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HCM Advanced Research Methods part 2: Qualitative methods (lectures/working groups)

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Notes of the lectures and working groups from the second part of the course: advanced research methods. In this part the qualitative methods are discussed. My exam grade: 7.8 Master Healthcare Management.

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  • July 3, 2022
  • 28
  • 2021/2022
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Qualitative part – Advanced Research Methods – Joyce Rommens


Lecture 4: Discourse analysis

Objectives qualitative methods:
- To recognize and evaluate different forms of discourse analysis (critical discourse analysis, conversation analysis)
- To perform a discourse analysis of a policy report and to compare one’s own analysis with the analysis presented
in a scientific publication
- To evaluate the role of theory in specific qualitative research studies by using the distinctions
between gap spotting and problematization - as well as - between inductive and deductive
reasoning
- To judge the quality of observations in ethnography by using nine observation dimensions
- To evaluate digital and multi-sited ethnographic studies in ethical and methodological terms
- To perform an ethnographic analysis and to compare one’s own analysis with the
analysis presented in a scientific publication

Learning goals lecture 4:
- Understanding what discourse analysis is
- Understanding strategic use of language and its consequences
- Understanding different forms of discourse analysis
- Understanding do’s and don’ts and applying it yourself




A more holistic perspective to study the object is used; investigate phenomena and consider them in
their context. The researcher is involved in the study by doing interviews, observations etc. ® it is
inevitable, try to reflect on their involvement as well. In qualitative research the question is more
open (how, what, and why it happens). The aim is to explore, understand, gain insight in a certain
phenomenon. Research process is more flexible and in a naturalistic setting (when doing interviews,
you may ask different questions than on your list) ® more iterative approach. Data collection is
about text (language in use); observations, interviews, document analysis. Data analysis is presented
in words and described, interpreted, or reasoned.

With discourse analysis you can research things you normally take for granted. Different data forms
can be used for discourse analysis; language both spoken and written; policy text and reports,
organizational document, occurring talk, speeches. Often it is said that language is not important, is
inconsequential and unconnected to action ® it is just empty talk.

However, it is not. Certain words generate high expectations about being, for example participation
society; it has expectations of self-reliant, autonomous, strong, responsible. This will be further
farther connected to certain practices and requirements ® it is more than just words; what do you
need to do to get something.




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, Qualitative part – Advanced Research Methods – Joyce Rommens


The key assumption about language from a discourse analytical perspective are the opposite of
assumptions about language in general. The use of language has consequences, it can be and is
strategically used, language is important and can therefore be the object of study.

Discourse analysis = studying and analyzing the uses of language (Hodges et al. 2008). This can be
written text or natural conversation.

Core assumptions about language on which the method of discourse analysis is based:
- Language is not innocent and can be strategically used by all kinds of actors, e.g., to steer
behavior in a certain way, to achieve status (in the lecture on discourse analysis examples
were given about middle managers using professional talk to steer the behaviour of care
workers)
- Words are not neural signifiers; they embody certain meanings and associations
(positive/negative).
- Language is connected to action (performative in nature) and has certain consequences.

There are no clear-cut or single definitions of what a discourse is ® it is hard to define but it involves
the study and analysis of the use of language (not language in and of itself). Discourse is a broad,
sensitizing concept to research language (structure and practice) in use; it is possible to have
different books on the same topic, with no overlapping content. Discourse stems from political and
social structures in which power structures do not appear naturally but instead are seen as socially
constructed. Discourses consists of two parts: both structures (social cultural resource that people
use in creating meaning about their world and action) and practices (the structure of meaning in
use).

Discourse is the study of social texts (everyday interaction) ® what do people do with language in
specific social settings. Discourse is the study of social reality as discursively constructed and
maintained (discursive moves) ® the shaping of social reality through language.

Reality and discourse are co-constituting each other.

Language – empirical data you can study.
- Mundane conversations
- Speeches and debates
- Policy and text reports (how certain problems and solutions is framed)
- Organizational documents
- Content on social media

Discourse is an assembly of 5 concepts (Laffey):
- Practices – discourses manifest themselves in both linguistic and non-linguistic practices ® it
materializes into social practices.
- Rules – discourses are sets of rules that both enable practices and are reproduced and/or
transformed by them ® for example discourses on gender; there is a binary distinction
between male and female; women can wear skirts and dresses, and men wear suits. There
are certain rules that allow you to do some things and disallow to do other things.
- Productivity – discourses are productive. They produce subjects, objects, and the relations
among them. They produce truth as well, stipulating the criteria according to which claims
are judged ® different kinds of truths are produced; there is new knowledge.
- Institutions – discourses are always implicated in institutions, broadly conceived. They
circulate through and around– sometimes reinforcing, sometimes challenging, some-times




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, Qualitative part – Advanced Research Methods – Joyce Rommens


participating in or being expressed through, sometimes completely ignored, or marginalized
by –sites of institutionalized power
- Politics – discourses are inherently political. They are about the production and distribution
of power, and struggles over knowledge, interests, identity, and the social relations they
enable or undermine.

Application in healthcare:
- Changing roles of patients and doctors (e.g., shared decision-making)
- Changing views of illness/positive health
- Justification of healthcare reform (decentralizations, regulated market competition, etc.)
- Shifting power relations in the field of healthcare management
- How we deal with crisis (e.g., covid)

Commons sense notions of language:
- A lot of talk, no action
- No words, but deeds
- Just words
- Empty talk
® Language is not important.
® Language is inconsequential.
® Language is not connected to action.

Test case: the word ‘professional’
- Is not a neutral act or factual description
- It generates high expectations: someone can work independently, can be trusted, is an
expert
- It evokes positive associations and feelings
- It gives status to individuals
- It can also be used against your people get fired for ‘unprofessional behavior’

® Language use is important and should be the object of study.
® Language can be strategically used for all kinds of purposes.
® The use of language can have consequences: it can shape how we think and how we behave.

To avoid confusions in different types of discourse analysis, authors Hodges, Karreman & Alvesson
have made categorizations.

Hodges et al. (2008):
- Formal linguistic discourse
- Studying text to discover grammatical and linguistic rules ® reveal a textual
structure by focusing on the syntax, the way sentences are structured, the position
of a word in the sentence, length of sentences to find general underlying rules of
linguistic or communicative function behind text.
- Sources of data are samples of written or oral language and texts. It is quite technical
and not often used in healthcare.
- Empirical/conversation analysis
- Studying talk ‘in interaction’ to study social practice ® language in use; for example,
record and analyze doctor-patient conversations about diabetes management,
emphasis on certain words and their effects in the context (how does talk change a
certain social practice) ® look at broad themes and functions of language in action




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