Submitted by Gino De Pinto, BEd HBSc RRT FCSRT

For the past 16 years I have been working in healthcare as a Registered Respiratory Therapist (RRT).

For the past 16 years I have been working in healthcare as a Registered Respiratory Therapist (RRT). While in this role, I have had the pleasure of helping patients in their most vulnerable state while they are dealing with a disease process or recovering from surgery. As a healthcare provider dealing with acutely ill patients, reviewing and applying evidence informed practice from literature was essential. Analyzing current literature ensured patients received the best possible care and treatment. For the patients receiving the treatment, they are benefiting from the knowledge that aids in a positive outcome for their specific disease process, which is based on the evidence available that informs and justifies the actions of the healthcare team (Reid, Greaves & Kirby, 2017). As questions arise in my own practice as a healthcare provider and educator, an opportunity to better treat patients by conducting my own research can not be ignored. In this paper, I will be reviewing the qualitative paradigm to better position myself in utilizing this method of research, reflect on its philosophical foundation, describe the scope of its focus and outline its strengths and limitations.

As a preceptor for respiratory therapy students, pointing students to the literature so they can perform a review and be up to date is a crucial skill set that is a core competency and an essential employability skill. As students enter the workforce and evolve through their professional career stages, questions will arise in the treatment of their patients that live outside of the available literature. These questions will encourage students to gain tools for interpreting the vast amounts of knowledge and information that surrounds them. It will provide them a route to gain influence and provide a voice as a result of documenting and producing new knowledge (Reid et al., 2017). As an educator I need to understand the research process, perform my own research, and have a solid foundation in its practice so I can better guide my students when it is time for them to conduct their own research.

Professional Context
In the past 10 years I have been fortunate to gain full-time employment as a professor in the advanced respiratory therapy program at Conestoga College. During my first years of teaching at Conestoga College I am most proud of the relationships formed with our clinical partners. Ensuring all stakeholders had a voice in the education of RRTs helped to position our students for success and eventual employment. Helping to establish and integrate clinically immersive simulation into the program was another career highlight. Working on the design and implementation of simulation into our curriculum leveraged opportunities to gain clinical competencies in all patient populations and has given our students a competitive advantage when seeking employment. This type of education was tied to the behavioural theory where the goal of learning was changing observable behaviour. I was able to write learning objectives, provide stimulus, ask for responses and provide reinforcement to the learner (Ozuah, 2017). This teaching strategy positioned my students for success when attaining competencies through practical skill attainment, during simulation and eventual patient care in the hospital setting.

Philosophical Foundation
The goal of research is to educate and inform from developing knowledge to advancing knowledge for the good of society. A philosophical position is based on a specific ontological and epistemological assumptions regarding how the world is perceived (Roux, 2017). The first challenge in identifying the research goal is to form the basis of the criteria required for validity and trustworthiness.

When connecting the ontological and epistemological principles of research the interactive paradigm reshapes the interaction between researcher and participants during the research process and helps bring forth the notion of the researcher as author (Mills, Bonner, & Francis, 2017).
I will be reviewing my own philosophical resonance by connecting the different social locations, power relations and their experiences that shape an individual’s health, economic status and social well being. Recognizing that one single factor will not influence human characteristics will ensure that multiple, fluid, and flexible social categories will drive and guide my critical research (Reid et al., 2017).

With my personal interests in healthcare and adult education, qualitative research and its methodology align with the social meanings, interactions and behaviour patterns within healthcare (Crosseti, Goes, & DeBrum, 2016). Since the profession of respiratory therapy is small in comparison to nursing or medical doctors, I will need to lean on the research of other health care disciplines to help guide my methodology when answering my research question.
Grounded theory is a method for collecting, analyzing data and forming results which provides a substantive theory interpretation of knowledge. Like nursing, respiratory therapy is a social and humanistic discipline whose interaction amongst the healthcare team focuses on patient care. This allows for a phenomenon of practice that enables interpretation, promotion and development of subject matter. The theoretical knowledge produced from this type of qualitative research is founded on the principles in guiding of being, knowing and doing respiratory therapy, which leads towards a practice of accuracy within the health care process (Crosseti et al., 2016).

The Scope and Focus
When I reflect on my own personal experiences with adult education, I am most interested in interprofessional education, clinical immersive simulation and applied practical application. Over the years, I have seen anecdotal evidence of its merit with my students, and the merit is echoed when I speak with them after graduation. They have an overall feeling of empowerment when entering the workforce, noting a strong foundation with their knowledge and practical skill set. This anecdotal evidence produced questions about the validity of my teaching and what type of questions needed answers. This type of situational context is interactional within the professional setting which allows for a point of view that is defined dynamically within a healthcare or educational setting (Malthouse, Watts, & Roffey-Barentsen, 2015).
Teaching in healthcare has led me to interests that align with the interactive paradigm. How students learn and what resonates with their learning style is quite subjective. The subject matter must have meaning, be grounded in theory and allow students to interpret the theoretical base through symbolic interactionism (Reid et al., 2017). Clinically immersive simulation allows students to gain knowledge by participating in a world of meaning created by their professor. It captures the student’s understanding of people or patients in their environment based on the acuity of their disease process.

Strengths and Limitations
The strength of qualitative research is that it is good at simplifying and managing data without terminating its context. Its purpose is to learn and understand from the participants in a setting and how they experience and interpret its meaning (Atieno, 2009). The researcher’s method allows for a discovery and does justice to the perceptions and complexity of their interpretation of data. The research question will determine the choice of method and determine how the data is collected which is linked to a common way of thinking. It will allow for an understanding of phenomena through the discovery of central themes and analysis of core concerns (Atieno, 2009).
Some of the limitations of qualitative research include its ambiguities regarding the human language and how the analysis of data cannot be extended to the wider population (Atieno, 2009). When coding some of the words while analyzing the data from the methodology, the meaning of certain words may be ambiguous or have two different meanings. For example, the word “left” can be interpreted as side of the room or leaving something behind. When trying to extend the analysis to the wider population, the findings of the research are left to chance and are not statistically significant.

Conclusion and Final Thoughts
As I reflect on my teaching style, I can see how it is heavily linked to competency-based training. This type of education is common in the medical field, where it is characterized by pre-determined training linked to assessment outcomes from the profession’s national competency framework (Jenkins, 2011). Since the program I teach in requires national accreditation for our students to challenge the licensing exam, industry involvement is featured in the process of learning. The curriculum underpinning is the National Competency Framework (NCF) for the Profession of Respiratory Therapy. Questions then arise on the delivery of outcomes to ensure students have a preparedness to deal with acutely ill patients. How does clinically immersive simulation play a part in the student’s learning process, and where can you leverage interprofessional education to meet the NCF outcomes? By asking the right questions, I can justify the teaching techniques through qualitative research that have anecdotally positioned my students for success.

References
Atieno, O. P. (2009). An analysis of the strengths and limitations of qualitative and quantitative research paradigms.
Problems of Education in 21st Century, 13(1), 13–18.
Retrieved from http://www.scientiasocialis.lt/pec/files/pdf/Atieno_Vol.13.pdf

Crosseti, M. G., Goes, M. G., & DeBrum, C. N. (2016).
Application of Constructivist Grounded Theory in Nursing Research.
The Qualitative Report, 21(13), 48–53.
Retrieved from https://nsuworks.nova.edu/cgi/viewcontent.cgi?article=2610&context=tqr

Jenkins, C. (2011, December 2). Authenticity through reflexivity: connecting teaching philosophy and practice.
Australian Journal of Adult Learning, Vol. 51, pp. 72–89.
Retrieved from https://search.ebscohost.com/login.aspx?direct=true&AuthType=url,cookie,ip,uid&db=ehh&AN=114972118

Malthouse, R., Watts, M., & Roffey-Barentsen, J. (2015). Reflective Questions, Self-Questioning and Managing Professionally Situated Practice.
Research in Education, 94(1), 71–87.
https://doi.org/10.7227/rie.0024

Ozuah, P. O. (2017). First, There Was Pedagogy And Then Came Andragogy.
Einstein Journal of Biology and Medicine, 21(2), 83.
https://doi.org/10.23861/ejbm20052190

Reid, C., Greaves, L., & Kirby, S. (2017).
Experience, research, social change: Critical methods (3rd ed.).
Toronto, Canada: University of Toronto Press.

Roux, C. S. Le. (2017). Exploring rigour in autoethnographic research.
International Journal of Social Research Methodology, 20(2), 195–207.
https://doi.org/10.1080/13645579.2016.1140965

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