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and question. Critics of mixed methods are usually those who hold fast to a philosophical tradition, believing it impossible to hold more than one philosophical position as the ‘true’ position at the same time, thereby making the mixing of methods at best ineffective and at worst untenable. In summary, we have looked at philosophies of research as a starting point for thinking about how we might undertake research to underpin our practice: an important part of the role and responsibilities of nurses and midwives to service users and patients, which is as important as updating clinical knowledge. We began by thinking about how we might come to know the social world in which we live. It is generally accepted that there are three philosophical positions, two of which have opposing views, namely positivism, with its emphasis on the observable and objective way of knowing the social world, and interpretivism, a subjective view of knowing the social world. We introduced the concept of critical realism, where ch_01.indd 10 13/09/2013 16:24 Understanding the language of research 11 emphasis is placed on understanding the ‘real’ world, as it is experienced by those we are interested in knowing more about. A third philosophical position (often subscribed to by the critical realist) is said to underpin ‘mixed methods’, which attempts to bridge the divide between the two well-established philosophies in the name of pragmatism. Whichever view is subscribed to on a personal level, the key point is to think about the research question, i.e. what do we want to know, and to design the research study in a way that best enables the question to be answered. For example, a researcher seeking to understand students’ experience of using the library would design a study grounded in interpretivism, whereby it is possible to come to know what it is like to use the library from the students’ perspective. On the other hand, a researcher wishing to know peak usage time for the library would design a study within the positivist paradigm and observe students using the library during certain times of the day. Both are useful pieces of research, but for different reasons and for different audiences. It is useful for library staff to know how students experience the library, so that they can facilitate improvements. However, if the question is one of how to make the best use of available resources, a different audience will be interested in the results, namely those responsible for resourcing the library and capital expenditure. A critical realist might use a mixed methods approach in order to understand the realities of library services for users within the context of an organisations diminishing resources. What is suitable for one research study may not be suitable for another depending on the question and the targeted audience for the research findings. The research question The research process begins when there is a problem in need of a solution, with the aim being to design a research study that will enable the problem to be solved. This is true irrespective of the preferred methodology, be it quantitative or qualitative. Identifying research problems in healthcare is relatively simple, as most of us have worked in the field in some capacity. Consequently, our exposure to and experience of healthcare situations means that we are best placed to identify problems of interest to the real world of healthcare practice. Often the identification of a research problem arises from a disagreement or discussion: for example, how nursing and midwifery care should be organch_01.indd 11 13/09/2013 16:24 Research skills for nurses and midwives 12 ised, how health services should be delivered, or what treatments and care patients and clients require or desire. The researcher then translates these disagreements or discussions into a researchable question and proceeds to design a research study using the most appropriate methodology to address the research question. In general, research ideas and questions arise from existing theories or previous research. Similarly, research questions in nursing and midwifery can arise from everyday practice, past nursing and midwifery research, or theory. One of the most fruitful areas for research ideas is everyday nursing and midwifery practice. Practitioners continually have to make decisions about how to organise care, when to alert medical staff to a change in a patient’s condition, when there are issues for a mother in labour, and (more often these days) how to make best use of available resources. Practitioners will be constantly observing and reflecting on their practice and the practice of others and thinking about how best to solve clinical and practice problems. Situations and experiences such as these, and many others you can think of, can be turned into research questions with the aim of improving practice for the benefit of patients and clients. Previous research studies are another source of research ideas and questions because they often recommended further research in a subject. An interesting feature of research is that it tends to generate more questions than it answers. In addition, from reviewing and analysing research articles as a student you may have found issues in the published research that are problematic. In this case, your critique may be a good starting place to propose further research, which in turn adds to the body of
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