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The pull of a more qualitative research family methodology with its overall philosophical base concerned more with the perspective of the participants, as discussed by Blaxter et al (2006), seemed to reflect both the needs of the research and the researcher. However, as Blaxter et al (2006) also point out, a more quantitative research family places the researcher’s needs as priority, and as this research very much stemmed from a personal need, the use of both families seemed to be suggested. However, except for a nod to quantitative data in the use of descriptive statistics, qualitative data collection is very much the norm. There is an obvious bias in the way the study was conducted. However, as the research questions are fundamentally about opinions and practice, a qualitative framework would reflect this more. In the reflective sections this is covered in more detail, but it is acknowledged that the author’s philosophy about ‘how to understand the world’ may be an influencing factor, as well as the ‘right tool for the job’. In considering this view, Woodrow (2000) suggests that research students may feel pressure to believe that objectivity is fundamental, and not have the confidence to express their professional knowledge and experience. Although this view is supported, the need to pass a doctorate is another pressure as well as the

115 practitioner role, and therefore more detailed justification of the approach used is offered and expected.

In considering the research questions there is a need to look at present practice as well as future potential, so the collection of statistics is useful alongside the need to reflect meaning to those numbers. This desire to understand human experiences, norms and purposes fits in with what Alexander (2007:117) states is one of the “conceptions of knowledge”: that of qualitative research, whilst quantitative aims at relations between dependent and independent variables. Referring back to the influences on nursing research, Alexander (2007:127) goes on to suggest that an RCT cannot be the “gold standard” for educational research, as the need to control behaviour in order to make generalisations is problematic:

Inquiry at its best endows us with the insights to better control ourselves, not generalisations to more efficiently dominate others; and the surest path to self-governance lies in reaffirming Socrates’ realisation that genuine wisdom begins with the recognition of how little we really know (Alexander 2007:128).

As discussed by Blaxter et al 2006, it is common for researchers to use more than one method. For example to follow up a survey with interviews, and using quantitative and qualitative combined to provide a general picture. Relating back to the author’s professional role as an education practitioner, Woodrow (2000) would suggest that the choice of methods in this study is as much about doing the task effectively as using the approach to help to ensure validity and reliability. He suggests that ‘authenticity’ is the main aim in the education research community. This, he says, is not about obtaining the truth, but concerns the representation of a reality which is recognised by the research community, in this case nursing and

116 education. He goes on to add that the choice of methods used should address questions that are of professional interest, and obtain answers which reflect the complexity of practitioner research (Woodrow 2000). Johnson and Onwueybuzie (2004) suggest that this ‘mixed method’ research should be widely recognised in education, as the third major paradigm.

5.4.1 Mixed Methods Research

Bazeley (2010) defines mixed methods to include any study which uses more than one methodology, approach, method of data collection, and/or type of analysis strategy. They are employed for a common purpose regardless of whether quantitative or qualitative. Integration would have to show use of more than one method/approach or strategy for data analysis. This is reflected in this thesis in the following ways: The common purpose being the research questions, the interdependence through the definition of ‘added-value, with the iterative exchange being the numerous data collection tools and how they are used, explained in more detail in the next chapter.

Halcomb et al (2009) argue that mixed methods research relates to the current trends in nursing and health sciences research. Trends include rapid social change, pressures of contemporary living, ageing population, increase in complex and chronic disease which all have an impact of healthcare delivery. They go on to highlight the urgent needs to review the various roles of clinicians, an aspect of this thesis, and models of care and delivery. To do this Halcomb et al (2009) state that health professionals need to be able to access, criticise and analyse new findings, and mixed methods they say offers the way in conducting research. In relation to

117 education, Yin (2006:41) states that “Mixed methods research plays an important if not essential role in educational research”.

In relating back to the philosophical basis of the research and the paradigms, Halcomb et al (2009) highlight the importance of reflexivity and the importance of the researcher being transparent about the relationship to those the researcher wishes to study. Omission they say “May lead to the suspicion of mixed methods research as a ‘Trojan horse for positivism’” p.8.

Considering the research families as defined by Blaxter et al (2006), Halcomb et al (2009) distinguish between ‘mixed method’s and ‘multi-method’ research. Mixed methods as a combination of qualitative and quantitative, as used in this thesis and multi-method as a combination of methods from the same paradigm and family.

Kroll and Neri (2009) discuss whether a mixed method design is appropriate or needed and the needs for researchers to justify this. In planning the use of mixed methods you need to consider they say, the sequencing, whether one has more priority, how they will be integrated and the overall theoretical perspective. The practicalities of the approach are considered in the next chapter, where issues to do with the chose and timing of research tools are explored in more detail.

In relation to the overall approach to this research as defined by Blaxter et al (2006), Kroll and Neri (2009) discuss the importance of a theoretical perspective or a conceptual framework to mixed methods research and suggest examples of social cognitive theory and epistemological positions such as Phenomenology, the approach used in this thesis and discussed later. Creswell and Piano Clark (2007)

118 mirror this in stressing the importance of defining the theoretical perspective such as interpretivism and subsequently ‘Phenomenology’. However, Kroll and Neri (2009) also consider more practical influences, which in relation to this thesis could be its interdisciplinary nature.