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How to conduct qualitative interviews (tips and best practices)

Last updated

18 May 2023

Reviewed by

Miroslav Damyanov

However, conducting qualitative interviews can be challenging, even for seasoned researchers. Poorly conducted interviews can lead to inaccurate or incomplete data, significantly compromising the validity and reliability of your research findings.

When planning to conduct qualitative interviews, you must adequately prepare yourself to get the most out of your data. Fortunately, there are specific tips and best practices that can help you conduct qualitative interviews effectively.

  • What is a qualitative interview?

A qualitative interview is a research technique used to gather in-depth information about people's experiences, attitudes, beliefs, and perceptions. Unlike a structured questionnaire or survey, a qualitative interview is a flexible, conversational approach that allows the interviewer to delve into the interviewee's responses and explore their insights and experiences.

In a qualitative interview, the researcher typically develops a set of open-ended questions that provide a framework for the conversation. However, the interviewer can also adapt to the interviewee's responses and ask follow-up questions to understand their experiences and views better.

  • How to conduct interviews in qualitative research

Conducting interviews involves a well-planned and deliberate process to collect accurate and valid data. 

Here’s a step-by-step guide on how to conduct interviews in qualitative research, broken down into three stages:

1. Before the interview

The first step in conducting a qualitative interview is determining your research question . This will help you identify the type of participants you need to recruit. Once you have your research question, you can start recruiting participants by identifying potential candidates and contacting them to gauge their interest in participating in the study. 

After that, it's time to develop your interview questions. These should be open-ended questions that will elicit detailed responses from participants. You'll also need to get consent from the participants, ideally in writing, to ensure that they understand the purpose of the study and their rights as participants. Finally, choose a comfortable and private location to conduct the interview and prepare the interview guide.

2. During the interview

Start by introducing yourself and explaining the purpose of the study. Establish a rapport by putting the participants at ease and making them feel comfortable. Use the interview guide to ask the questions, but be flexible and ask follow-up questions to gain more insight into the participants' responses. 

Take notes during the interview, and ask permission to record the interview for transcription purposes. Be mindful of the time, and cover all the questions in the interview guide.

3. After the interview

Once the interview is over, transcribe the interview if you recorded it. If you took notes, review and organize them to make sure you capture all the important information. Then, analyze the data you collected by identifying common themes and patterns. Use the findings to answer your research question. 

Finally, debrief with the participants to thank them for their time, provide feedback on the study, and answer any questions they may have.

  • What kinds of questions should you ask in a qualitative interview?

Qualitative interviews involve asking questions that encourage participants to share their experiences, opinions, and perspectives on a particular topic. These questions are designed to elicit detailed and nuanced responses rather than simple yes or no answers.

Effective questions in a qualitative interview are generally open-ended and non-leading. They avoid presuppositions or assumptions about the participant's experience and allow them to share their views in their own words. 

In customer research , you might ask questions such as:

What motivated you to choose our product/service over our competitors?

How did you first learn about our product/service?

Can you walk me through your experience with our product/service?

What improvements or changes would you suggest for our product/service?

Have you recommended our product/service to others, and if so, why?

The key is to ask questions relevant to the research topic and allow participants to share their experiences meaningfully and informally. 

  • How to determine the right qualitative interview participants

Choosing the right participants for a qualitative interview is a crucial step in ensuring the success and validity of the research . You need to consider several factors to determine the right participants for a qualitative interview. These may include:

Relevant experiences : Participants should have experiences related to the research topic that can provide valuable insights.

Diversity : Aim to include diverse participants to ensure the study's findings are representative and inclusive.

Access : Identify participants who are accessible and willing to participate in the study.

Informed consent : Participants should be fully informed about the study's purpose, methods, and potential risks and benefits and be allowed to provide informed consent.

You can use various recruitment methods, such as posting ads in relevant forums, contacting community organizations or social media groups, or using purposive sampling to identify participants who meet specific criteria.

  • How to make qualitative interview subjects comfortable

Making participants comfortable during a qualitative interview is essential to obtain rich, detailed data. Participants are more likely to share their experiences openly when they feel at ease and not judged. 

Here are some ways to make interview subjects comfortable:

Explain the purpose of the study

Start the interview by explaining the research topic and its importance. The goal is to give participants a sense of what to expect.

Create a comfortable environment

Conduct the interview in a quiet, private space where the participant feels comfortable. Turn off any unnecessary electronics that can create distractions. Ensure your equipment works well ahead of time. Arrive at the interview on time. If you conduct a remote interview, turn on your camera and mute all notetakers and observers.

Build rapport

Greet the participant warmly and introduce yourself. Show interest in their responses and thank them for their time.

Use open-ended questions

Ask questions that encourage participants to elaborate on their thoughts and experiences.

Listen attentively

Resist the urge to multitask . Pay attention to the participant's responses, nod your head, or make supportive comments to show you’re interested in their answers. Avoid interrupting them.

Avoid judgment

Show respect and don't judge the participant's views or experiences. Allow the participant to speak freely without feeling judged or ridiculed.

Offer breaks

If needed, offer breaks during the interview, especially if the topic is sensitive or emotional.

Creating a comfortable environment and establishing rapport with the participant fosters an atmosphere of trust and encourages open communication. This helps participants feel at ease and willing to share their experiences.

  • How to analyze a qualitative interview

Analyzing a qualitative interview involves a systematic process of examining the data collected to identify patterns, themes, and meanings that emerge from the responses. 

Here are some steps on how to analyze a qualitative interview:

1. Transcription

The first step is transcribing the interview into text format to have a written record of the conversation. This step is essential to ensure that you can refer back to the interview data and identify the important aspects of the interview.

2. Data reduction

Once you’ve transcribed the interview, read through it to identify key themes, patterns, and phrases emerging from the data. This process involves reducing the data into more manageable pieces you can easily analyze.

The next step is to code the data by labeling sections of the text with descriptive words or phrases that reflect the data's content. Coding helps identify key themes and patterns from the interview data.

4. Categorization

After coding, you should group the codes into categories based on their similarities. This process helps to identify overarching themes or sub-themes that emerge from the data.

5. Interpretation

You should then interpret the themes and sub-themes by identifying relationships, contradictions, and meanings that emerge from the data. Interpretation involves analyzing the themes in the context of the research question.

6. Comparison

The next step is comparing the data across participants or groups to identify similarities and differences. This step helps to ensure that the findings aren’t just specific to one participant but can be generalized to the wider population.

7. Triangulation

To ensure the findings are valid and reliable, you should use triangulation by comparing the findings with other sources, such as observations or interview data.

8. Synthesis

The final step is synthesizing the findings by summarizing the key themes and presenting them clearly and concisely. This step involves writing a report that presents the findings in a way that is easy to understand, using quotes and examples from the interview data to illustrate the themes.

  • Tips for transcribing a qualitative interview

Transcribing a qualitative interview is a crucial step in the research process. It involves converting the audio or video recording of the interview into written text. 

Here are some tips for transcribing a qualitative interview:

Use transcription software

Transcription software can save time and increase accuracy by automatically transcribing audio or video recordings.

Listen carefully

When manually transcribing, listen carefully to the recording to ensure clarity. Pause and rewind the recording as necessary.

Use appropriate formatting

Use a consistent format for transcribing, such as marking pauses, overlaps, and interruptions. Indicate non-verbal cues such as laughter, sighs, or changes in tone.

Edit for clarity

Edit the transcription to ensure clarity and readability. Use standard grammar and punctuation, correct misspellings, and remove filler words like "um" and "ah."

Proofread and edit

Verify the accuracy of the transcription by listening to the recording again and reviewing the notes taken during the interview.

Use timestamps

Add timestamps to the transcription to reference specific interview sections.

Transcribing a qualitative interview can be time-consuming, but it’s essential to ensure the accuracy of the data collected. Following these tips can produce high-quality transcriptions useful for analysis and reporting.

  • Why are interview techniques in qualitative research effective?

Unlike quantitative research methods, which rely on numerical data, qualitative research seeks to understand the richness and complexity of human experiences and perspectives. 

Interview techniques involve asking open-ended questions that allow participants to express their views and share their stories in their own words. This approach can help researchers to uncover unexpected or surprising insights that may not have been discovered through other research methods.

Interview techniques also allow researchers to establish rapport with participants, creating a comfortable and safe space for them to share their experiences. This can lead to a deeper level of trust and candor, leading to more honest and authentic responses.

  • What are the weaknesses of qualitative interviews?

Qualitative interviews are an excellent research approach when used properly, but they have their drawbacks. 

The weaknesses of qualitative interviews include the following:

Subjectivity and personal biases

Qualitative interviews rely on the researcher's interpretation of the interviewee's responses. The researcher's biases or preconceptions can affect how the questions are framed and how the responses are interpreted, which can influence results.

Small sample size

The sample size in qualitative interviews is often small, which can limit the generalizability of the results to the larger population.

Data quality

The quality of data collected during interviews can be affected by various factors, such as the interviewee's mood, the setting of the interview, and the interviewer's skills and experience.

Socially desirable responses

Interviewees may provide responses that they believe are socially acceptable rather than truthful or genuine.

Conducting qualitative interviews can be expensive, especially if the researcher must travel to different locations to conduct the interviews.

Time-consuming

The data analysis process can be time-consuming and labor-intensive, as researchers need to transcribe and analyze the data manually.

Despite these weaknesses, qualitative interviews remain a valuable research tool. You can take steps to mitigate the impact of these weaknesses by incorporating the perspectives of other researchers or participants in the analysis process, using multiple data sources , and critically analyzing your biases and assumptions.

Mastering the art of qualitative interviews is an essential skill for businesses looking to gain deep insights into their customers' needs, preferences, and behaviors. By following the tips and best practices outlined in this article, you can conduct interviews that provide you with rich data that you can use to make informed decisions about your products, services, and marketing strategies. 

Remember that effective communication, active listening, and proper analysis are critical components of successful qualitative interviews. By incorporating these practices into your customer research, you can gain a competitive edge and build stronger customer relationships.

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Chapter 11. Interviewing

Introduction.

Interviewing people is at the heart of qualitative research. It is not merely a way to collect data but an intrinsically rewarding activity—an interaction between two people that holds the potential for greater understanding and interpersonal development. Unlike many of our daily interactions with others that are fairly shallow and mundane, sitting down with a person for an hour or two and really listening to what they have to say is a profound and deep enterprise, one that can provide not only “data” for you, the interviewer, but also self-understanding and a feeling of being heard for the interviewee. I always approach interviewing with a deep appreciation for the opportunity it gives me to understand how other people experience the world. That said, there is not one kind of interview but many, and some of these are shallower than others. This chapter will provide you with an overview of interview techniques but with a special focus on the in-depth semistructured interview guide approach, which is the approach most widely used in social science research.

An interview can be variously defined as “a conversation with a purpose” ( Lune and Berg 2018 ) and an attempt to understand the world from the point of view of the person being interviewed: “to unfold the meaning of peoples’ experiences, to uncover their lived world prior to scientific explanations” ( Kvale 2007 ). It is a form of active listening in which the interviewer steers the conversation to subjects and topics of interest to their research but also manages to leave enough space for those interviewed to say surprising things. Achieving that balance is a tricky thing, which is why most practitioners believe interviewing is both an art and a science. In my experience as a teacher, there are some students who are “natural” interviewers (often they are introverts), but anyone can learn to conduct interviews, and everyone, even those of us who have been doing this for years, can improve their interviewing skills. This might be a good time to highlight the fact that the interview is a product between interviewer and interviewee and that this product is only as good as the rapport established between the two participants. Active listening is the key to establishing this necessary rapport.

Patton ( 2002 ) makes the argument that we use interviews because there are certain things that are not observable. In particular, “we cannot observe feelings, thoughts, and intentions. We cannot observe behaviors that took place at some previous point in time. We cannot observe situations that preclude the presence of an observer. We cannot observe how people have organized the world and the meanings they attach to what goes on in the world. We have to ask people questions about those things” ( 341 ).

Types of Interviews

There are several distinct types of interviews. Imagine a continuum (figure 11.1). On one side are unstructured conversations—the kind you have with your friends. No one is in control of those conversations, and what you talk about is often random—whatever pops into your head. There is no secret, underlying purpose to your talking—if anything, the purpose is to talk to and engage with each other, and the words you use and the things you talk about are a little beside the point. An unstructured interview is a little like this informal conversation, except that one of the parties to the conversation (you, the researcher) does have an underlying purpose, and that is to understand the other person. You are not friends speaking for no purpose, but it might feel just as unstructured to the “interviewee” in this scenario. That is one side of the continuum. On the other side are fully structured and standardized survey-type questions asked face-to-face. Here it is very clear who is asking the questions and who is answering them. This doesn’t feel like a conversation at all! A lot of people new to interviewing have this ( erroneously !) in mind when they think about interviews as data collection. Somewhere in the middle of these two extreme cases is the “ semistructured” interview , in which the researcher uses an “interview guide” to gently move the conversation to certain topics and issues. This is the primary form of interviewing for qualitative social scientists and will be what I refer to as interviewing for the rest of this chapter, unless otherwise specified.

Types of Interviewing Questions: Unstructured conversations, Semi-structured interview, Structured interview, Survey questions

Informal (unstructured conversations). This is the most “open-ended” approach to interviewing. It is particularly useful in conjunction with observational methods (see chapters 13 and 14). There are no predetermined questions. Each interview will be different. Imagine you are researching the Oregon Country Fair, an annual event in Veneta, Oregon, that includes live music, artisan craft booths, face painting, and a lot of people walking through forest paths. It’s unlikely that you will be able to get a person to sit down with you and talk intensely about a set of questions for an hour and a half. But you might be able to sidle up to several people and engage with them about their experiences at the fair. You might have a general interest in what attracts people to these events, so you could start a conversation by asking strangers why they are here or why they come back every year. That’s it. Then you have a conversation that may lead you anywhere. Maybe one person tells a long story about how their parents brought them here when they were a kid. A second person talks about how this is better than Burning Man. A third person shares their favorite traveling band. And yet another enthuses about the public library in the woods. During your conversations, you also talk about a lot of other things—the weather, the utilikilts for sale, the fact that a favorite food booth has disappeared. It’s all good. You may not be able to record these conversations. Instead, you might jot down notes on the spot and then, when you have the time, write down as much as you can remember about the conversations in long fieldnotes. Later, you will have to sit down with these fieldnotes and try to make sense of all the information (see chapters 18 and 19).

Interview guide ( semistructured interview ). This is the primary type employed by social science qualitative researchers. The researcher creates an “interview guide” in advance, which she uses in every interview. In theory, every person interviewed is asked the same questions. In practice, every person interviewed is asked mostly the same topics but not always the same questions, as the whole point of a “guide” is that it guides the direction of the conversation but does not command it. The guide is typically between five and ten questions or question areas, sometimes with suggested follow-ups or prompts . For example, one question might be “What was it like growing up in Eastern Oregon?” with prompts such as “Did you live in a rural area? What kind of high school did you attend?” to help the conversation develop. These interviews generally take place in a quiet place (not a busy walkway during a festival) and are recorded. The recordings are transcribed, and those transcriptions then become the “data” that is analyzed (see chapters 18 and 19). The conventional length of one of these types of interviews is between one hour and two hours, optimally ninety minutes. Less than one hour doesn’t allow for much development of questions and thoughts, and two hours (or more) is a lot of time to ask someone to sit still and answer questions. If you have a lot of ground to cover, and the person is willing, I highly recommend two separate interview sessions, with the second session being slightly shorter than the first (e.g., ninety minutes the first day, sixty minutes the second). There are lots of good reasons for this, but the most compelling one is that this allows you to listen to the first day’s recording and catch anything interesting you might have missed in the moment and so develop follow-up questions that can probe further. This also allows the person being interviewed to have some time to think about the issues raised in the interview and go a little deeper with their answers.

Standardized questionnaire with open responses ( structured interview ). This is the type of interview a lot of people have in mind when they hear “interview”: a researcher comes to your door with a clipboard and proceeds to ask you a series of questions. These questions are all the same whoever answers the door; they are “standardized.” Both the wording and the exact order are important, as people’s responses may vary depending on how and when a question is asked. These are qualitative only in that the questions allow for “open-ended responses”: people can say whatever they want rather than select from a predetermined menu of responses. For example, a survey I collaborated on included this open-ended response question: “How does class affect one’s career success in sociology?” Some of the answers were simply one word long (e.g., “debt”), and others were long statements with stories and personal anecdotes. It is possible to be surprised by the responses. Although it’s a stretch to call this kind of questioning a conversation, it does allow the person answering the question some degree of freedom in how they answer.

Survey questionnaire with closed responses (not an interview!). Standardized survey questions with specific answer options (e.g., closed responses) are not really interviews at all, and they do not generate qualitative data. For example, if we included five options for the question “How does class affect one’s career success in sociology?”—(1) debt, (2) social networks, (3) alienation, (4) family doesn’t understand, (5) type of grad program—we leave no room for surprises at all. Instead, we would most likely look at patterns around these responses, thinking quantitatively rather than qualitatively (e.g., using regression analysis techniques, we might find that working-class sociologists were twice as likely to bring up alienation). It can sometimes be confusing for new students because the very same survey can include both closed-ended and open-ended questions. The key is to think about how these will be analyzed and to what level surprises are possible. If your plan is to turn all responses into a number and make predictions about correlations and relationships, you are no longer conducting qualitative research. This is true even if you are conducting this survey face-to-face with a real live human. Closed-response questions are not conversations of any kind, purposeful or not.

In summary, the semistructured interview guide approach is the predominant form of interviewing for social science qualitative researchers because it allows a high degree of freedom of responses from those interviewed (thus allowing for novel discoveries) while still maintaining some connection to a research question area or topic of interest. The rest of the chapter assumes the employment of this form.

Creating an Interview Guide

Your interview guide is the instrument used to bridge your research question(s) and what the people you are interviewing want to tell you. Unlike a standardized questionnaire, the questions actually asked do not need to be exactly what you have written down in your guide. The guide is meant to create space for those you are interviewing to talk about the phenomenon of interest, but sometimes you are not even sure what that phenomenon is until you start asking questions. A priority in creating an interview guide is to ensure it offers space. One of the worst mistakes is to create questions that are so specific that the person answering them will not stray. Relatedly, questions that sound “academic” will shut down a lot of respondents. A good interview guide invites respondents to talk about what is important to them, not feel like they are performing or being evaluated by you.

Good interview questions should not sound like your “research question” at all. For example, let’s say your research question is “How do patriarchal assumptions influence men’s understanding of climate change and responses to climate change?” It would be worse than unhelpful to ask a respondent, “How do your assumptions about the role of men affect your understanding of climate change?” You need to unpack this into manageable nuggets that pull your respondent into the area of interest without leading him anywhere. You could start by asking him what he thinks about climate change in general. Or, even better, whether he has any concerns about heatwaves or increased tornadoes or polar icecaps melting. Once he starts talking about that, you can ask follow-up questions that bring in issues around gendered roles, perhaps asking if he is married (to a woman) and whether his wife shares his thoughts and, if not, how they negotiate that difference. The fact is, you won’t really know the right questions to ask until he starts talking.

There are several distinct types of questions that can be used in your interview guide, either as main questions or as follow-up probes. If you remember that the point is to leave space for the respondent, you will craft a much more effective interview guide! You will also want to think about the place of time in both the questions themselves (past, present, future orientations) and the sequencing of the questions.

Researcher Note

Suggestion : As you read the next three sections (types of questions, temporality, question sequence), have in mind a particular research question, and try to draft questions and sequence them in a way that opens space for a discussion that helps you answer your research question.

Type of Questions

Experience and behavior questions ask about what a respondent does regularly (their behavior) or has done (their experience). These are relatively easy questions for people to answer because they appear more “factual” and less subjective. This makes them good opening questions. For the study on climate change above, you might ask, “Have you ever experienced an unusual weather event? What happened?” Or “You said you work outside? What is a typical summer workday like for you? How do you protect yourself from the heat?”

Opinion and values questions , in contrast, ask questions that get inside the minds of those you are interviewing. “Do you think climate change is real? Who or what is responsible for it?” are two such questions. Note that you don’t have to literally ask, “What is your opinion of X?” but you can find a way to ask the specific question relevant to the conversation you are having. These questions are a bit trickier to ask because the answers you get may depend in part on how your respondent perceives you and whether they want to please you or not. We’ve talked a fair amount about being reflective. Here is another place where this comes into play. You need to be aware of the effect your presence might have on the answers you are receiving and adjust accordingly. If you are a woman who is perceived as liberal asking a man who identifies as conservative about climate change, there is a lot of subtext that can be going on in the interview. There is no one right way to resolve this, but you must at least be aware of it.

Feeling questions are questions that ask respondents to draw on their emotional responses. It’s pretty common for academic researchers to forget that we have bodies and emotions, but people’s understandings of the world often operate at this affective level, sometimes unconsciously or barely consciously. It is a good idea to include questions that leave space for respondents to remember, imagine, or relive emotional responses to particular phenomena. “What was it like when you heard your cousin’s house burned down in that wildfire?” doesn’t explicitly use any emotion words, but it allows your respondent to remember what was probably a pretty emotional day. And if they respond emotionally neutral, that is pretty interesting data too. Note that asking someone “How do you feel about X” is not always going to evoke an emotional response, as they might simply turn around and respond with “I think that…” It is better to craft a question that actually pushes the respondent into the affective category. This might be a specific follow-up to an experience and behavior question —for example, “You just told me about your daily routine during the summer heat. Do you worry it is going to get worse?” or “Have you ever been afraid it will be too hot to get your work accomplished?”

Knowledge questions ask respondents what they actually know about something factual. We have to be careful when we ask these types of questions so that respondents do not feel like we are evaluating them (which would shut them down), but, for example, it is helpful to know when you are having a conversation about climate change that your respondent does in fact know that unusual weather events have increased and that these have been attributed to climate change! Asking these questions can set the stage for deeper questions and can ensure that the conversation makes the same kind of sense to both participants. For example, a conversation about political polarization can be put back on track once you realize that the respondent doesn’t really have a clear understanding that there are two parties in the US. Instead of asking a series of questions about Republicans and Democrats, you might shift your questions to talk more generally about political disagreements (e.g., “people against abortion”). And sometimes what you do want to know is the level of knowledge about a particular program or event (e.g., “Are you aware you can discharge your student loans through the Public Service Loan Forgiveness program?”).

Sensory questions call on all senses of the respondent to capture deeper responses. These are particularly helpful in sparking memory. “Think back to your childhood in Eastern Oregon. Describe the smells, the sounds…” Or you could use these questions to help a person access the full experience of a setting they customarily inhabit: “When you walk through the doors to your office building, what do you see? Hear? Smell?” As with feeling questions , these questions often supplement experience and behavior questions . They are another way of allowing your respondent to report fully and deeply rather than remain on the surface.

Creative questions employ illustrative examples, suggested scenarios, or simulations to get respondents to think more deeply about an issue, topic, or experience. There are many options here. In The Trouble with Passion , Erin Cech ( 2021 ) provides a scenario in which “Joe” is trying to decide whether to stay at his decent but boring computer job or follow his passion by opening a restaurant. She asks respondents, “What should Joe do?” Their answers illuminate the attraction of “passion” in job selection. In my own work, I have used a news story about an upwardly mobile young man who no longer has time to see his mother and sisters to probe respondents’ feelings about the costs of social mobility. Jessi Streib and Betsy Leondar-Wright have used single-page cartoon “scenes” to elicit evaluations of potential racial discrimination, sexual harassment, and classism. Barbara Sutton ( 2010 ) has employed lists of words (“strong,” “mother,” “victim”) on notecards she fans out and asks her female respondents to select and discuss.

Background/Demographic Questions

You most definitely will want to know more about the person you are interviewing in terms of conventional demographic information, such as age, race, gender identity, occupation, and educational attainment. These are not questions that normally open up inquiry. [1] For this reason, my practice has been to include a separate “demographic questionnaire” sheet that I ask each respondent to fill out at the conclusion of the interview. Only include those aspects that are relevant to your study. For example, if you are not exploring religion or religious affiliation, do not include questions about a person’s religion on the demographic sheet. See the example provided at the end of this chapter.

Temporality

Any type of question can have a past, present, or future orientation. For example, if you are asking a behavior question about workplace routine, you might ask the respondent to talk about past work, present work, and ideal (future) work. Similarly, if you want to understand how people cope with natural disasters, you might ask your respondent how they felt then during the wildfire and now in retrospect and whether and to what extent they have concerns for future wildfire disasters. It’s a relatively simple suggestion—don’t forget to ask about past, present, and future—but it can have a big impact on the quality of the responses you receive.

Question Sequence

Having a list of good questions or good question areas is not enough to make a good interview guide. You will want to pay attention to the order in which you ask your questions. Even though any one respondent can derail this order (perhaps by jumping to answer a question you haven’t yet asked), a good advance plan is always helpful. When thinking about sequence, remember that your goal is to get your respondent to open up to you and to say things that might surprise you. To establish rapport, it is best to start with nonthreatening questions. Asking about the present is often the safest place to begin, followed by the past (they have to know you a little bit to get there), and lastly, the future (talking about hopes and fears requires the most rapport). To allow for surprises, it is best to move from very general questions to more particular questions only later in the interview. This ensures that respondents have the freedom to bring up the topics that are relevant to them rather than feel like they are constrained to answer you narrowly. For example, refrain from asking about particular emotions until these have come up previously—don’t lead with them. Often, your more particular questions will emerge only during the course of the interview, tailored to what is emerging in conversation.

Once you have a set of questions, read through them aloud and imagine you are being asked the same questions. Does the set of questions have a natural flow? Would you be willing to answer the very first question to a total stranger? Does your sequence establish facts and experiences before moving on to opinions and values? Did you include prefatory statements, where necessary; transitions; and other announcements? These can be as simple as “Hey, we talked a lot about your experiences as a barista while in college.… Now I am turning to something completely different: how you managed friendships in college.” That is an abrupt transition, but it has been softened by your acknowledgment of that.

Probes and Flexibility

Once you have the interview guide, you will also want to leave room for probes and follow-up questions. As in the sample probe included here, you can write out the obvious probes and follow-up questions in advance. You might not need them, as your respondent might anticipate them and include full responses to the original question. Or you might need to tailor them to how your respondent answered the question. Some common probes and follow-up questions include asking for more details (When did that happen? Who else was there?), asking for elaboration (Could you say more about that?), asking for clarification (Does that mean what I think it means or something else? I understand what you mean, but someone else reading the transcript might not), and asking for contrast or comparison (How did this experience compare with last year’s event?). “Probing is a skill that comes from knowing what to look for in the interview, listening carefully to what is being said and what is not said, and being sensitive to the feedback needs of the person being interviewed” ( Patton 2002:374 ). It takes work! And energy. I and many other interviewers I know report feeling emotionally and even physically drained after conducting an interview. You are tasked with active listening and rearranging your interview guide as needed on the fly. If you only ask the questions written down in your interview guide with no deviations, you are doing it wrong. [2]

The Final Question

Every interview guide should include a very open-ended final question that allows for the respondent to say whatever it is they have been dying to tell you but you’ve forgotten to ask. About half the time they are tired too and will tell you they have nothing else to say. But incredibly, some of the most honest and complete responses take place here, at the end of a long interview. You have to realize that the person being interviewed is often discovering things about themselves as they talk to you and that this process of discovery can lead to new insights for them. Making space at the end is therefore crucial. Be sure you convey that you actually do want them to tell you more, that the offer of “anything else?” is not read as an empty convention where the polite response is no. Here is where you can pull from that active listening and tailor the final question to the particular person. For example, “I’ve asked you a lot of questions about what it was like to live through that wildfire. I’m wondering if there is anything I’ve forgotten to ask, especially because I haven’t had that experience myself” is a much more inviting final question than “Great. Anything you want to add?” It’s also helpful to convey to the person that you have the time to listen to their full answer, even if the allotted time is at the end. After all, there are no more questions to ask, so the respondent knows exactly how much time is left. Do them the courtesy of listening to them!

Conducting the Interview

Once you have your interview guide, you are on your way to conducting your first interview. I always practice my interview guide with a friend or family member. I do this even when the questions don’t make perfect sense for them, as it still helps me realize which questions make no sense, are poorly worded (too academic), or don’t follow sequentially. I also practice the routine I will use for interviewing, which goes something like this:

  • Introduce myself and reintroduce the study
  • Provide consent form and ask them to sign and retain/return copy
  • Ask if they have any questions about the study before we begin
  • Ask if I can begin recording
  • Ask questions (from interview guide)
  • Turn off the recording device
  • Ask if they are willing to fill out my demographic questionnaire
  • Collect questionnaire and, without looking at the answers, place in same folder as signed consent form
  • Thank them and depart

A note on remote interviewing: Interviews have traditionally been conducted face-to-face in a private or quiet public setting. You don’t want a lot of background noise, as this will make transcriptions difficult. During the recent global pandemic, many interviewers, myself included, learned the benefits of interviewing remotely. Although face-to-face is still preferable for many reasons, Zoom interviewing is not a bad alternative, and it does allow more interviews across great distances. Zoom also includes automatic transcription, which significantly cuts down on the time it normally takes to convert our conversations into “data” to be analyzed. These automatic transcriptions are not perfect, however, and you will still need to listen to the recording and clarify and clean up the transcription. Nor do automatic transcriptions include notations of body language or change of tone, which you may want to include. When interviewing remotely, you will want to collect the consent form before you meet: ask them to read, sign, and return it as an email attachment. I think it is better to ask for the demographic questionnaire after the interview, but because some respondents may never return it then, it is probably best to ask for this at the same time as the consent form, in advance of the interview.

What should you bring to the interview? I would recommend bringing two copies of the consent form (one for you and one for the respondent), a demographic questionnaire, a manila folder in which to place the signed consent form and filled-out demographic questionnaire, a printed copy of your interview guide (I print with three-inch right margins so I can jot down notes on the page next to relevant questions), a pen, a recording device, and water.

After the interview, you will want to secure the signed consent form in a locked filing cabinet (if in print) or a password-protected folder on your computer. Using Excel or a similar program that allows tables/spreadsheets, create an identifying number for your interview that links to the consent form without using the name of your respondent. For example, let’s say that I conduct interviews with US politicians, and the first person I meet with is George W. Bush. I will assign the transcription the number “INT#001” and add it to the signed consent form. [3] The signed consent form goes into a locked filing cabinet, and I never use the name “George W. Bush” again. I take the information from the demographic sheet, open my Excel spreadsheet, and add the relevant information in separate columns for the row INT#001: White, male, Republican. When I interview Bill Clinton as my second interview, I include a second row: INT#002: White, male, Democrat. And so on. The only link to the actual name of the respondent and this information is the fact that the consent form (unavailable to anyone but me) has stamped on it the interview number.

Many students get very nervous before their first interview. Actually, many of us are always nervous before the interview! But do not worry—this is normal, and it does pass. Chances are, you will be pleasantly surprised at how comfortable it begins to feel. These “purposeful conversations” are often a delight for both participants. This is not to say that sometimes things go wrong. I often have my students practice several “bad scenarios” (e.g., a respondent that you cannot get to open up; a respondent who is too talkative and dominates the conversation, steering it away from the topics you are interested in; emotions that completely take over; or shocking disclosures you are ill-prepared to handle), but most of the time, things go quite well. Be prepared for the unexpected, but know that the reason interviews are so popular as a technique of data collection is that they are usually richly rewarding for both participants.

One thing that I stress to my methods students and remind myself about is that interviews are still conversations between people. If there’s something you might feel uncomfortable asking someone about in a “normal” conversation, you will likely also feel a bit of discomfort asking it in an interview. Maybe more importantly, your respondent may feel uncomfortable. Social research—especially about inequality—can be uncomfortable. And it’s easy to slip into an abstract, intellectualized, or removed perspective as an interviewer. This is one reason trying out interview questions is important. Another is that sometimes the question sounds good in your head but doesn’t work as well out loud in practice. I learned this the hard way when a respondent asked me how I would answer the question I had just posed, and I realized that not only did I not really know how I would answer it, but I also wasn’t quite as sure I knew what I was asking as I had thought.

—Elizabeth M. Lee, Associate Professor of Sociology at Saint Joseph’s University, author of Class and Campus Life , and co-author of Geographies of Campus Inequality

How Many Interviews?

Your research design has included a targeted number of interviews and a recruitment plan (see chapter 5). Follow your plan, but remember that “ saturation ” is your goal. You interview as many people as you can until you reach a point at which you are no longer surprised by what they tell you. This means not that no one after your first twenty interviews will have surprising, interesting stories to tell you but rather that the picture you are forming about the phenomenon of interest to you from a research perspective has come into focus, and none of the interviews are substantially refocusing that picture. That is when you should stop collecting interviews. Note that to know when you have reached this, you will need to read your transcripts as you go. More about this in chapters 18 and 19.

Your Final Product: The Ideal Interview Transcript

A good interview transcript will demonstrate a subtly controlled conversation by the skillful interviewer. In general, you want to see replies that are about one paragraph long, not short sentences and not running on for several pages. Although it is sometimes necessary to follow respondents down tangents, it is also often necessary to pull them back to the questions that form the basis of your research study. This is not really a free conversation, although it may feel like that to the person you are interviewing.

Final Tips from an Interview Master

Annette Lareau is arguably one of the masters of the trade. In Listening to People , she provides several guidelines for good interviews and then offers a detailed example of an interview gone wrong and how it could be addressed (please see the “Further Readings” at the end of this chapter). Here is an abbreviated version of her set of guidelines: (1) interview respondents who are experts on the subjects of most interest to you (as a corollary, don’t ask people about things they don’t know); (2) listen carefully and talk as little as possible; (3) keep in mind what you want to know and why you want to know it; (4) be a proactive interviewer (subtly guide the conversation); (5) assure respondents that there aren’t any right or wrong answers; (6) use the respondent’s own words to probe further (this both allows you to accurately identify what you heard and pushes the respondent to explain further); (7) reuse effective probes (don’t reinvent the wheel as you go—if repeating the words back works, do it again and again); (8) focus on learning the subjective meanings that events or experiences have for a respondent; (9) don’t be afraid to ask a question that draws on your own knowledge (unlike trial lawyers who are trained never to ask a question for which they don’t already know the answer, sometimes it’s worth it to ask risky questions based on your hypotheses or just plain hunches); (10) keep thinking while you are listening (so difficult…and important); (11) return to a theme raised by a respondent if you want further information; (12) be mindful of power inequalities (and never ever coerce a respondent to continue the interview if they want out); (13) take control with overly talkative respondents; (14) expect overly succinct responses, and develop strategies for probing further; (15) balance digging deep and moving on; (16) develop a plan to deflect questions (e.g., let them know you are happy to answer any questions at the end of the interview, but you don’t want to take time away from them now); and at the end, (17) check to see whether you have asked all your questions. You don’t always have to ask everyone the same set of questions, but if there is a big area you have forgotten to cover, now is the time to recover ( Lareau 2021:93–103 ).

Sample: Demographic Questionnaire

ASA Taskforce on First-Generation and Working-Class Persons in Sociology – Class Effects on Career Success

Supplementary Demographic Questionnaire

Thank you for your participation in this interview project. We would like to collect a few pieces of key demographic information from you to supplement our analyses. Your answers to these questions will be kept confidential and stored by ID number. All of your responses here are entirely voluntary!

What best captures your race/ethnicity? (please check any/all that apply)

  • White (Non Hispanic/Latina/o/x)
  • Black or African American
  • Hispanic, Latino/a/x of Spanish
  • Asian or Asian American
  • American Indian or Alaska Native
  • Middle Eastern or North African
  • Native Hawaiian or Pacific Islander
  • Other : (Please write in: ________________)

What is your current position?

  • Grad Student
  • Full Professor

Please check any and all of the following that apply to you:

  • I identify as a working-class academic
  • I was the first in my family to graduate from college
  • I grew up poor

What best reflects your gender?

  • Transgender female/Transgender woman
  • Transgender male/Transgender man
  • Gender queer/ Gender nonconforming

Anything else you would like us to know about you?

Example: Interview Guide

In this example, follow-up prompts are italicized.  Note the sequence of questions.  That second question often elicits an entire life history , answering several later questions in advance.

Introduction Script/Question

Thank you for participating in our survey of ASA members who identify as first-generation or working-class.  As you may have heard, ASA has sponsored a taskforce on first-generation and working-class persons in sociology and we are interested in hearing from those who so identify.  Your participation in this interview will help advance our knowledge in this area.

  • The first thing we would like to as you is why you have volunteered to be part of this study? What does it mean to you be first-gen or working class?  Why were you willing to be interviewed?
  • How did you decide to become a sociologist?
  • Can you tell me a little bit about where you grew up? ( prompts: what did your parent(s) do for a living?  What kind of high school did you attend?)
  • Has this identity been salient to your experience? (how? How much?)
  • How welcoming was your grad program? Your first academic employer?
  • Why did you decide to pursue sociology at the graduate level?
  • Did you experience culture shock in college? In graduate school?
  • Has your FGWC status shaped how you’ve thought about where you went to school? debt? etc?
  • Were you mentored? How did this work (not work)?  How might it?
  • What did you consider when deciding where to go to grad school? Where to apply for your first position?
  • What, to you, is a mark of career success? Have you achieved that success?  What has helped or hindered your pursuit of success?
  • Do you think sociology, as a field, cares about prestige?
  • Let’s talk a little bit about intersectionality. How does being first-gen/working class work alongside other identities that are important to you?
  • What do your friends and family think about your career? Have you had any difficulty relating to family members or past friends since becoming highly educated?
  • Do you have any debt from college/grad school? Are you concerned about this?  Could you explain more about how you paid for college/grad school?  (here, include assistance from family, fellowships, scholarships, etc.)
  • (You’ve mentioned issues or obstacles you had because of your background.) What could have helped?  Or, who or what did? Can you think of fortuitous moments in your career?
  • Do you have any regrets about the path you took?
  • Is there anything else you would like to add? Anything that the Taskforce should take note of, that we did not ask you about here?

Further Readings

Britten, Nicky. 1995. “Qualitative Interviews in Medical Research.” BMJ: British Medical Journal 31(6999):251–253. A good basic overview of interviewing particularly useful for students of public health and medical research generally.

Corbin, Juliet, and Janice M. Morse. 2003. “The Unstructured Interactive Interview: Issues of Reciprocity and Risks When Dealing with Sensitive Topics.” Qualitative Inquiry 9(3):335–354. Weighs the potential benefits and harms of conducting interviews on topics that may cause emotional distress. Argues that the researcher’s skills and code of ethics should ensure that the interviewing process provides more of a benefit to both participant and researcher than a harm to the former.

Gerson, Kathleen, and Sarah Damaske. 2020. The Science and Art of Interviewing . New York: Oxford University Press. A useful guidebook/textbook for both undergraduates and graduate students, written by sociologists.

Kvale, Steiner. 2007. Doing Interviews . London: SAGE. An easy-to-follow guide to conducting and analyzing interviews by psychologists.

Lamont, Michèle, and Ann Swidler. 2014. “Methodological Pluralism and the Possibilities and Limits of Interviewing.” Qualitative Sociology 37(2):153–171. Written as a response to various debates surrounding the relative value of interview-based studies and ethnographic studies defending the particular strengths of interviewing. This is a must-read article for anyone seriously engaging in qualitative research!

Pugh, Allison J. 2013. “What Good Are Interviews for Thinking about Culture? Demystifying Interpretive Analysis.” American Journal of Cultural Sociology 1(1):42–68. Another defense of interviewing written against those who champion ethnographic methods as superior, particularly in the area of studying culture. A classic.

Rapley, Timothy John. 2001. “The ‘Artfulness’ of Open-Ended Interviewing: Some considerations in analyzing interviews.” Qualitative Research 1(3):303–323. Argues for the importance of “local context” of data production (the relationship built between interviewer and interviewee, for example) in properly analyzing interview data.

Weiss, Robert S. 1995. Learning from Strangers: The Art and Method of Qualitative Interview Studies . New York: Simon and Schuster. A classic and well-regarded textbook on interviewing. Because Weiss has extensive experience conducting surveys, he contrasts the qualitative interview with the survey questionnaire well; particularly useful for those trained in the latter.

  • I say “normally” because how people understand their various identities can itself be an expansive topic of inquiry. Here, I am merely talking about collecting otherwise unexamined demographic data, similar to how we ask people to check boxes on surveys. ↵
  • Again, this applies to “semistructured in-depth interviewing.” When conducting standardized questionnaires, you will want to ask each question exactly as written, without deviations! ↵
  • I always include “INT” in the number because I sometimes have other kinds of data with their own numbering: FG#001 would mean the first focus group, for example. I also always include three-digit spaces, as this allows for up to 999 interviews (or, more realistically, allows for me to interview up to one hundred persons without having to reset my numbering system). ↵

A method of data collection in which the researcher asks the participant questions; the answers to these questions are often recorded and transcribed verbatim. There are many different kinds of interviews - see also semistructured interview , structured interview , and unstructured interview .

A document listing key questions and question areas for use during an interview.  It is used most often for semi-structured interviews.  A good interview guide may have no more than ten primary questions for two hours of interviewing, but these ten questions will be supplemented by probes and relevant follow-ups throughout the interview.  Most IRBs require the inclusion of the interview guide in applications for review.  See also interview and  semi-structured interview .

A data-collection method that relies on casual, conversational, and informal interviewing.  Despite its apparent conversational nature, the researcher usually has a set of particular questions or question areas in mind but allows the interview to unfold spontaneously.  This is a common data-collection technique among ethnographers.  Compare to the semi-structured or in-depth interview .

A form of interview that follows a standard guide of questions asked, although the order of the questions may change to match the particular needs of each individual interview subject, and probing “follow-up” questions are often added during the course of the interview.  The semi-structured interview is the primary form of interviewing used by qualitative researchers in the social sciences.  It is sometimes referred to as an “in-depth” interview.  See also interview and  interview guide .

The cluster of data-collection tools and techniques that involve observing interactions between people, the behaviors, and practices of individuals (sometimes in contrast to what they say about how they act and behave), and cultures in context.  Observational methods are the key tools employed by ethnographers and Grounded Theory .

Follow-up questions used in a semi-structured interview  to elicit further elaboration.  Suggested prompts can be included in the interview guide  to be used/deployed depending on how the initial question was answered or if the topic of the prompt does not emerge spontaneously.

A form of interview that follows a strict set of questions, asked in a particular order, for all interview subjects.  The questions are also the kind that elicits short answers, and the data is more “informative” than probing.  This is often used in mixed-methods studies, accompanying a survey instrument.  Because there is no room for nuance or the exploration of meaning in structured interviews, qualitative researchers tend to employ semi-structured interviews instead.  See also interview.

The point at which you can conclude data collection because every person you are interviewing, the interaction you are observing, or content you are analyzing merely confirms what you have already noted.  Achieving saturation is often used as the justification for the final sample size.

An interview variant in which a person’s life story is elicited in a narrative form.  Turning points and key themes are established by the researcher and used as data points for further analysis.

Introduction to Qualitative Research Methods Copyright © 2023 by Allison Hurst is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License , except where otherwise noted.

Qualitative Interviewing

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Qualitative interviewing is a foundational method in qualitative research and is widely used in health research and the social sciences. Both qualitative semi-structured and in-depth unstructured interviews use verbal communication, mostly in face-to-face interactions, to collect data about the attitudes, beliefs, and experiences of participants. Interviews are an accessible, often affordable, and effective method to understand the socially situated world of research participants. The approach is typically informed by an interpretive framework where the data collected is not viewed as evidence of the truth or reality of a situation or experience but rather a context-bound subjective insight from the participants. The researcher needs to be open to new insights and to privilege the participant’s experience in data collection. The data from qualitative interviews is not generalizable, but its exploratory nature permits the collection of rich data which can answer questions about which little is already known. This chapter introduces the reader to qualitative interviewing, the range of traditions within which interviewing is utilized as a method, and highlights the advantages and some of the challenges and misconceptions in its application. The chapter also provides practical guidance on planning and conducting interview studies. Three case examples are presented to highlight the benefits and risks in the use of interviewing with different participants, providing situated insights as well as advice about how to go about learning to interview if you are a novice.

  • In-depth interviews
  • Semi-structured interviews
  • Qualitative interviewing
  • Interview study design
  • Interview methodology
  • Interview method

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Nathan, S., Newman, C., Lancaster, K. (2019). Qualitative Interviewing. In: Liamputtong, P. (eds) Handbook of Research Methods in Health Social Sciences. Springer, Singapore. https://doi.org/10.1007/978-981-10-5251-4_77

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Textbooks, Guidebooks, and Handbooks  

  • The Ethnographic Interview by James P. Spradley  “Spradley wrote this book for the professional and student who have never done ethnographic fieldwork (p. 231) and for the professional ethnographer who is interested in adapting the author’s procedures (p. iv). Part 1 outlines in 3 chapters Spradley’s version of ethnographic research, and it provides the background for Part 2 which consists of 12 guided steps (chapters) ranging from locating and interviewing an informant to writing an ethnography. Most of the examples come from the author’s own fieldwork among U.S. subcultures . . . Steps 6 and 8 explain lucidly how to construct a domain and a taxonomic analysis” (excerpted from book review by James D. Sexton, 1980).  
  • Fundamentals of Qualitative Research by Johnny Saldana (Series edited by Patricia Leavy)  Provides a soup-to-nuts overview of the qualitative data collection process, including interviewing, participant observation, and other methods.  
  • InterViews by Steinar Kvale  Interviewing is an essential tool in qualitative research and this introduction to interviewing outlines both the theoretical underpinnings and the practical aspects of the process. After examining the role of the interview in the research process, Steinar Kvale considers some of the key philosophical issues relating to interviewing: the interview as conversation, hermeneutics, phenomenology, concerns about ethics as well as validity, and postmodernism. Having established this framework, the author then analyzes the seven stages of the interview process - from designing a study to writing it up.  
  • Practical Evaluation by Michael Quinn Patton  Surveys different interviewing strategies, from, a) informal/conversational, to b) interview guide approach, to c) standardized and open-ended, to d) closed/quantitative. Also discusses strategies for wording questions that are open-ended, clear, sensitive, and neutral, while supporting the speaker. Provides suggestions for probing and maintaining control of the interview process, as well as suggestions for recording and transcription.  
  • The SAGE Handbook of Interview Research by Amir B. Marvasti (Editor); James A. Holstein (Editor); Jaber F. Gubrium (Editor); Karyn D. McKinney (Editor)  The new edition of this landmark volume emphasizes the dynamic, interactional, and reflexive dimensions of the research interview. Contributors highlight the myriad dimensions of complexity that are emerging as researchers increasingly frame the interview as a communicative opportunity as much as a data-gathering format. The book begins with the history and conceptual transformations of the interview, which is followed by chapters that discuss the main components of interview practice. Taken together, the contributions to The SAGE Handbook of Interview Research: The Complexity of the Craft encourage readers simultaneously to learn the frameworks and technologies of interviewing and to reflect on the epistemological foundations of the interview craft.  
  • The SAGE Handbook of Online Research Methods by Nigel G. Fielding, Raymond M. Lee and Grant Blank (Editors) Bringing together the leading names in both qualitative and quantitative online research, this new edition is organised into nine sections: 1. Online Research Methods 2. Designing Online Research 3. Online Data Capture and Data Collection 4. The Online Survey 5. Digital Quantitative Analysis 6. Digital Text Analysis 7. Virtual Ethnography 8. Online Secondary Analysis: Resources and Methods 9. The Future of Online Social Research

ONLINE RESOURCES, COMMUNITIES, AND DATABASES  

  • Interviews as a Method for Qualitative Research (video) This short video summarizes why interviews can serve as useful data in qualitative research.  
  • Companion website to Bloomberg and Volpe's  Completing Your Qualitative Dissertation: A Road Map from Beginning to End,  4th ed Provides helpful templates and appendices featured in the book, as well as links to other useful dissertation resources.
  • International Congress of Qualitative Inquiry Annual conference hosted by the International Center for Qualitative Inquiry at the University of Illinois at Urbana-Champaign, which aims to facilitate the development of qualitative research methods across a wide variety of academic disciplines, among other initiatives.  
  • METHODSPACE ​​​​​​​​An online home of the research methods community, where practicing researchers share how to make research easier.  
  • SAGE researchmethods ​​​​​​​Researchers can explore methods concepts to help them design research projects, understand particular methods or identify a new method, conduct their research, and write up their findings. A "methods map" facilitates finding content on methods.

The decision to conduct interviews, and the type of interviewing to use, should flow from, or align with, the methodological paradigm chosen for your study, whether that paradigm is interpretivist, critical, positivist, or participative in nature (or a combination of these).

Structured:

  • Structured Interview. Entry in The SAGE Encyclopedia of Social Science Research Methodsby Floyd J. Fowler Jr., Editors: Michael S. Lewis-Beck; Alan E. Bryman; Tim Futing Liao (Editor)  A concise article noting standards, procedures, and recommendations for developing and testing structured interviews. For an example of structured interview questions, you may view the Current Population Survey, May 2008: Public Participation in the Arts Supplement (ICPSR 29641), Apr 15, 2011 at https://doi.org/10.3886/ICPSR29641.v1 (To see the survey questions, preview the user guide, which can be found under the "Data and Documentation" tab. Then, look for page 177 (attachment 8).

Semi-Structured:

  • Semi-Structured Interview. Entry in The SAGE Encyclopedia of Qualitative Research Methodsby Lioness Ayres; Editor: Lisa M. Given  The semi-structured interview is a qualitative data collection strategy in which the researcher asks informants a series of predetermined but open-ended questions. The researcher has more control over the topics of the interview than in unstructured interviews, but in contrast to structured interviews or questionnaires that use closed questions, there is no fixed range of responses to each question.

Unstructured:

  • Unstructured Interview. Entry in The SAGE Encyclopedia of Qualitative Research Methodsby Michael W. Firmin; Editor: Lisa M. Given  Unstructured interviews in qualitative research involve asking relatively open-ended questions of research participants in order to discover their percepts on the topic of interest. Interviews, in general, are a foundational means of collecting data when using qualitative research methods. They are designed to draw from the interviewee constructs embedded in his or her thinking and rationale for decision making. The researcher uses an inductive method in data gathering, regardless of whether the interview method is open, structured, or semi-structured. That is, the researcher does not wish to superimpose his or her own viewpoints onto the person being interviewed. Rather, inductively, the researcher wishes to understand the participant's perceptions, helping him or her to articulate percepts such that they will be understood clearly by the journal reader.

Genres and Uses

Focus groups:.

  • "Focus Groups." Annual Review of Sociology 22 (1996): 129-1524.by David L. Morgan  Discusses the use of focus groups and group interviews as methods for gathering qualitative data used by sociologists and other academic and applied researchers. Focus groups are recommended for giving voice to marginalized groups and revealing the group effect on opinion formation.  
  • Qualitative Research Methods: A Data Collector's Field Guide (See Module 4: "Focus Groups")by Mack, N., et al.  This field guide is based on an approach to doing team-based, collaborative qualitative research that has repeatedly proven successful in research projects sponsored by Family Health International (FHI) throughout the developing world. With its straightforward delivery of information on the main qualitative methods being used in public health research today, the guide speaks to the need for simple yet effective instruction on how to do systematic and ethically sound qualitative research. The aim of the guide is thus practical. In bypassing extensive discussion on the theoretical underpinnings of qualitative research, it distinguishes itself as a how-to guide to be used in the field.

In-Depth (typically One-on-One):

  • A Practical Introduction to in-Depth Interviewingby Alan Morris  Are you new to qualitative research or a bit rusty and in need of some inspiration? Are you doing a research project involving in-depth interviews? Are you nervous about carrying out your interviews? This book will help you complete your qualitative research project by providing a nuts and bolts introduction to interviewing. With coverage of ethics, preparation strategies and advice for handling the unexpected in the field, this handy guide will help you get to grips with the basics of interviewing before embarking on your research. While recognising that your research question and the context of your research will drive your approach to interviewing, this book provides practical advice often skipped in traditional methods textbooks.  
  • Qualitative Research Methods: A Data Collector's Field Guide (See Module 3: "In-Depth Interviews")by Mack, N., et al.  This field guide is based on an approach to doing team-based, collaborative qualitative research that has repeatedly proven successful in research projects sponsored by Family Health International (FHI) throughout the developing world. With its straightforward delivery of information on the main qualitative methods being used in public health research today, the guide speaks to the need for simple yet effective instruction on how to do systematic and ethically sound qualitative research. The aim of the guide is thus practical. In bypassing extensive discussion on the theoretical underpinnings of qualitative research, it distinguishes itself as a how-to guide to be used in the field.

Folklore Research and Oral Histories:

In addition to the following resource, see the  Oral History   page of this guide for helpful resources on Oral History interviewing.

American Folklife Center at the Library of Congress. Folklife and Fieldwork: A Layman’s Introduction to Field Techniques Interviews gathered for purposes of folklore research are similar to standard social science interviews in some ways, but also have a good deal in common with oral history approaches to interviewing. The focus in a folklore research interview is on documenting and trying to understand the interviewee's way of life relative to a culture or subculture you are studying. This guide includes helpful advice and tips for conducting fieldwork in folklore, such as tips for planning, conducting, recording, and archiving interviews.

An interdisciplinary scientific program within the Institute for Quantitative Social Science which encourages and facilitates research and instruction in the theory and practice of survey research. The primary mission of PSR is to provide survey research resources to enhance the quality of teaching and research at Harvard.

  • Internet, Phone, Mail, and Mixed-Mode Surveysby Don A. Dillman; Jolene D. Smyth; Leah Melani Christian  The classic survey design reference, updated for the digital age. The new edition is thoroughly updated and revised, and covers all aspects of survey research. It features expanded coverage of mobile phones, tablets, and the use of do-it-yourself surveys, and Dillman's unique Tailored Design Method is also thoroughly explained. This new edition is complemented by copious examples within the text and accompanying website. It includes: Strategies and tactics for determining the needs of a given survey, how to design it, and how to effectively administer it. How and when to use mail, telephone, and Internet surveys to maximum advantage. Proven techniques to increase response rates. Guidance on how to obtain high-quality feedback from mail, electronic, and other self-administered surveys. Direction on how to construct effective questionnaires, including considerations of layout. The effects of sponsorship on the response rates of surveys. Use of capabilities provided by newly mass-used media: interactivity, presentation of aural and visual stimuli. The Fourth Edition reintroduces the telephone--including coordinating land and mobile.

User Experience (UX) and Marketing:

  • See the  "UX & Market Research Interviews"  tab on this guide, above. May include  Focus Groups,  above.

Screening for Research Site Selection:

  • Research interviews are used not only to furnish research data for theoretical analysis in the social sciences, but also to plan other kinds of studies. For example, interviews may allow researchers to screen appropriate research sites to conduct empirical studies (such as randomized controlled trials) in a variety of fields, from medicine to law. In contrast to interviews conducted in the course of social research, such interviews do not typically serve as the data for final analysis and publication.

ENGAGING PARTICIPANTS

Research ethics  .

  • Human Subjects (IRB) The Committee on the Use of Human Subjects (CUHS) serves as the Institutional Review Board for the University area which includes the Cambridge and Allston campuses at Harvard. Find your IRB  contact person , or learn about  required ethics training.  You may also find the  IRB Lifecycle Guide  helpful. This is the preferred IRB portal for Harvard graduate students and other researchers. IRB forms can be downloaded via the  ESTR Library  (click on the "Templates and Forms" tab, then navigate to pages 2 and 3 to find the documents labelled with “HUA” for the Harvard University Area IRB. Nota bene: You may use these forms only if you submit your study to the Harvard University IRB). The IRB office can be reached through email at [email protected] or by telephone at (617) 496-2847.  
  • Undergraduate Research Training Program (URTP) Portal The URTP at Harvard University is a comprehensive platform to create better prepared undergraduate researchers. The URTP is comprised of research ethics training sessions, a student-focused curriculum, and an online decision form that will assist students in determining whether their project requires IRB review. Students should examine the  URTP's guide for student researchers: Introduction to Human Subjects Research Protection.  
  • Ethics reports From the Association of Internet Researchers (AoIR)  
  • Respect, Beneficence, and Justice: QDR General Guidance for Human Participants If you are hoping to share your qualitative interview data in a repository after it has been collected, you will need to plan accordingly via informed consent, careful de-identification procedures, and data access controls. Consider  consulting with the Qualitative Research Support Group at Harvard Library  and consulting with  Harvard's Dataverse contacts  to help you think through all of the contingencies and processes.  
  • "Conducting a Qualitative Child Interview: Methodological Considerations." Journal of Advanced Nursing 42/5 (2003): 434-441 by Kortesluoma, R., et al.  The purpose of this article is to illustrate the theoretical premises of child interviewing, as well as to describe some practical methodological solutions used during interviews. Factors that influence data gathered from children and strategies for taking these factors into consideration during the interview are also described.  
  • "Crossing Cultural Barriers in Research Interviewing." Qualitative Social Work 63/3 (2007): 353-372 by Sands, R., et al.  This article critically examines a qualitative research interview in which cultural barriers between a white non-Muslim female interviewer and an African American Muslim interviewee, both from the USA, became evident and were overcome within the same interview.  
  • Decolonizing Methodologies: Research and Indigenous Peoples by Linda Tuhiwai Smith  This essential volume explores intersections of imperialism and research - specifically, the ways in which imperialism is embedded in disciplines of knowledge and tradition as 'regimes of truth.' Concepts such as 'discovery' and 'claiming' are discussed and an argument presented that the decolonization of research methods will help to reclaim control over indigenous ways of knowing and being. The text includes case-studies and examples, and sections on new indigenous literature and the role of research in indigenous struggles for social justice.  

This resource, sponsored by University of Oregon Libraries, exemplifies the use of interviewing methodologies in research that foregrounds traditional knowledge. The methodology page summarizes the approach.

  • Ethics: The Need to Tread Carefully. Chapter in A Practical Introduction to in-Depth Interviewing by Alan Morris  Pay special attention to the sections in chapter 2 on "How to prevent and respond to ethical issues arising in the course of the interview," "Ethics in the writing up of your interviews," and "The Ethics of Care."  
  • Handbook on Ethical Issues in Anthropology by Joan Cassell (Editor); Sue-Ellen Jacobs (Editor)  This publication of the American Anthropological Association presents and discusses issues and sources on ethics in anthropology, as well as realistic case studies of ethical dilemmas. It is meant to help social science faculty introduce discussions of ethics in their courses. Some of the topics are relevant to interviews, or at least to studies of which interviews are a part. See chapters 3 and 4 for cases, with solutions and commentary, respectively.  
  • Research Ethics from the Chanie Wenjack School for Indigenous Studies, Trent University  (Open Access) An overview of Indigenous research ethics and protocols from the across the globe.  
  • Resources for Equity in Research Consult these resources for guidance on creating and incorporating equitable materials into public health research studies that entail community engagement.

The SAGE Handbook of Qualitative Research Ethics by Ron Iphofen (Editor); Martin Tolich (Editor)  This handbook is a much-needed and in-depth review of the distinctive set of ethical considerations which accompanies qualitative research. This is particularly crucial given the emergent, dynamic and interactional nature of most qualitative research, which too often allows little time for reflection on the important ethical responsibilities and obligations. Contributions from leading international researchers have been carefully organized into six key thematic sections: Part One: Thick Descriptions Of Qualitative Research Ethics; Part Two: Qualitative Research Ethics By Technique; Part Three: Ethics As Politics; Part Four: Qualitative Research Ethics With Vulnerable Groups; Part Five: Relational Research Ethics; Part Six: Researching Digitally. This Handbook is a one-stop resource on qualitative research ethics across the social sciences that draws on the lessons learned and the successful methods for surmounting problems - the tried and true, and the new.

RESEARCH COMPLIANCE AND PRIVACY LAWS

Research Compliance Program for FAS/SEAS at Harvard : The Faculty of Arts and Sciences (FAS), including the School of Engineering and Applied Sciences (SEAS), and the Office of the Vice Provost for Research (OVPR) have established a shared Research Compliance Program (RCP). An area of common concern for interview studies is international projects and collaboration . RCP is a resource to provide guidance on which international activities may be impacted by US sanctions on countries, individuals, or entities and whether licenses or other disclosure are required to ship or otherwise share items, technology, or data with foreign collaborators.

  • Harvard Global Support Services (GSS) is for students, faculty, staff, and researchers who are studying, researching, or working abroad. Their services span safety and security, health, culture, outbound immigration, employment, financial and legal matters, and research center operations. These include travel briefings and registration, emergency response, guidance on international projects, and managing in-country operations.

Generative AI: Harvard-affiliated researchers should not enter data classified as confidential ( Level 2 and above ), including non-public research data, into publicly-available generative AI tools, in accordance with the University’s Information Security Policy. Information shared with generative AI tools using default settings is not private and could expose proprietary or sensitive information to unauthorized parties.

Privacy Laws: Be mindful of any potential privacy laws that may apply wherever you conduct your interviews. The General Data Protection Regulation is a high-profile example (see below):

  • General Data Protection Regulation (GDPR) This Regulation lays down rules relating to the protection of natural persons with regard to the processing of personal data and rules relating to the free movement of personal data. It protects fundamental rights and freedoms of natural persons and in particular their right to the protection of personal data. The free movement of personal data within the Union shall be neither restricted nor prohibited for reasons connected with the protection of natural persons with regard to the processing of personal data. For a nice summary of what the GDPR requires, check out the GDPR "crash course" here .

SEEKING CONSENT  

If you would like to see examples of consent forms, ask your local IRB, or take a look at these resources:

  • Model consent forms for oral history, suggested by the Centre for Oral History and Digital Storytelling at Concordia University  
  • For NIH-funded research, see this  resource for developing informed consent language in research studies where data and/or biospecimens will be stored and shared for future use.

POPULATION SAMPLING

If you wish to assemble resources to aid in sampling, such as the USPS Delivery Sequence File, telephone books, or directories of organizations and listservs, please contact our  data librarian  or write to  [email protected] .

  • Research Randomizer   A free web-based service that permits instant random sampling and random assignment. It also contains an interactive tutorial perfect for students taking courses in research methods.  
  • Practical Tools for Designing and Weighting Survey Samples by Richard Valliant; Jill A. Dever; Frauke Kreuter  Survey sampling is fundamentally an applied field. The goal in this book is to put an array of tools at the fingertips of practitioners by explaining approaches long used by survey statisticians, illustrating how existing software can be used to solve survey problems, and developing some specialized software where needed. This book serves at least three audiences: (1) Students seeking a more in-depth understanding of applied sampling either through a second semester-long course or by way of a supplementary reference; (2) Survey statisticians searching for practical guidance on how to apply concepts learned in theoretical or applied sampling courses; and (3) Social scientists and other survey practitioners who desire insight into the statistical thinking and steps taken to design, select, and weight random survey samples. Several survey data sets are used to illustrate how to design samples, to make estimates from complex surveys for use in optimizing the sample allocation, and to calculate weights. Realistic survey projects are used to demonstrate the challenges and provide a context for the solutions. The book covers several topics that either are not included or are dealt with in a limited way in other texts. These areas include: sample size computations for multistage designs; power calculations related to surveys; mathematical programming for sample allocation in a multi-criteria optimization setting; nuts and bolts of area probability sampling; multiphase designs; quality control of survey operations; and statistical software for survey sampling and estimation. An associated R package, PracTools, contains a number of specialized functions for sample size and other calculations. The data sets used in the book are also available in PracTools, so that the reader may replicate the examples or perform further analyses.  
  • Sampling: Design and Analysis by Sharon L. Lohr  Provides a modern introduction to the field of sampling. With a multitude of applications from a variety of disciplines, the book concentrates on the statistical aspects of taking and analyzing a sample. Overall, the book gives guidance on how to tell when a sample is valid or not, and how to design and analyze many different forms of sample surveys.  
  • Sampling Techniques by William G. Cochran  Clearly demonstrates a wide range of sampling methods now in use by governments, in business, market and operations research, social science, medicine, public health, agriculture, and accounting. Gives proofs of all the theoretical results used in modern sampling practice. New topics in this edition include the approximate methods developed for the problem of attaching standard errors or confidence limits to nonlinear estimates made from the results of surveys with complex plans.  
  • "Understanding the Process of Qualitative Data Collection" in Chapter 13 (pp. 103–1162) of 30 Essential Skills for the Qualitative Researcher by John W. Creswell  Provides practical "how-to" information for beginning researchers in the social, behavioral, and health sciences with many applied examples from research design, qualitative inquiry, and mixed methods.The skills presented in this book are crucial for a new qualitative researcher starting a qualitative project.  
  • Survey Methodology by Robert M. Groves; Floyd J. Fowler; Mick P. Couper; James M. Lepkowski; Eleanor Singer; Roger Tourangeau; Floyd J. Fowler  coverage includes sampling frame evaluation, sample design, development of questionnaires, evaluation of questions, alternative modes of data collection, interviewing, nonresponse, post-collection processing of survey data, and practices for maintaining scientific integrity.

The way a qualitative researcher constructs and approaches interview questions should flow from, or align with, the methodological paradigm chosen for the study, whether that paradigm is interpretivist, critical, positivist, or participative in nature (or a combination of these).

Constructing Your Questions

Helpful texts:.

  • "Developing Questions" in Chapter 4 (pp. 98–108) of Becoming Qualitative Researchers by Corrine Glesne  Ideal for introducing the novice researcher to the theory and practice of qualitative research, this text opens students to the diverse possibilities within this inquiry approach, while helping them understand how to design and implement specific research methods.  
  • "Learning to Interview in the Social Sciences" Qualitative Inquiry, 9(4) 2003, 643–668 by Roulston, K., deMarrais, K., & Lewis, J. B. See especially the section on "Phrasing and Negotiating Questions" on pages 653-655 and common problems with framing questions noted on pages 659 - 660.  
  • Qualitative Research Interviewing: Biographic Narrative and Semi-Structured Methods (See sections on “Lightly and Heavily Structured Depth Interviewing: Theory-Questions and Interviewer-Questions” and “Preparing for any Interviewing Sequence") by Tom Wengraf  Unique in its conceptual coherence and the level of practical detail, this book provides a comprehensive resource for those concerned with the practice of semi-structured interviewing, the most commonly used interview approach in social research, and in particular for in-depth, biographic narrative interviewing. It covers the full range of practices from the identification of topics through to strategies for writing up research findings in diverse ways.  
  • "Scripting a Qualitative Purpose Statement and Research Questions" in Chapter 12 (pp. 93–102) of 30 Essential Skills for the Qualitative Researcher by John W. Creswell  Provides practical "how-to" information for beginning researchers in the social, behavioral, and health sciences with many applied examples from research design, qualitative inquiry, and mixed methods.The skills presented in this book are crucial for a new qualitative researcher starting a qualitative project.  
  • Some Strategies for Developing Interview Guides for Qualitative Interviews by Sociology Department, Harvard University Includes general advice for conducting qualitative interviews, pros and cons of recording and transcription, guidelines for success, and tips for developing and phrasing effective interview questions.  
  • Tip Sheet on Question Wording by Harvard University Program on Survey Research

Let Theory Guide You:

The quality of your questions depends on how you situate them within a wider body of knowledge. Consider the following advice:

A good literature review has many obvious virtues. It enables the investigator to define problems and assess data. It provides the concepts on which percepts depend. But the literature review has a special importance for the qualitative researcher. This consists of its ability to sharpen his or her capacity for surprise (Lazarsfeld, 1972b). The investigator who is well versed in the literature now has a set of expectations the data can defy. Counterexpectational data are conspicuous, readable, and highly provocative data. They signal the existence of unfulfilled theoretical assumptions, and these are, as Kuhn (1962) has noted, the very origins of intellectual innovation. A thorough review of the literature is, to this extent, a way to manufacture distance. It is a way to let the data of one's research project take issue with the theory of one's field.

McCracken, G. (1988), The Long Interview, Sage: Newbury Park, CA, p. 31

When drafting your interview questions, remember that everything follows from your central research question. Also, on the way to writing your "operationalized" interview questions, it's  helpful to draft broader, intermediate questions, couched in theory. Nota bene:  While it is important to know the literature well before conducting your interview(s), be careful not to present yourself to your research participant(s) as "the expert," which would be presumptuous and could be intimidating. Rather, the purpose of your knowledge is to make you a better, keener listener.

If you'd like to supplement what you learned about relevant theories through your coursework and literature review, try these sources:

  • Annual Reviews   Review articles sum up the latest research in many fields, including social sciences, biomedicine, life sciences, and physical sciences. These are timely collections of critical reviews written by leading scientists.  
  • HOLLIS - search for resources on theories in your field   Modify this example search by entering the name of your field in place of "your discipline," then hit search.  
  • Oxford Bibliographies   Written and reviewed by academic experts, every article in this database is an authoritative guide to the current scholarship in a variety of fields, containing original commentary and annotations.  
  • ProQuest Dissertations & Theses (PQDT)   Indexes dissertations and masters' theses from most North American graduate schools as well as some European universities. Provides full text for most indexed dissertations from 1990-present.  
  • Very Short Introductions   Launched by Oxford University Press in 1995, Very Short Introductions offer concise introductions to a diverse range of subjects from Climate to Consciousness, Game Theory to Ancient Warfare, Privacy to Islamic History, Economics to Literary Theory.

CONDUCTING INTERVIEWS

Equipment and software:  .

  • Lamont Library  loans microphones and podcast starter kits, which will allow you to capture audio (and you may record with software, such as Garage Band). 
  • Cabot Library  loans digital recording devices, as well as USB microphones.

If you prefer to use your own device, you may purchase a small handheld audio recorder, or use your cell phone.

  • Audio Capture Basics (PDF)  - Helpful instructions, courtesy of the Lamont Library Multimedia Lab.
  • Getting Started with Podcasting/Audio:  Guidelines from Harvard Library's Virtual Media Lab for preparing your interviewee for a web-based recording (e.g., podcast, interview)
  • ​ Camtasia Screen Recorder and Video Editor
  • Zoom: Video Conferencing, Web Conferencing
  • Visit the Multimedia Production Resources guide! Consult it to find and learn how to use audiovisual production tools, including: cameras, microphones, studio spaces, and other equipment at Cabot Science Library and Lamont Library.
  • Try the virtual office hours offered by the Lamont Multimedia Lab!

TIPS FOR CONDUCTING INTERVIEWS

Quick handout:  .

  • Research Interviewing Tips (Courtesy of Dr. Suzanne Spreadbury)

Remote Interviews:  

  • For Online or Distant Interviews, See "Remote Research & Virtual Fieldwork" on this guide .  
  • Deborah Lupton's Bibliography: Doing Fieldwork in a Pandemic

Seeking Consent:

Books and articles:  .

  • "App-Based Textual Interviews: Interacting With Younger Generations in a Digitalized Social Reallity."International Journal of Social Research Methodology (12 June 2022). Discusses the use of texting platforms as a means to reach young people. Recommends useful question formulations for this medium.  
  • "Learning to Interview in the Social Sciences." Qualitative Inquiry, 9(4) 2003, 643–668 by Roulston, K., deMarrais, K., & Lewis, J. B. See especially the section on "Phrasing and Negotiating Questions" on pages 653-655 and common problems with framing questions noted on pages 659-660.  
  • "Slowing Down and Digging Deep: Teaching Students to Examine Interview Interaction in Depth." LEARNing Landscapes, Spring 2021 14(1) 153-169 by Herron, Brigette A. and Kathryn Roulston. Suggests analysis of videorecorded interviews as a precursor to formulating one's own questions. Includes helpful types of probes.  
  • Using Interviews in a Research Project by Nigel Joseph Mathers; Nicholas J Fox; Amanda Hunn; Trent Focus Group.  A work pack to guide researchers in developing interviews in the healthcare field. Describes interview structures, compares face-to-face and telephone interviews. Outlines the ways in which different types of interview data can be analysed.  
  • “Working through Challenges in Doing Interview Research.” International Journal of Qualitative Methods, (December 2011), 348–66 by Roulston, Kathryn.  The article explores (1) how problematic interactions identified in the analysis of focus group data can lead to modifications in research design, (2) an approach to dealing with reported data in representations of findings, and (3) how data analysis can inform question formulation in successive rounds of data generation. Findings from these types of examinations of interview data generation and analysis are valuable for informing both interview practice as well as research design.

Videos:  

video still image

The way a qualitative researcher transcribes interviews should flow from, or align with, the methodological paradigm chosen for the study, whether that paradigm is interpretivist, critical, positivist, or participative in nature (or a combination of these).

TRANSCRIPTION

Before embarking on a transcription project, it's worthwhile to invest in the time and effort necessary to capture good audio, which will make the transcription process much easier. If you haven't already done so, check out the  audio capture guidelines from Harvard Library's Virtual Media Lab , or  contact a media staff member  for customized recommendations. First and foremost, be mindful of common pitfalls by watching this short video that identifies  the most common errors to avoid!

SOFTWARE:  

  • Adobe Premiere Pro Speech-To-Text  automatically generates transcripts and adds captions to your videos. Harvard affiliates can download Adobe Premiere in the Creative Cloud Suite.  
  • GoTranscript  provides cost-effective human-generated transcriptions.  
  • pyTranscriber  is an app for generating automatic transcription and/or subtitles for audio and video files. It uses the Google Cloud Speech-to-Text service, has a friendly graphical user interface, and is purported to work nicely with Chinese.   
  • Otter  provides a new way to capture, store, search and share voice conversations, lectures, presentations, meetings, and interviews. The startup is based in Silicon Valley with a team of experienced Ph.Ds and engineers from Google, Facebook, Yahoo and Nuance (à la Dragon). Free accounts available. This is the software that  Zoom  uses to generate automated transcripts, so if you have access to a Zoom subscription, you have access to Otter transcriptions with it (applicable in several  languages ). As with any automated approach, be prepared to correct any errors after the fact, by hand.  
  • Panopto  is available to Harvard affiliates and generates  ASR (automated speech recognition) captions . You may upload compatible audio files into it. As with any automatically generated transcription, you will need to make manual revisions. ASR captioning is available in several  languages . Panopto maintains robust security practices, including strong authentication measures and end-to-end encryption, ensuring your content remains private and protected.  
  • REV.Com  allows you to record and transcribe any calls on the iPhone, both outgoing and incoming. It may be useful for recording phone interviews. Rev lets you choose whether you want an AI- or human-generated transcription, with a fast turnaround. Rev has Service Organization Controls Type II (SOC2) certification (a SOC2 cert looks at and verifies an organization’s processing integrity, privacy practices, and security safeguards).   
  • Scribie Audio/Video Transcription  provides automated or manual transcriptions for a small fee. As with any transcription service, some revisions will be necessary after the fact, particularly for its automated transcripts.  
  • Sonix  automatically transcribes, translates, and helps to organize audio and video files in over 40 languages. It's fast and affordable, with good accuracy. The free trial includes 30 minutes of free transcription.  
  • TranscriptionWing  uses a human touch process to clean up machine-generated transcripts so that the content will far more accurately reflect your audio recording.   
  • Whisper is a tool from OpenAI that facilitates transcription of sensitive audiovisual recordings (e.g., of research interviews) on your own device. Installation and use depends on your operating system and which version you install. Important Note: The Whisper API, where audio is sent to OpenAI to be processed by them and then sent back (usually through a programming language like Python) is NOT appropriate for sensitive data. The model should be downloaded with tools such as those described in this FAQ , so that audio is kept to your local machine. For assistance, contact James Capobianco .

EQUIPMENT:  

  • Transcription pedals  are in circulation and available to borrow from the Circulation desk at Lamont, or use at Lamont Library's Media Lab on level B. For hand-transcribing your interviews, they work in conjunction with software such as  Express Scribe , which is loaded on Media Lab computers, or you may download for free on your own machine (Mac or PC versions; scroll down the downloads page for the latter). The pedals are plug-and-play USB, allow a wide range of playback speeds, and have 3 programmable buttons, which are typically set to rewind/play/fast-forward. Instructions are included in the bag that covers installation and set-up of the software, and basic use of the pedals.

NEED HELP?  

  • Try the virtual office hours offered by the Lamont Multimedia Lab!    
  • If you're creating podcasts, login to  Canvas  and check out the  Podcasting/Audio guide . 

Helpful Texts:  

  • "Transcription as a Crucial Step of Data Analysis" in Chapter 5 of The SAGE Handbook of Qualitative Data Analysisby Uwe Flick (Editor)  Covers basic terminology for transcription, shares caveats for transcribers, and identifies components of vocal behavior. Provides notation systems for transcription, suggestions for transcribing turn-taking, and discusses new technologies and perspectives. Includes a bibliography for further reading.  
  • "Transcribing the Oral Interview: Part Art, Part Science " on p. 10 of the Centre for Community Knowledge (CCK) newsletter: TIMESTAMPby Mishika Chauhan and Saransh Srivastav

QUALITATIVE DATA ANALYSIS

Software  .

  • Free download available for Harvard Faculty of Arts and Sciences (FAS) affiliates
  • Desktop access at Lamont Library Media Lab, 3rd floor
  • Desktop access at Harvard Kennedy School Library (with HKS ID)
  • Remote desktop access for Harvard affiliates from  IQSS Computer Labs . Email them at  [email protected] and ask for a new lab account and remote desktop access to NVivo.
  • Virtual Desktop Infrastructure (VDI) access available to Harvard T.H. Chan School of Public Health affiliates

CODING AND THEMEING YOUR DATA

Data analysis methods should flow from, or align with, the methodological paradigm chosen for your study, whether that paradigm is interpretivist, critical, positivist, or participative in nature (or a combination of these). Some established methods include Content Analysis, Critical Analysis, Discourse Analysis, Gestalt Analysis, Grounded Theory Analysis, Interpretive Analysis, Narrative Analysis, Normative Analysis, Phenomenological Analysis, Rhetorical Analysis, and Semiotic Analysis, among others. The following resources should help you navigate your methodological options and put into practice methods for coding, themeing, interpreting, and presenting your data.

  • Users can browse content by topic, discipline, or format type (reference works, book chapters, definitions, etc.). SRM offers several research tools as well: a methods map, user-created reading lists, a project planner, and advice on choosing statistical tests.  
  • Abductive Coding: Theory Building and Qualitative (Re)Analysis by Vila-Henninger, et al.  The authors recommend an abductive approach to guide qualitative researchers who are oriented towards theory-building. They outline a set of tactics for abductive analysis, including the generation of an abductive codebook, abductive data reduction through code equations, and in-depth abductive qualitative analysis.  
  • Analyzing and Interpreting Qualitative Research: After the Interview by Charles F. Vanover, Paul A. Mihas, and Johnny Saldana (Editors)   Providing insight into the wide range of approaches available to the qualitative researcher and covering all steps in the research process, the authors utilize a consistent chapter structure that provides novice and seasoned researchers with pragmatic, "how-to" strategies. Each chapter author introduces the method, uses one of their own research projects as a case study of the method described, shows how the specific analytic method can be used in other types of studies, and concludes with three questions/activities to prompt class discussion or personal study.   
  • "Analyzing Qualitative Data." Theory Into Practice 39, no. 3 (2000): 146-54 by Margaret D. LeCompte   This article walks readers though rules for unbiased data analysis and provides guidance for getting organized, finding items, creating stable sets of items, creating patterns, assembling structures, and conducting data validity checks.  
  • "Coding is Not a Dirty Word" in Chapter 1 (pp. 1–30) of Enhancing Qualitative and Mixed Methods Research with Technology by Shalin Hai-Jew (Editor)   Current discourses in qualitative research, especially those situated in postmodernism, represent coding and the technology that assists with coding as reductive, lacking complexity, and detached from theory. In this chapter, the author presents a counter-narrative to this dominant discourse in qualitative research. The author argues that coding is not necessarily devoid of theory, nor does the use of software for data management and analysis automatically render scholarship theoretically lightweight or barren. A lack of deep analytical insight is a consequence not of software but of epistemology. Using examples informed by interpretive and critical approaches, the author demonstrates how NVivo can provide an effective tool for data management and analysis. The author also highlights ideas for critical and deconstructive approaches in qualitative inquiry while using NVivo. By troubling the positivist discourse of coding, the author seeks to create dialogic spaces that integrate theory with technology-driven data management and analysis, while maintaining the depth and rigor of qualitative research.   
  • The Coding Manual for Qualitative Researchers by Johnny Saldana   An in-depth guide to the multiple approaches available for coding qualitative data. Clear, practical and authoritative, the book profiles 32 coding methods that can be applied to a range of research genres from grounded theory to phenomenology to narrative inquiry. For each approach, Saldaña discusses the methods, origins, a description of the method, practical applications, and a clearly illustrated example with analytic follow-up. Essential reading across the social sciences.  
  • Flexible Coding of In-depth Interviews: A Twenty-first-century Approach by Nicole M. Deterding and Mary C. Waters The authors suggest steps in data organization and analysis to better utilize qualitative data analysis technologies and support rigorous, transparent, and flexible analysis of in-depth interview data.  
  • From the Editors: What Grounded Theory is Not by Roy Suddaby Walks readers through common misconceptions that hinder grounded theory studies, reinforcing the two key concepts of the grounded theory approach: (1) constant comparison of data gathered throughout the data collection process and (2) the determination of which kinds of data to sample in succession based on emergent themes (i.e., "theoretical sampling").  
  • “Good enough” methods for life-story analysis, by Wendy Luttrell. In Quinn N. (Ed.), Finding culture in talk (pp. 243–268). Demonstrates for researchers of culture and consciousness who use narrative how to concretely document reflexive processes in terms of where, how and why particular decisions are made at particular stages of the research process.   
  • Presentation slides on coding and themeing your data, derived from Saldana, Spradley, and LeCompte Click to request access.  
  • Qualitative Data Analysis by Matthew B. Miles; A. Michael Huberman   A practical sourcebook for researchers who make use of qualitative data, presenting the current state of the craft in the design, testing, and use of qualitative analysis methods. Strong emphasis is placed on data displays matrices and networks that go beyond ordinary narrative text. Each method of data display and analysis is described and illustrated.  
  • "A Survey of Qualitative Data Analytic Methods" in Chapter 4 (pp. 89–138) of Fundamentals of Qualitative Research by Johnny Saldana   Provides an in-depth introduction to coding as a heuristic, particularly focusing on process coding, in vivo coding, descriptive coding, values coding, dramaturgical coding, and versus coding. Includes advice on writing analytic memos, developing categories, and themeing data.   
  • "Thematic Networks: An Analytic Tool for Qualitative Research." Qualitative Research : QR, 1(3), 385–405 by Jennifer Attride-Stirling Details a technique for conducting thematic analysis of qualitative material, presenting a step-by-step guide of the analytic process, with the aid of an empirical example. The analytic method presented employs established, well-known techniques; the article proposes that thematic analyses can be usefully aided by and presented as thematic networks.  
  • Using Thematic Analysis in Psychology by Virginia Braun and Victoria Clark Walks readers through the process of reflexive thematic analysis, step by step. The method may be adapted in fields outside of psychology as relevant. Pair this with One Size Fits All? What Counts as Quality Practice in Reflexive Thematic Analysis? by Virginia Braun and Victoria Clark

TESTING OR GENERATING THEORIES

The quality of your data analysis depends on how you situate what you learn within a wider body of knowledge. Consider the following advice:

Once you have coalesced around a theory, realize that a theory should  reveal  rather than  color  your discoveries. Allow your data to guide you to what's most suitable. Grounded theory  researchers may develop their own theory where current theories fail to provide insight.  This guide on Theoretical Models  from Alfaisal University Library provides a helpful overview on using theory.

MANAGING & FINDING INTERVIEW DATA

Managing your elicited interview data, general guidance:  .

  • Research Data Management @ Harvard A reference guide with information and resources to help you manage your research data. See also: Harvard Research Data Security Policy , on the Harvard University Research Data Management website.  
  • Data Management For Researchers: Organize, Maintain and Share Your Data for Research Success by Kristin Briney. A comprehensive guide for scientific researchers providing everything they need to know about data management and how to organize, document, use and reuse their data.  
  • Open Science Framework (OSF) An open-source project management tool that makes it easy to collaborate within and beyond Harvard throughout a project's lifecycle. With OSF you can manage, store, and share documents, datasets, and other information with your research team. You can also publish your work to share it with a wider audience. Although data can be stored privately, because this platform is hosted on the Internet and designed with open access in mind, it is not a good choice for highly sensitive data.  
  • Free cloud storage solutions for Harvard affiliates to consider include:  Google Drive ,  DropBox , or  OneDrive ( up to DSL3 )  

Data Confidentiality and Secure Handling:  

  • Data Security Levels at Harvard - Research Data Examples This resource provided by Harvard Data Security helps you determine what level of access is appropriate for your data. Determine whether it should be made available for public use, limited to the Harvard community, or be protected as either "confidential and sensitive," "high risk," or "extremely sensitive." See also:  Harvard Data Classification Table  
  • Harvard's Best Practices for Protecting Privacy and  Harvard Information Security Collaboration Tools Matrix Follow the nuts-and-bolts advice for privacy best practices at Harvard. The latter resource reveals the level of security that can be relied upon for a large number of technological tools and platforms used at Harvard to conduct business, such as email, Slack, Accellion Kiteworks, OneDrive/SharePoint, etc.  
  • “Protecting Participant Privacy While Maintaining Content and Context: Challenges in Qualitative Data De‐identification and Sharing.” Proceedings of the ASIST Annual Meeting 57 (1) (2020): e415-420 by Myers, Long, and Polasek Presents an informed and tested protocol, based on the De-Identification guidelines published by the Qualitative Data Repository (QDR) at Syracuse University. Qualitative researchers may consult it to guide their data de-identification efforts.  
  • QDS Qualitative Data Sharing Toolkit The Qualitative Data Sharing (QDS) project and its toolkit was funded by the NIH National Human Genome Research Institute (R01HG009351). It provides tools and resources to help researchers, especially those in the health sciences, share qualitative research data while protecting privacy and confidentiality. It offers guidance on preparing data for sharing through de-identification and access control. These health sciences research datasets in ICPSR's Qualitative Data Sharing (QDS) Project Series were de-identified using the QuaDS Software and the project’s QDS guidelines.  
  • Table of De-Identification Techniques  
  • Generative AI Harvard-affiliated researchers should not enter data classified as confidential ( Level 2 and above ), including non-public research data, into publicly-available generative AI tools, in accordance with the University’s Information Security Policy. Information shared with generative AI tools using default settings is not private and could expose proprietary or sensitive information to unauthorized parties.  
  • Harvard Information Security Quick Reference Guide Storage guidelines, based on the data's security classification level (according to its IRB classification) is displayed on page 2, under "handling."  
  • Email Encryption Harvard Microsoft 365 users can now send encrypted messages and files directly from the Outlook web or desktop apps. Encrypting an email adds an extra layer of security to the message and its attachments (up to 150MB), and means only the intended recipient (and their inbox delegates with full access) can view it. Message encryption in Outlook is approved for sending high risk ( level 4 ) data and below.  

Sharing Qualitative Data:  

  • Repositories for Qualitative Data If you have cleared this intention with your IRB, secured consent from participants, and properly de-identified your data, consider sharing your interviews in one of the data repositories included in the link above. Depending on the nature of your research and the level of risk it may present to participants, sharing your interview data may not be appropriate. If there is any chance that sharing such data will be desirable, you will be much better off if you build this expectation into your plans from the beginning.  
  • Guide for Sharing Qualitative Data at ICPSR The Inter-university Consortium for Political and Social Research (ICPSR) has created this resource for investigators planning to share qualitative data at ICPSR. This guide provides an overview of elements and considerations for archiving qualitative data, identifies steps for investigators to follow during the research life cycle to ensure that others can share and reuse qualitative data, and provides information about exemplars of qualitative data  

International Projects:

  • Research Compliance Program for FAS/SEAS at Harvard The Faculty of Arts and Sciences (FAS), including the School of Engineering and Applied Sciences (SEAS), and the Office of the Vice Provost for Research (OVPR) have established a shared Research Compliance Program (RCP). An area of common concern for interview studies is international projects and collaboration . RCP is a resource to provide guidance on which international activities may be impacted by US sanctions on countries, individuals, or entities and whether licenses or other disclosure are required to ship or otherwise share items, technology, or data with foreign collaborators.

Finding Extant Interview Data

Finding journalistic interviews:  .

  • Academic Search Premier This all-purpose database is great for finding articles from magazines and newspapers. In the Advanced Search, it allows you to specify "Document Type":  Interview.  
  • Guide to Newspapers and Newspaper Indexes Use this guide created to Harvard Librarians to identify newspapers collections you'd like to search. To locate interviews, try adding the term  "interview"  to your search, or explore a database's search interface for options to  limit your search to interviews.  Nexis Uni  and  Factiva  are the two main databases for current news.   
  • Listen Notes Search for podcast episodes at this podcast aggregator, and look for podcasts that include interviews. Make sure to vet the podcaster for accuracy and quality! (Listen Notes does not do much vetting.)  
  • NPR  and  ProPublica  are two sites that offer high-quality long-form reporting, including journalistic interviews, for free.

Finding Oral History and Social Research Interviews:  

  • To find oral histories, see the Oral History   page of this guide for helpful resources on Oral History interviewing.  
  • Repositories for Qualitative Data It has not been a customary practice among qualitative researchers in the social sciences to share raw interview data, but some have made this data available in repositories, such as the ones listed on the page linked above. You may find published data from structured interview surveys (e.g., questionnaire-based computer-assisted telephone interview data), as well as some semi-structured and unstructured interviews.  
  • If you are merely interested in studies interpreting data collected using interviews, rather than finding raw interview data, try databases like  PsycInfo ,  Sociological Abstracts , or  Anthropology Plus , among others. 

Finding Interviews in Archival Collections at Harvard Library:

In addition to the databases and search strategies mentioned under the  "Finding Oral History and Social Research Interviews" category above,  you may search for interviews and oral histories (whether in textual or audiovisual formats) held in archival collections at Harvard Library.

  • HOLLIS searches all documented collections at Harvard, whereas HOLLIS for Archival Discovery searches only those with finding aids. Although HOLLIS for Archival Discovery covers less material, you may find it easier to parse your search results, especially when you wish to view results at the item level (within collections). Try these approaches:

Search in  HOLLIS :  

  • To retrieve items available online, do an Advanced Search for  interview* OR "oral histor*" (in Subject), with Resource Type "Archives/Manuscripts," then refine your search by selecting "Online" under "Show Only" on the right of your initial result list.  Revise the search above by adding your topic in the Keywords or Subject field (for example:  African Americans ) and resubmitting the search.  
  •  To enlarge your results set, you may also leave out the "Online" refinement; if you'd like to limit your search to a specific repository, try the technique of searching for  Code: Library + Collection on the "Advanced Search" page .   

Search in  HOLLIS for Archival Discovery :  

  • To retrieve items available online, search for   interview* OR "oral histor*" limited to digital materials . Revise the search above by adding your topic (for example:  artist* ) in the second search box (if you don't see the box, click +).  
  • To preview results by collection, search for  interview* OR "oral histor*" limited to collections . Revise the search above by adding your topic (for example:  artist* ) in the second search box (if you don't see the box, click +). Although this method does not allow you to isolate digitized content, you may find the refinement options on the right side of the screen (refine by repository, subject or names) helpful.  Once your select a given collection, you may search within it  (e.g., for your topic or the term interview).

UX & MARKET RESEARCH INTERVIEWS

Ux at harvard library  .

  • User Experience and Market Research interviews can inform the design of tangible products and services through responsive, outcome-driven insights. The  User Research Center  at Harvard Library specializes in this kind of user-centered design, digital accessibility, and testing. They also offer guidance and  resources  to members of the Harvard Community who are interested in learning more about UX methods. Contact [email protected] or consult the URC website for more information.

Websites  

  • User Interviews: The Beginner’s Guide (Chris Mears)  
  • Interviewing Users (Jakob Nielsen)

Books  

  • Interviewing Users: How to Uncover Compelling Insights by Steve Portigal; Grant McCracken (Foreword by)  Interviewing is a foundational user research tool that people assume they already possess. Everyone can ask questions, right? Unfortunately, that's not the case. Interviewing Users provides invaluable interviewing techniques and tools that enable you to conduct informative interviews with anyone. You'll move from simply gathering data to uncovering powerful insights about people.  
  • Rapid Contextual Design by Jessamyn Wendell; Karen Holtzblatt; Shelley Wood  This handbook introduces Rapid CD, a fast-paced, adaptive form of Contextual Design. Rapid CD is a hands-on guide for anyone who needs practical guidance on how to use the Contextual Design process and adapt it to tactical projects with tight timelines and resources. Rapid Contextual Design provides detailed suggestions on structuring the project and customer interviews, conducting interviews, and running interpretation sessions. The handbook walks you step-by-step through organizing the data so you can see your key issues, along with visioning new solutions, storyboarding to work out the details, and paper prototype interviewing to iterate the design all with as little as a two-person team with only a few weeks to spare *Includes real project examples with actual customer data that illustrate how a CD project actually works.

Videos  

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Instructional Presentations on Interview Skills  

  • Interview/Oral History Research for RSRA 298B: Master's Thesis Reading and Research (Spring 2023) Slideshow covers: Why Interviews?, Getting Context, Engaging Participants, Conducting the Interview, The Interview Guide, Note Taking, Transcription, File management, and Data Analysis.  
  • Interview Skills From an online class on February 13, 2023:  Get set up for interview research. You will leave prepared to choose among the three types of interviewing methods, equipped to develop an interview schedule, aware of data management options and their ethical implications, and knowledgeable of technologies you can use to record and transcribe your interviews. This workshop complements Intro to NVivo, a qualitative data analysis tool useful for coding interview data.

NIH Data Management & Sharing Policy (DMSP) This policy, effective January 25, 2023, applies to all research, funded or conducted in whole or in part by NIH, that results in the generation of  scientific data , including NIH-funded qualitative research. Click here to see some examples of how the DMSP policy has been applied in qualitative research studies featured in the 2021 Qualitative Data Management Plan (DMP) Competition . As a resource for the community, NIH has developed a resource for developing informed consent language in research studies where data and/or biospecimens will be stored and shared for future use. It is important to note that the DMS Policy does NOT require that informed consent obtained from research participants must allow for broad sharing and the future use of data (either with or without identifiable private information). See the FAQ for more information.

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How to use and assess qualitative research methods

Loraine busetto.

1 Department of Neurology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany

Wolfgang Wick

2 Clinical Cooperation Unit Neuro-Oncology, German Cancer Research Center, Heidelberg, Germany

Christoph Gumbinger

Associated data.

Not applicable.

This paper aims to provide an overview of the use and assessment of qualitative research methods in the health sciences. Qualitative research can be defined as the study of the nature of phenomena and is especially appropriate for answering questions of why something is (not) observed, assessing complex multi-component interventions, and focussing on intervention improvement. The most common methods of data collection are document study, (non-) participant observations, semi-structured interviews and focus groups. For data analysis, field-notes and audio-recordings are transcribed into protocols and transcripts, and coded using qualitative data management software. Criteria such as checklists, reflexivity, sampling strategies, piloting, co-coding, member-checking and stakeholder involvement can be used to enhance and assess the quality of the research conducted. Using qualitative in addition to quantitative designs will equip us with better tools to address a greater range of research problems, and to fill in blind spots in current neurological research and practice.

The aim of this paper is to provide an overview of qualitative research methods, including hands-on information on how they can be used, reported and assessed. This article is intended for beginning qualitative researchers in the health sciences as well as experienced quantitative researchers who wish to broaden their understanding of qualitative research.

What is qualitative research?

Qualitative research is defined as “the study of the nature of phenomena”, including “their quality, different manifestations, the context in which they appear or the perspectives from which they can be perceived” , but excluding “their range, frequency and place in an objectively determined chain of cause and effect” [ 1 ]. This formal definition can be complemented with a more pragmatic rule of thumb: qualitative research generally includes data in form of words rather than numbers [ 2 ].

Why conduct qualitative research?

Because some research questions cannot be answered using (only) quantitative methods. For example, one Australian study addressed the issue of why patients from Aboriginal communities often present late or not at all to specialist services offered by tertiary care hospitals. Using qualitative interviews with patients and staff, it found one of the most significant access barriers to be transportation problems, including some towns and communities simply not having a bus service to the hospital [ 3 ]. A quantitative study could have measured the number of patients over time or even looked at possible explanatory factors – but only those previously known or suspected to be of relevance. To discover reasons for observed patterns, especially the invisible or surprising ones, qualitative designs are needed.

While qualitative research is common in other fields, it is still relatively underrepresented in health services research. The latter field is more traditionally rooted in the evidence-based-medicine paradigm, as seen in " research that involves testing the effectiveness of various strategies to achieve changes in clinical practice, preferably applying randomised controlled trial study designs (...) " [ 4 ]. This focus on quantitative research and specifically randomised controlled trials (RCT) is visible in the idea of a hierarchy of research evidence which assumes that some research designs are objectively better than others, and that choosing a "lesser" design is only acceptable when the better ones are not practically or ethically feasible [ 5 , 6 ]. Others, however, argue that an objective hierarchy does not exist, and that, instead, the research design and methods should be chosen to fit the specific research question at hand – "questions before methods" [ 2 , 7 – 9 ]. This means that even when an RCT is possible, some research problems require a different design that is better suited to addressing them. Arguing in JAMA, Berwick uses the example of rapid response teams in hospitals, which he describes as " a complex, multicomponent intervention – essentially a process of social change" susceptible to a range of different context factors including leadership or organisation history. According to him, "[in] such complex terrain, the RCT is an impoverished way to learn. Critics who use it as a truth standard in this context are incorrect" [ 8 ] . Instead of limiting oneself to RCTs, Berwick recommends embracing a wider range of methods , including qualitative ones, which for "these specific applications, (...) are not compromises in learning how to improve; they are superior" [ 8 ].

Research problems that can be approached particularly well using qualitative methods include assessing complex multi-component interventions or systems (of change), addressing questions beyond “what works”, towards “what works for whom when, how and why”, and focussing on intervention improvement rather than accreditation [ 7 , 9 – 12 ]. Using qualitative methods can also help shed light on the “softer” side of medical treatment. For example, while quantitative trials can measure the costs and benefits of neuro-oncological treatment in terms of survival rates or adverse effects, qualitative research can help provide a better understanding of patient or caregiver stress, visibility of illness or out-of-pocket expenses.

How to conduct qualitative research?

Given that qualitative research is characterised by flexibility, openness and responsivity to context, the steps of data collection and analysis are not as separate and consecutive as they tend to be in quantitative research [ 13 , 14 ]. As Fossey puts it : “sampling, data collection, analysis and interpretation are related to each other in a cyclical (iterative) manner, rather than following one after another in a stepwise approach” [ 15 ]. The researcher can make educated decisions with regard to the choice of method, how they are implemented, and to which and how many units they are applied [ 13 ]. As shown in Fig.  1 , this can involve several back-and-forth steps between data collection and analysis where new insights and experiences can lead to adaption and expansion of the original plan. Some insights may also necessitate a revision of the research question and/or the research design as a whole. The process ends when saturation is achieved, i.e. when no relevant new information can be found (see also below: sampling and saturation). For reasons of transparency, it is essential for all decisions as well as the underlying reasoning to be well-documented.

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Iterative research process

While it is not always explicitly addressed, qualitative methods reflect a different underlying research paradigm than quantitative research (e.g. constructivism or interpretivism as opposed to positivism). The choice of methods can be based on the respective underlying substantive theory or theoretical framework used by the researcher [ 2 ].

Data collection

The methods of qualitative data collection most commonly used in health research are document study, observations, semi-structured interviews and focus groups [ 1 , 14 , 16 , 17 ].

Document study

Document study (also called document analysis) refers to the review by the researcher of written materials [ 14 ]. These can include personal and non-personal documents such as archives, annual reports, guidelines, policy documents, diaries or letters.

Observations

Observations are particularly useful to gain insights into a certain setting and actual behaviour – as opposed to reported behaviour or opinions [ 13 ]. Qualitative observations can be either participant or non-participant in nature. In participant observations, the observer is part of the observed setting, for example a nurse working in an intensive care unit [ 18 ]. In non-participant observations, the observer is “on the outside looking in”, i.e. present in but not part of the situation, trying not to influence the setting by their presence. Observations can be planned (e.g. for 3 h during the day or night shift) or ad hoc (e.g. as soon as a stroke patient arrives at the emergency room). During the observation, the observer takes notes on everything or certain pre-determined parts of what is happening around them, for example focusing on physician-patient interactions or communication between different professional groups. Written notes can be taken during or after the observations, depending on feasibility (which is usually lower during participant observations) and acceptability (e.g. when the observer is perceived to be judging the observed). Afterwards, these field notes are transcribed into observation protocols. If more than one observer was involved, field notes are taken independently, but notes can be consolidated into one protocol after discussions. Advantages of conducting observations include minimising the distance between the researcher and the researched, the potential discovery of topics that the researcher did not realise were relevant and gaining deeper insights into the real-world dimensions of the research problem at hand [ 18 ].

Semi-structured interviews

Hijmans & Kuyper describe qualitative interviews as “an exchange with an informal character, a conversation with a goal” [ 19 ]. Interviews are used to gain insights into a person’s subjective experiences, opinions and motivations – as opposed to facts or behaviours [ 13 ]. Interviews can be distinguished by the degree to which they are structured (i.e. a questionnaire), open (e.g. free conversation or autobiographical interviews) or semi-structured [ 2 , 13 ]. Semi-structured interviews are characterized by open-ended questions and the use of an interview guide (or topic guide/list) in which the broad areas of interest, sometimes including sub-questions, are defined [ 19 ]. The pre-defined topics in the interview guide can be derived from the literature, previous research or a preliminary method of data collection, e.g. document study or observations. The topic list is usually adapted and improved at the start of the data collection process as the interviewer learns more about the field [ 20 ]. Across interviews the focus on the different (blocks of) questions may differ and some questions may be skipped altogether (e.g. if the interviewee is not able or willing to answer the questions or for concerns about the total length of the interview) [ 20 ]. Qualitative interviews are usually not conducted in written format as it impedes on the interactive component of the method [ 20 ]. In comparison to written surveys, qualitative interviews have the advantage of being interactive and allowing for unexpected topics to emerge and to be taken up by the researcher. This can also help overcome a provider or researcher-centred bias often found in written surveys, which by nature, can only measure what is already known or expected to be of relevance to the researcher. Interviews can be audio- or video-taped; but sometimes it is only feasible or acceptable for the interviewer to take written notes [ 14 , 16 , 20 ].

Focus groups

Focus groups are group interviews to explore participants’ expertise and experiences, including explorations of how and why people behave in certain ways [ 1 ]. Focus groups usually consist of 6–8 people and are led by an experienced moderator following a topic guide or “script” [ 21 ]. They can involve an observer who takes note of the non-verbal aspects of the situation, possibly using an observation guide [ 21 ]. Depending on researchers’ and participants’ preferences, the discussions can be audio- or video-taped and transcribed afterwards [ 21 ]. Focus groups are useful for bringing together homogeneous (to a lesser extent heterogeneous) groups of participants with relevant expertise and experience on a given topic on which they can share detailed information [ 21 ]. Focus groups are a relatively easy, fast and inexpensive method to gain access to information on interactions in a given group, i.e. “the sharing and comparing” among participants [ 21 ]. Disadvantages include less control over the process and a lesser extent to which each individual may participate. Moreover, focus group moderators need experience, as do those tasked with the analysis of the resulting data. Focus groups can be less appropriate for discussing sensitive topics that participants might be reluctant to disclose in a group setting [ 13 ]. Moreover, attention must be paid to the emergence of “groupthink” as well as possible power dynamics within the group, e.g. when patients are awed or intimidated by health professionals.

Choosing the “right” method

As explained above, the school of thought underlying qualitative research assumes no objective hierarchy of evidence and methods. This means that each choice of single or combined methods has to be based on the research question that needs to be answered and a critical assessment with regard to whether or to what extent the chosen method can accomplish this – i.e. the “fit” between question and method [ 14 ]. It is necessary for these decisions to be documented when they are being made, and to be critically discussed when reporting methods and results.

Let us assume that our research aim is to examine the (clinical) processes around acute endovascular treatment (EVT), from the patient’s arrival at the emergency room to recanalization, with the aim to identify possible causes for delay and/or other causes for sub-optimal treatment outcome. As a first step, we could conduct a document study of the relevant standard operating procedures (SOPs) for this phase of care – are they up-to-date and in line with current guidelines? Do they contain any mistakes, irregularities or uncertainties that could cause delays or other problems? Regardless of the answers to these questions, the results have to be interpreted based on what they are: a written outline of what care processes in this hospital should look like. If we want to know what they actually look like in practice, we can conduct observations of the processes described in the SOPs. These results can (and should) be analysed in themselves, but also in comparison to the results of the document analysis, especially as regards relevant discrepancies. Do the SOPs outline specific tests for which no equipment can be observed or tasks to be performed by specialized nurses who are not present during the observation? It might also be possible that the written SOP is outdated, but the actual care provided is in line with current best practice. In order to find out why these discrepancies exist, it can be useful to conduct interviews. Are the physicians simply not aware of the SOPs (because their existence is limited to the hospital’s intranet) or do they actively disagree with them or does the infrastructure make it impossible to provide the care as described? Another rationale for adding interviews is that some situations (or all of their possible variations for different patient groups or the day, night or weekend shift) cannot practically or ethically be observed. In this case, it is possible to ask those involved to report on their actions – being aware that this is not the same as the actual observation. A senior physician’s or hospital manager’s description of certain situations might differ from a nurse’s or junior physician’s one, maybe because they intentionally misrepresent facts or maybe because different aspects of the process are visible or important to them. In some cases, it can also be relevant to consider to whom the interviewee is disclosing this information – someone they trust, someone they are otherwise not connected to, or someone they suspect or are aware of being in a potentially “dangerous” power relationship to them. Lastly, a focus group could be conducted with representatives of the relevant professional groups to explore how and why exactly they provide care around EVT. The discussion might reveal discrepancies (between SOPs and actual care or between different physicians) and motivations to the researchers as well as to the focus group members that they might not have been aware of themselves. For the focus group to deliver relevant information, attention has to be paid to its composition and conduct, for example, to make sure that all participants feel safe to disclose sensitive or potentially problematic information or that the discussion is not dominated by (senior) physicians only. The resulting combination of data collection methods is shown in Fig.  2 .

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Possible combination of data collection methods

Attributions for icons: “Book” by Serhii Smirnov, “Interview” by Adrien Coquet, FR, “Magnifying Glass” by anggun, ID, “Business communication” by Vectors Market; all from the Noun Project

The combination of multiple data source as described for this example can be referred to as “triangulation”, in which multiple measurements are carried out from different angles to achieve a more comprehensive understanding of the phenomenon under study [ 22 , 23 ].

Data analysis

To analyse the data collected through observations, interviews and focus groups these need to be transcribed into protocols and transcripts (see Fig.  3 ). Interviews and focus groups can be transcribed verbatim , with or without annotations for behaviour (e.g. laughing, crying, pausing) and with or without phonetic transcription of dialects and filler words, depending on what is expected or known to be relevant for the analysis. In the next step, the protocols and transcripts are coded , that is, marked (or tagged, labelled) with one or more short descriptors of the content of a sentence or paragraph [ 2 , 15 , 23 ]. Jansen describes coding as “connecting the raw data with “theoretical” terms” [ 20 ]. In a more practical sense, coding makes raw data sortable. This makes it possible to extract and examine all segments describing, say, a tele-neurology consultation from multiple data sources (e.g. SOPs, emergency room observations, staff and patient interview). In a process of synthesis and abstraction, the codes are then grouped, summarised and/or categorised [ 15 , 20 ]. The end product of the coding or analysis process is a descriptive theory of the behavioural pattern under investigation [ 20 ]. The coding process is performed using qualitative data management software, the most common ones being InVivo, MaxQDA and Atlas.ti. It should be noted that these are data management tools which support the analysis performed by the researcher(s) [ 14 ].

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From data collection to data analysis

Attributions for icons: see Fig. ​ Fig.2, 2 , also “Speech to text” by Trevor Dsouza, “Field Notes” by Mike O’Brien, US, “Voice Record” by ProSymbols, US, “Inspection” by Made, AU, and “Cloud” by Graphic Tigers; all from the Noun Project

How to report qualitative research?

Protocols of qualitative research can be published separately and in advance of the study results. However, the aim is not the same as in RCT protocols, i.e. to pre-define and set in stone the research questions and primary or secondary endpoints. Rather, it is a way to describe the research methods in detail, which might not be possible in the results paper given journals’ word limits. Qualitative research papers are usually longer than their quantitative counterparts to allow for deep understanding and so-called “thick description”. In the methods section, the focus is on transparency of the methods used, including why, how and by whom they were implemented in the specific study setting, so as to enable a discussion of whether and how this may have influenced data collection, analysis and interpretation. The results section usually starts with a paragraph outlining the main findings, followed by more detailed descriptions of, for example, the commonalities, discrepancies or exceptions per category [ 20 ]. Here it is important to support main findings by relevant quotations, which may add information, context, emphasis or real-life examples [ 20 , 23 ]. It is subject to debate in the field whether it is relevant to state the exact number or percentage of respondents supporting a certain statement (e.g. “Five interviewees expressed negative feelings towards XYZ”) [ 21 ].

How to combine qualitative with quantitative research?

Qualitative methods can be combined with other methods in multi- or mixed methods designs, which “[employ] two or more different methods [ …] within the same study or research program rather than confining the research to one single method” [ 24 ]. Reasons for combining methods can be diverse, including triangulation for corroboration of findings, complementarity for illustration and clarification of results, expansion to extend the breadth and range of the study, explanation of (unexpected) results generated with one method with the help of another, or offsetting the weakness of one method with the strength of another [ 1 , 17 , 24 – 26 ]. The resulting designs can be classified according to when, why and how the different quantitative and/or qualitative data strands are combined. The three most common types of mixed method designs are the convergent parallel design , the explanatory sequential design and the exploratory sequential design. The designs with examples are shown in Fig.  4 .

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Three common mixed methods designs

In the convergent parallel design, a qualitative study is conducted in parallel to and independently of a quantitative study, and the results of both studies are compared and combined at the stage of interpretation of results. Using the above example of EVT provision, this could entail setting up a quantitative EVT registry to measure process times and patient outcomes in parallel to conducting the qualitative research outlined above, and then comparing results. Amongst other things, this would make it possible to assess whether interview respondents’ subjective impressions of patients receiving good care match modified Rankin Scores at follow-up, or whether observed delays in care provision are exceptions or the rule when compared to door-to-needle times as documented in the registry. In the explanatory sequential design, a quantitative study is carried out first, followed by a qualitative study to help explain the results from the quantitative study. This would be an appropriate design if the registry alone had revealed relevant delays in door-to-needle times and the qualitative study would be used to understand where and why these occurred, and how they could be improved. In the exploratory design, the qualitative study is carried out first and its results help informing and building the quantitative study in the next step [ 26 ]. If the qualitative study around EVT provision had shown a high level of dissatisfaction among the staff members involved, a quantitative questionnaire investigating staff satisfaction could be set up in the next step, informed by the qualitative study on which topics dissatisfaction had been expressed. Amongst other things, the questionnaire design would make it possible to widen the reach of the research to more respondents from different (types of) hospitals, regions, countries or settings, and to conduct sub-group analyses for different professional groups.

How to assess qualitative research?

A variety of assessment criteria and lists have been developed for qualitative research, ranging in their focus and comprehensiveness [ 14 , 17 , 27 ]. However, none of these has been elevated to the “gold standard” in the field. In the following, we therefore focus on a set of commonly used assessment criteria that, from a practical standpoint, a researcher can look for when assessing a qualitative research report or paper.

Assessors should check the authors’ use of and adherence to the relevant reporting checklists (e.g. Standards for Reporting Qualitative Research (SRQR)) to make sure all items that are relevant for this type of research are addressed [ 23 , 28 ]. Discussions of quantitative measures in addition to or instead of these qualitative measures can be a sign of lower quality of the research (paper). Providing and adhering to a checklist for qualitative research contributes to an important quality criterion for qualitative research, namely transparency [ 15 , 17 , 23 ].

Reflexivity

While methodological transparency and complete reporting is relevant for all types of research, some additional criteria must be taken into account for qualitative research. This includes what is called reflexivity, i.e. sensitivity to the relationship between the researcher and the researched, including how contact was established and maintained, or the background and experience of the researcher(s) involved in data collection and analysis. Depending on the research question and population to be researched this can be limited to professional experience, but it may also include gender, age or ethnicity [ 17 , 27 ]. These details are relevant because in qualitative research, as opposed to quantitative research, the researcher as a person cannot be isolated from the research process [ 23 ]. It may influence the conversation when an interviewed patient speaks to an interviewer who is a physician, or when an interviewee is asked to discuss a gynaecological procedure with a male interviewer, and therefore the reader must be made aware of these details [ 19 ].

Sampling and saturation

The aim of qualitative sampling is for all variants of the objects of observation that are deemed relevant for the study to be present in the sample “ to see the issue and its meanings from as many angles as possible” [ 1 , 16 , 19 , 20 , 27 ] , and to ensure “information-richness [ 15 ]. An iterative sampling approach is advised, in which data collection (e.g. five interviews) is followed by data analysis, followed by more data collection to find variants that are lacking in the current sample. This process continues until no new (relevant) information can be found and further sampling becomes redundant – which is called saturation [ 1 , 15 ] . In other words: qualitative data collection finds its end point not a priori , but when the research team determines that saturation has been reached [ 29 , 30 ].

This is also the reason why most qualitative studies use deliberate instead of random sampling strategies. This is generally referred to as “ purposive sampling” , in which researchers pre-define which types of participants or cases they need to include so as to cover all variations that are expected to be of relevance, based on the literature, previous experience or theory (i.e. theoretical sampling) [ 14 , 20 ]. Other types of purposive sampling include (but are not limited to) maximum variation sampling, critical case sampling or extreme or deviant case sampling [ 2 ]. In the above EVT example, a purposive sample could include all relevant professional groups and/or all relevant stakeholders (patients, relatives) and/or all relevant times of observation (day, night and weekend shift).

Assessors of qualitative research should check whether the considerations underlying the sampling strategy were sound and whether or how researchers tried to adapt and improve their strategies in stepwise or cyclical approaches between data collection and analysis to achieve saturation [ 14 ].

Good qualitative research is iterative in nature, i.e. it goes back and forth between data collection and analysis, revising and improving the approach where necessary. One example of this are pilot interviews, where different aspects of the interview (especially the interview guide, but also, for example, the site of the interview or whether the interview can be audio-recorded) are tested with a small number of respondents, evaluated and revised [ 19 ]. In doing so, the interviewer learns which wording or types of questions work best, or which is the best length of an interview with patients who have trouble concentrating for an extended time. Of course, the same reasoning applies to observations or focus groups which can also be piloted.

Ideally, coding should be performed by at least two researchers, especially at the beginning of the coding process when a common approach must be defined, including the establishment of a useful coding list (or tree), and when a common meaning of individual codes must be established [ 23 ]. An initial sub-set or all transcripts can be coded independently by the coders and then compared and consolidated after regular discussions in the research team. This is to make sure that codes are applied consistently to the research data.

Member checking

Member checking, also called respondent validation , refers to the practice of checking back with study respondents to see if the research is in line with their views [ 14 , 27 ]. This can happen after data collection or analysis or when first results are available [ 23 ]. For example, interviewees can be provided with (summaries of) their transcripts and asked whether they believe this to be a complete representation of their views or whether they would like to clarify or elaborate on their responses [ 17 ]. Respondents’ feedback on these issues then becomes part of the data collection and analysis [ 27 ].

Stakeholder involvement

In those niches where qualitative approaches have been able to evolve and grow, a new trend has seen the inclusion of patients and their representatives not only as study participants (i.e. “members”, see above) but as consultants to and active participants in the broader research process [ 31 – 33 ]. The underlying assumption is that patients and other stakeholders hold unique perspectives and experiences that add value beyond their own single story, making the research more relevant and beneficial to researchers, study participants and (future) patients alike [ 34 , 35 ]. Using the example of patients on or nearing dialysis, a recent scoping review found that 80% of clinical research did not address the top 10 research priorities identified by patients and caregivers [ 32 , 36 ]. In this sense, the involvement of the relevant stakeholders, especially patients and relatives, is increasingly being seen as a quality indicator in and of itself.

How not to assess qualitative research

The above overview does not include certain items that are routine in assessments of quantitative research. What follows is a non-exhaustive, non-representative, experience-based list of the quantitative criteria often applied to the assessment of qualitative research, as well as an explanation of the limited usefulness of these endeavours.

Protocol adherence

Given the openness and flexibility of qualitative research, it should not be assessed by how well it adheres to pre-determined and fixed strategies – in other words: its rigidity. Instead, the assessor should look for signs of adaptation and refinement based on lessons learned from earlier steps in the research process.

Sample size

For the reasons explained above, qualitative research does not require specific sample sizes, nor does it require that the sample size be determined a priori [ 1 , 14 , 27 , 37 – 39 ]. Sample size can only be a useful quality indicator when related to the research purpose, the chosen methodology and the composition of the sample, i.e. who was included and why.

Randomisation

While some authors argue that randomisation can be used in qualitative research, this is not commonly the case, as neither its feasibility nor its necessity or usefulness has been convincingly established for qualitative research [ 13 , 27 ]. Relevant disadvantages include the negative impact of a too large sample size as well as the possibility (or probability) of selecting “ quiet, uncooperative or inarticulate individuals ” [ 17 ]. Qualitative studies do not use control groups, either.

Interrater reliability, variability and other “objectivity checks”

The concept of “interrater reliability” is sometimes used in qualitative research to assess to which extent the coding approach overlaps between the two co-coders. However, it is not clear what this measure tells us about the quality of the analysis [ 23 ]. This means that these scores can be included in qualitative research reports, preferably with some additional information on what the score means for the analysis, but it is not a requirement. Relatedly, it is not relevant for the quality or “objectivity” of qualitative research to separate those who recruited the study participants and collected and analysed the data. Experiences even show that it might be better to have the same person or team perform all of these tasks [ 20 ]. First, when researchers introduce themselves during recruitment this can enhance trust when the interview takes place days or weeks later with the same researcher. Second, when the audio-recording is transcribed for analysis, the researcher conducting the interviews will usually remember the interviewee and the specific interview situation during data analysis. This might be helpful in providing additional context information for interpretation of data, e.g. on whether something might have been meant as a joke [ 18 ].

Not being quantitative research

Being qualitative research instead of quantitative research should not be used as an assessment criterion if it is used irrespectively of the research problem at hand. Similarly, qualitative research should not be required to be combined with quantitative research per se – unless mixed methods research is judged as inherently better than single-method research. In this case, the same criterion should be applied for quantitative studies without a qualitative component.

The main take-away points of this paper are summarised in Table ​ Table1. 1 . We aimed to show that, if conducted well, qualitative research can answer specific research questions that cannot to be adequately answered using (only) quantitative designs. Seeing qualitative and quantitative methods as equal will help us become more aware and critical of the “fit” between the research problem and our chosen methods: I can conduct an RCT to determine the reasons for transportation delays of acute stroke patients – but should I? It also provides us with a greater range of tools to tackle a greater range of research problems more appropriately and successfully, filling in the blind spots on one half of the methodological spectrum to better address the whole complexity of neurological research and practice.

Take-away-points

Acknowledgements

Abbreviations, authors’ contributions.

LB drafted the manuscript; WW and CG revised the manuscript; all authors approved the final versions.

no external funding.

Availability of data and materials

Ethics approval and consent to participate, consent for publication, competing interests.

The authors declare no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Grad Coach

Qualitative Research 101: Interviewing

5 Common Mistakes To Avoid When Undertaking Interviews

By: David Phair (PhD) and Kerryn Warren (PhD) | March 2022

Undertaking interviews is potentially the most important step in the qualitative research process. If you don’t collect useful, useable data in your interviews, you’ll struggle through the rest of your dissertation or thesis.  Having helped numerous students with their research over the years, we’ve noticed some common interviewing mistakes that first-time researchers make. In this post, we’ll discuss five costly interview-related mistakes and outline useful strategies to avoid making these.

Overview: 5 Interviewing Mistakes

  • Not having a clear interview strategy /plan
  • Not having good interview techniques /skills
  • Not securing a suitable location and equipment
  • Not having a basic risk management plan
  • Not keeping your “ golden thread ” front of mind

1. Not having a clear interview strategy

The first common mistake that we’ll look at is that of starting the interviewing process without having first come up with a clear interview strategy or plan of action. While it’s natural to be keen to get started engaging with your interviewees, a lack of planning can result in a mess of data and inconsistency between interviews.

There are several design choices to decide on and plan for before you start interviewing anyone. Some of the most important questions you need to ask yourself before conducting interviews include:

  • What are the guiding research aims and research questions of my study?
  • Will I use a structured, semi-structured or unstructured interview approach?
  • How will I record the interviews (audio or video)?
  • Who will be interviewed and by whom ?
  • What ethics and data law considerations do I need to adhere to?
  • How will I analyze my data? 

Let’s take a quick look at some of these.

The core objective of the interviewing process is to generate useful data that will help you address your overall research aims. Therefore, your interviews need to be conducted in a way that directly links to your research aims, objectives and research questions (i.e. your “golden thread”). This means that you need to carefully consider the questions you’ll ask to ensure that they align with and feed into your golden thread. If any question doesn’t align with this, you may want to consider scrapping it.

Another important design choice is whether you’ll use an unstructured, semi-structured or structured interview approach . For semi-structured interviews, you will have a list of questions that you plan to ask and these questions will be open-ended in nature. You’ll also allow the discussion to digress from the core question set if something interesting comes up. This means that the type of information generated might differ a fair amount between interviews.

Contrasted to this, a structured approach to interviews is more rigid, where a specific set of closed questions is developed and asked for each interviewee in exactly the same order. Closed questions have a limited set of answers, that are often single-word answers. Therefore, you need to think about what you’re trying to achieve with your research project (i.e. your research aims) and decided on which approach would be best suited in your case.

It is also important to plan ahead with regards to who will be interviewed and how. You need to think about how you will approach the possible interviewees to get their cooperation, who will conduct the interviews, when to conduct the interviews and how to record the interviews. For each of these decisions, it’s also essential to make sure that all ethical considerations and data protection laws are taken into account.

Finally, you should think through how you plan to analyze the data (i.e., your qualitative analysis method) generated by the interviews. Different types of analysis rely on different types of data, so you need to ensure you’re asking the right types of questions and correctly guiding your respondents.

Simply put, you need to have a plan of action regarding the specifics of your interview approach before you start collecting data. If not, you’ll end up drifting in your approach from interview to interview, which will result in inconsistent, unusable data.

Your interview questions need to directly  link to your research aims, objectives and  research questions - your "golden thread”.

2. Not having good interview technique

While you’re generally not expected to become you to be an expert interviewer for a dissertation or thesis, it is important to practice good interview technique and develop basic interviewing skills .

Let’s go through some basics that will help the process along.

Firstly, before the interview , make sure you know your interview questions well and have a clear idea of what you want from the interview. Naturally, the specificity of your questions will depend on whether you’re taking a structured, semi-structured or unstructured approach, but you still need a consistent starting point . Ideally, you should develop an interview guide beforehand (more on this later) that details your core question and links these to the research aims, objectives and research questions.

Before you undertake any interviews, it’s a good idea to do a few mock interviews with friends or family members. This will help you get comfortable with the interviewer role, prepare for potentially unexpected answers and give you a good idea of how long the interview will take to conduct. In the interviewing process, you’re likely to encounter two kinds of challenging interviewees ; the two-word respondent and the respondent who meanders and babbles. Therefore, you should prepare yourself for both and come up with a plan to respond to each in a way that will allow the interview to continue productively.

To begin the formal interview , provide the person you are interviewing with an overview of your research. This will help to calm their nerves (and yours) and contextualize the interaction. Ultimately, you want the interviewee to feel comfortable and be willing to be open and honest with you, so it’s useful to start in a more casual, relaxed fashion and allow them to ask any questions they may have. From there, you can ease them into the rest of the questions.

As the interview progresses , avoid asking leading questions (i.e., questions that assume something about the interviewee or their response). Make sure that you speak clearly and slowly , using plain language and being ready to paraphrase questions if the person you are interviewing misunderstands. Be particularly careful with interviewing English second language speakers to ensure that you’re both on the same page.

Engage with the interviewee by listening to them carefully and acknowledging that you are listening to them by smiling or nodding. Show them that you’re interested in what they’re saying and thank them for their openness as appropriate. This will also encourage your interviewee to respond openly.

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qualitative interview in research

3. Not securing a suitable location and quality equipment

Where you conduct your interviews and the equipment you use to record them both play an important role in how the process unfolds. Therefore, you need to think carefully about each of these variables before you start interviewing.

Poor location: A bad location can result in the quality of your interviews being compromised, interrupted, or cancelled. If you are conducting physical interviews, you’ll need a location that is quiet, safe, and welcoming . It’s very important that your location of choice is not prone to interruptions (the workplace office is generally problematic, for example) and has suitable facilities (such as water, a bathroom, and snacks).

If you are conducting online interviews , you need to consider a few other factors. Importantly, you need to make sure that both you and your respondent have access to a good, stable internet connection and electricity. Always check before the time that both of you know how to use the relevant software and it’s accessible (sometimes meeting platforms are blocked by workplace policies or firewalls). It’s also good to have alternatives in place (such as WhatsApp, Zoom, or Teams) to cater for these types of issues.

Poor equipment: Using poor-quality recording equipment or using equipment incorrectly means that you will have trouble transcribing, coding, and analyzing your interviews. This can be a major issue , as some of your interview data may go completely to waste if not recorded well. So, make sure that you use good-quality recording equipment and that you know how to use it correctly.

To avoid issues, you should always conduct test recordings before every interview to ensure that you can use the relevant equipment properly. It’s also a good idea to spot check each recording afterwards, just to make sure it was recorded as planned. If your equipment uses batteries, be sure to always carry a spare set.

Where you conduct your interviews and the equipment you use to record them play an important role in how the process unfolds.

4. Not having a basic risk management plan

Many possible issues can arise during the interview process. Not planning for these issues can mean that you are left with compromised data that might not be useful to you. Therefore, it’s important to map out some sort of risk management plan ahead of time, considering the potential risks, how you’ll minimize their probability and how you’ll manage them if they materialize.

Common potential issues related to the actual interview include cancellations (people pulling out), delays (such as getting stuck in traffic), language and accent differences (especially in the case of poor internet connections), issues with internet connections and power supply. Other issues can also occur in the interview itself. For example, the interviewee could drift off-topic, or you might encounter an interviewee who does not say much at all.

You can prepare for these potential issues by considering possible worst-case scenarios and preparing a response for each scenario. For instance, it is important to plan a backup date just in case your interviewee cannot make it to the first meeting you scheduled with them. It’s also a good idea to factor in a 30-minute gap between your interviews for the instances where someone might be late, or an interview runs overtime for other reasons. Make sure that you also plan backup questions that could be used to bring a respondent back on topic if they start rambling, or questions to encourage those who are saying too little.

In general, it’s best practice to plan to conduct more interviews than you think you need (this is called oversampling ). Doing so will allow you some room for error if there are interviews that don’t go as planned, or if some interviewees withdraw. If you need 10 interviews, it is a good idea to plan for 15. Likely, a few will cancel , delay, or not produce useful data.

You should consider all the potential risks, how you’ll reduce their probability and how you'll respond if they do indeed materialize.

5. Not keeping your golden thread front of mind

We touched on this a little earlier, but it is a key point that should be central to your entire research process. You don’t want to end up with pages and pages of data after conducting your interviews and realize that it is not useful to your research aims . Your research aims, objectives and research questions – i.e., your golden thread – should influence every design decision and should guide the interview process at all times. 

A useful way to avoid this mistake is by developing an interview guide before you begin interviewing your respondents. An interview guide is a document that contains all of your questions with notes on how each of the interview questions is linked to the research question(s) of your study. You can also include your research aims and objectives here for a more comprehensive linkage. 

You can easily create an interview guide by drawing up a table with one column containing your core interview questions . Then add another column with your research questions , another with expectations that you may have in light of the relevant literature and another with backup or follow-up questions . As mentioned, you can also bring in your research aims and objectives to help you connect them all together. If you’d like, you can download a copy of our free interview guide here .

Recap: Qualitative Interview Mistakes

In this post, we’ve discussed 5 common costly mistakes that are easy to make in the process of planning and conducting qualitative interviews.

To recap, these include:

If you have any questions about these interviewing mistakes, drop a comment below. Alternatively, if you’re interested in getting 1-on-1 help with your thesis or dissertation , check out our dissertation coaching service or book a free initial consultation with one of our friendly Grad Coaches.

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The qualitative research interview

Affiliation.

  • 1 Department of Family Medicine, University of Medicine and Dentistry at Robert Wood Johnson Medical School, Somerset, New Jersey 08873, USA. [email protected]
  • PMID: 16573666
  • DOI: 10.1111/j.1365-2929.2006.02418.x

Background: Interviews are among the most familiar strategies for collecting qualitative data. The different qualitative interviewing strategies in common use emerged from diverse disciplinary perspectives resulting in a wide variation among interviewing approaches. Unlike the highly structured survey interviews and questionnaires used in epidemiology and most health services research, we examine less structured interview strategies in which the person interviewed is more a participant in meaning making than a conduit from which information is retrieved.

Purpose: In this article we briefly review the more common qualitative interview methods and then focus on the widely used individual face-to-face in-depth interview, which seeks to foster learning about individual experiences and perspectives on a given set of issues. We discuss methods for conducting in-depth interviews and consider relevant ethical issues with particular regard to the rights and protection of the participants.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Data Collection / methods
  • Ethics, Research
  • Interpersonal Relations
  • Interviews as Topic / methods*
  • Qualitative Research*

Grants and funding

  • 1D12HP00167/PHS HHS/United States

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  • Published: 05 October 2018

Interviews and focus groups in qualitative research: an update for the digital age

  • P. Gill 1 &
  • J. Baillie 2  

British Dental Journal volume  225 ,  pages 668–672 ( 2018 ) Cite this article

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Highlights that qualitative research is used increasingly in dentistry. Interviews and focus groups remain the most common qualitative methods of data collection.

Suggests the advent of digital technologies has transformed how qualitative research can now be undertaken.

Suggests interviews and focus groups can offer significant, meaningful insight into participants' experiences, beliefs and perspectives, which can help to inform developments in dental practice.

Qualitative research is used increasingly in dentistry, due to its potential to provide meaningful, in-depth insights into participants' experiences, perspectives, beliefs and behaviours. These insights can subsequently help to inform developments in dental practice and further related research. The most common methods of data collection used in qualitative research are interviews and focus groups. While these are primarily conducted face-to-face, the ongoing evolution of digital technologies, such as video chat and online forums, has further transformed these methods of data collection. This paper therefore discusses interviews and focus groups in detail, outlines how they can be used in practice, how digital technologies can further inform the data collection process, and what these methods can offer dentistry.

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A review of technical and quality assessment considerations of audio-visual and web-conferencing focus groups in qualitative health research

Hiba Bawadi, Sara Elshami, … Banan Mukhalalati

Introduction

Traditionally, research in dentistry has primarily been quantitative in nature. 1 However, in recent years, there has been a growing interest in qualitative research within the profession, due to its potential to further inform developments in practice, policy, education and training. Consequently, in 2008, the British Dental Journal (BDJ) published a four paper qualitative research series, 2 , 3 , 4 , 5 to help increase awareness and understanding of this particular methodological approach.

Since the papers were originally published, two scoping reviews have demonstrated the ongoing proliferation in the use of qualitative research within the field of oral healthcare. 1 , 6 To date, the original four paper series continue to be well cited and two of the main papers remain widely accessed among the BDJ readership. 2 , 3 The potential value of well-conducted qualitative research to evidence-based practice is now also widely recognised by service providers, policy makers, funding bodies and those who commission, support and use healthcare research.

Besides increasing standalone use, qualitative methods are now also routinely incorporated into larger mixed method study designs, such as clinical trials, as they can offer additional, meaningful insights into complex problems that simply could not be provided by quantitative methods alone. Qualitative methods can also be used to further facilitate in-depth understanding of important aspects of clinical trial processes, such as recruitment. For example, Ellis et al . investigated why edentulous older patients, dissatisfied with conventional dentures, decline implant treatment, despite its established efficacy, and frequently refuse to participate in related randomised clinical trials, even when financial constraints are removed. 7 Through the use of focus groups in Canada and the UK, the authors found that fears of pain and potential complications, along with perceived embarrassment, exacerbated by age, are common reasons why older patients typically refuse dental implants. 7

The last decade has also seen further developments in qualitative research, due to the ongoing evolution of digital technologies. These developments have transformed how researchers can access and share information, communicate and collaborate, recruit and engage participants, collect and analyse data and disseminate and translate research findings. 8 Where appropriate, such technologies are therefore capable of extending and enhancing how qualitative research is undertaken. 9 For example, it is now possible to collect qualitative data via instant messaging, email or online/video chat, using appropriate online platforms.

These innovative approaches to research are therefore cost-effective, convenient, reduce geographical constraints and are often useful for accessing 'hard to reach' participants (for example, those who are immobile or socially isolated). 8 , 9 However, digital technologies are still relatively new and constantly evolving and therefore present a variety of pragmatic and methodological challenges. Furthermore, given their very nature, their use in many qualitative studies and/or with certain participant groups may be inappropriate and should therefore always be carefully considered. While it is beyond the scope of this paper to provide a detailed explication regarding the use of digital technologies in qualitative research, insight is provided into how such technologies can be used to facilitate the data collection process in interviews and focus groups.

In light of such developments, it is perhaps therefore timely to update the main paper 3 of the original BDJ series. As with the previous publications, this paper has been purposely written in an accessible style, to enhance readability, particularly for those who are new to qualitative research. While the focus remains on the most common qualitative methods of data collection – interviews and focus groups – appropriate revisions have been made to provide a novel perspective, and should therefore be helpful to those who would like to know more about qualitative research. This paper specifically focuses on undertaking qualitative research with adult participants only.

Overview of qualitative research

Qualitative research is an approach that focuses on people and their experiences, behaviours and opinions. 10 , 11 The qualitative researcher seeks to answer questions of 'how' and 'why', providing detailed insight and understanding, 11 which quantitative methods cannot reach. 12 Within qualitative research, there are distinct methodologies influencing how the researcher approaches the research question, data collection and data analysis. 13 For example, phenomenological studies focus on the lived experience of individuals, explored through their description of the phenomenon. Ethnographic studies explore the culture of a group and typically involve the use of multiple methods to uncover the issues. 14

While methodology is the 'thinking tool', the methods are the 'doing tools'; 13 the ways in which data are collected and analysed. There are multiple qualitative data collection methods, including interviews, focus groups, observations, documentary analysis, participant diaries, photography and videography. Two of the most commonly used qualitative methods are interviews and focus groups, which are explored in this article. The data generated through these methods can be analysed in one of many ways, according to the methodological approach chosen. A common approach is thematic data analysis, involving the identification of themes and subthemes across the data set. Further information on approaches to qualitative data analysis has been discussed elsewhere. 1

Qualitative research is an evolving and adaptable approach, used by different disciplines for different purposes. Traditionally, qualitative data, specifically interviews, focus groups and observations, have been collected face-to-face with participants. In more recent years, digital technologies have contributed to the ongoing evolution of qualitative research. Digital technologies offer researchers different ways of recruiting participants and collecting data, and offer participants opportunities to be involved in research that is not necessarily face-to-face.

Research interviews are a fundamental qualitative research method 15 and are utilised across methodological approaches. Interviews enable the researcher to learn in depth about the perspectives, experiences, beliefs and motivations of the participant. 3 , 16 Examples include, exploring patients' perspectives of fear/anxiety triggers in dental treatment, 17 patients' experiences of oral health and diabetes, 18 and dental students' motivations for their choice of career. 19

Interviews may be structured, semi-structured or unstructured, 3 according to the purpose of the study, with less structured interviews facilitating a more in depth and flexible interviewing approach. 20 Structured interviews are similar to verbal questionnaires and are used if the researcher requires clarification on a topic; however they produce less in-depth data about a participant's experience. 3 Unstructured interviews may be used when little is known about a topic and involves the researcher asking an opening question; 3 the participant then leads the discussion. 20 Semi-structured interviews are commonly used in healthcare research, enabling the researcher to ask predetermined questions, 20 while ensuring the participant discusses issues they feel are important.

Interviews can be undertaken face-to-face or using digital methods when the researcher and participant are in different locations. Audio-recording the interview, with the consent of the participant, is essential for all interviews regardless of the medium as it enables accurate transcription; the process of turning the audio file into a word-for-word transcript. This transcript is the data, which the researcher then analyses according to the chosen approach.

Types of interview

Qualitative studies often utilise one-to-one, face-to-face interviews with research participants. This involves arranging a mutually convenient time and place to meet the participant, signing a consent form and audio-recording the interview. However, digital technologies have expanded the potential for interviews in research, enabling individuals to participate in qualitative research regardless of location.

Telephone interviews can be a useful alternative to face-to-face interviews and are commonly used in qualitative research. They enable participants from different geographical areas to participate and may be less onerous for participants than meeting a researcher in person. 15 A qualitative study explored patients' perspectives of dental implants and utilised telephone interviews due to the quality of the data that could be yielded. 21 The researcher needs to consider how they will audio record the interview, which can be facilitated by purchasing a recorder that connects directly to the telephone. One potential disadvantage of telephone interviews is the inability of the interviewer and researcher to see each other. This is resolved using software for audio and video calls online – such as Skype – to conduct interviews with participants in qualitative studies. Advantages of this approach include being able to see the participant if video calls are used, enabling observation of non-verbal communication, and the software can be free to use. However, participants are required to have a device and internet connection, as well as being computer literate, potentially limiting who can participate in the study. One qualitative study explored the role of dental hygienists in reducing oral health disparities in Canada. 22 The researcher conducted interviews using Skype, which enabled dental hygienists from across Canada to be interviewed within the research budget, accommodating the participants' schedules. 22

A less commonly used approach to qualitative interviews is the use of social virtual worlds. A qualitative study accessed a social virtual world – Second Life – to explore the health literacy skills of individuals who use social virtual worlds to access health information. 23 The researcher created an avatar and interview room, and undertook interviews with participants using voice and text methods. 23 This approach to recruitment and data collection enables individuals from diverse geographical locations to participate, while remaining anonymous if they wish. Furthermore, for interviews conducted using text methods, transcription of the interview is not required as the researcher can save the written conversation with the participant, with the participant's consent. However, the researcher and participant need to be familiar with how the social virtual world works to engage in an interview this way.

Conducting an interview

Ensuring informed consent before any interview is a fundamental aspect of the research process. Participants in research must be afforded autonomy and respect; consent should be informed and voluntary. 24 Individuals should have the opportunity to read an information sheet about the study, ask questions, understand how their data will be stored and used, and know that they are free to withdraw at any point without reprisal. The qualitative researcher should take written consent before undertaking the interview. In a face-to-face interview, this is straightforward: the researcher and participant both sign copies of the consent form, keeping one each. However, this approach is less straightforward when the researcher and participant do not meet in person. A recent protocol paper outlined an approach for taking consent for telephone interviews, which involved: audio recording the participant agreeing to each point on the consent form; the researcher signing the consent form and keeping a copy; and posting a copy to the participant. 25 This process could be replicated in other interview studies using digital methods.

There are advantages and disadvantages of using face-to-face and digital methods for research interviews. Ultimately, for both approaches, the quality of the interview is determined by the researcher. 16 Appropriate training and preparation are thus required. Healthcare professionals can use their interpersonal communication skills when undertaking a research interview, particularly questioning, listening and conversing. 3 However, the purpose of an interview is to gain information about the study topic, 26 rather than offering help and advice. 3 The researcher therefore needs to listen attentively to participants, enabling them to describe their experience without interruption. 3 The use of active listening skills also help to facilitate the interview. 14 Spradley outlined elements and strategies for research interviews, 27 which are a useful guide for qualitative researchers:

Greeting and explaining the project/interview

Asking descriptive (broad), structural (explore response to descriptive) and contrast (difference between) questions

Asymmetry between the researcher and participant talking

Expressing interest and cultural ignorance

Repeating, restating and incorporating the participant's words when asking questions

Creating hypothetical situations

Asking friendly questions

Knowing when to leave.

For semi-structured interviews, a topic guide (also called an interview schedule) is used to guide the content of the interview – an example of a topic guide is outlined in Box 1 . The topic guide, usually based on the research questions, existing literature and, for healthcare professionals, their clinical experience, is developed by the research team. The topic guide should include open ended questions that elicit in-depth information, and offer participants the opportunity to talk about issues important to them. This is vital in qualitative research where the researcher is interested in exploring the experiences and perspectives of participants. It can be useful for qualitative researchers to pilot the topic guide with the first participants, 10 to ensure the questions are relevant and understandable, and amending the questions if required.

Regardless of the medium of interview, the researcher must consider the setting of the interview. For face-to-face interviews, this could be in the participant's home, in an office or another mutually convenient location. A quiet location is preferable to promote confidentiality, enable the researcher and participant to concentrate on the conversation, and to facilitate accurate audio-recording of the interview. For interviews using digital methods the same principles apply: a quiet, private space where the researcher and participant feel comfortable and confident to participate in an interview.

Box 1: Example of a topic guide

Study focus: Parents' experiences of brushing their child's (aged 0–5) teeth

1. Can you tell me about your experience of cleaning your child's teeth?

How old was your child when you started cleaning their teeth?

Why did you start cleaning their teeth at that point?

How often do you brush their teeth?

What do you use to brush their teeth and why?

2. Could you explain how you find cleaning your child's teeth?

Do you find anything difficult?

What makes cleaning their teeth easier for you?

3. How has your experience of cleaning your child's teeth changed over time?

Has it become easier or harder?

Have you changed how often and how you clean their teeth? If so, why?

4. Could you describe how your child finds having their teeth cleaned?

What do they enjoy about having their teeth cleaned?

Is there anything they find upsetting about having their teeth cleaned?

5. Where do you look for information/advice about cleaning your child's teeth?

What did your health visitor tell you about cleaning your child's teeth? (If anything)

What has the dentist told you about caring for your child's teeth? (If visited)

Have any family members given you advice about how to clean your child's teeth? If so, what did they tell you? Did you follow their advice?

6. Is there anything else you would like to discuss about this?

Focus groups

A focus group is a moderated group discussion on a pre-defined topic, for research purposes. 28 , 29 While not aligned to a particular qualitative methodology (for example, grounded theory or phenomenology) as such, focus groups are used increasingly in healthcare research, as they are useful for exploring collective perspectives, attitudes, behaviours and experiences. Consequently, they can yield rich, in-depth data and illuminate agreement and inconsistencies 28 within and, where appropriate, between groups. Examples include public perceptions of dental implants and subsequent impact on help-seeking and decision making, 30 and general dental practitioners' views on patient safety in dentistry. 31

Focus groups can be used alone or in conjunction with other methods, such as interviews or observations, and can therefore help to confirm, extend or enrich understanding and provide alternative insights. 28 The social interaction between participants often results in lively discussion and can therefore facilitate the collection of rich, meaningful data. However, they are complex to organise and manage, due to the number of participants, and may also be inappropriate for exploring particularly sensitive issues that many participants may feel uncomfortable about discussing in a group environment.

Focus groups are primarily undertaken face-to-face but can now also be undertaken online, using appropriate technologies such as email, bulletin boards, online research communities, chat rooms, discussion forums, social media and video conferencing. 32 Using such technologies, data collection can also be synchronous (for example, online discussions in 'real time') or, unlike traditional face-to-face focus groups, asynchronous (for example, online/email discussions in 'non-real time'). While many of the fundamental principles of focus group research are the same, regardless of how they are conducted, a number of subtle nuances are associated with the online medium. 32 Some of which are discussed further in the following sections.

Focus group considerations

Some key considerations associated with face-to-face focus groups are: how many participants are required; should participants within each group know each other (or not) and how many focus groups are needed within a single study? These issues are much debated and there is no definitive answer. However, the number of focus groups required will largely depend on the topic area, the depth and breadth of data needed, the desired level of participation required 29 and the necessity (or not) for data saturation.

The optimum group size is around six to eight participants (excluding researchers) but can work effectively with between three and 14 participants. 3 If the group is too small, it may limit discussion, but if it is too large, it may become disorganised and difficult to manage. It is, however, prudent to over-recruit for a focus group by approximately two to three participants, to allow for potential non-attenders. For many researchers, particularly novice researchers, group size may also be informed by pragmatic considerations, such as the type of study, resources available and moderator experience. 28 Similar size and mix considerations exist for online focus groups. Typically, synchronous online focus groups will have around three to eight participants but, as the discussion does not happen simultaneously, asynchronous groups may have as many as 10–30 participants. 33

The topic area and potential group interaction should guide group composition considerations. Pre-existing groups, where participants know each other (for example, work colleagues) may be easier to recruit, have shared experiences and may enjoy a familiarity, which facilitates discussion and/or the ability to challenge each other courteously. 3 However, if there is a potential power imbalance within the group or if existing group norms and hierarchies may adversely affect the ability of participants to speak freely, then 'stranger groups' (that is, where participants do not already know each other) may be more appropriate. 34 , 35

Focus group management

Face-to-face focus groups should normally be conducted by two researchers; a moderator and an observer. 28 The moderator facilitates group discussion, while the observer typically monitors group dynamics, behaviours, non-verbal cues, seating arrangements and speaking order, which is essential for transcription and analysis. The same principles of informed consent, as discussed in the interview section, also apply to focus groups, regardless of medium. However, the consent process for online discussions will probably be managed somewhat differently. For example, while an appropriate participant information leaflet (and consent form) would still be required, the process is likely to be managed electronically (for example, via email) and would need to specifically address issues relating to technology (for example, anonymity and use, storage and access to online data). 32

The venue in which a face to face focus group is conducted should be of a suitable size, private, quiet, free from distractions and in a collectively convenient location. It should also be conducted at a time appropriate for participants, 28 as this is likely to promote attendance. As with interviews, the same ethical considerations apply (as discussed earlier). However, online focus groups may present additional ethical challenges associated with issues such as informed consent, appropriate access and secure data storage. Further guidance can be found elsewhere. 8 , 32

Before the focus group commences, the researchers should establish rapport with participants, as this will help to put them at ease and result in a more meaningful discussion. Consequently, researchers should introduce themselves, provide further clarity about the study and how the process will work in practice and outline the 'ground rules'. Ground rules are designed to assist, not hinder, group discussion and typically include: 3 , 28 , 29

Discussions within the group are confidential to the group

Only one person can speak at a time

All participants should have sufficient opportunity to contribute

There should be no unnecessary interruptions while someone is speaking

Everyone can be expected to be listened to and their views respected

Challenging contrary opinions is appropriate, but ridiculing is not.

Moderating a focus group requires considered management and good interpersonal skills to help guide the discussion and, where appropriate, keep it sufficiently focused. Avoid, therefore, participating, leading, expressing personal opinions or correcting participants' knowledge 3 , 28 as this may bias the process. A relaxed, interested demeanour will also help participants to feel comfortable and promote candid discourse. Moderators should also prevent the discussion being dominated by any one person, ensure differences of opinions are discussed fairly and, if required, encourage reticent participants to contribute. 3 Asking open questions, reflecting on significant issues, inviting further debate, probing responses accordingly, and seeking further clarification, as and where appropriate, will help to obtain sufficient depth and insight into the topic area.

Moderating online focus groups requires comparable skills, particularly if the discussion is synchronous, as the discussion may be dominated by those who can type proficiently. 36 It is therefore important that sufficient time and respect is accorded to those who may not be able to type as quickly. Asynchronous discussions are usually less problematic in this respect, as interactions are less instant. However, moderating an asynchronous discussion presents additional challenges, particularly if participants are geographically dispersed, as they may be online at different times. Consequently, the moderator will not always be present and the discussion may therefore need to occur over several days, which can be difficult to manage and facilitate and invariably requires considerable flexibility. 32 It is also worth recognising that establishing rapport with participants via online medium is often more challenging than via face-to-face and may therefore require additional time, skills, effort and consideration.

As with research interviews, focus groups should be guided by an appropriate interview schedule, as discussed earlier in the paper. For example, the schedule will usually be informed by the review of the literature and study aims, and will merely provide a topic guide to help inform subsequent discussions. To provide a verbatim account of the discussion, focus groups must be recorded, using an audio-recorder with a good quality multi-directional microphone. While videotaping is possible, some participants may find it obtrusive, 3 which may adversely affect group dynamics. The use (or not) of a video recorder, should therefore be carefully considered.

At the end of the focus group, a few minutes should be spent rounding up and reflecting on the discussion. 28 Depending on the topic area, it is possible that some participants may have revealed deeply personal issues and may therefore require further help and support, such as a constructive debrief or possibly even referral on to a relevant third party. It is also possible that some participants may feel that the discussion did not adequately reflect their views and, consequently, may no longer wish to be associated with the study. 28 Such occurrences are likely to be uncommon, but should they arise, it is important to further discuss any concerns and, if appropriate, offer them the opportunity to withdraw (including any data relating to them) from the study. Immediately after the discussion, researchers should compile notes regarding thoughts and ideas about the focus group, which can assist with data analysis and, if appropriate, any further data collection.

Qualitative research is increasingly being utilised within dental research to explore the experiences, perspectives, motivations and beliefs of participants. The contributions of qualitative research to evidence-based practice are increasingly being recognised, both as standalone research and as part of larger mixed-method studies, including clinical trials. Interviews and focus groups remain commonly used data collection methods in qualitative research, and with the advent of digital technologies, their utilisation continues to evolve. However, digital methods of qualitative data collection present additional methodological, ethical and practical considerations, but also potentially offer considerable flexibility to participants and researchers. Consequently, regardless of format, qualitative methods have significant potential to inform important areas of dental practice, policy and further related research.

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Gill, P., Baillie, J. Interviews and focus groups in qualitative research: an update for the digital age. Br Dent J 225 , 668–672 (2018). https://doi.org/10.1038/sj.bdj.2018.815

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Issue Date : 12 October 2018

DOI : https://doi.org/10.1038/sj.bdj.2018.815

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Interviews in Qualitative Research

Interviews in Qualitative Research

  • Nigel King - University of Huddersfield, UK
  • Christine Horrocks - Manchester Metropolitan University, UK
  • Joanna Brooks - University of Manchester, UK
  • Description

This dynamic user-focused book will help you to get the data you want from your interviews. It provides practical guidance regarding technique, gives top-tips from real world case studies and shares achievable checklists and interview plans.

Whether you are doing interviews in your own research or just using other researchers’ data, this book will tell you everything you need to know about designing, planning, conducting and analyzing quality interviews. It explains how to:

-          Construct ethical research designs

-          Record and manage your data

-          Transcribe your notes

-          Analyse your findings

-          Disseminate your conclusions

Written using clear, jargon-free terminology and with coverage of practical, theoretical and philosophical issues all grounded in examples from real interviews, this is the ideal guide for new and experienced researchers alike.

Nigel King  is Professor of Applied Psychology at the University of Huddersfield.

Christine Horrocks  is Professor of Applied Social Psychology and Head of the Department of Psychology at Manchester Metropolitan University. 

Joanna Brooks  is Lecturer in the Manchester Centre for Health Psychology at the University of Manchester. 

See what’s new to this edition by selecting the Features tab on this page. Should you need additional information or have questions regarding the HEOA information provided for this title, including what is new to this edition, please email [email protected] . Please include your name, contact information, and the name of the title for which you would like more information. For information on the HEOA, please go to http://ed.gov/policy/highered/leg/hea08/index.html .

For assistance with your order: Please email us at [email protected] or connect with your SAGE representative.

SAGE 2455 Teller Road Thousand Oaks, CA 91320 www.sagepub.com

As a researcher and educator I find this book to be an invaluable resource, a detailed yet accessible guide for all those engaged in qualitative research . 

Interviews in Qualitative Research (Second Edition)  should be your first line of defense as you voyage through the minefield of using the method of interviewing. As a supervisor and qualitative researcher, this is a must-have, accessible read to support researchers at any stage. A helping, comforting hand to hold for qualitative researchers!

This is an impressive and comprehensive exploration of the use of interviews in qualitative research  –  theoretically rich, practically sensible, robust in application and academically relevant. It is essential reading for researchers at all levels of their research journey – an excellent resource and contribution to the literature.

Interviews in Qualitative Research is a must read for ambitious students and developing researchers. The authors holistically detail the interview method whilst remaining clear, concise and coherent. I am confident this book will help produce high quality qualitative research!

A comprehensive and accessible introduction to qualitative interviews. It is particularly strong on the practical aspects of designing and conducting interview-based studies using a wide range of settings, methods and approaches. It will become a trusted companion to many an undergraduate or postgraduate student, especially those who value an applied perspective. The new edition therefore deserves to defend its place on many a qualitative methods reading list – including my own.

This is an accessible and authoritative text that provides a detailed outline of the interview process from start to finish [...] The book usefully adopts an applied perspective and draws on ‘real world’ case studies to exemplify the possibilities and challenges that might arise throughout the interview process. It provides much practical guidance about how interviews might be planned, conducted and analysed – with boxes, tables and figures proving a particularly useful feature

This is a very good resource for students and teaching

This is a very good reference in qualitative research. The chapters are nicely laid and it is very easy to follow both from students and teachers' perspectives. I will highly recommend this book for students, teachers and researchers.

A useful book on using qualitative interviews in research for my students who spend this year undertaking a research project.

this books outlines the benefits of conducting interviews within the area of field data. The suggestion allow students to identify areas that they are interested in and also highlights potential pitfalls that they may encounter on the way to completing a dissertation.

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6 Easy Steps in Learning How to Analyze Interview Data in Qualitative Studies

Daniel Chang

It’s understandable if you find qualitative data analysis quite challenging. Unlike quantitative methodologies, qualitative data analysis doesn’t follow a systematic, rigid, and formulaic process. Once you decide to analyze interview transcripts in qualitative research, the work is slightly more intuitive than tangible.

We won’t sugarcoat things and say that qualitative analysis is an easy task. However, there are practical steps you can take to avoid turning the entire process into something chaotic. In most cases, you’ll start by having accurate interview transcripts that you need to read over and over again. 

This article will guide teach you how to  transcribe and analyze interview data  for qualitative research.

Why It’s Important to Analyze Interview Data in Qualitative Research

Quantitative data may offer rigor to your research. However, it is qualitative analysis that will add color to your business or academic report. By taking this approach, you can add context to your data and make it more readable. It will inspire a more meaningful discussion that goes beyond the hard numbers in your report.

Most of the time, interviews allow you to acquire subjective data from direct sources. As a researcher, you’ll get relatable perspectives and stories. You can also get important quotes from subject matter experts. Interviews provide qualitative data that strengthens the integrity and eliminates embellishment in their research.

Now, how do you acquire the information you need for qualitative data? Well, transcribing interviews provides you with the best resources for qualitative analysis. You can add life to your research by interviewing the following sources:

  • Business leaders
  • Scientists and investors
  • Trial or study participants
  • Journal and research authors

You can include sources that may contribute to the quality of the research. Now, whenever you conduct an interview, you should use the right methods to ensure you’ll get the information you need. You must maximize your recorded interviews by transcribing them accurately. 

How to Get an Accurate Qualitative Interview Transcript

It’s more challenging to get the information you need in a qualitative interview. However, by taking a systematic approach, it will be easier for you to gather the data you need. Here are some steps to follow:

1. Gather Qualitative Data

Qualitative data can be collected through various means. For one, you can record the interview and take advantage of legal-grade transcription services. Taking this approach will help you avoid data loss and inaccuracies. This method is ideal for focus group discussions and customer interviews. With this process, respondents can be more open in answering the questions.

You may have above-average note-taking skills, but that’s usually unreliable in qualitative research. Whether you’re conducting the interview over the phone, on a video conference call, or in person, you can collect accurate data by recording the conversation. You can either record the interview in an audio-only or video format.

2. Compile Your Interview Recordings Neatly

Your interview video or audio files should be easy to find, identify, and share. Use file-naming conventions that are easy to recall and organize. Ideally, you must include the date of the interview, the source’s last name, and the discussion topic. 

No matter what file naming convention you choose, you need to be consistent in the format. This way, it’s easier for you to find the necessary files later when you analyze interview data.

3. Transcribe the Focus Group and Interview Recordings

The next step is to transcribe the recordings. Now, there are plenty of tools online that can automate the process. However, remember that you are working on qualitative research, and you need an accurate transcription.

So, your best bet here is to use 100% human-generated transcription services. GoTranscript offers verbatim results, allowing you to get legal-level accuracy for your qualitative interview recordings. If you’re following tight deadlines, you can opt for a rush order. This way, you’ll get your files within your requested turnaround time and begin your qualitative analysis.

What Are the Methods Used to Analyze Interview Data in Qualitative Research?

When it comes to qualitative data analysis, you can choose from two primary approaches – inductive and deductive. If you opt for the former, you can take an unstructured approach to your research by conducting narrative or thematic content analysis.

Inductive Method for Analyzing Qualitative Interview Transcripts

  • Thematic content analysis – This method starts by identifying your overarching impressions of the information and weeding out biases. Instead of establishing a framework for approaching the data, you search the materials organically and look for common themes. You aim to discover the recurring patterns across the data set.
  • Narrative content analysis – This method requires you to make sense of the individual stories of your interview respondents. It is the ideal approach for identifying important aspects of the data that resonate well with your readers. 

Deductive Method for Analyzing Qualitative Interview Transcripts

Deductive data analysis is a more systematic or structured approach. Before you begin to analyze interview data, you need to develop categories. During the process, you’ll connect information from the data to those pre-determined categories.

Both approaches to data analysis bring benefits to your research. If you want more nuanced findings, the inductive method is the ideal option. Now, if you want to point to key themes that are crucial to your research, opt for deductive analysis.

6 Practical Steps in Performing Qualitative Analysis of Interview Transcripts

Most of the time, researchers opt for thematic content analysis. Many find it to be the most effective and trustworthy method. The approach makes it easier for anyone to verify and trace the findings of the analysis. Here are six practical steps for conducting a thematic analysis of your interview transcripts:

Step 1: Go Through the Transcripts Carefully

At this point, you likely have a digital copy of your transcript files. You may have them stored locally on your computer or in the cloud. Begin by skimming through the transcripts, and along the process, write down your first impressions. This makes to easier to analyze interview data.

Taking this approach will help you identify common patterns in the data. Your quick notes will also be instrumental in helping you come up with a final summation of the data.

Now, you need to read every transcript carefully. After multiple run-throughs, the common themes will become more visible. As a result, you will be able to come up with crucial and significant insights. 

During this process, you should also identify biases. Even within your methodologies and objectives, biases will surface in the data and among the interviewees.  Sage Publishing  recommends that as early as this step, you should actively neutralize the preconceived notions you identify. This way, you can take an objective approach when you begin to analyze interview data.

Step 2: Begin Annotating the Transcripts

Once you get to this step, you need to label the key phrases, terms, sentences, or section codes on the transcript. Annotating your transcripts allows you to identify important qualitative data patterns and types. 

The labels can highlight the varying interviewee opinions, concepts, and data differences. This process makes it easier for you to organize your data set for dissemination. As a result, you’re cutting down the time it takes to analyze interview data.

Step 3: Align the Data with Important Themes

This step requires you to conceptualize the qualitative data by aligning it with important themes for your final content. At this phase, you will have identified the common patterns from the initial transcript reviews.

When conceptualizing the data, you need to group the codes from the annotation to create categories and subcategories. You can combine or eliminate certain codes instead of using all of them. You should identify and retain the codes that are relevant to your analysis. 

Step 4: Position and Connect Your Categories

Now, you need to segment the data by positioning and connecting your categories. During this step, you will be able to cohesively establish most of your data. You can begin by labeling the categories, and describing how they connect to each other. The descriptions will be instrumental in optimizing your final output. Here are the steps you can take:

  • Compile your data conveniently by using a spreadsheet.
  • Structure the data’s critical variables by labeling the columns with proper reference codes.
  • The document containing the coding table should be on a separate tab. This tab functions as a glossary containing critical codes for the segmentation process. As a result, you can quickly identify what the codes are referring to.

Most researchers prefer doing all these steps electronically for convenience. However, some people prefer having a printed copy so they can highlight segments using pens. In any case, you should save a copy of the transcript files. You can print them out when you need to.

Step 5: Perform a Deep Analysis of the Data Segments

Once you’ve segmented the data, it’s time to perform a deep analysis. You can begin by identifying the categories’ hierarchy. You need to decide if one category is more important than the other. You can also summarize the results by drawing a figure. This stage should also let you align the qualitative data with your quantitative data.

Step 6: Write Your Findings

Once you’ve performed a deep analysis of your data, you’re ready to write the results into a body of content. Establish and verify theories by using your data insights. You can also answer key questions that your field may ask, and don’t forget to adequately support your research goals. Use an objective, neutral voice in describing how your categories connect to each other.

Naturally, you will use your own research and pull insights heavily from it. However, make sure to consider the context of your field when writing your results. Interpret your findings alongside relevant theories, studies, and concepts when you analyze interview data.

Accurate Transcription Is Necessary in Qualitative Research Analysis

Researchers often find qualitative data analysis challenging. As such, it is important to have transcripts that capture the nuanced, unadulterated responses from interviewees. You can get their organic responses because they are using their own words and not the shortened version from your notes.

What’s great about having a transcript is that you can go back to it whenever you gain find new context. However, to ensure a reasonable level of objectivity, you must ensure that your transcript is accurate.

With GoTranscript, you can have a convenient yet efficient way of transcribing your qualitative interviews. You can save time and focus on more important aspects of your research.

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How to carry out great interviews in qualitative research.

11 min read An interview is one of the most versatile methods used in qualitative research. Here’s what you need to know about conducting great qualitative interviews.

What is a qualitative research interview?

Qualitative research interviews are a mainstay among q ualitative research techniques, and have been in use for decades either as a primary data collection method or as an adjunct to a wider research process. A qualitative research interview is a one-to-one data collection session between a researcher and a participant. Interviews may be carried out face-to-face, over the phone or via video call using a service like Skype or Zoom.

There are three main types of qualitative research interview – structured, unstructured or semi-structured.

  • Structured interviews Structured interviews are based around a schedule of predetermined questions and talking points that the researcher has developed. At their most rigid, structured interviews may have a precise wording and question order, meaning that they can be replicated across many different interviewers and participants with relatively consistent results.
  • Unstructured interviews Unstructured interviews have no predetermined format, although that doesn’t mean they’re ad hoc or unplanned. An unstructured interview may outwardly resemble a normal conversation, but the interviewer will in fact be working carefully to make sure the right topics are addressed during the interaction while putting the participant at ease with a natural manner.
  • Semi-structured interviews Semi-structured interviews are the most common type of qualitative research interview, combining the informality and rapport of an unstructured interview with the consistency and replicability of a structured interview. The researcher will come prepared with questions and topics, but will not need to stick to precise wording. This blended approach can work well for in-depth interviews.

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What are the pros and cons of interviews in qualitative research?

As a qualitative research method interviewing is hard to beat, with applications in social research, market research, and even basic and clinical pharmacy. But like any aspect of the research process, it’s not without its limitations. Before choosing qualitative interviewing as your research method, it’s worth weighing up the pros and cons.

Pros of qualitative interviews:

  • provide in-depth information and context
  • can be used effectively when their are low numbers of participants
  • provide an opportunity to discuss and explain questions
  • useful for complex topics
  • rich in data – in the case of in-person or video interviews , the researcher can observe body language and facial expression as well as the answers to questions

Cons of qualitative interviews:

  • can be time-consuming to carry out
  • costly when compared to some other research methods
  • because of time and cost constraints, they often limit you to a small number of participants
  • difficult to standardize your data across different researchers and participants unless the interviews are very tightly structured
  • As the Open University of Hong Kong notes, qualitative interviews may take an emotional toll on interviewers

Qualitative interview guides

Semi-structured interviews are based on a qualitative interview guide, which acts as a road map for the researcher. While conducting interviews, the researcher can use the interview guide to help them stay focused on their research questions and make sure they cover all the topics they intend to.

An interview guide may include a list of questions written out in full, or it may be a set of bullet points grouped around particular topics. It can prompt the interviewer to dig deeper and ask probing questions during the interview if appropriate.

Consider writing out the project’s research question at the top of your interview guide, ahead of the interview questions. This may help you steer the interview in the right direction if it threatens to head off on a tangent.

qualitative interview in research

Avoid bias in qualitative research interviews

According to Duke University , bias can create significant problems in your qualitative interview.

  • Acquiescence bias is common to many qualitative methods, including focus groups. It occurs when the participant feels obliged to say what they think the researcher wants to hear. This can be especially problematic when there is a perceived power imbalance between participant and interviewer. To counteract this, Duke University’s experts recommend emphasizing the participant’s expertise in the subject being discussed, and the value of their contributions.
  • Interviewer bias is when the interviewer’s own feelings about the topic come to light through hand gestures, facial expressions or turns of phrase. Duke’s recommendation is to stick to scripted phrases where this is an issue, and to make sure researchers become very familiar with the interview guide or script before conducting interviews, so that they can hone their delivery.

What kinds of questions should you ask in a qualitative interview?

The interview questions you ask need to be carefully considered both before and during the data collection process. As well as considering the topics you’ll cover, you will need to think carefully about the way you ask questions.

Open-ended interview questions – which cannot be answered with a ‘yes’ ‘no’ or ‘maybe’ – are recommended by many researchers as a way to pursue in depth information.

An example of an open-ended question is “What made you want to move to the East Coast?” This will prompt the participant to consider different factors and select at least one. Having thought about it carefully, they may give you more detailed information about their reasoning.

A closed-ended question , such as “Would you recommend your neighborhood to a friend?” can be answered without too much deliberation, and without giving much information about personal thoughts, opinions and feelings.

Follow-up questions can be used to delve deeper into the research topic and to get more detail from open-ended questions. Examples of follow-up questions include:

  • What makes you say that?
  • What do you mean by that?
  • Can you tell me more about X?
  • What did/does that mean to you?

As well as avoiding closed-ended questions, be wary of leading questions. As with other qualitative research techniques such as surveys or focus groups, these can introduce bias in your data. Leading questions presume a certain point of view shared by the interviewer and participant, and may even suggest a foregone conclusion.

An example of a leading question might be: “You moved to New York in 1990, didn’t you?” In answering the question, the participant is much more likely to agree than disagree. This may be down to acquiescence bias or a belief that the interviewer has checked the information and already knows the correct answer.

Other leading questions involve adjectival phrases or other wording that introduces negative or positive connotations about a particular topic. An example of this kind of leading question is: “Many employees dislike wearing masks to work. How do you feel about this?” It presumes a positive opinion and the participant may be swayed by it, or not want to contradict the interviewer.

Harvard University’s guidelines for qualitative interview research add that you shouldn’t be afraid to ask embarrassing questions – “if you don’t ask, they won’t tell.” Bear in mind though that too much probing around sensitive topics may cause the interview participant to withdraw. The Harvard guidelines recommend leaving sensitive questions til the later stages of the interview when a rapport has been established.

More tips for conducting qualitative interviews

Observing a participant’s body language can give you important data about their thoughts and feelings. It can also help you decide when to broach a topic, and whether to use a follow-up question or return to the subject later in the interview.

Be conscious that the participant may regard you as the expert, not themselves. In order to make sure they express their opinions openly, use active listening skills like verbal encouragement and paraphrasing and clarifying their meaning to show how much you value what they are saying.

Remember that part of the goal is to leave the interview participant feeling good about volunteering their time and their thought process to your research. Aim to make them feel empowered , respected and heard.

Unstructured interviews can demand a lot of a researcher, both cognitively and emotionally. Be sure to leave time in between in-depth interviews when scheduling your data collection to make sure you maintain the quality of your data, as well as your own well-being .

Recording and transcribing interviews

Historically, recording qualitative research interviews and then transcribing the conversation manually would have represented a significant part of the cost and time involved in research projects that collect qualitative data.

Fortunately, researchers now have access to digital recording tools, and even speech-to-text technology that can automatically transcribe interview data using AI and machine learning. This type of tool can also be used to capture qualitative data from qualitative research (focus groups,ect.) making this kind of social research or market research much less time consuming.

qualitative interview in research

Data analysis

Qualitative interview data is unstructured, rich in content and difficult to analyze without the appropriate tools. Fortunately, machine learning and AI can once again make things faster and easier when you use qualitative methods like the research interview.

Text analysis tools and natural language processing software can ‘read’ your transcripts and voice data and identify patterns and trends across large volumes of text or speech. They can also perform khttps://www.qualtrics.com/experience-management/research/sentiment-analysis/

which assesses overall trends in opinion and provides an unbiased overall summary of how participants are feeling.

qualitative interview in research

Another feature of text analysis tools is their ability to categorize information by topic, sorting it into groupings that help you organize your data according to the topic discussed.

All in all, interviews are a valuable technique for qualitative research in business, yielding rich and detailed unstructured data. Historically, they have only been limited by the human capacity to interpret and communicate results and conclusions, which demands considerable time and skill.

When you combine this data with AI tools that can interpret it quickly and automatically, it becomes easy to analyze and structure, dovetailing perfectly with your other business data. An additional benefit of natural language analysis tools is that they are free of subjective biases, and can replicate the same approach across as much data as you choose. By combining human research skills with machine analysis, qualitative research methods such as interviews are more valuable than ever to your business.

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This paper is in the following e-collection/theme issue:

Published on 29.3.2024 in Vol 26 (2024)

Telehealth Care Through Internet Hospitals in China: Qualitative Interview Study of Physicians’ Views on Access, Expectations, and Communication

Authors of this article:

Author Orcid Image

Original Paper

  • Yuqiong Zhong 1, 2 , Mphil   ; 
  • Jessica Hahne 3 , MA, MPH   ; 
  • Xiaomin Wang 4, 5 , PhD   ; 
  • Xuxi Wang 1 , Bphil   ; 
  • Ying Wu 1 , MPhil   ; 
  • Xin Zhang 2, 6 * , MD, PhD   ; 
  • Xing Liu 6, 7 * , PhD  

1 School of Humanities, Central South University, Changsha, China

2 Xiangya Hospital, Central South University, Changsha, China

3 Department of Psychological & Brain Sciences, Washington University in St Louis, St Louis, MO, United States

4 Center for Clinical Pharmacology, The Third Xiangya Hospital of Central South University, Changsha, China

5 Center for Medical Ethics, Central South University, Changsha, China

6 Medical Humanities Research Center, Central South University, Changsha, China

7 Office of International Cooperation and Exchanges, Xiangya Hospital, Central South University, Changsha, China

*these authors contributed equally

Corresponding Author:

Xing Liu, PhD

Office of International Cooperation and Exchanges

Xiangya Hospital, Central South University

No 87 Xiangya Road, Kaifu District

Changsha, 410008

Phone: 86 18229765509

Email: [email protected]

Background: Internet hospitals in China are an emerging medical service model similar to other telehealth models used worldwide. Internet hospitals are currently in a stage of rapid development, giving rise to a series of new opportunities and challenges for patient care. Little research has examined the views of chronic disease physicians regarding internet hospitals in China.

Objective: We aimed to explore the experience and views of chronic disease physicians at 3 tertiary hospitals in Changsha, China, regarding opportunities and challenges in internet hospital care.

Methods: We conducted semistructured qualitative interviews with physicians (n=26) who had experience working in internet hospitals affiliated with chronic disease departments in 3 tertiary hospitals in Changsha, Hunan province, south central China. Interviews were transcribed verbatim and analyzed by content analysis using NVivo software (version 11; Lumivero).

Results: Physicians emphasized that internet hospitals expand opportunities to conduct follow-up care and health education for patients with chronic illnesses. However, physicians described disparities in access for particular groups of patients, such as patients who are older, patients with lower education levels, patients with limited internet or technology access, and rural patients. Physicians also perceived a gap between patients’ expectations and the reality of limitations regarding both physicians’ availability and the scope of services offered by internet hospitals, which raised challenges for doctor-patient boundaries and trust. Physicians noted challenges in doctor-patient communication related to comprehension and informed consent in internet hospital care.

Conclusions: This study explored the experience and views of physicians in 3 tertiary hospitals in Changsha, China, regarding access to care, patients’ expectations versus the reality of services, and doctor-patient communication in internet hospital care. Findings from this study highlight the need for physician training in telehealth communication skills, legislation regulating informed consent in telehealth care, public education clarifying the scope of internet hospital services, and design of internet hospitals that is informed by the needs of patient groups with barriers to access, such as older adults.

Introduction

As information technology develops rapidly in the current era, telehealth is growing exponentially in use [ 1 - 3 ]. Particularly in the wake of the COVID-19 pandemic, the use of telehealth for both primary and specialist care has accelerated around the globe [ 4 ]. In particular, telehealth is being implemented at an increasing scale in various countries with aging populations to improve health care access and quality for growing numbers of patients with chronic diseases [ 5 - 9 ].

The internet hospital is 1 major emerging telehealth model that is distinct to China, a country with a particularly large aging population and a high chronic disease burden [ 10 - 12 ]. Designed to make health care services more available, convenient, affordable, and efficient, internet hospitals are a type of online platform through which certain health care services can be conducted remotely. There are 3 main types of internet hospitals—those initiated by physical hospitals, those jointly established by physical hospitals and business enterprises, and those initiated by business enterprises relying on physical medical institutions. Research suggests that internet hospitals initiated solely by physical hospitals are the most widespread type [ 13 ]. In terms of the target patient population, internet hospitals primarily aim to facilitate services for patients with common illnesses requiring relatively simple treatment [ 14 ], patients with chronic diseases (diabetes, hypertension, and cancer) [ 15 ], and patients in remote and rural areas [ 16 ].

However, the scope of internet hospitals goes beyond telemedicine services for patients. Services provided by internet hospitals can be classified into three categories, (1) “core medical services,” which mainly include follow-up care for in-person medical services, telemedicine consultations, guidance on chronic disease management, and guidance on medication use; (2) “non-core medical services,” which mainly include medical consultations between health care providers and remote education for health care providers; and (3) “convenience services,” which mainly include health care appointment scheduling, mobile payment for health services, remote examination of medical test results, and dispensation and distribution of some medications [ 10 , 13 , 17 , 18 ]. Thus, the internet hospital model has the potential to increase access to health care for patients and training for providers, and to decrease costs across the health care system.

A number of recent policies by the Chinese national government have promoted rapid development and uptake of the internet hospital model. In 2015 [ 19 ] and 2018 [ 20 ], the State Council issued guidelines promoting “‘Internet +’ Healthcare,” which emphasized the development of internet hospitals as part of the “Health China” strategy for health care reform. Concurrently in 2018, the National Health Commission formulated specific regulations on internet hospital management, which officially authorized internet hospitals to facilitate a range of telehealth services and marked the start of their standardized development [ 21 - 23 ]. In 2020, the National Health Commission issued the “Notice on Strengthening Informatization to Support the Prevention and Control of the Novel Coronavirus Pneumonia Epidemic,” emphasizing the advantages of internet hospitals in controlling the spread of the COVID-19 pandemic [ 24 ]. In the wake of these policies, by June 2023, the number of internet hospitals had reached more than 3000, and 364 million of China’s 1.079 billion internet users were using online medical services [ 25 , 26 ]. However, research suggests that most internet hospitals are not yet fully developed or providing the full scope of services intended to achieve these goals [ 27 - 29 ].

At this early stage of the model’s development, little research to date has evaluated the views of Chinese medical professionals and patients regarding internet hospitals. However, research on telehealth in other countries reveals that telehealth raises many new concerns and challenges alongside the aforementioned opportunities [ 30 - 32 ]. One of the most common concerns raised by patients is the potential for misdiagnosis due to the inability to conduct physical examinations through telehealth [ 33 , 34 ]. Particular groups such as lower-income older adults also commonly report barriers to the use of telehealth such as lack of familiarity with technology or limited access to technological devices or internet connections [ 35 ]. Smartphone data or internet connection problems can also lower patient satisfaction and limit access among rural patient populations [ 36 , 37 ]. Various groups of patients also commonly report feeling concerned about patient privacy and the security and protection of medical data when using telehealth [ 38 ].

In order to guide the direction of internet hospital development in China, further research is needed to examine the emerging challenges and opportunities to patient care presented by this country-specific telehealth platform. The aim of this study was to explore the experience and views of chronic disease physicians at 3 tertiary hospitals in Changsha, China, regarding opportunities and challenges presented by internet hospital care.

The methodology whereby this study was designed and conducted is reported following the items in the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist [ 39 ]. See Multimedia Appendix 1 [ 39 ] for more information.

Setting, Participant Recruitment, and Eligibility Criteria

We conducted in-depth, semistructured interviews with physicians at 3 tertiary hospitals in Changsha, Hunan Province, south central China. Inclusion criteria for participants were 18 years of age or older, experience working in internet hospitals, and employment in a chronic disease department at one of the study hospitals. Our rationale for these inclusion criteria was to select doctors who had work experience relevant to the research questions. Enrollment occurred over a 2-month period from April to May 2022. Using a purposive sampling approach, we obtained a list of doctors who had previous experience working in internet hospitals. We then messaged or called the doctors on the list to briefly explain the primary and secondary objectives of the study, invited them to share their perspectives related to the study, and asked them to be available for interviews. Out of the 28 doctors contacted, 26 agreed to participate, while 2 physicians declined due to a lack of time. Those who responded positively to the invitation were subsequently contacted by the author, YZ, either via WeChat (Tencent Holdings Limited) or telephone to schedule an interview.

We recruited participants until reaching data saturation, at which point no new information about the meaning of codes or themes and the relationship between them continued to appear [ 40 ].

In order to allow spontaneous answers and mitigate bias, participants were given minimum information in advance about specific interview topics.

Ethical Considerations

In April 2022, the research protocol was approved by the institutional review board of Xiangya Hospital, Central South University (#202204092). No prior relationships existed between study participants and members of the research team. Verbal informed consent was recorded via an audio recorder for each participant before participation. Participants were informed in advance that their interviews would be recorded, with the assurance that these recordings would be subject to encryption for security purposes, and they provided their verbal consent accordingly. All participants received a compensation of 200 RMB (1 CNY=US $0.15 on May 2022) for their participation, which was disbursed through a WeChat transfer. To protect the information of the interviewees, the interview data were deidentified in the process of transcription from audio recordings.

Data Collection

The interview guide was collaboratively developed and then subjected to pilot-testing by the research team. Throughout the concurrent phases of data collection and analysis, the interview guide underwent iterative refinement in response to emerging insights and participant responses. This adaptive approach is considered vital to the robustness of qualitative research [ 41 ]. Revisions were implemented subsequent to discussions involving YZ, JH, and Xiaomin Wang, aiming to clarify, define, and critically examine emerging content from interviews as relevant to the research questions. All questions from the finalized interview guide are listed in Textbox 1 .

Q1: What are your views on internet hospitals?

Q2: Could you tell me about your experience working in internet hospitals?

Q3: What do you think are the biggest advantages of internet hospitals? Can you give some examples?

Q4: What do you think are the most troubling or difficult aspects of internet hospitals? Can you give some examples?

Q5: How do you inform the patients who come to the internet hospitals before treatment?

Q6: Do you think there are any differences between doctor-patient communication in internet hospitals and physical hospitals?

Q7: What impact do you think internet hospitals have on doctor-patient communication? Can you give some examples?

Q8: What training have you participated in regarding internet hospitals? What do you think of this training?

Q9: What do you think about the current status of the development of internet hospital laws and regulations in China? How could they be improved? What other aspects can promote the further development of internet hospitals?

Q10: Is there anything else you would like to add about doctor-patient communication in internet hospitals?

Data for this study were collected from April to May 2022. We carried out interviews through a combination of online and offline modalities, depending on each participant’s preference and availability. Online interviews were conducted remotely by video call, via the mobile app WeChat. Offline interviews were conducted in private rooms at the study hospitals. The interviews were conducted in Mandarin Chinese by the authors, YZ (a postgraduate student) and Xiaomin Wang (an associate professor). Both interviewers have received professional training in qualitative interviewing and had extensive experience conducting qualitative research prior to this study.

The research team discussed possible probes and follow-up questions before beginning interviews, and interviewers used them when necessary to draw out more information relevant to the main research question. Concurrently, a second interviewer assumed the role of an observer to ensure the standardization of interview methods and to mitigate potential biases.

Interviews were audio recorded, transcribed, and uploaded into qualitative data management NVivo software (version 11; Lumivero) on password-protected computers to facilitate the analysis. Field notes made by interviewers during the interview process were also stored on password-protected computers, to be used for reference by the research team during analysis. Interviews ranged from 20 to 50 minutes long. Transcripts were sent to participants upon request, but no corrections, comments, or notes were made to transcripts.

Data Analysis

Analysis of the data was performed through conventional content analysis, using guidelines described by Hsieh and Shannon [ 42 ]. An advantage of conventional content analysis is that it avoids using preconceived categories, to generate codes inductively from the data. This modality is considered appropriate when current knowledge of the phenomenon being researched is limited [ 42 ].

Authors YZ and Xuxi Wang transcribed all interviews verbatim and reviewed transcripts several times to acquire a thorough understanding of the whole data set. They then read transcripts line-by-line and highlighted keywords and sentences from a set of initial transcripts, to generate primary codes that captured key concepts. Primary codes were repeatedly reviewed and revised through discussion among the authors and comparison across the transcripts. A finalized codebook including 17 codes and 61 subcodes was used to code all interviews, using NVivo software (version 11). Data saturation was reached after 26 interviews, once the research team determined by the consensus that we had interviewed a sufficiently varied sample of physicians from the 3 study hospitals, while also having obtained sufficiently content-rich data.

Following the coding of all transcripts, all coded segments of the interview data were translated into English by authors YZ and Xuxi Wang, native Mandarin speakers, and double-checked for accuracy by author JH, a native English speaker. Codes and subcodes were repeatedly reviewed and were grouped into clusters according to similarities and differences. Clusters of codes were then treated as subcategories and aggregated into the main categories that were representative of the key findings. These categories were repeatedly reviewed until fully developed, through a process of identifying and comparing exemplary excerpts for each code, category, and subcategory.

This process of analysis culminated in three main categories describing the experiences and views of chronic disease physicians regarding the opportunities and challenges presented by internet hospital care, (1) advancements and shortcomings in care access due to internet hospitals, (2) patients’ expectations versus limitations on doctors’ availability and the scope of services—implications for doctor-patient boundaries and trust, and (3) advantages and downsides of online communication for comprehension and informed consent. These main categories are shown in Textbox 2 , alongside the subcategories from which they were aggregated, and further explained in the results narrative below.

Advancements and shortcomings in care access due to internet hospitals

  • Enhanced ability to conduct follow-up care for patients with chronic illness
  • More efficient channels for health education
  • Disparities in access (ie, for older adults, patients with lower education levels, patients with limited internet or technology access, rural patients)

Patients’ expectations versus limitations on doctors’ availability and the scope of services

  • Patients’ expectations of doctors’ availability create unclear professional boundaries.
  • Patients’ expectations of the service scope of internet hospitals affect doctor-patient trust.

Advantages and downsides of online communication for comprehension and informed consent:

  • Doctors value having extra time to think carefully about replies to patients’ messages, compared to in-person communication.
  • Internet hospitals’ restrictions on consultation times, procedures, and arbitrary rules or schedules can hinder effective patient communication.
  • Doctors have concerns about the quality of online diagnoses and advice, as well as patient accuracy and comprehension, due to the limitations of online care.
  • Doctors have concerns about the completeness and uniformity of clinical informed consent in internet hospitals.

Description of Study Participants

The 26 participants came from 3 different affiliated hospitals with 10, 5, and 11 participants interviewed from each hospital, respectively. Participants ranged in age from 29 to 49 years, and all 26 participants had PhD degrees. Only 5 participants stated that they had received specific training for working in internet hospitals, and 1 of them stated that training included discussion of clinical ethics in internet hospital care. We interviewed doctors from several departments involved in care for patients with chronic disease—oncology, cardiovasology, hematology, endocrinology, gastroenterology, nephrology, and infection departments. Aggregated participant characteristics are presented in Table 1 .

a Some percentages may not add up to 100 due to rounding.

Advancements and Shortcomings in Care Access Due to Internet Hospitals: Follow-Up Care, Health Education, and Disparities

Most doctors stated that internet hospitals affiliated with their physical hospitals of employment were still in the early stages of development and that their internet hospital work experience mainly took place in enterprise-initiated internet hospitals. Doctors stated that internet hospitals initiated by physical hospitals were “not fully operational yet,” (Dr B) and “the consultation volume of patients is relatively small” (Dr C). They also suggested that there was currently a “lack of incentives” (Dr D) to work in internet hospitals initiated by physical hospitals, whereas enterprise-initiated internet hospitals offered “higher income” (Dr B) and a setting where “doctors set their own prices” (Dr C).

In both internet hospitals initiated by physical hospitals and enterprise-initiated internet hospitals, doctors stated that the majority of their work consisted of online consultation for common or easily diagnosable diseases, and follow-up services for patients with chronic diseases who had previously received care at physical hospitals, such as adjusting medications and ordering medical tests to be scheduled in person. Most doctors were motivated to work for internet hospitals particularly because of the opportunity to be part of expanding follow-up care for patients with chronic diseases.

Most of the patients who come to the internet hospitals are chronic disease patients, with conditions such as hypertension, diabetes, coronary heart disease, etc. These patients have been clearly diagnosed in our hospital, and some of them need to be guided or communicated with about what needs to be paid attention to in the process of home-based management. For example, patients' blood pressure might fluctuate, or they can consult online if they have any uncomfortable symptoms, which is quite common. [Dr X]

Some doctors also believed based on experience that internet hospitals could serve as a more efficient channel to provide health education for patients, particularly for the management of chronic diseases.

We also feel that doctors in tertiary hospitals do not have much time to do health education with patients, but through the internet hospitals platforms, we can explain to patients the concept of health or a healthy way of life. For example, for a patient with heart failure, he isn’t expected to come back to the hospital again and again, because I have instilled him with an understanding of healthy lifestyle and diet, and the workload of the doctor will be reduced in the long run. [Dr C]

Despite the ways in which doctors felt internet hospitals expanded access to care and services, they had also observed disparities in access to internet hospitals across several groups, including older adults and patients with lower levels of education or technological literacy: “Older patients may not use smartphones or might need assistance to do so from family members” (Dr E).

Relatively speaking, if the patients come to the internet hospital for consultation, the education level of these patients will be higher, otherwise they will not be able to fully communicate with their doctor. [Dr O]

Most doctors mentioned that internet hospitals are especially suitable for patients with chronic diseases. Doctors also stated that while older adults are one of the most common groups of patients with chronic diseases, many older adults have difficulties in using or accessing internet hospitals (Dr D and Dr X). Some doctors mentioned that internet hospitals currently have limited connections and overlap with local health services in rural areas. They believed moving toward more connection with local services was an important goal—particularly because the demand at tertiary hospitals frequently outstrips resources (Dr P and Dr Q), and because many rural patients travel long distances to receive care at tertiary hospitals.

Even for follow-up visits for chronic diseases or common diseases, many patients will still go to tertiary hospitals. Instead, the patient can go to a qualified local hospital and send us the results of the test, and then [through internet hospital care,] we can advise the patient or tell him how to adjust the medication, or refer the patient to a tertiary hospital for testing. But at present, internet hospitals have not played a big enough role in these aspects. [Dr E]

Patients’ Expectations Versus Limitations on Doctors’ Availability and the Scope of Services: Implications for Doctor-Patient Boundaries and Trust

Patients’ expectations of doctors’ availability create unclear professional boundaries.

When asked about new challenges in patient care posed by internet hospitals, only 1 doctor mentioned risks related to patient privacy and data security.

The internet hospital platform where I am located requires patients to provide their name, gender, age, ID number, and other information, which can be seen on the doctor's portal, but as a doctor I will definitely not disclose the patient's private information but just give him diagnostic advice according to the necessary information provided by the patient. [Dr G]

By contrast, many doctors expressed concerns about their own privacy. Some doctors shared stories from their work in physical hospitals of willingly sharing their personal WeChat with patients in case patients had questions after discharge (Dr D, Dr M, and Dr R). While some doctors did not seem to mind-bending this boundary with patients, others remembered negative experiences when patients had sent messages making demands of doctors’ time at all hours (Dr E, Dr M, Dr P, and Dr Z). They also recalled times when patients obtained the doctor’s personal contact information through their own means and contacted them after leaving the hospital without the doctor’s consent (Dr V and Dr Z). As a result, some doctors had positive views of internet hospitals because they can serve as a means for online communication with patients without requiring the doctor to disclose their own personal contact information.

I prefer to use the official platform to communicate with patients, rather than through private WeChat or phone, because I really don't want to receive phone calls or text messages from patients after I work. But if the phone does ring, I will take into account that he is an old patient of mine, and I will still answer it, because I am not sure if there is any emergency. But for patients on such online hospital platforms, I rarely give them my phone number and personal WeChat. [Dr P]

Several doctors were also uncomfortable that they were required to post information about themselves when working on internet hospital platforms, such as their name, location, and credentials (Dr P and Dr X). Because the audience of patients in internet hospitals is wider, they worried that patients who were dissatisfied with care may have the ability to post negative information about them in public forums online, citing their personal information. As a result, doctors stated that they would be more cautious in diagnosis and giving advice when dealing with patients in internet hospitals with whom they were less familiar (Dr J, Dr O, and Dr V).

Patients’ Expectations of the Service Scope of Internet Hospitals Affect Doctor-Patient Trust

Another concern expressed by many doctors was that patients held unrealistic expectations of the scope of services that internet hospital doctors provide. Some doctors mentioned that some patients feel that just because they spend money in an internet hospital, they should be able to get all their problems solved at once or get immediate treatment (Dr E and Dr G)—when in reality in many cases, the doctor might need to conduct tests over multiple online consultations or might recommend that patients seek further medical services in offline, physical settings. Doctors were concerned that patients’ dissatisfaction with unmet expectations might generate distrust toward the doctor.

What patients don't know is that in fact, most of the time, seeing a doctor is a step-by-step process, and it is necessary to do examinations step-by-step to exclude diseases or diagnose diseases. They often have high expectations for the effect of consultation in internet hospitals, and they think that doctors should be able to diagnose their diseases at one time; and not only to diagnose them, but also to propose a treatment plan. [Dr E]

Some doctors suggested that this gap between expectations and reality could be especially strong for new patients whom the doctor had not seen previously for in-person care. They described that they often recommend for new internet hospital patients to go to physical hospitals to be examined before receiving further internet hospital care or advice, and that patients who are expecting immediate solutions can find this disappointing (Dr U and Dr X). One doctor suggested the need to educate patients and the general public on the scope of internet hospital care, in light of this mismatch in patients’ and doctors’ expectations (Dr Y).

However, some doctors raised concerns about issues related to doctor-patient trust that had less to do with adjusting patients’ expectations and more to do with the format of online communication itself.

Doctor-patient trust will be better in physical hospitals. Because the doctor-patient relationship is a very special relationship, offline communication can observe the patient's expression, speed of speech, action, etc, and is more suitable for empathy with patients. When it comes to the doctor-patient relationship and trust, I think face-to-face consultation is still necessary. [Dr J]
Face-to-face communication in physical hospitals may be more detailed, because if it is through text messages or phone calls, I may be able to talk to the patient in a few words, but if the patient is communicating in our hospital, it may take me half an hour. Because there is unequal information in medicine itself, the patient himself is not very clear about medicine, and without adequate communication, there is no trust between doctors and patients. [Dr W]

Advantages and Downsides of Online Communication for Comprehension and Informed Consent

Doctors working in internet hospitals mainly used pictures and texts, and rarely video calls, to communicate with patients. Some doctors valued the extra time gained by this format to think carefully about their replies to patients’ messages (Dr E, Dr U, and Dr X). However, most doctors pointed out how the lack of nonverbal communication could increase miscommunication and misunderstandings.

Online communication is through typing, and some doctors can't see the facial expressions of patients, which is very inconvenient. The communication between doctors and patients may need body language, facial expressions and other aspects.... I want the patient to really understand me in terms of attitude or tone or feeling or whatever. [Dr G]

Doctors also expressed dissatisfaction with limitations on the time and procedures for consultation through various internet hospitals, and how sometimes arbitrary rules or schedules hindered communication with patients.

The doctors in our department need to be on duty every month in the internet hospitals. When it is my turn to be on duty, a patient will send his questions to me through the platform, but I think this mode is not good. For example, the patient might leave a message for me, but I am busy and don’t reply to him in time, and he may not see my reply in time when I reply. If I go back and forth with him several times, this problem will not be solved until I come back on duty next month, and then the patient's problem will not be solved at all. [Dr C]
The internet hospital at our hospital stipulates that patients can ask five questions at a time.... Sometimes doctors are not able to inquire in detail in order to understand the condition. [Dr G]

Doctors had concerns about the quality of diagnoses and advice that they provided online, due to the inability to do direct physical examination. These concerns were intensified by their perception that many patients could not describe their symptoms clearly and accurately.

Currently, a lot of people still lack of basic medical knowledge, which will lead to ineffective or inefficient consultation on the internet, because they cannot describe their own symptoms, or cannot collect their own data and then summarize it. Patients cannot provide information about their condition sufficiently and accurately, which will seriously affect the efficiency of consultation. [Dr E]

Two doctors also specifically mentioned the difficulty in internet hospital care of not being able to use the “four-diagnosis method”—a method used by doctors in traditional Chinese medicine for diagnosing illness, including diagnosis through observation, diagnosis through auscultation and olfaction, diagnosis through inquiry, and diagnosis through pulse feeling [ 43 ]. Although doctors in this study practiced mainly “Western” medicine, they described integrating certain traditional practices such as this method into their care at physical hospitals (Dr D and Dr H).

In light of concerns about the potential for miscommunication with patients, a few doctors also expressed uncertainty about the completeness and uniformity of clinical informed consent as it is currently practiced in internet hospitals. While they believed that a standardized process of online informed consent for medical advice and treatment was needed, they did not know of any relevant laws or procedures.

Because we have so little time to communicate online, and such a narrow scope of care services, we don't usually obtain informed consent online. I might listen to the patient explain his symptoms. I might tell him what tests he needs before I give my advice, or if I'm dealing with a familiar patient, I might just prescribe his medication, so there's no need for informed consent. However, I think how to issue online informed consent, whether online informed consent is legally effective, and how to sign online informed consent all need to be considered. This is also for the protection of medical staff. [Dr U]

Principal Findings

This study sheds light on previously underresearched aspects of internet hospitals in China, as both the first interview study to examine physicians’ perceptions of internet hospitals and one of the few studies on internet hospitals conducted in China outside of its most major cities. Our research revealed that physicians see enhanced opportunities in internet hospitals to conduct follow-up care for patients with chronic illnesses and to provide health education. However, physicians noted disparities in access for different groups, such as older adults, patients with lower education levels, patients with limited internet or technology access, and rural patients. One particularly novel finding was the conflict between patients’ expectations and the reality of limitations on doctors’ availability and the scope of services available through internet hospitals. Physicians perceived that this gap affected both boundaries and trust in the doctor-patient relationship. Physicians also discussed opportunities and challenges in doctor-patient communication, including issues of comprehension and informed consent. Considering that the development of internet hospitals involves multiple industries, including medical institutions, national policymaking departments, and technology providers, we raise several suggestions below on physician training, patient education, regulations, and design, as well as directions for future research.

Training for Doctors

Internet hospital care involves real-time online sharing of medical data. Information about both doctors and patients is centralized and easily accessible to authorized users on the internet hospital platform. Some doctors in our study were uncomfortable when required to publicly post their names, basic personal information, and credentials on internet hospital platforms because it might make them more vulnerable to public criticism. Doctors’ reasons for being concerned about this were in line with previous research showing a high degree of conflict in the doctor-patient relationship in China [ 44 , 45 ]. This underscores the importance of current efforts both locally and internationally that aim to rebuild trust in the doctor-patient relationship [ 46 - 48 ]. Considering doctors’ concerns about patients requesting for them to disclose their WeChat in both physical and internet hospital work, communication skills training for doctors should prepare doctors for how to interact with patients with empathy and care, while also maintaining their preferred professional boundaries.

It was also notable that only 1 doctor who was interviewed discussed concerns related to patient privacy and data security when asked about challenges presented by internet hospitals. By contrast, Li et al’s [ 49 ] study on the determinants of patients’ use of internet hospitals in China showed that while patients generally desire to use internet hospitals, they are apprehensive about the associated risk of their personal information being leaked. Due to the heightened potential for data leaks and breaches of patient health information associated with the use of internet hospitals, it is imperative that health care professionals undergo training to raise their awareness of data security precautions. For instance, physicians should be trained on proactive measures that they can take to guarantee that the internet hospital services they are affiliated with implement adequate security protocols around patient information. Furthermore, physicians should be trained to communicate with internet hospital patients or their legal proxies about potential risks related to data security and to apprise them of protective measures enacted to safeguard information. Future research should also evaluate the frequency with which data leaks and breaches in internet hospitals actually occur.

Findings from our study also suggest that internet hospitals have led to changes in doctor-patient communication. Doctors in our study considered it to be an advantage of internet hospital care that they generally had more time to communicate with patients compared to in-person care. However, a previous study on internet hospitals suggested that while doctors can obtain key information from patients within a few minutes through in-person communication and examination, information received in the same amount of time online tends to be more limited [ 43 ]. Research conducted by Deng et al [ 50 ] also highlights that engaging in online consultation work while simultaneously engaging in a main career providing in-person medical consultation may place excessive demands on doctors’ time and energy. This phenomenon of work overload could potentially impede the widespread adoption of internet hospitals and introduce added risk to medical practice.

Relatedly, doctors in our study mentioned that when working in internet hospitals, they could only communicate with patients in the form of text, pictures, or video-based consultations, and that they had to rely largely on patient self-report. Both of these factors caused doctors to worry about the accuracy of their diagnoses. This aligns with recent research showing that about 70% of surveyed health care providers believe communication difficulties between patients and health care providers result in online consultations being insufficient [ 51 ], and about 70% of providers report feeling apprehensive about the possibility of misdiagnosis when providing care through internet hospitals [ 51 ]. Recent research has also found that patients who use internet hospitals have more negative views on the doctor-patient relationship than nonusers—including both interpersonal factors such as the degree to which patients trust doctors and practical factors such as the degree to which patients agree with their doctors’ medical opinions. Studies from other countries have similarly shown that telehealth can present new challenges or deficiencies in communication [ 52 - 55 ].

To address such challenges, telehealth communication competencies need to become a core component of both future research and physician training for internet hospitals in China—just as similar competencies are emerging as a priority for telehealth enhancement around the world [ 56 ]. Physicians providing care through internet hospitals should undergo standardized training for web-based communication skills, as research from other countries suggests such training can adapt interpersonal skills to the telehealth environment [ 57 ] and enhance empathic expression. More training for physicians on this skill set might reduce their apprehension about communicating through internet hospitals and assist them in communicating in a manner that improves outcomes for patients. Considering that doctors in our study expressed concern about patient comprehension and diagnostic accuracy, further research is also needed to evaluate and establish methods for measuring patient satisfaction, patient comprehension of information communicated by doctors, and diagnostic accuracy in internet hospital care. Future research should also examine the feasibility of integrating traditional Chinese medical practices such as the four-diagnosis method into telehealth care in China.

Education for Patients or the Public

Findings from our study highlight new challenges in the doctor-patient relationship posed by internet hospital care. One especially novel finding in our study was doctors’ perception that patients subconsciously expected them to be online 24 hours a day, while doctors actually had limited hours working in the internet hospital and could not meet this expectation. Particularly when patients still needed to ask questions after the end of the physician’s available time for consultation, doctors described the risk of conflicts with patients. These findings suggest many patients may be unaware when message-based interactions with physicians in internet hospitals are discontinuous or asynchronous. Therefore, public information about internet hospitals should specify the boundaries of physicians’ availability for internet hospital consultations. While the scope of services may expand as internet hospitals continue to develop, information disseminated to the public should make it clear that internet hospital care is currently only intended for either follow-up care for previously diagnosed patients with chronic diseases, or for new patients with common and more easily diagnosable conditions. Finally, public education should equip patients or their proxies for distinct ways in which they might self-advocate for optimal care in the context of internet hospitals compared to in-person care. This may involve the development of interventions such as question-prompt lists that are specific to equipping patients for internet hospital consultations.

Regulations and Laws

Doctors in our study believed that difficulties with nonverbal communication in internet hospitals often led to miscommunication and misunderstanding, and many raised concerns that there were no specific laws regulating online doctor-patient communication. As a result, most doctors in our study expressed that they felt they were walking on eggshells concerning possible conflicts with patients. This builds on findings from the “2022 China E-hospital development research report” [ 51 ], in which one of the most common suggestions made by health care providers for the further development of internet hospitals was to standardize legal protection for doctors practicing in internet hospitals. Gaps in relevant laws and regulations may reduce the willingness of risk-conscious clinicians to provide medical services through internet hospitals.

Existing internet hospital laws and regulations in China are still mainly in the trial stage [ 51 , 58 ], and are being outpaced by evolving challenges in internet hospital care. The doctors in our study believed that internet hospitals may increase the difficulty of diagnosis and treatment, increase medical safety risks related to miscommunication, and increase the risk of medical malpractice liability. Research by Zhi et al describes how the inability of doctors to perform physical examinations or certain laboratory or imaging examinations through internet hospitals may compromise the accuracy of doctors’ judgments [ 59 ]. However, the legal responsibilities of physical medical institutions, internet hospitals, and doctors regarding issues such as these have not been fully clarified. We suggest that further refinement and clarification of these and other aspects of internet hospital law will help doctors feel more protected in their work and increase the motivation of doctors to work in internet hospitals.

Doctors in our study mentioned that China also lacks detailed legal provisions on the implementation of online informed consent. Internationally recognized ethics standards highlight 4 core elements of informed consent—capacity to consent, information disclosure, comprehension, and voluntary authorization [ 60 ]. Informed consent issues involved in telehealth in other countries are similar to those described by doctors working in internet hospitals in this study, namely, the degree of discernment required from providers to ensure that patients are sufficiently informed to provide consent increases dramatically in telehealth [ 61 ]. In the United States, different states have different regulations on remote informed consent, and no federal policy has been formed at present. Some states require patients to fill out and sign written consent forms, while others do not [ 62 ]. In China, the Administrative Measures for internet hospitals stipulate that “internet hospitals must warn patients of risks and obtain informed consent from patients” [ 22 ]. However, current laws in China do not provide clear rules regarding the validity of electronic signatures for informed consent in internet hospital care. Informed consent in internet hospital care also involves unique information security issues due to the use of electronic health records, but there is currently no specific legal guidance for internet hospital platform developers or doctors concerning data security protection of informed consent in internet hospital care.

Tackling Disparities

Our research revealed that while older adults are at higher risk for chronic illness and are the main target population for internet hospitals, they are also reported by doctors to experience a number of barriers to internet hospital use. This finding aligns with research from various countries showing that older adults are less likely than younger patients to express positive attitudes toward using telehealth [ 63 , 64 ]. Health care providers in China and other countries have observed that older adults may be apprehensive about telehealth due to difficulty in operating computers or smartphones [ 65 ], may need the help of care partners to log into telehealth accounts successfully, and may need more time on average to download and set up applications [ 43 , 66 ]. Previous surveys have also shown that medical personnel believe that the low efficiency of online communication between doctors and patients and the low internet use rate of some patient groups (such as older adults) are the main factors hindering the development of internet hospitals [ 51 ].

Previous research in various countries has shown that the ease of use and perceived usefulness of telehealth systems have a positive impact on the acceptance of telehealth in patients who are older [ 67 , 68 ]. However, to date, China has not established an effective quality control system for internet hospitals [ 27 , 69 ], and the aforementioned ways in which internet hospitals currently pose increased risks for patient safety may affect general patients’, let alone older adults’ willingness to use them [ 49 ]. We recommend that the needs of older adults be considered in the design and development of internet hospital platforms and that older adults participate in the system design process [ 70 , 71 ]. Community health workers may be a workforce that could be mobilized to support telehealth training efforts among patients who are older, assist individuals with limited telehealth literacy in attending online appointments, and provide culturally and linguistically appropriate information about telehealth to rural patients and communities [ 64 , 72 , 73 ]. In general, health care organizations should invest in developing internet hospitals that are functional and easy to use. Drawing from research on telehealth design improvement in other countries, internet hospitals could be designed with features in mind to help physicians communicate more clearly with patients, such as providing notifications to physicians when patients read messages [ 74 ]. In addition, it may be beneficial for platforms to provide training materials to patients when patients register and log into internet hospitals for the first time [ 75 ]. Considering that a major goal of internet hospital development is to expand health care access, it will be crucial to address disparities in internet hospital use through these and other educational and design considerations.

Limitations

This study should be interpreted in the light of certain limitations. As most participants interviewed were attending physicians, findings may not be generalizable to the perspective of other health care workers or patients. The generalizability of our study findings from a single region and time point may also be limited, as there may be variations in internet hospital features and practice in other regions in China, and over time as internet hospitals continue to develop rapidly.

Conclusions

This study explored the experience and views of physicians in 3 tertiary hospitals in Changsha, China regarding access to care, patients’ expectations versus the reality of services, and doctor-patient communication in internet hospital care. Findings from this study indicate that there is a need to train physicians in telehealth-specific communication skills. National policymaking departments should also further refine laws and regulations concerning internet hospitals, particularly those related to online informed consent. Technology developers should take the needs of older adults into particular account in the design of internet hospital platforms.

Acknowledgments

This study was supported by Major Program of National Social Science Fund of China, Research on Moral Issues in the Field of Contemporary Science and Technology (22&ZD044), the Xiangya Medical Humanities Series: Principles of Biomedical Ethics (monograph Award) Fund (KTZZPT019), Hunan Provincial Innovation Foundation for Postgraduate (CX20220133), the Fundamental Research Funds for the Central Universities of Central South University (2022ZZTS0041), the China Scholarship Council (CSC,202206370069), and the Natural Science of Changsha City (kq2202362).

Data Availability

The data generated and analyzed during this study are available from the corresponding author upon reasonable request.

Authors' Contributions

YZ and XL conceptualized this study and designed the methodology. YZ and Xiaomin Wang conducted the interviews for data collection. Xuxi Wang and YZ transcribed the interviews. YZ, Xuxi Wang, YW, and XZ conducted and provided resources for preliminary analysis of the data. YZ and JH wrote and edited the paper. JH, XL, and XZ oversaw the implementation of all study activities. All authors read and approved the final paper.

Conflicts of Interest

None declared.

COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist.

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Abbreviations

Edited by T de Azevedo Cardoso; submitted 22.03.23; peer-reviewed by Y Cao, N Mungoli, A Gangadhara Rao; comments to author 06.09.23; revised version received 27.09.23; accepted 26.02.24; published 29.03.24.

©Yuqiong Zhong, Jessica Hahne, Xiaomin Wang, Xuxi Wang, Ying Wu, Xin Zhang, Xing Liu. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 29.03.2024.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

This paper is in the following e-collection/theme issue:

Published on 29.3.2024 in Vol 8 (2024)

Factors Explaining the Use of Web-Based Consultations With Physicians by Young and Middle-Aged Individuals in China: Qualitative Comparative Analysis

Authors of this article:

Author Orcid Image

Original Paper

  • Chunyu Zhang 1 , PhD   ; 
  • Ning Hu 2 , MSc   ; 
  • Rui Li 3 , MA   ; 
  • Aiping Zhu 4 , BMed   ; 
  • Zhongguang Yu 3 , PhD  

1 Department of Human Resources, China-Japan Friendship Hospital, Beijing, China

2 School of Management, Beijing University of Chinese Medicine, Beijing, China

3 Respiratory Centre, China-Japan Friendship Hospital, Beijing, China

4 Hospital Office, China-Japan Friendship Hospital, Beijing, China

Corresponding Author:

Zhongguang Yu, PhD

Respiratory Centre

China-Japan Friendship Hospital

Yinghua Road 2#

Beijing, 100013

Phone: 86 84206468

Email: [email protected]

Background: It was only upon the occurrence of the COVID-19 pandemic that the demand for web-based consultations with physicians grew at unprecedented rates. To meet the demand, the service environment developed rapidly during the pandemic.

Objective: This study aimed to identify the current status of the use of web-based consultations with physicians among young and middle-aged Chinese individuals and explore users’ perspectives on key factors that influence its use in terms of optimizing benefits and compensating for disadvantages.

Methods: We conducted semistructured interviews with 65 individuals (aged 18 to 60 years) across China between September and October 2022. The interviewees were selected through snowball sampling. They described their experiences of using web-based physician consultations and the reasons for using or not using the service. Based on the Andersen Behavioral Model, a qualitative comparative analysis was used to analyze the factors associated with the use of web-based physician consultations and explore the combinations of these factors.

Results: In all, 31 (48%) of the 65 interviewees used web-based consultation services. The singular necessary condition analysis revealed that the complementary role of the service and perceived convenience are necessary conditions for the use of web-based consultation services, and user’s confidence in the service was a sufficient condition. Based on the Andersen Behavioral Model, the configuration analysis uncovered 2 interpretation models: an enabling-oriented model and a need-oriented model. The basic combination of the enabling-oriented model included income and perceived convenience. The basic combination of the need-oriented model included complementary role and user’s confidence.

Conclusions: Among the factors associated with the use of web-based consultations, perceived convenience, complementary role, and user’s confidence were essential factors. Clear instructions on the conduct of the service, cost regulations, provider qualifications guarantee, privacy and safety supervision, the consultations’ application in chronic disease management settings, and subsequent visits can promote the positive development of web-based consultations.

Introduction

The term “internet health care service” refers to a closed-loop service that includes health education, medical information inquiry, electronic health files, disease risk assessment, web-based consultation with physicians, electronic prescription, remote consultation, and remote treatment and rehabilitation via the internet and other technological means [ 1 ].

The COVID-19 pandemic created a demand for internet health care services at an unprecedented rate [ 2 - 4 ], as patients became reluctant to go to hospitals because of the fear of infection [ 5 , 6 ]. Accordingly, an increasing number of hospitals and internet companies started to, and continue to, venture into the internet health care industry. Reports show that 52% of outpatient departments in Germany have already adopted internet health care services [ 7 ]. By June 2022, more than 1700 hospitals in China were providing services using the internet, an increase from 100 in December 2018 [ 8 ].

These rapid changes and the quick adoption of internet health care services during the pandemic, however, have impeded the possibility of sufficient analyses on the experience of accessing these services and on how providers can complement the functions of these services to make them more accessible and attractive to users, as well as promote patients’ intention to use the service.

In this study, we only focus on web-based consultations with physicians, which is a core and controversial segment of internet health care services. Some researchers have studied the barriers to and facilitators of web-based consultations and found that perceived convenience, emotional preference, perceived risks, etc, influence behavioral intention [ 9 , 10 ].

However, factors associated with the use of web-based consultations are mixed. Understanding which factors are essential is conducive to optimizing benefits and compensating for disadvantages. Given that young (18-35 years) and middle-aged (35-60 years) individuals are the groups that use web-based consultations the most frequently, we conducted interviews among them to explore the reasons why web-based consultations are used or not used. Then, based on the Andersen Behavioral Model, we applied a qualitative comparative analysis (QCA) approach to analyze evidence from the interviews, to identify how combinations of these interdependent factors lead to the use of web-based consultations with physicians.

qualitative interview in research

Theoretical Background

The Anderson Behavioral Model, developed by Andersen [ 11 ] in 1968, has been widely used to analyze the factors associated with health service use based on 3 dimensions: predisposing, enabling, and need factors [ 12 - 14 ]. Based on the Andersen Behavioral Model, this study also discussed the factors affecting web-based consultations with physicians in China.

QCA Methodology

The use of web-based consultation has complex influences rather than a single effect. QCA has been applied to explore the different combinations of health care interventions because it bridges qualitative and quantitative methodologies [ 15 ]. Based on set theory, QCA compares characteristics of the cases in relation to the outcomes by a scoring system. Moreover, QCA has an advantage in analyzing small samples, which usually requires 10 to 80 cases [ 16 , 17 ]. Crisp-set QCA (csQCA) yields binary scores of 0 and 1, indicating “full out” or “full in” in certain conditions [ 18 ].

Sample Selection and Data Collection

The semistructured interviews were centered around three broad questions: (1) Do you have experience using internet health care services? (2) If yes, which function do you use and why do you use it? Which function do you never use and why are you are reluctant to use it? and (3) If no, why do you never use internet health care services? When describing their experiences, the participants were asked to share examples and not only feelings about internet health care services.

We conducted interviews with residents of provinces in Eastern, Western, and Central China between September and October 2022.

The initial 5 samples were selected by convenience, and they were patients visiting the China-Japan Friendship Hospital. Subsequently, we asked them to recommend 1 or 2 interviewees, such as their friends, colleagues, or relatives, randomly. We repeated this process until the information on why internet health care services were or were not used was saturated. To obtain representative samples, we analyzed the characteristics of former samples and provided detailed requirements with regard to age, location, income, education, and sex for the following samples.

In total, 70 participants were interviewed, and 5 interviews were excluded owing to a lack of information regarding web-based consultations with physicians. The sample size for QCA should be at least 2 k , where k is the number of conditions [ 17 , 19 ]. The study includes 6 conditions; hence, the sample size should be at least 64. Ultimately, the study included 65 interviews.

Variable Measurement and Calibration

We analyzed the transcripts using a team-based inductive approach. First, the audio data were transcribed verbatim by a third-party company specialized in transcriptions in the Chinese language; once transcribed, the audio recordings were subsequently discarded to protect the participants’ confidentiality. Second, the first round of open coding was conducted using NVivo 12 (QSR International), and we coded the transcripts independently. We discussed and resolved discrepancies and then recoded the data to compile the major themes. Finally, based on the Andersen Behavioral Model, both the conditions and the results were identified by the lead author, reviewed by coauthors, and finalized by the corresponding author (see Table 1 ). In this study, csQCA was conducted using a program for crisp and fuzzy set with the fsQCA3.0 package (Charles C Ragin and Sean Davey).

Ethical Considerations

This study was approved by the China-Japan Friendship Hospital (approval 202-ky-032). We asked the participants whether they would be willing to be interviewed over the phone. Once the participants confirmed that they were interested in participating in the study, we made an appointment with them before the interview. At the beginning of the interview, we reviewed a consent form with the participants and obtained their verbal consent to proceed. Interviews were conducted primarily through phone calls because we aimed to reach more residents from different regions across China. All interviews were recorded and transcribed verbatim for data analysis. No compensation was provided for participation.

Participants’ Characteristics

Participants were recruited from the provinces of Beijing, Shanghai, Guangdong, and Zhejiang in Eastern China (31/65, 48%); Jilin, Henan, and Jiangxi in Central China (14/65, 22%); and Sichuan, Yunan, and Qinghai in Western China (20/65, 31%). In total, 38% (25/65) of the participants were male and 62% (40/65) were female, and the participants’ average age was 35.4 (range 18-51) years ( Table 2 ).

Participants’ Experiences of Web-Based Consultations

In total, 31 (48%) out of 65 participants had experience consulting with physicians over the web. During the COVID-19 pandemic, web-based consultations allowed people to avoid going out and minimized the risk of infection. Although web-based consultations were not always feasible with regard to curing diseases, the participants used them as a prediagnosis tool, which helped them make appropriate decisions regarding what to do next about their potential condition. Participant 1 shared his web-based consultation experience with us:

My wife was suffering from gallstones. We paid for an appointment with a famous physician to receive advice on the need for surgery. After uploading the results of an exam and consulting with the physician through the internet, we accepted his suggestion and she underwent an operation.

Factors Explaining the Use of Web-Based Consultations With Physicians

Necessity analysis of individual conditions.

The first step of QCA is to examine whether a single condition (including its noncollection) is necessary for a complete merger. When the consistency level is greater than 0.8, the condition is considered sufficient for the use of web-based consultations with physicians. When the consistency level is greater than 0.9, the condition is regarded as necessary for the use [ 17 , 20 , 21 ].

Table 3 shows the test result of the necessary conditions for the use of web-based consultations with physician using the fsQCA 3.0 package. The consistency of “complementary role” and “perceived convenience” exceeded 0.9. Thus, the complementary role of web-based consultations and its perceived convenience are necessary conditions for the use (consistency of 0.968 and 0.935, respectively), followed by user’s confidence (consistency of 0.806), which is a sufficient condition for the use.

a “~” means that a factor does not appear or is “not.”

b Italics denote that the consistency exceeded 0.8.

Adequacy Analysis of Conditional Configuration

In operating the truth table, the configuration analysis was applied to reveal the sufficiency analysis of the use caused by different configurations composed of multiple conditions. We set the consistency threshold to 0.8 and the case frequency threshold to 1 and calculated the complex solution, parsimonious solution, and intermediate solution.

As indicated in Table 4 , there are 4 paths to promote the “use of web-based consultation with physicians.” Among the 4 combined paths, the unique coverage of S2 and S4 was 0.177 and 0.274, respectively. The unique coverage of S1 and S3 was 0.032. In total, these 4 paths showed strong explanatory power due to the good consistency (0.953) and the relative high coverage (0.661).

a General conditions.

b General conditions do not appear.

c Core condition.

d Corresponding conditions with path do not matter.

e Core conditions do not appear.

Based on the Andersen Behavioral Model [ 11 ], we merged the 4 paths into 2 to build a more explanatory model. The first interpretation model is an enabling-oriented model (M1), which includes paths S1 and S2. The basic expression is M1 = age × income × perceived convenience × complementary role (× education + × user’s confidence). The basic combination is the enabling dimension including income and perceived convenience. That is, when web-based consultation brings perceived convenience, the relative high-income group will opt for it.

The participants regarded time saving and avoiding infection during the COVID-19 pandemic as the main conveniences brought by web-based consultations, whereas they regarded complex conduct procedures and late responses as inconveniences.

Participant 2 used web-based consultations because of its time saving characteristic. He said the following:

I have always made appointments with physicians through Haodaifu [an internet health care platform]. I am satisfied with their services because this website informs me about an upcoming appointment beforehand. Meanwhile, the physicians come [for the consultation] on time. The waiting time is not much.

Participant 3 used web-based consultations to avoid COVID-19 infection. She said the following:

I get nervous when my little kid feels any discomfort. On the one hand, I am afraid to go to the hospital because of the risk of infection owing to the COVID-19 pandemic. On the other hand, I also get worried about the adverse consequences of delaying [the child’s treatment]. As a result, I usually opt for a web-based consultation immediately, and use it to determine the necessity of an in-person visit.

Participant 4 complained about the complex procedures that lack instructions. He said the following:

The registration process is complex. A lot of personal information must be entered before beginning the web-based consultation. Due to a lack of clear instructions, it is difficult to figure out how to begin the service. I attempted to register the system, but it was unable to use the service.

The second interpretation model is a need-oriented model (M2), which includes paths S3 and S4. The basic expression is M2 = complementary role × user’s confidence × ~income (× age × ~education × ~perceived convenience + × ~age × education × perceived convenience). The basic combination is the need dimension including complementary role and user’s confidence. That is, regardless of age and education, when web-based consultations are needed, the relative non–high-income group does not care whether it is inconvenient and will opt for it.

In terms of minor problems or primary suggestions, web-based consultations were regarded as complementary to conventional consultations. Participants 3 and 5 said the following, respectively:

I also get worried about the adverse consequences of delaying [the child’s treatment]. As a result, I usually opt for a web-based consultation immediately, and use it to determine the necessity of an in-person visit.
Some specialties, such as dentistry and ophthalmology, require careful examination through the use of instruments before making the diagnosis. Regarding urgent cases, it would still be better for patients to visit the hospital.

Compared with in-person consultations, web-based communications are less smooth because physicians are unable to observe the patient’s body language and emotions. Some participants mentioned that web-based consultation services cannot perform laboratory tests and physical exams when it comes to diagnosis. Moreover, the costs of web-based consultations are not yet covered by the social health care insurance system. This means that patients will have to bear the cost of internet health care services. Due these reasons, some participants did not regard it as a substitute for in-person consultations. Regarding this, Participants 6 and 7 stated the following, respectively:

If it is not face-to-face consultation, I am afraid I could not describe [the symptom] clearly and the doctors would misunderstand me.
For senior physicians of P Hospital, the cost of a web-based consultation is three times that of a conventional consultation. Meanwhile, the expenditure on web-based consultations cannot be reimbursed by social healthcare insurance.

Some participants do not have confidence in web-based consultation services owing to privacy, safety, and qualification concerns, as well as problems surrounding web-based diagnosis. Below is an interview excerpt of Participant 8, who has experience in using text web-based consultations but not video consultations:

Although I never used video consultations, I am afraid that the system records the whole process automatically. I am worried that the video will be misused without my permission. Meanwhile, it is difficult to confirm the qualification of the doctors providing the service. After visiting the professor in C Hospital for a lung infection, I uploaded the results of a chest CT for further suggestions. I doubted the suggestion made by the professor’s students primarily. Given the busy schedule of the professor, his students had made the initial suggestions, which were later checked by the professor himself. So, I only trust the platforms run by public hospitals.

Robustness Test

To test the robustness, we increased the consistency level from 0.8 to 0.85 and we also decreased it to 0.72. The result showed that the configuration paths after the adjustment were consistent with those before the adjustment, and the coverage and consistency did not change substantially. Therefore, the results were robust.

Principal Findings

We examined the current status of the use of web-based consultations with physicians and the factors associated with the service among young and middle-aged Chinese individuals. About half (31/65, 48%) of 18- to 60-year-old residents have experienced web-based consultations. Among the factors associated with the use of web-based consultation, perceived convenience, complementary role, and user’s confidence were found to be the most essential factors.

Optimizing Web-Based Consultations

We found that perceived convenience is a necessary condition enabling participants to use web-based consultations. In this study, time saving and avoiding COVID-19 infection, which are conveniences provided by web-based consultations, promote the participants’ use of it. Participants in our study, similar to patients in other countries, strongly wish to spend less time to access the services, both when making appointments and while waiting for the appointment at the location; they prefer web-based access to appointment scheduling, want SMS text messaging services for reminders, and prefer for physicians to be available during evenings and weekends [ 22 ]. The web-based consultation system provided patients with time-saving and convenient solutions for their health care needs across all treatment processes. Patients could make appointments according to their own schedule and do not have to spend time traveling to the appointments. These findings concur with the research done in the United States. Almathami et al [ 23 ] conducted a survey in Saudi Arabia and found that saving time would increase the motivation toward the use of web-based consultations.

The COVID-19 pandemic positively influenced web-based consultation use. This is in line with findings of past studies. Studies show that internet health care services enable patients to avoid going out, decrease the time spent at hospitals when patients need to visit hospitals, and minimize infection risks [ 3 , 22 , 24 ]. Thus, it is not surprising that the COVID-19 pandemic catalyzed the development and use of the service. Although the service cannot fully substitute traditional in-person appointments, various patients were willing to use web-based consultations in the post–COVID-19 era in the long term.

In our research, participants remarked about the unclear instructions hampering the use of the service. Prior studies also find that patients who lack basic internet-related knowledge are excluded from internet health care services [ 25 , 26 ]. The web-based consultation environment requires patients to be well versed in using web-based platforms and electronic gadgets, and the skill levels regarding this vary by patient. Those with low literacy or limited internet-related knowledge are reluctant to use the service. This potential situation was highlighted in prior studies [ 27 , 28 ]. In the future, web-based consultation providers could attempt to assist persons with less accessibility to the platforms by creating intuitive instructions or even providing staff to support these people and explain how they can navigate the service step-by-step. They can also train patients on the use of available technologies prior to them making an appointment. For example, a video on how to book a web-based consultation could be provided on the front page to guide patients.

Focusing on the Needs of Residents

We found that once the participants’ needs were met, they opted to use web-based consultations with physicians.

In the study, although web-based consultations do not have provisions for laboratory tests and physical exams, they serve as a supplement for minor issues and primary suggestions.

Meanwhile, some studies reported that web-based consultations improved outcomes in chronic disease management such as diabetes and hyperactivity disorder [ 29 , 30 ]. Considering patients’ preference and need, applying the service in chronic diseases management and subsequent visits may expand its complementary role and benefit patients to a greater extent.

Our results found that some participants did not regard web-based consultations as complementary due to its cost. This is in line with previous studies that found that the cost is a barrier influencing the use of the service, even in high-income countries [ 26 ]. Moreover, similar to Germany and the United States, clear regulations about web-based consultations are lacking in China; accordingly, not only do the costs of web-based consultations vary widely, but expenditures on the service are not yet covered by the social health insurance systems [ 5 , 31 ]. Thus, the economic burden on patients may impede their use of web-based consultations.

Users’ confidence is a sufficient factor influencing the use of web-based consultations in the study. The participants use the service if they feel safe. Several participants expressed concerns about the safety and privacy of web-based platforms, as well as the qualification of physicians. This corroborates the findings of prior studies, wherein participants expressed their concern about such safety and privacy issues and believed that the safety and privacy of users should be guaranteed by clear regulations for such services [ 32 , 33 ]. These regulations should ensure that patient data cannot be misused for purposes other than health care or shared without patients’ informed consent. Best practices and standards should also be created to ensure that providers have the relevant qualifications and service quality to provide web-based consultations.

Limitations

Because of the COVID-19 pandemic, our semistructured interviews were mostly conducted through phone calls. This hindered our ability to observe the participants’ body language and nonverbal cues. Nonetheless, we contacted the participants to explain the topic and purpose of the interview. We shared the questions with the participants 1-7 days in advance, which the participants deemed as adequate and reasonable, enabling them to provide more comprehensive information.

Conclusions

In conclusion, the Andersen Behavioral Model represents a profound reflection and exploration of the factors associated with web-based consultation use from the user’s perspective. Additionally, the csQCA offers guidance for optimizing the benefits of the service. Perceived convenience, complementary role, and user’s confidence are the essential influencers associated with the use of the service. Clear instructions, comprehensive regulations, and appropriate application can promote the positive development of web-based consultations.

Acknowledgments

We would like to thank the interviewees who participated in the study. This work was supported by National Natural Science Fund for Young Scholars of China (72104255), Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Sciences (CIFMS; 2021-I2M-1-046), and National Health Commission Human Resources Development Center for Public Hospital Human Resource Research Project (RCLX2215018).

Data Availability

The data that support the findings presented in this study are available from the corresponding author on reasonable request.

Authors' Contributions

CZ and ZY played a significant role in study design, recruitment, data coding, and paper writing. NH was responsible for conducting the statistical analysis and drafting the Methods and Results sections. RL performed all interviews and data coding. AZ contributed to data coding. All authors thoroughly reviewed the paper before submission and granted their approval for publication.

Conflicts of Interest

None declared.

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Abbreviations

Edited by A Mavragani; submitted 17.06.23; peer-reviewed by S Wu, C Juhra, P Codyre, P Huang, W LaMendola; comments to author 01.12.23; revised version received 19.01.24; accepted 07.03.24; published 29.03.24.

©Chunyu Zhang, Ning Hu, Rui Li, Aiping Zhu, Zhongguang Yu. Originally published in JMIR Formative Research (https://formative.jmir.org), 29.03.2024.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on https://formative.jmir.org, as well as this copyright and license information must be included.

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