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August 2014 Article of the Month
 
This month's article selection is by Chaplain John Ehman,
University of Pennsylvania Medical Center-Penn Presbyterian, Philadelphia PA.

 

Grossoehme, D. H. "Overview of qualitative research." Journal of Health Care Chaplaincy 20, no. 3 (2014): 109-122.

 

SUMMARY and COMMENT: This month's article is an excellent introduction to qualitative methodology for chaplains, from a leader in spirituality and health research. Daniel H. Grossoehme writes in a clear, personal, and effective style to engage CPE students new to research, whether they are interested in conducting original studies or becoming informed consumers of the literature. Supervisors should consider this a core article for any CPE research curriculum.

The author notes at the outset that qualitative research "can be the most accessible means of entry for chaplains into the world of research because, like clinical conversations, it focuses on eliciting people’s stories" [p. 109], and at various points he makes connections between chaplains' natural tendencies or accomplished skills and the venture of research. For instance, chaplaincy training may be useful for "writing good open-ended questions that elicit stories" [p. 110], and phenomenological methodology may be especially "chaplain-friendly … because it is all about the search for meaning" [p. 116]. Grossoehme draws upon his own story, from his early CPE experiences in working through the verbatim process to his practice as a professional, and this approach may help students see themselves in relation to research per se and understand the methodology as a "tool that chaplains can use to develop new knowledge and contribute to professional chaplaincy’s ability to facilitate the healing of brokenness and disease" [p. 121].

The article has in many places the quality of an almost private communication to an inquiring student. For instance, in explaining grounded theory as "the method of choice when there is no existing hypothesis to test" [p. 114], Grossoehme provides a few verbatim exchanges from one of his studies' interview transcripts (which students should recognize as similar in form to a CPE verbatim) and then says of the process of coding the data:

Focus on the action in the narrative. Although it can be difficult, you as a researcher must try very hard to set your own ideas aside. Remember you are doing this because there is no pre-existing theory about what you are studying, so you should not be guided by a theory you have in your mind. You must let the data speak for themselves. [p. 115]
That's the kind of advice that students should be able to grasp for research, and it also is guidance that could be turned back onto CPE verbatim exercises as students become aware of how they are at risk of reading meaning into others' stories instead of hearing the meaning out of those stories.

The author emphasizes interview approaches to data collection (though with some attention to focus groups), pointing up issues of rigor, validity, and reliability. He then addresses how qualitative research may be pursued through ethnographic, grounded theory, and phenomenological studies; and for each of these three there is consideration of sampling, design, and analysis. Brief illustrations from his own work and others' give a good sense of what it is like to carry out a project: especially what basic decisions need to be made in planning, implementing, and writing. Throughout, Grossoehme provides a mid-level view of methodology that describes the process of research without getting bogged down in technicalities that could be overwhelming to chaplains new to the field.

Finally, the article covers practical and ethical concerns, from the wisdom of using two audio recorders in interviews (in case one fails) to strategies for transcribing non-verbal gestures, from the need to protect privacy to the obligation to plan for potential risks to the study participants. A section also raises the issue of power dynamics and the "possibility of subtle coercion" [p. 120] of subjects, either from the "inherent power differential between a research participant and the investigator" [p. 120] or from the social pressures that can exist in focus group settings.

This is an article meant not just to introduce chaplains to research but to encourage and inspire them to think of the possibilities for qualitative methodology to be an "accessible way for chaplains to contribute new knowledge regarding the sacred dimension of people's lived experience" and an "opportunity to develop working relationships with physicians, medical anthropologists, nurses, psychologists, and sociologists, all of whom have rich traditions of qualitative research" [p. 121]. Moreover, while it is not a stated goal of the article, chaplain readers may be spurred to think beyond how they could be suited for research, to reflect on how the discipline of conducting research might help them to become more intentional and accurate hearers of people who tell their stories in a purely pastoral context. This reader believes that chaplain students would benefit from the article, whether or not they plan to undertake a research project.


 

Suggestions for the Use of the Article for Discussion in CPE: 

This article would be suited for students early on in a CPE research curriculum, and perhaps also as a refresher prior to their contemplation of a residency project. Discussion could begin with students sharing how well they relate to qualitative methodology. Do they, for example, see connections between a research process of finding meaning in others' stories and a pastoral process of hearing and understanding hospital patients' stories? What might be similarities and differences in those two processes? What do students make of the various statements in the article along the lines of how "[q]ualitative investigators are not disinterested outsiders who merely observe without interacting with participants, but affect and are affected by their data" [p. 110], or "the investigator is a part of the experience being studied and the investigator’s values play a role in the investigation" [p. 117]? Discussion could explore especially the statement, "Simply asking 'research' questions can itself be a chaplaincy intervention: what we ask affects the other person and can lead them to reflect and change" [pp. 110-111, and see Related Items of Interest, §II (below)]. Also, are students drawn to any particular form of qualitative method, and why? Finally, students might consider the section on Ethical Issues, particularly the points about "power differential" [p. 120] and about developing a plan for research participants' negative reactions. How salient are such issues for students in their pastoral practice, and how might these concerns be addressed during a study?


 

Related Items of Interest:

I. Other recent work by Daniel Grossoehme was cited in the July 2014 Article-of-the-Month's Related Items of Interest. See also the website for the Grossoehme Lab at Cincinnati Children's Hospital.

 

II. Our featured author writes, "Simply asking 'research' questions can itself be a chaplaincy intervention: what we ask affects the other person and can lead them to reflect and change" [pp. 110-111]. For more on this thought, see his editorial: Grossoehme, D. H. "Research as a chaplaincy intervention." Journal of Health Care Chaplaincy 17, nos. 3-4 (2011): 97-99. [This article is part of a theme issue of the journal regarding chaplains' research. See the table of contents.]

 

III. Our article notes [p. 110] the Qualitative Research Guidelines Project of the Robert Wood Johnson Foundation. This is a web resource "for people developing, evaluating and engaging in qualitative research projects in healthcare settings" [--from the project home page]. Access at the site at www.qualres.org.

 

IV. For other basic introductions to qualitative research, see the following (but note that the VandeCreek book is aimed particularly at chaplains):

Mayan, M. J. "Essentials of Qualitative Inquiry." Walnut Creek, California: Left Coast Press, 2009. [Originally published through the Qual Institute Press in 2001 as An Introduction to Qualitative Methods: A Training Module for Students and Professionals.]

VandeCreek, L., Bender, H. and Jordan, M. R. "Research in Pastoral Care and Counseling: Quantitative and Qualitative Approaches." Eugene, Oregon: Wipf and Stock, Publishers, 1994/2008. [The first part of this book, focusing on quantitative research, was originally published in 1988 through the Journal of Pastoral Care Publications by Larry VandedCreek, DMin, as A Research Primer for Pastoral Care and Counseling.]

Weiss, R. S. Learning from Strangers: The Art and Method of Qualitative Interview Studies. New York: The Free Press, 1995. [This is a general text on interviewing techniques and dynamics. Most of the book itself is viewable online though a Harvard site.]

 

V. For an unusual approach to introducing qualitative research through poetry, see the following article originally intended for a nursing audience:

Raingruber, B. "Assigning poetry reading as a way of introducing students to qualitative data analysis." Journal of Advanced Nursing 65, no. 8 (August 2009): 1753-1761. [(Abstract:) AIM: The aim of the paper is to explain how poetry reading can be used to teach interpretive analysis of qualitative data. BACKGROUND: A number of studies were located in the nursing literature that focused on using poetry to help students develop empathy for patients, to teach students to reflect on their own practice, and to assist them in developing self-understanding. No studies were found that described the use of poetry reading as a way of teaching the skill of interpretive analysis. There are, however, a number of parallels between the principles of poetry reading and qualitative analysis that suggest that this method of teaching would be successful. DATA SOURCES: International papers published on PubMed, Medline, and CINAHL were reviewed to identify challenges facing educators and ways of teaching the process of qualitative data analysis using poetry reading. FINDINGS: Using poetry reading to teach skills of qualitative data analysis helps motivate students, cultivates a reflective mindset, and develops the skill of working as a member of an interpretive group. Framing interpretive work as being like reading poetry helps students pick up more quickly on the art that is a major component of the work. This approach also helps students learn the importance of cultural and contextual particulars as they begin analyzing qualitative data. CONCLUSION: Using poetry reading to introduce students to the complex skill of qualitative data analysis is an effective pedagogical strategy.]

 

VI. Chaplains might be interested in an example of ethnographic research which explored CPE programs: Simon J. Craddock Lee's In a secular spirit: strategies of Clinical Pastoral Education, reviewed by Larry VandeCreek for our October 2003 Article-of-the-Month. The article itself is available online to the Network by permission of the author.

 

 


If you have suggestions about the form and/or content of the site, e-mail Chaplain John Ehman (Network Convener) at john.ehman@uphs.upenn.edu .
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