Noura A. Abouammoh

5.8 Evaluating the qualitative research

Reliability and validity in qualitative research is made up of four criteria: credibility, transferability, dependability, and confirmability (Lincoln and Guba, 1985).

The following section discusses some established ways of evaluating the reliability and validity of qualitative research and how these were applied to the current study.

5.8.1 Credibility

Credibility refers to whether the researcher produces a feasible account of participants’ responses (Bryman, 2008).

Triangulation was sought in the current study as a measurement to ensure credibility. Triangulation refers to combining different methods or different sources of information to obtain a rich picture of the issue under investigation (Silverman, 2010, Bryman, 2008). Using different methods in collecting data, such as focus groups and individual semi-structured interviews, may compensate for their individual limitations. Furthermore, using more than one source of information may allow verification of experiences against one another (Shenton, 2004). In the current study, IMGs and patients’ accounts were drawn together to develop the themes.

Additionally, in presenting the findings, the researcher sought fair representation of participants’ responses by highlighting and discussing responses that countered the majority response.

5.8.2 Transferability

Transferability is the degree to which findings can be transferred to other settings. Qualitative researchers do not seek generalizability to other settings; rather, they seek to gain an in-depth understanding of events in peoples’ everyday lives. Therefore, qualitative studies do not usually require large numbers of participants (Bryman, 2008). Whilst the aim of qualitative research may not be to produce reproducible findings, it might be expected that the findings could be generalizable in the sense of being relevant in other settings or, in this case, to other groups of IMGs or diabetes patients (Green and Britten, 1998).

The aim of this study was to provide in-depth analysis of the issues under investigation for this particular setting. The finding of the current study could be potentially useful to other countries such as the Arab Gulf Cooperation Countries, which include Kuwait, the United Arab Emirates, Qatar and Oman where IMGs have the same status and similar cultural structure is found.

5.8.3 Dependability

Dependability refers to the degree to which a study can be replicated to produce the same findings. Post-positivists acknowledge that the social world is constantly changing and a study itself might affect the world it is trying to document.

Using maximum diversity sampling in the current study helps in mediating these changes by including the behaviours, perspectives and needs of people from different age, gender and socioeconomic levels. Being transparent through all phases of the research and providing detailed information with regards to problem formulation, selection of potential participants, taking field notes, data analysis decisions, and so on, were sought (Bryman, 2008). Furthermore, complete records of all phases of the study were presented in this thesis. These included the basis on which this topic was conceived, details about selection of the participants, and data analysis decisions.

5.8.4 Confirmability

Confirmability means ensuring that personal values and theoretical inclinations are not allowed to influence the conduct of the research, nor the findings deriving from it (Bryman, 2008). This can be achieved by being reflexive about the researcher’s role throughout the research process. It should be noted, however, that complete objectivity is impossible in qualitative research.

Guba and Lincoln (1994) described reflexivity as “progressive subjectivity” as this practice allows the researcher to make his or her socio-cultural position explicit to the readers. Thus, the reader will have the ability to judge whether the researcher’s position interfered with the research process.

Researcher bias may be an important concern if the researcher enters the field with previous experience and pre-existing ideas (Silverman, 2010). This might put her at risk of attempting to focus on the points that feed a pre-existing idea. In this study, the researcher aimed to play a neutral role, as much as possible, throughout the data collection and analysis process. The researcher shares the same professional background as the IMGs, as well as their work experience and familiarity with the requirements of successful patient-physician interaction. Furthermore, the researcher had experience of being used as an interpreter between Saudi patients and IMGs during her internship. In this sense, the ability of the researcher to present a combination of the emic and the etic perspectives (see section 5.3) helped in bringing personal and professional understanding to the research process, as well as descriptions of the experiences of IMGs and Saudi patients with diabetes. IMG participants may have perceived the researcher as a fellow professional who is concerned about developing the service, which may make them more candid in revealing their views and experiences. At the same time, however, the researcher is Saudi, and this fact may mean that they hold back from revealing negative views related to Saudi people or the Saudi culture, as in their minds, she might identify with the patients in this sense. The researcher was born and lived in SA for 26 years. Thus she might share the same culture with the patients studied, but not their experiences, as she is not a patient with a chronic health condition. Patients may see the researcher as a Saudi female who understands their perspectives and cares about their experiences with IMGs. Being a female who interacts with male participants without a male guardian may prevent some male patients in the conservative Saudi culture from being involved with the researcher in lengthy conversations. As the researcher shares the experiences of the IMGs and the culture of the patients, she might be in a strong position to understand the participants and then interpret the data. However, it also requires her to be alert regarding how the participants may view her, as well as requiring awareness of the fact that her own vantage point will inevitably influence both their interactions and the data produced. The research supervisors, who belong to a different contextual background, engaged regularly in discussions on data analysis with the researcher. This added a deeper level of reflexivity, as they raised issues and asked questions that helped to explain hidden meanings, which had been overlooked by the researcher, who belongs to different culture from that of the supervisors.