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Sue/Denis/Mags Sue, you raise a very interesting question and Denis has, as usual, provided an insightful reply. I am aware of some writers who argue that the 'quality' of qualitative research cannot be assessed through prescriptive formulas or protocols while others argue for a more rigorous use and publication of procedures to ensure reliability and validity of qualitative research, which may go some way toward the development of a structured approach to judging rigour within these studies. Personally and at the risk of heresy, I fall into the latter category and would suggest that there is often less attention paid to rigour in qualitative studies to the point where it is almost seen as less important. If we want to advance the 'humanist imperative' (Streubert and Carpenter's title) then serious consideration should be given to advancing interpretative research not only on the basis of it's contribution to knowledge but also on the basis of it's methodological rigour. I know the below text has been referenced before on the list but it does provide a review of 'frameworks' with appraisal criteria for qualitative research. Oakley A. (2000) Experiments in knowing: gender and method in social sciences. Polity Press: Cambridge I also have the following reference but have yet to get the article Popay J, Rogers A, Williams G. (1998) Rationale and standards in the systematic review of qualitative literature in health services research. Qualitative Health Research, 341-351. Declan Declan Devane, Lecturer/Course Co-ordinator, MSc in Nursing/MSc in Midwifery, School of Nursing and Midwifery Studies, University of Dublin Trinity College, Trinity Centre for Health Sciences Education, St. James's Hospital, Dublin 8. Tel: +353 1 608 2694 Fax: +353 1 4732984 Email: [log in to unmask] ******************************************* Please note that electronic mail to, from or within Trinity College may be the subject of a request under the Freedom of Information Act ******************************************* -----Original Message----- From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]]On Behalf Of denis.walsh Sent: 30 August 2002 08:04 To: [log in to unmask] Subject: Re: Grading of midwifery evidence To my knowledge, this has not been sorted by official body's yet. There are criteria around to address the robustness of qualitative research but these do not then transfer into a hierarchy table which quantitative research has to judge its generalisability. Qualitative research's applicability works more intuitively - when you read it, it 'rings bells' for your practice environment, gives you insights, challenges taken-for-granted assumptions etc. In this way, it can be very relevant to your situation. I've seen its relevance explored locally through a 'focus group' reflective activity where group members read it in advance and then discuss its implications for their practice situation. Hierarchy of evidence tables of quantitative research can work very positively for midwifery practice - most notably with the EFM NICE Guideline which recommended abandoning the admission trace because the research design used in the original research came midway down the hierarchy table ( a non-randomised cohort study I think). One problem with the hierarchy table is that at the bottom comes professional expertise/opinion when there are no studies, and this begs the question - which professional group and who decides on expertise. The other is that a table suggests a kind of objectivity and an apolitical process - not so as both the stages of quantitative research and its application to practice are intensely political processes. Denis Walsh Midwife, Leicester ----- Original Message ----- From: "Sue Dennett" <[log in to unmask]> To: <[log in to unmask]> Sent: Thursday, August 29, 2002 8:46 PM Subject: Grading of midwifery evidence > Hello all, > > A demoralised breast feeding co-ordinator came to me for advice today. She > has been asked to grade the level of evidence which support her latest 3 > policies -skin to skin, hypoglycaemia and bottle feeding. > > This brought an issue to a head for me - especially as we are also all busily > developing midwifery guidelines for antenatal and intrapartum care. > > I would be grateful to hear your opinions on grading midwifery research, > especially when much of it is qualitative and, in most situations, not > appropriate for RCTs. I do feel that many of us working within large NHS > trusts will be increasingly faced with this issue especially when dealing > with such bodies as CNST (clinical negligence scheme for trusts) and others. > > I would be grateful for some advice or directions to useful literature. > > Best wishes > > > Sue Dennett