Interview workshop slides final

In-Depth Interviews: Techniques and Best Practices

A workshop in conjunction with the ACEHP Annual Conference

Friday, January 17, 20144:15pm-6:15pm

Wendy Turell, DrPH, CCMEPPresidentContextive Research LLCwendy@contextiveresearch.com

Alexandra Howson MA, PhD, CCMEPOwnerThistle Editorial, LLCalexhowson@thistleeditorial.com

OverviewLearning Objectives: After participating, learners will be able to:

• Develop, pilot, and administer an interview guide for an IDI series

• Demonstrate optimal interviewer skills and techniques to encourage full feedback from interviewees

The qualitative approach

Search for objective, universal truths using standardized data gathering techniques

Naturalisticinterpretative approach

Focus on how people perceive their worlds and interpret experience

Data: What vs WhyQuantitative Data:A 37% drop-off was observed in adherence to post surgery medication regimens

Qualitative Data“After their bypass surgery, when they have seen God and all that, they listen, but after they are out of the hospital and they are going through rehab and they are fine, that period of after the bypass, they are invincible.”

Relevance to CEHP

Needs assessment

Formative evaluation

Outcomes evaluation

Why Interview?• It’s good to talk

o Provides depth + context to other data

• Lopsided conversation• Relies on interaction 

What Defines an Interview?

A tool to direct or guide a conversation between 2 or more people towards a particular outcome.

Frey and Oishi (1995:01) define Interview as “a purposeful conversation in which one person asks prepared questions (interviewer) and another answers them (respondent).” 

Examples: • Journalistic• Clinical• Research• Occupational

Activity 1: Core Components of Interviews

http://www.youtube.com/watch?v=blpq-Iwu25s

• What went well in this interview?

• What did not work?

Debrief

Interview Planning

Components of an Interview

• Opening/building rapport

• Language (word choices) and tone

• Body language

• Empathy

• Questions that will elicit deep response

The Interview Guide

• Keeps you on track

• Ensures material/research question coverage

• Establishes sequence

Question Order

sensitive

more serious

Small chat/ice-breaker

conversation

Types of Questions

Question Types• Open ended, neutral, sensitive, clear to

respondent

Patton, MQ. How to use qualitative methods in evaluation. London: Sage, 1987.

1. Main questions2. Probes3. Various follow up questions

Main/Introducing

• “Tell me about….?”

• “Do you remember an occasion when…?”

• “What happened when you...?”

Prompts + Probes• Extensions of main question

• Aimed to encourage respondents to share more information and touch on areas they did not initially address

• May reflect statements or use vocabulary of respondent

“You mention patients come into visits with opinions from these ads. How does that impact the interaction?”

“Could you say something more about that?”

“Can you give a more detailed description of what happened?”

“Do you have further examples of this?”

Specifying

• “What did you think at that point?”

• “What did you actually do when you realized he had this side effect?”

• “How did your colleagues react when you started the new program?”

Direct/Indirect

Direct Indirect“In what ways do you

implement these guidelines post

diagnosis? “

“How do you believe other physicians view

these guidelines?”

“Describe ways in which you support your

patients’ adherence efforts”

“What do you think are the reasons behind your

patients’ lack of adherence?”

Interpreting

“When you use the term ‘uncontrolled’ disease, are you referring mainly to A1Cs?”

“So do you mean that the patients have literacy challenges?”

“Is it correct to say that you are typically unable to chose your ideal treatment due to these barriers?”

“Does the expression ‘trying to keep up’ describe what you have just expressed?”

More about Questions• Use vocabulary of respondent• Appropriate tone• Language that may invoke defensiveness• Leading questions

Time to Craft Some Questions

Activity 2: Your Mission…

• As CME Director of Main Street Community Hospital, you and your team have been asked to interview 20 recently discharged patients who received joint replacement surgery. The hospital administration would like to learn about patient satisfaction during their stay as part of an education program designed to reduce readmission rates.

• Develop 5-7 questions that will help hospital leadership better understand more about “patient satisfaction”.

Activity Debrief

Interview Presence

Face-to-face ‘live’

WHAT ARE YOU REALLY SAYING?

Telephone

Pros + cons

Optional Webcam-

enabled images

Text based chat &

audio capable

Online: Virtual Interview Room

Skype video call

Administering an interview

Interviewer Behavior• Active Listening – Be ‘in the moment’

o Patience, okay with silence

• Encourage respondento Give appropriate verbal and non-verbal feedback

• Stay neutralo Avoid presenting your perspective (bias interview)o Avoid counseling, teaching

• Reflectingo Paraphrase/reflect back

Capturing Informationo Audio Recording

• Digital RecorderoConference linesoPhone apps (e.g., italk)

• Video recording• Pen and paper notetaking

Activity 3: Interviewing with partners

• 1st: revisit your questions

Interview Practice• 1:1 pairing• Practice using revised questions• Chose one partner to share information on experience• Take turns!

REMEMBER:Active ListeningReflect back to respondentStay neutral

Interview Disadvantages

• Time intensive

• Bias (researcher + interviewee)

• Skill requires practice!

• Lack of generalization

Subjects

• Recruitment• Screening

o participants/inclusion criterion

• Subject preparationoWhat to expecto Institutional Review Boards (IRBs)o Informed Consent

Questions?

Follow-up Questions?Contact Us

Wendy Turell, DrPH, CCMEPPresidentContextive Research LLCwendy@contextiveresearch.com

Alexandra Howson MA, PhD, CCMEPOwnerThistle Editorial, LLCalexhowson@thistleeditorial.com

ResourcesFind this *updated* presentation on slideshare.net

Title: Qualitative Interview Workshop_ ACEHP 2014 under user name: wendyturell

Software Resources: Coding & Organization

• Free (QDA Miner Lite)o http://provalisresearch.com/products/qualitative-data-analysis-software

/freeware/

• Low Cost: dedoose ($10 per month)o http://www.dedoose.com/

• Bells and Whistles software: Nvivo or Atlas Tio http://www.qsrinternational.com/products_nvivo.aspxo http://www.atlasti.com/index.html

Resources Cont.• Hopkins Open Coursework: http://ocw.jhsph.edu/• Qualitative course materials:

o http://ocw.jhsph.edu/index.cfm/go/viewCourse/course/qualitativedataanalysis/coursePage/index/

• Online Qual. Textbook: http://onlineqda.hud.ac.uk/Introduction/index.php

Resources Cont.• Cater JK. SKYPE: a cost-effective method for

qualitative research. Rehab, Counselors + Educators Journal. 20011;4:

• Cohen DJ, Crabtree BF. Evaluative criteria for qualitative research in health care: controversies and recommendations. Ann Fam Med. 2008;6:331-339.

 • Curry L, Nembhard IM, Bradley EH. Qualitative and

mixed methods provide unique contributions to outcomes research. Circulation. 2009. 119:1442-1452.

Appendix

Conversation vs. InterviewConversation Interview

Respondent Friend/Acquaintance

Recruited respondent

Who provides Questions/Answers

Generally equal questions/answers among participants

Lopsided

Tone Share true feelings, reactions to what you hear

Maintain objective tone, non judgmental, non reactionary

Focus Typical focus on immediate outcome (e.g.: how was the game?)

Process, cause/consequences, context, search for patterns

Depth Most often a range of issues, not always deep

Narrow range of issues, greater depth

 Qualitative Research

Quantitative Research

Type of Questions

Probing “below the surface”; immediate follow up & adjustment

Limited probing; pre-determined questions NOT adjusted

Sample Size Small Any size including large

Information per respondent

Much Varies; Limited to answer choices

AdministrationRequires skilled researcher

Fewer specialist skills required

Type of Analysis

Follows structured steps; subjective and interpretative

Statistical; objective

Type of ResearchExploratory, descriptive Descriptive or Causal

White Board Exercise example

Which drug class do you prefer to use in patients who fail on oral monotherapy?

DPP4 Inhibitors

SGLT2 inhibitors