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The article Professional status in a changing world: The case of medicines use reviews in English community pharmacy, reflects the study taken to examine community pharmacist's views on new reforms and how this affects their professional status. The study is published in Social Science and Medicine journal (McDonald et.al, 2010).
The title of the study reflects the research subject and the abstract of the paper allows understanding the purpose of the study. It has got a good overview of the paper, includes the argument, findings, sample.
Writing style of the paper is very consistent, authors do not use jargon, and there are no anecdotal quotations from the participants, which add the weight to the quality.
Authors, however were not introduced in the beginning of the paper, therefore this does not allow to identify the full the extent of their reflexivity in this study. There are four different authors and one of them is corresponding author. Through my review all the authors are referred as "the author". The author has chosen to name respondents as participants, but I would like to stress this approach and as suggested by the module Tutor, and would like to use the term "co- researcher" where appropriate, because this allows me to think about respondents as taking part in the research project rather than being one supportive element of it. The study is consistent, author has chosen relevant methods of interviewing and analyzing data, and it does include the major components of the qualitative research. The author has correctively chosen qualitative methods to conduct this research. The measure was used to examine phenomena of chosen sample with co-researchers having direct connection to it. Methods appropriately reflect the research argument. The paper is consistent and leading to findings that claim the addition to knowledge as creating theory from explored data. The author is using valid literature that illustrates the previous knowledge on the field in the introduction of the paper, and repeats in the discussion of the findings. The discussion of data develops throughout the study, which adds the weight to the transparency of the study. I have chosen to review this paper, because I am a community pharmacist, and raised issues in the study do reflect to my own experience. My aim was to identify and assess the suitability of the methods and approaches used for this particular study, evaluate the aspects which add the quality to the study as well as identifying the weak points which could have been improved while writing up the paper or conducting the study. I am going to look at this work in the light of the revised disciplined inquiry model adaption (Hiles, 2006) with main stages- paradigm, strategy, method, analysis and critical evaluation. I am going to follow the framework suggested by the module Tutor as the main structural guide to my work.
2 What is the paradigm?
The introduction of the paper enables the reader to understand the purpose of the research and the aspects, which could be used to get the full approach of the research object. The basic and the most important pre-supposition is that pharmacists in the English community pharmacy are affected by various socioeconomic factors, which have got the impact to their ability to enhance the professional status. The paper is examining medicines use reviews as a potential to enhance the professional status in the light of such factors. Suggesting this assumption, the author used different techniques to make the qualitative inquiry logical and presumably give the value by identifying the findings, giving the addition to knowledge. The author is using constructivism paradigm (Plack, 2005). The paradigm is particularly concerned with ontological and epistemological issues. Ontological - the author identifies the meaning of the subject with the previous experiences, not suggesting one truth, but in this case, the truth is wanted to emerge at the different social circumstances, and how pharmacist is responding in the context of the changing world of the profession. Epistemological - how this knowledge around the research question could be obtained through different interpretations. The aim of this paradigm is not to collect more data to test the hypothesis, but to explore different individual experiences- identify differences and similarities of the phenomenon.
The author has got the practical knowledge about the subject, has got the sense of the living experience in the text. Highly self-reflective approach and co-researchers are involved in the process not just by the inquiry process but as well as the model of the collection of data.
Through the whole introduction, the author, not directly, but by using various data tries to explain the importance of the study. The aim of the study it is easy to spot while reading the first paragraph of the introduction. However, this could be due to my own experience from working at the community pharmacy and for someone who is not very familiar to this field, it might be confusing to extract the significance of the possible findings. The author has not directly indicated why this research was needed.
3 What is the research question?
The author has chosen to use data driven grounded theory logic of inquiry. (MODULIS) Author has identified the idea of the research question and has expressed it in the beginning of the paper. After overview of the literature sources and previous findings, the author raised three specific concerns, emerging from the data, which is already known to explore the possible aspects, which are still not known, therefore these three research questions are fitting to consistent logic of inquiry. The questions are clearly formulated and purely focused to develop findings- differences and similarities to what is already known. The research questions fits to the type 2 question: "What are reported advantages in using the new intervention as compared to the traditional methods?" (MODULIS 4b) This ideally reflects to these three questions raised: the context of delegation dispensing procedures and focusing on MURs, MURs in the light of the social world and MURs and the changing nature of community pharmacy. (McDonald et.al, 2010)
4 What is the claim of addition to knowledge?
The paper's analysis of findings stresses that pharmacists are unable take full advantage of the potential to enhance their professional status with the resources that have been provided by recent reforms. The study reflects gathered information from different pharmacists in contrasting circumstances and analyses different factors in changing status of the pharmacy profession. The significance of the findings would be best explained, as not like invention of new theory, changing all previous knowledge, but as a significant information, which was systematically collected and analyzed and produced new approaches and extension to the previous theories.
5 Transparency: method/analysis
The paper provides consistently and sufficiently detailed information for the reader which allows to understand the aim of the study and if it was needed, allows to replicate the study using the information about the used methods provided by the author. The identified phenomenon is strongly connected to the research questions that explore the experiences of co-researchers in different dimensions.
The author is carrying out sufficient literature review that allows grasping the context where the data is emerging from. The author presents a separate section about the MURs, which add more clarification to the subject and transparency of the study.
The methods describing section is very clear. Author has indicated the sample and the size of it. The co-researchers were suitable for the sample, as they were pharmacists experiencing the indicated phenomenon and having a close connection to it. However, even though the snowballing technique of interviewing was suitable for this type of the study, the author has not indicated in the paper how and why exactly this method was chosen.
Data interpretation method was identified in the paper, the author has used the constant comparative method (Strauss & Corbin, 1990) and key concepts were found by using the open coding method. There was no clear indication when the data saturation was reached, it was just mentioned the total number of respondents and that once the coding was complete, there were separate categories identified, depending on the common elements (McDonald et.al, 2010).
The data analysis was discussed in the desired depth on the separate section. The analysis was split into three sections according to three research questions raised earlier, with a use of open coding method (Goulding, 1999)
The presentation of the findings reflects the original aim of the study. The findings were discussed in the light of the previous knowledge.
6 Could you replicate the procedures?
The presentation of the study has got acceptable structure, well designed, and, I would remark that it is reader oriented. It is quite easy to read this paper and follow the author's thoughts. Author with this writing has achieved consistency and transparency describing the work. The methods of the research are reliable and valid. The interview questions used are adapted to achieve the highest possible knowledge from the data, and answers the research question. It can be expected that the reader could grasp the authors attempt to give "thick description" (Geertz 1973 ) of the concept of this work. I do not think that someone could disagree that this study is transparent and the procedures are repeatable. I would stress the sense that even the findings would be similar. They would not be exactly the same, but it is very likely that there would be the same pattern found.
7 Does the argument work?
Discussion of findings as such is quite convincing and the literature used to analyze findings is reflecting the same resources used in the introduction of the paper. However, reading the conclusion, there is a sense that it is capped, or shortened; there is a gap between two paragraphs, which allows to think that there is a low level of consistency in this part. However, the author clearly indicated the findings, which answered three research concerns. The answers are presented in the way that author can claim that the addition to knowledge has been achieved. The limitations of the study are effectively identified, and written in the methods part, as being the limitations of the interviewing technique used by the author. However there are no further discussion of the limitations and not much consideration about the limitation in the discussion of the findings. Again, the technique used does fit the study, however there are no observations from the author why and to what extent this method chosen is the most suitable for this kind of study.
8 Is there appropriate reflexivity?
The reflexivity measure in the qualitative research shows authors influence in the interpretation of the findings. It has to be acceptable and should not reach undesirable level. To identify this I have focused on the discussion of the findings and the analysis of the responses. I believe that reflexivity is directly connected to the ethics processes and the transparency- if the methods and research design have to be appropriately recognized. As mentioned above, it is feasible that if someone would attempt to replicate the study, the findings would have the same pattern. By writing this I would like to stress the idea that the author does not over influence the findings. Meanwhile there is a statement that the study was approved by the Leeds East Research Ethics Committee, the code of ethics is not clearly indicated in the methods section, not mentioned about the consent forms or the data confidentiality. This is raising a few concerns, especially where in the findings section, the discussion of the Dispensing and MURs (McDonald et.al, 2010) author indicated that some pharmacists have often been interrupted while interviewed, to perform a clinical check. With regards the transparency, because the author has clearly indicated the methods and the strategy, there is a significant risk reduction of bias and misinterpretation achieved.
There are appropriate critics of the findings regards the supportive mechanisms and how they are impacting pharmacists in different settings, how the pharmacists are responding to the changes. In the analysis of the responses, the author does not interpret the answers in any different way than the constructive criticism. Direct influence of the author is not been seen in the discussion ââ‚¬" this fact allows to achieve a required level of credibility to the study. (Silverman)
There is also no doubt that the findings achieved by any other researcher trying to replicate the study, would have the same pattern, therefore the study achieves the dependability measure.
Achieving the dependability and credibility, the study becomes worthwhile and meaningful, therefore accomplish the trustworthiness requirement and this is the component of transparency in the study.
9 Is the literature cited adequate?
The author is using Harvard literature citation method, and the sources used are valid and obtainable from the reference list. The literature sources noted in the introduction are used in the discussion of findings. There is no extra literature used in the discussion of the findings, which was not reviewed in the beginning of the paper. The author used four different works to support analysis of these findings.
10 Your own reflexivity
By choosing this module and trying to critique this example of qualitative inquiry, my aim was to meet this type of research. The focal point of my learning was to become familiar with the methodology, to understand the purposes of qualitative research, also, the main aspects and differences from the quantitative research and hopefully be able to identify when the qualitative research is the most suitable for the research problem. The biggest challenge for me in this module was to transform the thinking of the idea that you have to find the key points and identify one approach or the sharp frame that is fitting the study. For example this study, even if the author has identified one logic of inquiry as being the grounded theory, I could find similarities to the explanatory logic of inquiry approach and the paradigm could integrate to the participatory model together having the main aspects of constructivism paradigm. It took me time to rethink, and visualize this in the different view, where I must explore the literature resources about the qualitative research, not trying to extract the bullet points, and deny the thinking that I have to find the rule which gives all the answers. Another aspect, which I was grateful that I finally understood, that there is no one narrow decision made while doing the qualitative research, that there are various methods and approaches which are adapted and following the logic of inquiry can be transparent and can produce the addition to knowledge. Previously I did have this belief that qualitative research is very mystical comparing to quantitative, therefore it is very hard to claim that the addition to knowledge was achieved.
Regarding the discussion in Silverman's book (Silverman, 2010) about the reliability and validity, I would like to stress that in my view, this is something each author has to consider and aim to achieve in the beginning of the research project, not at the end, when there is not enough proof of the addition to knowledge and then would try to achieve the respect by using all possible supportive resources. Silverman is drawing attention how the validity, and seeking basic principles would give the strength to your work and spells out the meaning of validity very well. I did like the highlighted Mehan(1979) thoughts- identified weaknesses, which could be addressed to many works, so that if this is being known prior conducting the research, it could be prevented. Silverman has spelt out the key points what to look for and used examples to show how the good looks like. Regards his discussion about reliability, I found it not as clear as I would like it to be. It is harder to measure the extent of reliability and it is not that obvious, however I would refer it as the other measure of transparency to the work, meaning that consistency is crucial and is the measure of paper quality.
The addition to knowledge has been expressed by presenting the conclusions of the three main concerns of the study. The discussion is open ended therefore allows to develop more fields for future research to explore the phenomena. This enables to identify the transferability of the findings, which gives high value to them.
The aim of my review was to evaluate the strengths and weaknesses, also opportunities and threats of the study by using the tutors suggested framework. The strengths of the study would include the authors correctly chosen methods, following disciplined inquiry, which are fitting the purpose and meaning of the study, and therefore the findings enables to achieve the addition to knowledge. The study has achieved required levels of transparency measures, which fulfills the trustworthiness of the study and the paper is professionally presented in the reader oriented way, which makes it easy to understand therefore reducing the incidences of misinterpretation and reducing possible bias.
The weak points of the study would be some missing information of the authorââ‚¬â„¢s actions, therefore it requires some degree of assumption making by the reader. In some places there is a sense that the paper is shortened or capped, which could be due to word limit.
Overall the paper is valuable and achieved the good level of quality by measuring with the criteria used to review the study. The study findings have got opportunity to be used in future developments of similar inquiry studies.
This module and this exercise were worthwhile and enable me to identify different qualitative research aspects and used methodology. The module Tutors suggested framework of evaluating qualitative research, module material and suggested literature about the methods could be used for future works and transferred to review any other qualitative research works.
Geertz, C. (1973) The interpretation of Cultures. London: Fontana.
Goulding, C. (1999). Grounded theory: Some reflections on paradigm, procedures and misconceptions. Working paper series, WP006/99, Wolverhampton: University of Wolverhampton. (verified 10 December 2012)http://www.wlv.ac.uk/PDF/uwbs_WP006-99%20Goulding.pdf
Hiles, D.R. (2006) Methodological Diversity and the Logic of Human Inquiry. Paper presented at 25th International Human Science Research Conference, Pleasant Hill, California, August 2006.
McDonald, R. et.al, (2010) Professional status in a changing world: The case of medicines use
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