Chapter 2: Literature Review
3.3 Study design
Mixed methods research has been conducted throughout the 20th century but only described as a methodological approach due to the paradigm wars during the 1980`s (Creswell & Plano Clarke, 2007; Tashakkori & Teddlie,2003). The paradigm wars were a major catalyst for the emergence of mixed methods research as the third methodological movement (Creswell & Plano Clarke, 2007;Tashakkori & Teddlie, 2003). The
incompatibility thesis, which rested on the assumption that compatibility between
qualitative and quantitative methods was impossible, led scholars using mixed methods to adopt a paradigm to support their preference, i.e. pragmatism together with the
transformative-emancipatory paradigm was adopted as the philosophical underpinning of this methodological approach (Creswell & Plano Clarke, 2007;Tashakkori & Teddlie, 2003).
Mixed methods research has been defined as a research design that utilises both quantitative and qualitative research approaches in research questions, methods, data collection and analysis as well as inferences (Johnson & Onwuegbuzie, 2004; Tashakkori
& Teddlie, 2003). Mixed methods researchers believe that the research cycle moves
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inductively and deductively in an iterative manner, and that a particular research method is used appropriately depending on where the researcher is in this process (Teddlie &
Johnson, 2009). When conducting mixed methods research it is important to:
1. Consider the theoretical drive of the project
2. Recognize the role and range of approaches which might be imported into the project as it progresses in order to verify or further explore an unexpected finding 3. Adhere to the methodological assumptions of the core method
4. Work with as few data sets as possible (Morse, 2003).
Throughout the current study the researcher has made every effort to adhere to these considerations.
Sampling in mixed methods studies involves combining the well-established techniques of both qualitative and quantitative research designs in creative ways to answer the research questions (Teddlie & Yu, 2007). In mixed methods research the researcher will often have to make decisions about sampling based on resources of time and money, and may need to make trade-offs between representativeness and saturation (Teddlie & Yu, 2007). The sampling strategies employed in this study are explained in detail further on in this chapter with the principles inherent to the research designs of both the qualitative and quantitative phases having been respected.
Mixed methods research is not without criticism. Researchers embarking on a mixed methods study need to think carefully about the methodologies and designs they intend using, as not all study questions lend themselves to be mixed or blended (Lipscomb, 2008). The use of a mixed methods approach to the current research was justified by the research questions, which required the exploration, identification and description of factors
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related to access to health sciences in higher education and what the implications of these factors were on health sciences education. Mixed methods research, it may be argued, is less rigorous than multi-methods research, with the supplemental data it is claimed, being
‘thin’ (Morse, 2003). In order to overcome this criticism, this research reports in detail how the data was collected, analysed and verified. It outlines the verification method, which allows the reader to assess whether the research has been rigorous and if inferences were made. Creswell (2011) outlined some of the controversies in mixed methods
research, including the definition of mixed methods research, the use of quantitative and qualitative research terms, philosophical issues, the discourse of mixed methods, the design possibilities, and its value. However, he postulated a number of recommendations to address these controversies (Creswell & Plano Clarke, 2011):
Write a mixed methods methodological paper to advance the literature on mixed methods
“Define mixed methods” (p. 273)
Use mixed methods terminology in the research report
Make your philosophical position known and discuss it in the report
Be clear about your mixed methods design, why it is appropriate and ensure you show rigor
Substantiate the value of the mixed methods approach for your study.
In the current study, the researcher has endeavoured to be true to the research language of each method, and to use mixed methods terminology, to report the philosophical
underpinning of the research as well as her position with respect to why the particular mixed methods design was chosen and the value of the design to this study.
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If the researcher does not pay particular attention to whether the research has an inductive (reasoning from specific observations to more general (Polit & Beck, 2012) or deductive (reasoning from the general principles to the specific (Polit & Beck, 2012) drive, a mixed methods study may compromise the validity of the research (Morse, Niehaus, Wolfe &
Wilkins 2006). The current research has an inductive theoretical drive and throughout the study the researcher has therefore endeavoured to adhere to the underlying assumptions of inductive qualitative research. While this study has a quantitative phase, the overall thrust of the study is inductive, and the quantitative results were used to develop the Policy Delphi questionnaire that was used in the qualitative phase in a larger and more diverse sample of role players. The inductive theoretical drive was temporarily suspended during the deductive, quantitative phase because the qualitative phase had been completed. The inductive drive continued when the findings from the quantitative phase were integrated into those of the qualitative phase and a further review of the literature was done.
Transforming higher education in South Africa is a policy imperative of the national government (Department of Education, 1997), but the matter has not been extensively researched in South Africa. The mixed methods design allowed for the factors associated with access to health sciences education in universities to be identified, and then to establish whether these factors were perceived to be important to access to health sciences education in a larger and more diverse sample of universities. A mixed methods research design was used to encourage a deeper and more comprehensive understanding of the phenomenon under study. It allowed for data from the qualitative phase to be used to develop the Policy Delphi questionnaire that was used to collect data in the quantitative phase, enabling the corroboration of findings from the dominant qualitative phase.
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3.3.1 Mixed methods sequential exploratory design
The design used to conduct this research was the mixed methods sequential exploratory design (Creswell & Plano Clark, 2007), which consists of two distinct phases: qualitative followed by quantitative. The first qualitative phase allows for categories of factors to emerge that indicated the criteria used to determine who can access health sciences education. The quantitative phase identified the implications of these factors on access to health sciences education in universities using a Policy Delphi method. The qualitative phase preceded the quantitative phase because the study was exploratory, as not much research has been done in the area of access to health sciences education in South African universities.
Greene, Caracelli & Graham (1989) identified five purposes for mixed-method research:
triangulation, complementarity, development, initiation and expansion. This study was in the complementarity genre, which is defined as using the different methods to seek
elaboration, enhancement, illustration and clarification of the results from one method with results from the other method (Caracelli & Greene, 1993).
The researcher first collected and analysed qualitative data to identify and describe the factors related to access to health sciences education in four universities that offer health science education. This information was used to develop a questionnaire that asked about the policy implications of the identified criteria in Phase 2 as identified on Table 3.1. The results of the first two phases were used to develop guidelines to assist the Faculties of Health Sciences at South African universities regarding policies to inform access to health sciences education during the third phase of the research.
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