PubMed · 11571123
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J de Irala, M A Martínez-González, F Guillén Grima. 2001-09-22. [What is an effect modifier?].. https://doi.org/10.1016/s0025-7753(01)72092-1
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BACKGROUND: Qualitative research methods are recognized increasingly as valuable tools for primary care research, and add an extra dimension to quantitative work. OBJECTIVE: The aim of this study was to illustrate the benefits and problems attending the dual role of clinician/qualitative researcher. METHODS: As part of two studies employing semi-structured interviews of GPs in a North-West conurbation, about the topics of consultations on chronic low back pain and drug misuse in primary care, respondents' views on their interaction with a GP researcher were explored. RESULTS: Access to the GP by the interviewing GP was easier when the GP researcher was known to the respondent. Such prior knowledge, however, may then influence the content of the data and the manner in which the GP researcher is perceived. During the interview itself, where respondents recognized the researcher as a clinician, interviews were broader in scope and provided richer and more personal accounts of attitudes and behaviour in clinical practice. The GP was also identified as an expert and judge, not just of clinical decision making but also about moral judgements made by GPs in their work. This will impact on the data obtained at interview and must be taken into consideration when the data are interpreted and analysed. CONCLUSION: Qualitative research techniques increasingly are advocated as appropriate for research on and in general practice. The professional identity of the researcher plays an important part in constructing the kind of data obtained in such studies, and this must be made apparent in reporting and discussions of such qualitative work.
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The Hawthorne studies in the 1930s demonstrated how difficult it is to understand workplace behaviour, and this includes professional performance. Studies of interventions to improve professional performance, such as audit, can provide useful information for those considering using such methods, but cannot replace judgement. In particular, there is no single phenomenon that can be labelled 'the Hawthorne effect'. The process of triangulation, considering a subject from different perspectives, might overcome the problems of Hawthorne effects better than using a single method such as controlled trials.