Running head: THE IMPACT OF PEER INFLUENCE ON TEENAGERS IN EMOTIONAL DISTRESS 1 The impact of peer influence on teenagers in emotional distress According to a survey carried out by parent further research center (2017), only 10 percent of teenagers said that they had never been influenced by peer pressure. This is a clear indication that most teenagers will always turn to their peers in an effort to have a sense of belonging (Sturaro and van Lier, 2011). With teenagers seeking comfort in other teenagers, the question regarding the impact of peer influence on teenagers in emotional distress arises. The need to understand how teenagers who are in emotional distress end up being affected whenever they turn to their peers for emotional support arises from the fact that most teenagers tend to utilize the most ineffective ways to be able to get through emotional distress thereby making the situation even worse. There is need to understand why teenagers in emotional distress tend to turn to their peers instead of their parents or an adult who can guide them on the best way to handle their situation since peer influence on such teenagers usually ends up having a negative impact on their lives. This is majorly attributed to the fact that most teenagers tend to use harmful ways to be able to cope with distress. This is so since according to a survey carried out by pew research center (2017), about 41% of teenagers turn to alcohol and drugs when in distress (Desilver, 2018). This is an alarming figure because of over 54 % of teenagers struggle with either depression or anxiety. This problem has become a cause for concern due to the lack of extensive research geared towards understanding the impact that peer influence is having on teenagers in emotional distress. For this reason, this study will be of the essence in determining the negative impact of peer influence on teenagers suffering from emotional distress to encourage adults that are part of THE IMPACT OF PEER INFLUENCE ON TEENAGERS IN EMOTIONAL DISTRESS 2 their lives to be more engaged in helping them to get through such periods rather than allowing them to turn to their fellow teenagers. The intended audience for this research is parents as well as family therapists. This is so since these are adults who usually interact with teenagers from time to time. Therefore, by knowing the dangers that teenagers in emotional distress are exposed to whenever they turn to their peers for emotional support, they will end up encouraging teenagers to turn to them instead of their fellow teenagers. For this reason, the report will be in the form of a magazine article for the public. In summary, emotional distress among teenagers should be dealt with in the best way possible. This is so since teenagers are in a period in their lives where they are bound to make several mistakes some of which end up having a lasting effect on their lives. Therefore, the need to illuminate the negative impact of peer influence on such teenagers is of the essence in ensuring that adults in these teenager’s lives will end up paying close attention to them. THE IMPACT OF PEER INFLUENCE ON TEENAGERS IN EMOTIONAL DISTRESS 3 References Desilver, D. (2018). Dangers that teens and kids face: A look at the data. [online] Pew Research Center. Available at: http://www.pewresearch.org/fact-tank/2016/01/14/dangers-thatyoung-people-face-a-look-at-the-data/ [Accessed 26 Jan. 2019]. Parentfurther. (2017). Beyond Parenting Advice—Reflect, Connect, and Grow Together. [online] Available at: http://www.parentfurther.com/sites/default/files/downloads/Peer G.pdf [Accessed 26 Jan. 2019]. Sturaro, C. and van Lier, P. (2011). The Role of Peer Relationships in the Development of Early School-Age Externalizing Problems. Child Development, 82(3), pp.758-765. Running head: PEER INFLUENCE 1 Peer Influence on Teenagers in Emotional Distress Individuals are affected by different factors which play a significant role in shaping their lives. Teenagers are among the most vulnerable groups of people when it comes to growth and development aspects. They are a group of people who can easily get stressed and find themselves engaging in destructive acts, either intentionally or unintentionally. It is important that parents and guardians provide close monitoring of their teenagers once they reach adolescent age in order to take note of any peculiar behavior which may be suggestive of any form of vulnerability Peer influence plays a huge role in a number of problems associated with teenagers. Most adolescents are easily influenced by their age mates and this has a lot of detrimental effects not only on their psychological and emotional well-being but also on their physical, social, academic as well as spiritual aspects of life. Various articles and literature which provide an overview of the challenges and problems associated with peer pressure among teens have been reviewed. Five such works of literature have been done by Desilver (2018), Stepler (2015), Sturaro & van Lier (2011), Yang et al (2011), Carroll (2006). Emotional distress among teens has been on the rise over the past couple of years with parents form different regions and races being worried about the various trends in juvenile delinquency as a result of peer pressure. Certain factors and challenges have been associated with teenagers of different origin, race and color as noted by Desilver (2018). For instance, teens from low income families are at a higher pregnancy risk as compared to those from high income families while black parents have more concerns about their teens being shot as compared to white parents (Desilver, 2018). PEER INFLUENCE 2 Teen pregnancies have been witnessed not only in the United States of America but also in numerus countries all over the world. Cases of teen pregnancies are highly affected by the financial status of families; families with a low financial status are more at risk of their teens getting pregnant as compared to families which are financial advantaged (Desilver, 2018). The paper provides data on the trends in teen pregnancies in the United States since the early 1990s up to 2014. According to Desilver (2018), there has been a steady decrease in teen pregnancies witnessed in the US between 1990 and 2014; the pregnancy rates dropped from approximately seven percent in the early 90s to about two percent in 2014. The article further notes that data across the states showed that Arkansas had the highest teen pregnancy rates at about four percent while Massachusetts recorded the lowest rates at just below one percent. Negative peer influence is recognized as a critical determinant of addictive consumption and maladaptive social behaviors, including smoking, drinking, marijuana use, and risky sex (Yang et al. 2011). Close to one thousand three hundred deaths from gun incidences were reported in the US (Desilver, 2018). Further studies by Desilver (2018) determined that the most vulnerable groups of teens who were likely to suffer from gun incidences were black youths followed by the Hispanics and the white non-Hispanic youths. The paper further observes that the United States has witnessed a gradual decrease in the number of juvenile cases from the mid-1990s to the present day world. Teen girls have been shown to suffer from anxiety and depression more than teen boys (Desilver, 2018). Population-wise, native American teens have been shown to suffer less depression and anxiety effects as compared to diverse race teens (Desilver, 2018). The article also observes that cases of kidnappings among teens has been on the rise recently. Desilver PEER INFLUENCE 3 (2018) notes that more than half of the kidnapping cases in the USA in 2015 alone involved teenagers. Yang, et al (2011) states self-esteem affects peer relationships, behavioral problems, depression, anxiety, and other adjustmental factors. Bullying among teens was reported to have occurred both over the internet as well as in school. Drug and alcohol abuse are two other factors that affect teens as a result of negative peer pressure. Among the most commonly abused drugs by teens is Marijuana followed by inhalants (Desilver, 2018). Drug abuse among teens has been on the rise since the late 90s. The paper also notes a reduction in cigarette smoking and alcohol consumption among teens. Studies carried out in various schools determined that close to twenty-five percent of the students had engaged in physical fights in the last twelve months prior to the study (Desilver, 2018). Parents and guardians have a crucial role to play when it comes to parenting and guiding their children. Proper parenting is of great essence in the upright development of children. The article by Stepler (2015) provides an overview of parenting in the modern day world. Stepler (2015) provides statistics on the children living in homes and whether these children live with both parents, single parents, adopted parents or parents who are cohabiting. Parental support is important in helping children navigate through their teenage life safely. According to the article, there has been a worrying trend in the number of children living with single parents. The number of complete families (with both the husband and the wife) has been gradually reducing over the years. The study determines that single parenthood has increased from about ten percent in the 1960s to close to thirty percent in the present day world. Stepler (2015) also notes that there is an alarming increase in cases of divorce, cohabitation as well as people remarrying; these factors predispose children to negative peer pressure with no proper PEER INFLUENCE 4 guidance. The report further states that most mothers will agree to being caring about their children as compared to their fathers. The article by Stepler (2015) notes that there are various issues of greater concern among parents with respect to parenting. Among these parental concerns about their children are bullying and mental health. Other issues of concern among parents is that their children are more likely to suffer from racial abuse and ethnicity. The article seems to agree with the findings of Desilver (2018) that parents from low income backgrounds are more concerned about their teens getting pregnant as compared to rich parents. The article determines that parents in the USA think that too much involvement in their children’s education is bad. Most of the parents, especially those who are rich, opt to take less involvement in their children’s academic life. On the other hand, parents from poor families shoe a lot of interest in their children’s academic life. The study also notes that about forty percent of parents with schooling children admit to having no clear programs for the children once they come back home from school. This leaves the children with too much time unsupervised. The article by Sturaro, C. & van Lier, P. (2011) provides insight on the roles of peer rejection. It shows the study of how friends, specifically best friends, can influence the problems we have in late childhood and early adolescence. Peer rejection was found to have an additive effect on children’s externalizing problems independent from children’s behavioral dispositions, and to partially mediate the link between early disruptiveness and later problem behavior (Sturari et al 2011). This article gives the statistics on the behavior problems involved with peer rejections. PEER INFLUENCE 5 Peer influences on teenagers who are already in emotional distress can be dangerous. The literature gives insight and statistics of the effects of what happens when the distressed teenagers are influenced or rejected by their peers. PEER INFLUENCE 6 References DeSilver, D. (2018). Dangers that teens and kids face: A look at the data. Retrieved from http://www.pewresearch.org/fact-tank/2016/01/14/dangers-that-young-people-face-alook-at-the-data/ Stepler, R. (2015). 5 key takeaways about parenting in changing times. Retrieved from http://www.pewresearch.org/fact-tank/2015/12/17/key-takeaways-about-parenting/ Sturaro, C. & van Lier, P. (2011). The Role of Peer Relationships in the Development of Early School-Age Externalizing Problems. Child Development, 82(3), pp.758-765. Zhiyong Yang, Schaninger, C. M., & Laroche, M. (2011). Negative Peer Influence and Teen Drinking and Smoking: The Longitudinal Roles of Self-Esteem and Parenting. AMA Marketing & Public Policy Academic Conference Proceedings, 21, 112–113. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,uid&db=bth&AN=856 28733&site=eds-live Carroll, J. (2006). Drugs, Smoking, Alcohol Most Important Problem Facing Teens: Younger teens mention drugs, alcohol much more frequently than older teens. Gallup Poll Briefing, 1–4. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,uid&db=bth&AN=209 43719&site=eds-live American Journal of Pharmaceutical Education 2010; 74 (8) Article 141. SPECIAL ARTICLES Presenting and Evaluating Qualitative Research Claire Anderson, PhD, BPharm Univeristy of Nottingham, Nottingham United Kingdom The purpose of this paper is to help authors to think about ways to present qualitative research papers in the American Journal of Pharmaceutical Education. It also discusses methods for reviewers to assess the rigour, quality, and usefulness of qualitative research. Examples of different ways to present data from interviews, observations, and focus groups are included. The paper concludes with guidance for publishing qualitative research and a checklist for authors and reviewers. Keywords: qualitative research, research papers, American Journal of Pharmaceutical Education simple terms. Complex educational situations demand complex understanding; thus, the scope of educational research can be extended by the use of qualitative methods. Qualitative research can sometimes provide a better understanding of the nature of educational problems and thus add to insights into teaching and learning in a number of contexts. For example, at the University of Nottingham, we conducted in-depth interviews with pharmacists to determine their perceptions of continuing professional development and who had influenced their learning. We also have used a case study approach using observation of practice and in-depth interviews to explore physiotherapists’ views of influences on their leaning in practice. We have conducted in-depth interviews with a variety of stakeholders in Malawi, Africa, to explore the issues surrounding pharmacy academic capacity building. A colleague has interviewed and conducted focus groups with students to explore cultural issues as part of a joint Nottingham-Malaysia pharmacy degree program. Another colleague has interviewed pharmacists and patients regarding their expectations before and after clinic appointments and then observed pharmacist-patient communication in clinics and assessed it using the Calgary Cambridge model in order to develop recommendations for communication skills training.5 We have also performed documentary analysis on curriculum data to compare pharmacist and nurse supplementary prescribing courses in the United Kingdom. It is important to choose the most appropriate methods for what is being investigated. Qualitative research is not appropriate to answer every research question and researchers need to think carefully about their objectives. Do they wish to study a particular phenomenon in depth (eg, students’ perceptions of studying in a different culture)? Or are they more interested in making standardized comparisons and accounting for variance (eg, examining differences in examination grades after changing the way INTRODUCTION Policy and practice decisions, including those in education, increasingly are informed by findings from qualitative as well as quantitative research. Qualitative research is useful to policymakers because it often describes the settings in which policies will be implemented. Qualitative research is also useful to both pharmacy practitioners and pharmacy academics who are involved in researching educational issues in both universities and practice and in developing teaching and learning. Qualitative research involves the collection, analysis, and interpretation of data that are not easily reduced to numbers. These data relate to the social world and the concepts and behaviors of people within it. Qualitative research can be found in all social sciences and in the applied fields that derive from them, for example, research in health services, nursing, and pharmacy.1 It looks at X in terms of how X varies in different circumstances rather than how big is X or how many Xs are there?2 Textbooks often subdivide research into qualitative and quantitative approaches, furthering the common assumption that there are fundamental differences between the 2 approaches. With pharmacy educators who have been trained in the natural and clinical sciences, there is often a tendency to embrace quantitative research, perhaps due to familiarity. A growing consensus is emerging that sees both qualitative and quantitative approaches as useful to answering research questions and understanding the world. Increasingly mixed methods research is being carried out where the researcher explicitly combines the quantitative and qualitative aspects of the study.3,4 Like healthcare, education involves complex human interactions that can rarely be studied or explained in Corresponding Author: Claire Anderson, University of Nottingham, Nottingham, United Kingdom, Phone: 144 115951-5389. E-mail: Claire.Anderson@Nottingham.ac.uk 1 American Journal of Pharmaceutical Education 2010; 74 (8) Article 141. the content of a module is taught). Clearly a quantitative approach would be more appropriate in the last example. As with any research project, a clear research objective has to be identified to know which methods should be applied. Types of qualitative data include: d Audio recordings and transcripts from in-depth or semi-structured interviews d Structured interview questionnaires containing substantial open comments including a substantial number of responses to open comment items. d Audio recordings and transcripts from focus group sessions. d Field notes (notes taken by the researcher while in the field [setting] being studied) d Video recordings (eg, lecture delivery, class assignments, laboratory performance) d Case study notes d Images d Documents (reports, meeting minutes, e-mails) d Diaries, video diaries d Observation notes d Press clippings d Photographs insights offered. Respondent validation, which is allowing participants to read through the data and analyses and provide feedback on the researchers’ interpretations of their responses, provides researchers with a method of checking for inconsistencies, challenges the researchers’ assumptions, and provides them with an opportunity to re-analyze their data. The use of constant comparison means that one piece of data (for example, an interview) is compared with previous data and not considered on its own, enabling researchers to treat the data as a whole rather than fragmenting it. Constant comparison also enables the researcher to identify emerging/unanticipated themes within the research project. STRENGTHS AND LIMITATIONS OF QUALITATIVE RESEARCH Qualitative researchers have been criticized for overusing interviews and focus groups at the expense of other methods such as ethnography, observation, documentary analysis, case studies, and conversational analysis. Qualitative research has numerous strengths when properly conducted. Strengths of Qualitative Research d Issues can be examined in detail and in depth. d Interviews are not restricted to specific questions and can be guided/redirected by the researcher in real time. d The research framework and direction can be quickly revised as new information emerges. d The data based on human experience that is obtained is powerful and sometimes more compelling than quantitative data. d Subtleties and complexities about the research subjects and/or topic are discovered that are often missed by more positivistic enquiries. d Data usually are collected from a few cases or individuals so findings cannot be generalized to a larger population. Findings can however be transferable to another setting. RIGOUR IN QUALITATIVE RESEARCH Qualitative research is often criticized as biased, small scale, anecdotal, and/or lacking rigor; however, when it is carried out properly it is unbiased, in depth, valid, reliable, credible and rigorous. In qualitative research, there needs to be a way of assessing the ‘‘extent to which claims are supported by convincing evidence.’’1 Although the terms reliability and validity traditionally have been associated with quantitative research, increasingly they are being seen as important concepts in qualitative research as well. Examining the data for reliability and validity assesses both the objectivity and credibility of the research. Validity relates to the honesty and genuineness of the research data, while reliability relates to the reproducibility and stability of the data. The validity of research findings refers to the extent to which the findings are an accurate representation of the phenomena they are intended to represent. The reliability of a study refers to the reproducibility of the findings. Validity can be substantiated by a number of techniques including triangulation use of contradictory evidence, respondent validation, and constant comparison. Triangulation is using 2 or more methods to study the same phenomenon. Contradictory evidence, often known as deviant cases, must be sought out, examined, and accounted for in the analysis to ensure that researcher bias does not interfere with or alter their perception of the data and any Limitations of Qualitative Research d Research quality is heavily dependent on the individual skills of the researcher and more easily influenced by the researcher’s personal biases and idiosyncrasies. d Rigor is more difficult to maintain, assess, and demonstrate. d The volume of data makes analysis and interpretation time consuming. d It is sometimes not as well understood and accepted as quantitative research within the scientific community 2 American Journal of Pharmaceutical Education 2010; 74 (8) Article 141. d d d Calgary Cambridge guide.6,7 The data are first presented and a discussion follows: The researcher’s presence during data gathering, which is often unavoidable in qualitative research, can affect the subjects’ responses. Issues of anonymity and confidentiality can present problems when presenting findings Findings can be more difficult and time consuming to characterize in a visual way. Pharmacist: We will soon be starting a stop smoking clinic. Patient: Is the interview over now? Pharmacist: No this is part of it. (Laughs) You can’t tell me to bog off (sic) yet. (pause) We will be starting a stop smoking service here, Patient: Yes. Pharmacist: with one-to-one and we will be able to help you or try to help you. If you want it. PRESENTATION OF QUALITATIVE RESEARCH FINDINGS In this example, the pharmacist has picked up from the patient’s reaction to the stop smoking clinic that she is not receptive to advice about giving up smoking at this time; in fact she would rather end the consultation. The pharmacist draws on his prior relationship with the patient and makes use of a joke to lighten the tone. He feels his message is important enough to persevere but he presents the information in a succinct and nonpressurised way. His final comment of ‘‘If you want it’’ is important as this makes it clear that he is not putting any pressure on the patient to take up this offer. This extract shows that some patient cues were picked up, and appropriately dealt with, but this was not the case in all examples. The following extracts are examples of how qualitative data might be presented: Data From an Interview. The following is an example of how to present and discuss a quote from an interview. The researcher should select quotes that are poignant and/or most representative of the research findings. Including large portions of an interview in a research paper is not necessary and often tedious for the reader. The setting and speakers should be established in the text at the end of the quote. The student describes how he had used deep learning in a dispensing module. He was able to draw on learning from a previous module, ‘‘I found that while using the e learning programme I was able to apply the knowledge and skills that I had gained in last year’s diseases and goals of treatment module.’’ (interviewee 22, male) Data From Focus Groups This excerpt from a study involving 11 focus groups illustrates how findings are presented using representative quotes from focus group participants.8 This is an excerpt from an article on curriculum reform that used interviews 5: Those pharmacists who were initially familiar with CPD endorsed the model for their peers, and suggested it had made a meaningful difference in the way they viewed their own practice. In virtually all focus groups sessions, pharmacists familiar with and supportive of the CPD paradigm had worked in collaborative practice environments such as hospital pharmacy practice. For these pharmacists, the major advantage of CPD was the linking of workplace learning with continuous education. One pharmacist stated, ‘‘It’s amazing how much I have to learn every day, when I work as a pharmacist. With [the learning portfolio] it helps to show how much learning we all do, every day. It’s kind of satisfying to look it over and see how much you accomplish.’’ Within many of the learning portfolio-sharing sessions, debates emerged regarding the true value of traditional continuing education and its outcome in changing an individual’s practice. While participants appreciated the opportunity for social and professional networking inherent in some forms of traditional CE, most eventually conceded that the academic value of most CE programming was limited by the lack of a systematic process for following-up and implementing new learning in the workplace. ‘‘Well it’s nice to go to these [continuing education] events, but really, I The first question was, ‘‘Without the accreditation mandate, how much of this curriculum reform would have been attempted?’’ According to respondents, accreditation played a significant role in prompting the broadbased curricular change, and their comments revealed a nuanced view. Most indicated that the change would likely have occurred even without the mandate from the accreditation process: ‘‘It reflects where the profession wants to be . . . training a professional who wants to take on more responsibility.’’ However, they also commented that ‘‘if it were not mandated, it could have been a very difficult road.’’ Or it ‘‘would have happened, but much later.’’ The change would more likely have been incremental, ‘‘evolutionary,’’ or far more limited in its scope. ‘‘Accreditation tipped the balance’’ was the way one person phrased it. ‘‘Nobody got serious until the accrediting body said it would no longer accredit programs that did not change.’’ Data From Observations The following example is some data taken from observation of pharmacist patient consultations using the 3 American Journal of Pharmaceutical Education 2010; 74 (8) Article 141. corporates a wide range of different perspectives so that the viewpoint of 1 group is never presented as if it represents the sole truth about any situation. The process by which ethical and or research/institutional governance approval was obtained should be described and cited. Sampling. The study sample and the research setting should be described. Sampling differs between qualitative and quantitative studies. In quantitative survey studies, it is important to select probability samples so that statistics can be used to provide generalizations to the population from which the sample was drawn. Qualitative research necessitates having a small sample because of the detailed and intensive work required for the study. So sample sizes are not calculated using mathematical rules and probability statistics are not applied. Instead qualitative researchers should describe their sample in terms of characteristics and relevance to the wider population. Purposive sampling is common in qualitative research. Particular individuals are chosen with characteristics relevant to the study who are thought will be most informative. Purposive sampling also may be used to produce maximum variation within a sample. Participants being chosen based for example, on year of study, gender, place of work, etc. Representative samples also may be used, for example, 20 students from each of 6 schools of pharmacy. Convenience samples involve the researcher choosing those who are either most accessible or most willing to take part. This may be fine for exploratory studies; however, this form of sampling may be biased and unrepresentative of the population in question. Theoretical sampling uses insights gained from previous research to inform sample selection for a new study. The method for gaining informed consent from the participants should be described, as well as how anonymity and confidentiality of subjects were guaranteed. The method of recording, eg, audio or video recording, should be noted, along with procedures used for transcribing the data. Data Analysis. A description of how the data were analyzed also should be included. Was computer-aided qualitative data analysis software such as NVivo (QSR International, Cambridge, MA) used? Arrival at ‘‘data saturation’’ or the end of data collection should then be described and justified. A good rule when considering how much information to include is that readers should have been given enough information to be able to carry out similar research themselves. One of the strengths of qualitative research is the recognition that data must always be understood in relation to the context of their production.1 The analytical approach taken should be described in detail and theoretically justified in light of the research question. If the don’t know how useful they are. You go, you sit, you listen, but then, well I at least forget.’’ The following is an extract from a focus group (conducted by the author) with first-year pharmacy students about community placements. It illustrates how focus groups provide a chance for participants to discuss issues on which they might disagree. Interviewer: So you are saying that you would prefer health related placements? Student 1: Not exactly so long as I could be developing my communication skill. Student 2: Yes but I still think the more health related the placement is the more I’ll gain from it. Student 3: I disagree because other people related skills are useful and you may learn those from taking part in a community project like building a garden. Interviewer: So would you prefer a mixture of health and non health related community placements? GUIDANCE FOR PUBLISHING QUALITATIVE RESEARCH Qualitative research is becoming increasingly accepted and published in pharmacy and medical journals. Some journals and publishers have guidelines for presenting qualitative research, for example, the British Medical Journal9 and Biomedcentral.10Medical Education published a useful series of articles on qualitative research.11 Some of the important issues that should be considered by authors, reviewers and editors when publishing qualitative research are discussed below. Introduction. A good introduction provides a brief overview of the manuscript, including the research question and a statement justifying the research question and the reasons for using qualitative research methods. This section also should provide background information, including relevant literature from pharmacy, medicine, and other health professions, as well as literature from the field of education that addresses similar issues. Any specific educational or research terminology used in the manuscript should be defined in the introduction. Methods. The methods section should clearly state and justify why the particular method, for example, face to face semistructured interviews, was chosen. The method should be outlined and illustrated with examples such as the interview questions, focusing exercises, observation criteria, etc. The criteria for selecting the study participants should then be explained and justified. The way in which the participants were recruited and by whom also must be stated. A brief explanation/description should be included of those who were invited to participate but chose not to. It is important to consider ‘‘fair dealing,’’ ie, whether the research design explicitly in4 American Journal of Pharmaceutical Education 2010; 74 (8) Article 141. analysis was repeated by more than 1 researcher to ensure reliability or trustworthiness, this should be stated and methods of resolving any disagreements clearly described. Some researchers ask participants to check the data. If this was done, it should be fully discussed in the paper. An adequate account of how the findings were produced should be included A description of how the themes and concepts were derived from the data also should be included. Was an inductive or deductive process used? The analysis should not be limited to just those issues that the researcher thinks are important, anticipated themes, but also consider issues that participants raised, ie, emergent themes. Qualitative researchers must be open regarding the data analysis and provide evidence of their thinking, for example, were alternative explanations for the data considered and dismissed, and if so, why were they dismissed? It also is important to present outlying or negative/deviant cases that did not fit with the central interpretation. The interpretation should usually be grounded in interviewees or respondents’ contributions and may be semi-quantified, if this is possible or appropriate, for example, ‘‘Half of the respondents said . . .’’ ‘‘The majority said . . .’’ ‘‘Three said. . .’’ Readers should be presented with data that enable them to ‘‘see what the researcher is talking about.’’1 Sufficient data should be presented to allow the reader to clearly see the relationship between the data and the interpretation of the data. Qualitative data conventionally are presented by using illustrative quotes. Quotes are ‘‘raw data’’ and should be compiled and analyzed, not just listed. There should be an explanation of how the quotes were chosen and how they are labeled. For example, have pseudonyms been given to each respondent or are the respondents identified using codes, and if so, how? It is important for the reader to be able to see that a range of participants have contributed to the data and that not all the quotes are drawn from 1 or 2 individuals. There is a tendency for authors to overuse quotes and for papers to be dominated by a series of long quotes with little analysis or discussion. This should be avoided. Participants do not always state the truth and may say what they think the interviewer wishes to hear. A good qualitative researcher should not only examine what people say but also consider how they structured their responses and how they talked about the subject being discussed, for example, the person’s emotions, tone, nonverbal communication, etc. If the research was triangulated with other qualitative or quantitative data, this should be discussed. Discussion. The findings should be presented in the context of any similar previous research and or theories. A discussion of the existing literature and how this present research contributes to the area should be included. A consideration must also be made about how transferrable the research would be to other settings. Any particular strengths and limitations of the research also should be discussed. It is common practice to include some discussion within the results section of qualitative research and follow with a concluding discussion. The author also should reflect on their own influence on the data, including a consideration of how the researcher(s) may have introduced bias to the results. The researcher should critically examine their own influence on the design and development of the research, as well as on data collection and interpretation of the data, eg, were they an experienced teacher who researched teaching methods? If so, they should discuss how this might have influenced their interpretation of the results. Conclusion. The conclusion should summarize the main findings from the study and emphasize what the study adds to knowledge in the area being studied. Mays and Pope suggest the researcher ask the following 3 questions to determine whether the conclusions of a qualitative study are valid12: How well does this analysis explain why people behave in the way they do? How comprehensible would this explanation be to a thoughtful participant in the setting? How well does the explanation cohere with what we already know? CHECKLIST FOR QUALITATIVE PAPERS This paper establishes criteria for judging the quality of qualitative research. It provides guidance for authors and reviewers to prepare and review qualitative research papers for the American Journal of Pharmaceutical Education. A checklist is provided in Appendix 1 to assist both authors and reviewers of qualitative data. ACKNOWLEDGEMENTS Thank you to the 3 reviewers whose ideas helped me to shape this paper. REFERENCES 1. Murphy E, Dingwall R, Greatbatch D, Parker S, Watson P. Qualitative research methods in health technology assessment: a review of the literature. Health Technology Assessment 1998; Vol. 2: No. 16. http://www.ncchta.org/fullmono/mon216.pdf Accessed August 31, 2010. 2. Pope C, Mays N. Qualitative Research in Healthcare. 3rd ed. Oxford: Wiley Blackwell; 2006. 3. Creswell JW, Plano Clark VL. Designing and Conducting Mixed Methods Research. Thousand Oaks, CA: Sage; 2006. 4. Burke R, Johnson R. Mixed methods research: a research paradigm whose time has come. Educ Res. 2004;33(7):14-26. 5 American Journal of Pharmaceutical Education 2010; 74 (8) Article 141. attitudes, behaviors, and preferences in Ontario, Canada. Am J Pharm Educ. 2005;69(1):4. 9. Qualitative research. British Medical Journal Web site. http:// resources.bmj.com/bmj/authors/checklists-forms/qualitativeresearch. Accessed August 31, 2010. 10. Qualitative research review guidelines – RATS. BioMed Central. http://www.biomedcentral.com/info/ifora/rats Accessed August 31, 2010. 11. Britten N. Making sense of qualitative research: a new series. Med Educ. 2005;39:5-6. 12. Mays N, Pope C, eds. Qualitative Research in Health Care. London: BMJ Publishing Group; 1996. 5. Farris KB, Demb A, Janke KK, Kelley K, Scott SA. Assessment to transform competency-based curricula. Am J Pharm Educ. 2009;73(8):Article 158. 6. Kurtz S, Silverman J. The Calgary-Cambridge referenced observation guides: an aid to defining the curriculum and organizing the teaching in communication training programmes. Med Educ. 1996;30:83-89. 7. Greenhill N. An Exploration of Pharmacist-Patient Communication in Clinic-Style Consultations [doctoral thesis]. University of Nottingham, England; October 2010. 8. Austin Z, Marini A, Glover NM, Croteau D. Continuous professional development: a qualitative study of pharmacists’ 6 American Journal of Pharmaceutical Education 2010; 74 (8) Article 141. Appendix 1. Checklist for authors and reviewers of qualitative research. Introduction u Research question is clearly stated. u Research question is justified and related to the existing knowledge base (empirical research, theory, policy). u Any specific research or educational terminology used later in manuscript is defined. u The process by which ethical and or research/institutional governance approval was obtained is described and cited. Method u Reason for choosing particular research method is stated. u Criteria for selecting study participants are explained and justified. u Recruitment methods are explicitly stated. u Details of who chose not to participate and why are given. u Study sample and research setting used are described. u Method for gaining informed consent from the participants is described. u Maintenance/Preservation of subject anonymity and confidentiality is described. u Method of recording data (eg, audio or video recording) and procedures for transcribing data are described. u Methods are outlined and examples given (eg, interview guide). u Decision to stop data collection is described and justified. u Data analysis and verification are described, including by whom they were performed. u Methods for identifying/extrapolating themes and concepts from the data are discussed. Results u Sufficient data are presented to allow a reader to assess whether or not the interpretation is supported by the data. u Outlying or negative/deviant cases that do not fit with the central interpretation are presented. u Transferability of research findings to other settings is discussed. u Findings are presented in the context of any similar previous research and social theories. Discussion u Discussion often is incorporated into the results in qualitative papers. u A discussion of the existing literature and how this present research contributes to the area is included. u Any particular strengths and limitations of the research are discussed. u Reflection of the influence of the researcher(s) on the data, including a consideration of how the researcher(s) may have introduced bias to the results is included. Conclusions u The conclusion states the main finings of the study and emphasizes what the study adds to knowledge in the subject area. 7
Purchase answer to see full attachment