
Trigger Questions for Promoting Engagement With Stories
In using these interpretive questions in our teaching, we have found that they work to structure engagement with the stories in a flexible way. Posing the questions opens possibilities for ethical engagement. It is important to note that the aim is not to arrive at some concluding statement about the right or wrong way to act in research practice; rather, this approach opens up the potential for addressing the possibilities. It allows examination of the relevant ethical principles in the story. This requires knowledge of the key ethical principles that govern research ethics, knowledge that we think is imperative for researchers. The role of the narrator is explored in relation to the other characters; this requires reflexivity on the part of the narrator to examine his or her role in the event being portrayed. The way the story is cast, together with who is included and excluded, can offer important ethical insights. Asking what is ethically at stake in the story is often pivotal for synthesizing the ethical importance in the story. Finally, asking how it could have been otherwise offers possibilities for future practice. As we have stressed, when faced with ethical issues in research practice, there is a need to act. Giving consideration about how the story can inform future practice is imperative in the formation of ethical researchers.
Conclusion
Our experience in teaching novice qualitative researchers has led us to look for effective teaching and learning strategies for the development of knowledge, research skills, and ethical capabilities. Although we firmly believe that these three types of learning should be integrated, in this article we pay particular attention to students’ development of ethical know-how in situated research ethics. Focusing on the situatedness of research highlights its complexity and uncertainty, and calls on the researcher’s ethical mindfulness and ability to act in difficult ethical situations. Taking a situated approach points to the need to develop researchers’ awareness and capabilities about how they relate to participants in specific contexts and situations. A narrative approach provides a useful learning strategy to deal with the many different situated contexts of qualitative health research.
Over the last decades there has been an increased focus on research ethics. Although we welcome this and believe that this is important and timely, often the focus is on procedural ethics and a view that once ethics approval is gained from an ethics committee, then research ethics has been satisfactorily addressed. There is a risk that teaching only procedural ethics underplays the importance of cultivating researchers’ ethical awareness, skills, and capabilities. Although procedural ethics is of utmost importance, learning to be ethical also has to comprise situated research ethics and the formation of researchers. The concept of formation is helpful in encouraging us to consider the training of researchers in terms of developing professional identity. This is consistent with Jerome Bruner’s proposal to shift from “learning about” to “learning to be” (Walker et al., 2008 p. 133). Although the concept of formation is most frequently used in relation to the education of professionals, we follow the lead of Walker et al. in extending this concept beyond the formation of professionals, to the development of scholars and researchers.
Developing researchers’ professional ethical identity is particularly important in the current research context, in which there are increasing pressures on researchers. Research misconduct is an area of increasing concern in research institutions. The strategies in place to uncover research misconduct and failure to comply with codes of conduct are obviously important and legitimate; however, there is also a need to build and strengthen the importance of research ethics based on trust and professional virtue.
To develop the ethical capabilities of student researchers requires rethinking on the part of educators. Teachers must learn how to model their ethical research practice in their teaching, and to accept a different role as a teacher whereby the focus is not on the didactic delivery of knowledge and skills, but includes ethical know-how and practical wisdom. Interrogating narratives as a learning strategy for formation requires educators to be ethically mindful and able to integrate analytical insights with practical judgment and action in their own teaching (Sullivan & Rosin, 2008). We do not suggest that our proposed approach is a guarantee for developing ethical and responsible research practitioners, nor do we suggest that it is the only tool for developing ethical research practice. However, we suggest that it is a constructive teaching and learning approach with a potential for cultivating qualitative health researchers with ethical capabilities for being mindful and reflective in practice. Although our focus here has been on qualitative health research, this approach is applicable across a much broader range of research fields and practices. We believe that further investigation of this approach is warranted. This will allow its full potential to be examined across different research fields and provide different empirical examples that can benefit educators and learners of research ethics practice.
Footnotes
Acknowledgements
We thank the anonymous reviewers for their helpful and insightful comments on earlier drafts of this article.
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
The authors received no financial support for the research, authorship, and/or publication of this article.