Article Figures & Data
Tables
- Table 1
Reasons for Conducting Observations in Primary Care Research, With Clinical Examples
Reasons to Observe Clinical Examples To understand behavior Describe whether or how staff follow clinical guidelines or study protocols To understand context Understand environmental factors influencing uptake of an intervention To understand process Examine at baseline how clinical preventive services are delivered in offices To recognize patterns Examine variations in how clinical preventive services are implemented across multiple practices To see what people are reluctant to discuss Identify perceived cultural taboos, for example, parents reluctant to discuss HPV vaccination for prepubertal children To gain direct personal experience and knowledge Explore patient experiences of undergoing clinical procedures, for example, the experience of colonoscopy preparation To move beyond selected perceptions Observe how patients respond to universal screening questions, for example, depression screening, intimate personal violence screening HPV = human papillomavirus.
- Table 2
Potential Reasons for Not Conducting Unstructured Observations in Primary Care Research, With Clinical Examples
Potential Reasons Not to Observe Clinical Examples Research participants will not tolerate an observer Research on illicit behaviors, such as drug abuse, or sexual practices relative to use of barrier devices or contraceptives Participants will change Possible change in adolescent bullying behaviors in presence behavior if observer is present (Hawthorne effect39) of observer; altered communication behaviors of couples dealing with interpersonal violence; compromising of therapeutic rapport with the added presence of a stranger Research will compromise participant decency, privacy Research on physician-patient-family interactions that involves clinical examination of private areas; for example, breast, pelvic, male genital, rectal examinations may not be tolerable Reporting observations would be stigmatizing or unethical Risks of stigmatization, which are present for any socially marginalized population Category Definition Focus Context The circumstances (both material and theoretical) under which observations are being conducted, as well as any historical, sociocultural, political, and other information that may directly (or indirectly) influence data collection Who is there as observer? What is your reason for being there? Why this location? What is your state of mind (eg, confused, unhappy, tired, excited)? What are your key areas of (observational) interest based on your prior research experience and/or scholarly background? Content The matter or substance of what happened Who are the participants? How are they related, if at all (eg, physicians and patients, work colleagues, friends or family members, cancer survivors)? How do participants interact? What actions/events are occurring? What is the timing/sequence of events? What quotes best capture the exchange that occurred? Concepts The larger theoretical context to which observations connect, either as evidence of or refutation of theory; theoretical insights that emerge from observations (as in grounded theory); directions for future research What have you learned that you did not know before? Does this observation help support or refute your hypothesis/expectations? How is this observation related to prior observations or to your reading of the scholarly literature? What are some potential implications of what you have observed? What new questions (research or otherwise) arise from this observation? How do participants respond to the presence of an observer? (Are they excited, anxious, skeptical, wary, etc?) What historical or current events may influence this response?
Additional Files
The Article in Brief
The 3 Cs of Content, Context, and Concepts: A Practical Approach to Recording Unstructured Field Observations
Michael D. Fetters , and colleagues
Background Most primary care researchers lack a practical approach for including field observations in their studies, even though observations can offer important qualitative insights and provide a mechanism for documenting behaviors, events, and unexpected occurrences.
What This Study Found The authors present an overview of qualitative field observations, a research methodology that could be useful to enhance health research projects using primary data collection. The paper illustrates a practical approach to collecting and recording observational data through a "3 Cs" template of content, context, and concepts. To demonstrate how the method can be used routinely in practice, the authors provide an example of a completed template and discuss the analytical approach used during a study on informed consent for research participation in the primary care setting of Qatar.
Implications
- According to the authors, the 3Cs template, which can be submitted for IRB approval, provides a straightforward mechanism for recording events and behaviors in almost any project involving human subjects.
Supplemental Appendix
Supplemental Appendix
Files in this Data Supplement:
- Supplemental data: Appendix - PDF file
