Helena Liira1,2, Gabrielle Brand3, Hans Thulesius4,5. 1. a University of Helsinki , Helsinki , Finland. 2. b University of Western Australia , Perth , Australia. 3. c Health Professions Education , University of Western Australia , Perth , Australia. 4. d Department of Clinical Sciences, Family Medicine , Lund University , Malmö , Sweden. 5. e Department of Research and Development , Region Kronoberg , Växjö , Sweden.
Primary care faces many challenges with increasing complexities, multi-morbid aging patient populations and diminishing resources for health care. Qualitative research increases our understanding of real world issues, including how practitioners think and how our patients experience care. Recently 70 senior academics from 11 countries wrote an open letter to the BMJ challenging the journal to broaden their view on the value of qualitative health research by publishing a formal policy and criteria for judging qualitative and mixed method research [1]. Interestingly, they argued their stance by citing one of the most influential papers published in BMJ was an ethnographic study that explored how primary care clinicians make individual and collective healthcare decisions [2].In this issue of Scandinavian Journal of Primary Health Care (SJPHC), an ethnographic field study conducted by Ole Olsen draws on this research by exploring how 50 Danish GP’s ‘think and act’ when presented with new evidence that planned home birth for low risk women is as safe as a planned hospital birth with fewer intervention and complications [3]. The importance of this contribution is that it provides rich insights into variations amongst clinician’s readiness to change information practice.Also in this issue of SJPHC three professors of general practice from Denmark, Norway and Sweden highlight the important role and use of qualitative methods in PhD theses in Scandinavia [4]. They propose that whilst general practice is taking the lead in qualitative research, institutions are offering very little formal teaching or training in qualitative research methodologies, particularly for multimethod PhD theses. The authors offer a series of recommendations, including developing standard evaluation criteria that consists of transparently documenting the qualitative analysis processes, including the researcher’s reflexivity and honest accounts of methodological challenges that are inherent in the doing of qualitative research.This opinion paper also opens the discourse on the importance of growing knowledgeable supervisors with qualitative methodological skills and experience from a healthcare background. This is supported by a recent Australian qualitative study of GPs who have a PhD qualification [5]. The study found that in order to overcome the isolation and lack of critical mass in general practice research, it is necessary to improve research training, build professional networks, facilitate mentoring, and improve the way we market general practice research to the wider community.So, what are the best ways to train supervisors for qualitative health research? In Finland, since 2007 a one-year research course has encouraged primary care PhDs and also taught qualitative methods [6]. As a next step, the University of Helsinki has created formal training for supervisors of PhDs in primary care that focuses on research methods, funding and building networks.We need to create ‘communities of practice’ whereby groups of supervisors regularly interact and engage in the practice of sharing resources, tools and experiences in qualitative research [7]. In Perth, Australia, a Medical Humanities network has been formed to enhance teaching, research and cross collaboration between medicine, health, arts and social science disciplines. The strength of this type of network lies in the enhanced visibility of qualitative research that focuses on ‘meaning over measurement’ [8] and honours the complexity of human lives and the sociocultural conditions in which they live.
Authors: Trisha Greenhalgh; Ellen Annandale; Richard Ashcroft; James Barlow; Nick Black; Alan Bleakley; Ruth Boaden; Jeffrey Braithwaite; Nicky Britten; Franco Carnevale; Kath Checkland; Julianne Cheek; Alex Clark; Simon Cohn; Jack Coulehan; Benjamin Crabtree; Steven Cummins; Frank Davidoff; Huw Davies; Robert Dingwall; Mary Dixon-Woods; Glyn Elwyn; Eivind Engebretsen; Ewan Ferlie; Naomi Fulop; John Gabbay; Marie-Pierre Gagnon; Dariusz Galasinski; Ruth Garside; Lucy Gilson; Peter Griffiths; Penny Hawe; Jan-Kees Helderman; Brian Hodges; David Hunter; Margaret Kearney; Celia Kitzinger; Jenny Kitzinger; Ayelet Kuper; Saville Kushner; Andree Le May; France Legare; Lorelei Lingard; Louise Locock; Jill Maben; Mary Ellen Macdonald; Frances Mair; Russell Mannion; Martin Marshall; Carl May; Nicholas Mays; Lorna McKee; Marissa Miraldo; David Morgan; Janice Morse; Sarah Nettleton; Sandy Oliver; Warrren Pearce; Pierre Pluye; Catherine Pope; Glenn Robert; Celia Roberts; Stefania Rodella; Jo Rycroft-Malone; Margarete Sandelowski; Paul Shekelle; Fiona Stevenson; Sharon Straus; Deborah Swinglehurst; Sally Thorne; Göran Tomson; Gerd Westert; Sue Wilkinson; Brian Williams; Terry Young; Sue Ziebland Journal: BMJ Date: 2016-02-10