Background
The AltCon study
Team composition
Role in project | Task in focused ethnography | Background |
---|---|---|
1. Co-investigator (SZ) | Senior lead of focused ethnographers and data analysis | Medical Sociologist, background in qualitative research |
2. Co-investigator (HA) | Day-to-day lead of focused ethnographers and data analysis | Health services researcher, background in mixed methods, expert in field |
3. Project manager (HB) | Focused ethnographic researcher in 3 case study sites | Health psychologist, background in nursing and mixed methods |
4. Focused ethnographer (TP) | Focused ethnographic researcher in 3 case study sites | Medical anthropologist, background in qualitative methods |
5. Focused ethnographer (AB) | Focused ethnographic researcher in 2 case study sites | Social scientist, background in anthropology and mixed methods |
6.Principal investigator (CS) | Data analysis | GP, background in mixed methods, expert in field |
7. Co-investigator (BM) | Data analysis | GP, background in mixed methods, expert in field |
8. Co-investigator (JC) | Data analysis | GP, background in mixed methods, expert in field |
9. Co-investigator (AG) | Data analysis | Patient Public Involvement (PPI) expert |
Number of registered patients | Location of practice and level of deprivation | Types of alternative to the F2F consultation | No of days spent in observation |
---|---|---|---|
18,353 | Inner city, Depriveda
| phone e-consultations, isolated use of email | 25 |
8954 | Inner city, Depriveda
| phone, isolated use of email | 19 |
15,000 | Inner city, Mixeda
| phone, e-consultations & isolated use of email | 18 |
1938 | Rural, Mixedb
| phone, video | 8 |
7196 | Inner city, Deprivedb
| phone, e-consultations, isolated use of email | 17 |
13,778 | Semi-rural, Affluenta
| phone, email | 25 |
13,511 | Semi-rural, Mixeda
| phone, email | 16 |
6597 | Inner city, Affluenta
| phone, email | 11 |
Reflections on the team-based focussed ethnographic approach
Constructing a shared understanding within the focused ethnographic team
Workshops
Standardised documentation
Teleconferences
Field notes
Ethnographer 1 |
I noticed that sometimes the GP used a strange accent which was more obvious when he spoke to some-one from overseas in both face to face consultations and (but less so) telephone consultations! I wondered how much of a researcher effect I was observing |
Ethnographer 2 |
A lady comes in in her 50s saying that she just saw the message on the waiting room screens about the possibility of having telephone consultations and that if she had known before she would have used it. She tried once to speak to the GP for two minutes about her husband’s medication since he was given the wrong prescription and she could not speak to the GP. Her husband had to physically come to speak to the GP about it and she felt that if done over the phone it would have saved him the trouble of coming in. She complained as nobody offered the option to do so. Receptionist tells her that it was the fault of the staff for not offering her the option but that she would still need to book an appointment slot for consultation. |
Ethnographer 3 |
I observe the GP during a telephone clinic. She made 15 calls, asked 5 patients to come to the practice, all came. Calls are arranged in 5 min slots. I observe that she roughly follows the list, though she decides to phone back 2nd patient first. She says that she knows this patient. |
Division of tasks between the focused ethnographic team and the wider project team
Focused ethnographers (study researchers) |
• Question whether we are doing enough justice to the rich observational data |
• Worries related to own relative contribution to the project, am I doing enough? |
Leads of ethnographic team (two co-investigators) |
• Nature of role is to be involved in several projects at any one time, this can make it difficult |
• to stay on top of the data collection process. |
• Data management and analysis involves processing large amounts of information and data and the volume can feel overwhelming. |
Wider team (chief investigator and three co-investigators) |
• Feel a lack of control in project, less ‘hands on’ than in previous work |
• Involvement of other projects |
Data analysis
Functioning of the team, emotional and practical support
Reflexivity and trust in overall team
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What will we find is happening in the case study practices?
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What are the main issues that we will encounter in conducting the ethnography?