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J Athl Train. 2002 Oct-Dec; 37(4 suppl): S-168–S-173.
PMCID: PMC164420

Qualitative Research Applications in Athletic Training

Abstract

Objective: To explain the ethnographic, phenomenologic, and grounded theory approaches to qualitative research and to describe how these approaches can be applied to contemporary topics related to athletic training education.

Background: Athletic training education has recently experienced an increase in the use of qualitative methods, and various qualitative approaches are viable for answering many questions related to athletic training education. Ethnography focuses on describing a culture or subculture. Phenomenology focuses on the meaning of lived human experience. Grounded theory focuses on developing theory related to social processes. Each approach is contextual and attempts to facilitate insight and understanding related to the human condition.

Description: We provide an in-depth discussion of each of the selected qualitative approaches and explain the focus and unique data-collection and data-analysis strategies and identify the distinctive outcomes of each approach. Each research approach has a distinct purpose, and the specific application is driven by the questions asked. We also identify questions that are amenable to a specific method.

Applications: To better understand the interactive nature of education and learning, athletic training researchers are beginning to ask questions that require information to be gathered about meaning, contexts, culture, and processes. Such questions are best answered through the use of qualitative research methods that most commonly include ethnography, phenomenology, and grounded theory. In order for athletic training professionals to gain the most from the research conducted, it is essential that they have an understanding of the theoretic underpinnings of these methods and when each should be used.

Keywords: qualitative methodology, ethnography, phenomenology, grounded theory

The profession of athletic training has recently witnessed an increased use of qualitative methods to answer research questions pertaining to both educational and professional development issues.13 Although qualitative research methods generally share similar tenets and strategies,45 a variety of approaches is available. The ideal approach depends on the specific research questions posed and the purpose of the study.

As research in athletic training is continually expanded to form a considerable knowledge base, we are likely to witness the application of many forms of qualitative inquiry, necessitating that we fully understand the various approaches and research applications. Our purpose, therefore, is twofold. We will first provide an explanation of the 3 most commonly used approaches to qualitative research, specifically ethnography, phenomenology, and grounded theory.6 Second, we will give practical examples illustrating how a qualitative researcher might select and apply each approach to a specific research issue associated with athletic training. In order to provide readers with the necessary information and context, we have tried to tailor our examples to topics covered in this issue of the journal: clinical decision making and technology.

QUALITATIVE APPROACHES

A great number of qualitative approaches exist, including ethnography, phenomenology, grounded theory, hermeneutics, case studies, biography, ethology, ethnomethodology, historical, and phenomenography, just to name a few. Although the approaches may share common principles of qualitative inquiry, each is somewhat unique (Table) with respect to the central purpose of the study,21 data-collection and data-analysis strategies, and the outcome or end product that is derived.22

Table 1
A Comparison of Ethnography, Phenomenology, and Grounded Theory Qualitative Research Approaches

Ethnography

Ethnography has been identified as both a research product (ie, the written account of a culture) and a research process.7 Like grounded theory, ethnography corresponds to the theoretic requirements of symbolic interactionism23 and is based on social anthropology, which traditionally investigated small communities, although contemporary ethnography is applicable to any social research in everyday settings.8 As a research approach, ethnography focuses on describing and interpreting the beliefs, values, norms, and practices of cultures such as organizations, institutions, and communities.10,24 As such, ethnographers are interested in life ways or patterns of behavior within a culture or subculture,25 and the product of ethnography is a thick, rich description of a cultural setting.

Examples of athletic training-related research questions that suggest an ethnographic approach include, “What are the cultural influences that affect the professional development of certified athletic trainers in the high school setting?” and “What is the athletic trainer's role in an inner-city high school environment?” Although not a recent account, Field11 provided a good example of an ethnographic study in the health professions. Field specifically examined the beliefs and behaviors of nurses by investigating and describing their perspectives and how the work culture influenced them.

Ethnographic data-collection strategies fundamentally involve participant observation and prolonged fieldwork, but the extensive data collection involved in most ethnographies exceeds participant observation alone; ethnographers literally immerse themselves in the day-to-day activities and lives of the participants. Ethnographic data-collection strategies vary a great deal and tend to emerge over the course of a study. That is, a researcher maintains flexibility in the research design in order to employ the necessary variety of data-collection procedures to understand a specific culture. For this reason, ethnographers may traditionally focus on participant observations, then choose to use interviews, conversations, and surveys and collect artifacts such as memos, pictures, videos, etc, to describe a culture. Ethnographers often rely on specific individuals (gatekeepers) to help them gain access to the research site.

While many forms of data analysis are used by ethnographers,21 ethnographic data analysis often involves examining transcriptions from interviews, text from field notes, or observational summaries to create domains.25 Domains are composed of symbols, which are pieces of information, objects, ideas, or events that have specific meaning to those in a given culture.9 Once an ethnographer has identified domains, he or she generates a taxonomy to classify information and identify structures in the culture being studied.9 However, ethnographers do not limit themselves to this single data-analysis strategy. In fact, ethnographers may also use the grounded theory approach to organize and analyze their qualitative data. In addition, ethnographers commonly use quantitative data to understand various cultures. For example, in order to understand the extent to which a particular cultural group exhibited specific behaviors, an ethnographer would likely organize a matrix or coding sheet to record each time the behavior was witnessed.

Phenomenology

Phenomenology is both a philosophy and a qualitative research approach. As a philosophy, phenomenology is based on the initial work of Husserl, which was later extended by Heidegger and Merleau-Ponty.12,13 Husserl posited that experience is the basis of knowledge; phenomenology, therefore, has its hallmark in attempting to examine the meaning of human experience26 and describing the human life world.15 The context of the life world includes not only one's social and physical surroundings but also one's emotional, historical, and professional world, where meaning is created.13 As a qualitative research approach, phenomenology focuses on human action, experience, life world, and consciousness in order to understand the meaning a particular phenomenon has for that individual or group.14

Examples of athletic training-related research questions that suggest a phenomenologic investigation include, “How do nontraditional students experience clinical education with Approved Clinical Instructors who are substantially younger than themselves?” and “How do athletic training students experience student-centered learning in a clinical setting?” Kosowski27 offered an example of a phenomenologic investigation in the health professions. Her work examined how nursing students learn or experience professional nurse caring in the clinical context of nursing education.

Phenomenologic researchers often “bracket” their previous thoughts and experiences about the phenomenon. Bracketing involves thoroughly examining and then suspending one's beliefs so that a description about the phenomenon is not contaminated with the researcher's bias.28 Put another way, Munhall28 stated that the aim of bracketing is to “set aside our own beliefs for a period of time so that we can ‘hear’ and ‘see,’ as undisturbed as possible by our own knowing.” In traditional research reports, bracketing is accomplished in 3 ways. First, the author fully explains the basis for the study. Second, he or she identifies any presumptions about a phenomenon based on his or her previous experiences. Third, assumptions about phenomenology itself are disclosed. Bracketing allows researchers to be open to understand themselves and the participants as 2 distinctive beings and, ultimately, to discover perspectives about the phenomenon under investigation.28

Data-collection strategies for phenomenologic research often focus on in-depth interviewing of individuals so their experiences, and the meaning they give to the experiences, are shared. To ensure the richness of data, multiple and lengthy interviews are often conducted with participants. Moreover, many phenomenologic investigators interview individuals who have experienced a given phenomenon in groups. Interviews are transcribed in preparation for data analysis.

Giorgi14 identified 4 primary steps in phenomenologic data analysis. First, a sense of the whole phenomenon must be obtained. Second, the data from the interviews must be discriminated into meaning units, or smaller portions of data relating to the phenomenon. Third, the researcher transforms the participants' language with an emphasis on the phenomenon. Fourth, the researcher synthesizes the transformed meaning units into a consistent statement of the phenomenon's structure.

A sense of the whole phenomenon is obtained by reading and rereading transcripts, listening to audio recordings of interviews, and gaining a “sensitivity to the entire transcription from the participant's interview.”25 Meaning units are discriminated by examining the transcripts and identifying or specifying statements related to the phenomenon. Meaning units always maintain the exact words of the participants and are then reviewed by the researcher to later transform the language. Transforming the participants' language related to a phenomenon involves reviewing each meaning unit and expressing the meaning of the statement in language that is consistent with the discipline (ie, athletic training). The last step of analysis involves taking the transformed meaning units and synthesizing them to create an exhaustive description of the essence of the phenomenon, taking into account all of the participants' lived experience. Many phenomenologic researchers ask the participants to verify that the description is reasonable, based on their knowledge of, and experience with, the phenomenon. This is often referred to as a member check.

Grounded Theory

Grounded theory was originated by Glasser and Strauss20 in the mid to late 1960s and more recently refined by Strauss and Corbin16 in the late 1990s. The grounded theory approach makes explicit the purpose of generating theory that is grounded or formed on the data obtained in the study.20 Like ethnography, grounded theory is based on the theoretic framework of symbolic interactionism,17,18 which states that meaning is derived from social interactions. Grounded theory studies are most appropriately used for identifying and explaining social processes and creating theoretic models.29

Examples of athletic training-related questions that suggest a grounded theory approach include, “By which processes are students socialized into the profession of athletic training?” and “In what way do athletic training students become autonomous learners?” A recent study conducted by Pitney et al3 provides an example of a grounded theory investigation. One research question asked by these authors was, “What informal and formal processes socialize certified athletic trainers into their professional role in the NCAA Division I level?” Grounded theory procedures were used, and a socialization-process model was developed.

Grounded theory traditionally involves participant interviews and, to a lesser extent, observations.19 Interview and observation notes are transcribed and then analyzed using specific procedures, including open, axial, and selective coding.16 Data are collected until theoretic saturation or redundancy of information is achieved. This means that no new information is obtained or that the researcher is exposed to the same information over and over.

The initial step in data analysis is open coding, which occurs concurrently with data collection. This process involves “opening” the text contained in the transcripts and uncovering concepts such as thoughts, ideas, and meanings.16 Essentially, a researcher attempts to identify units of textual data that have significance based on the study's purpose. These units of data are then organized together into like categories and subcategories. Once the open-coding procedures are concluded, axial and selective coding are performed.

Axial coding is described as the process of relating the categories and subcategories in order to create “more precise and complete explanations about the phenomena” being studied.16 Axial coding attempts to make connections between and among the categories by exploring such things as the conditions that helped to create the category and the context in which the categories are embedded.17

Selective coding, which was originally called theoretic coding, involves identifying a category of data around which the others are integrated or linked.16,17 A central category is one that can explain the phenomenon or issue under investigation and all other categories related to it. Strauss and Corbin16 suggested that a central category may evolve from an existing category, or the researcher may create “a conceptual idea under which all the other categories can be subsumed.” Ultimately, selective coding is used to generate theory by creating a set of explanatory concepts linked to the stated purpose of the study.

An important point is that data collection and open coding occur simultaneously. That is, data collection and analysis are continuous and ongoing. Once theoretic saturation is obtained and data collection is terminated, then the researcher completes the axial and selective coding.

QUALITATIVE RESEARCH APPLICATIONS

Qualitative inquiry is potentially limitless in application to topics and content related to education. In the next section, we identify clinical decision making and technology, 2 topics germane to athletic training, with accompanying explanations of how each topic could be addressed by the qualitative approaches. Included within each topic are examples of purpose statements and descriptions of how qualitative researchers would address the subject differently depending upon their selected approach.

Clinical Decision Making

The recent interest in problem-based learning30 and critical thinking31 underscores the ability to learn appropriate decision making in a clinical setting as a significant outcome for athletic training education programs. Clinical decision making is a rich topic for qualitative investigation, considering that it can be influenced by specific contexts. The “win at all costs” attitude that permeates many athletic environments, for example, can raise unique questions regarding the cultural influences of making decisions, the decision-making processes in returning athletes to play, and what the clinical decision means for those involved. Figure Figure11 lists several questions that a researcher may pose about clinical decision-making and identifies the appropriate method for answering each question.

Figure 1
Potential research questions related to the topic of clinical decision making and the appropriate qualitative method to help answer each question.

An ethnographer might state, “The purpose of this ethnographic investigation is to gain insight and understanding about the culture of learning as it relates to developing clinical decision-making skills.” Ethnographers negotiate to gain access into a particular athletic training education program setting and spend a great deal of time observing the actions of the athletic training students, clinical instructors, program faculty, physicians, athletes, coaches, and administrators. They pay meticulous attention to the interactions of these individuals as they relate to decision-making processes, and they conduct interviews to further understand the culture. The ethnographer examines inter- and intradepartmental memos, learning modules, written assignments, injury evaluations, and other necessary documents. A great length of time is needed to fully experience the culture and understand the subcultures that influence the development of clinical decision-making skills. The end product is a thorough educational ethnography describing the athletic training education program culture and the learning of decision making among students.

From a phenomenologic perspective, clinical decision making is treated as a phenomenon, and the researcher might state, “The purpose of this phenomenologic investigation is to describe the essence and structure of learning to make clinical decisions as an athletic training student.” Athletic training students are first interviewed regarding their past experiences with clinical decision making. A second interview explores their current experiences with making clinical decisions, and a third interview integrates the 2 experiences and develops a thorough explanation of the students' overall experience.22 At interviews, the researcher attempts to understand the extent to which students make clinical decisions, the factors that influence their decision making, and how they make meaning from these experiences. Students are interviewed several times individually and may also be interviewed collectively to examine shared experiences. The researcher organizes the data into themes that ultimately provide an exhaustive description of how athletic training students learn to make clinical decisions.

A grounded theory researcher might state, “The purpose of this grounded theory investigation is to understand the process by which clinical decision making is learned by athletic training students.” Grounded theorists conduct in-depth interviews related to decision-making processes that athletic training students have experienced. Students, clinical instructors, and program faculty are interviewed and observed in action. The researcher collects and analyzes data simultaneously until theoretic saturation is reached, meaning that no new information is forthcoming. Grounded theorists create a process model of learning clinical decision making, resulting in a set of propositions explaining the phenomenon under investigation.

Technology

In many colleges and universities, technology is increasingly being used to promote student learning, reach multiple settings (via distance learning), and assist learning assessment (ie, electronic portfolios). As exemplified in the athletic training education literature, technology is being used for many purposes, including documenting clinical experiences32,33 and facilitating or assisting instruction.34,35 The use of technology, however, has been called into question36 due to its potential dehumanizing effects, although the problem may lie with how human beings relate to technology rather than technology itself.36 Technology is arguably a prime topic for qualitative inquiry, which is most appropriate for investigating humanistic aspects. Figure Figure22 raises several questions that a researcher might ask regarding the use of technology in athletic training education.

Figure 2
Potential research questions related to the topic of technology and the appropriate qualitative method to help answer each question.

An ethnographer focuses on understanding the culture of a given student group to learn its beliefs, values, perceptions, and general perspectives about the use of technology. A purpose statement might read, “The purpose of this investigation is to provide a cultural description of an athletic training program that uses many forms of technology to facilitate student learning.” An ethnography that gives a rich description of these perspectives and how culture influences the use of technology and, indeed, how technology influences a given culture, could help educators understand barriers and problems related to implementing technology.

From a phenomenologic approach, a researcher might state, “The purpose of this investigation is to understand how athletic training students experience technology in learning to be competent future practitioners.” Using the previously mentioned procedures, a phenomenologic investigator attempts to describe what technology means to the art of learning and applying content knowledge and skills in the athletic training context. Such a research approach facilitates insight at a humanistic level and entertains alternative perspectives to using technology in education.

Grounded theorists might state, “The purpose of this study is to gain insight and understanding and develop theory related to how technology is implemented and used among athletic training faculty.” Understanding how faculty view, use, and implement technology and how these processes affect students allows for the development of hypotheses for future testing and identifies the interactions between humans and technology.

IMPLICATIONS FOR ATHLETIC TRAINING

Qualitative research approaches are viable for answering many questions related to athletic training education and practice. Ethnography focuses on describing and interpreting cultural groups; phenomenology focuses on lived human experience; and grounded theory focuses on developing theory related to social processes. Each approach is contextual and attempts to facilitate insight and understanding related to the human condition. As researchers begin to investigate an increasingly complex athletic training environment, care must be taken to select and apply the appropriate methods. As suggested by Norton,19 the research method employed is not void of context or free of individual values. A researcher must, therefore, be reflective and understand the philosophic underpinnings and focus of the selected method. This paper offers an extended step toward understanding qualitative research methods for the readership of the Journal of Athletic Training, and we encourage continued dialogue regarding the application of qualitative inquiry within the profession of athletic training.

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Articles from Journal of Athletic Training are provided here courtesy of National Athletic Trainers Association