Q method in research on health professions education and digital technologies: a systematic review

Authors

DOI:

https://doi.org/10.33448/rsd-v10i10.19154

Keywords:

Q sort; Health professions education; Learning; Teaching; Digital technologies.

Abstract

Q method, a mixed methods research approach, is used to explore points of view and attitudes towards a specific phenomenon from subjective human perspectives. There has been an increase in the use of digital technologies in education and it has become necessary to investigate the difficulties and facilities of health professionals and students in order to improve the use of such technologies for teaching and learning. We aimed to identify and evaluate studies that employed Q method to investigate the use of digital technologies in Health Professions Education. To achieve this, a systematic review was conducted according to the PRISMA Statement Guidelines. The selection of articles was based on the search strategy (("Q-sort" OR "Q-methodology" OR "Q-technique")) AND (("Teaching") OR ("Learning")). Of the 1,398 articles found, 13 were selected in accordance with the adopted inclusion criteria. The articles successfully applied Q method to health issues, which expands its application possibilities and provides a contribution to mixed methods research. Another contribution is the use of the Mixed Methods Appraisal Tool in this type of review. In view of the pressing need for education changes, using mixed methods research, particularly Q method, to investigate teaching culture and practice, can successfully support the renewal of Health Professions Education.

References

Akhtar-Danesh, N., Baxter, P., Valaitis, R., Stanyon, W., & Sproul, S. (2009). Nurse faculty perceptions of simulation use in nursing education. Western Journal of Nursing Research, 31(3), 312-329. https://doi.org/10.1177/019394590832826.

Baxter, P., Akhtar-Danesh, N., Valaitis, R., Stanyon, W., & Sproul, S. (2009). Simulated experiences: Nursing students share their experiences. Nurse Education Today, 29(8), 859-866. https://doi.org/10.1016/j.nedt.2009.05.003.

Brandão, M. L., Araújo, U. P., Sartorelli, I. C., & Ribeiro, J. E. (2017). O uso da metodologia Q em pesquisas brasileiras: Uma abordagem esquecida para o estudo sistemático da subjetividade. Paper presented at the Congresso de Administração, Sociologia e Inovação, 30 November-1 December, Petrópolis, Rio de Janeiro. Retrieved May 8th, 2021 from: https://even3.blob.core.windows.net/processos/28b6b3c7e3654623b549.pdf.

Brewer‐Deluce, D., Sharma, B., Akhtar‐Danesh, N., Jackson, T., & Wainman, B. C. (2019). Beyond average information: How Q‐methodology enhances course evaluations in anatomy. Anatomical Sciences Education, 13(2), 137-148. https://doi.org/10.1002/ase.1885.

Brown, S. R. (1993). A primer on Q methodology. Operant Subjectivity, 16(3/4), 91-138. https://doi.org/10.15133/j.os.1993.002.

Brown, S. R. (1980). Political subjectivity: Applications of Q methodology in political science. Yale University Press, New Haven.

Brown, S. R. (2009). Q technique, method, and methodology: Comments on Stentor Danielson’s article. Field Methods, 21(3), 238-241. https://doi.org/10.1177/1525822X09332080.

Chicca, J., & Shellenbarger, T. (2018). Connecting with Geration Z: Approaches in nursing education. Teaching and Learning in Nursing, 13(3), 180-184. https://doi.org/10.1016/j.teln.2018.03.008.

Clarke, M., Oxman, A. D., Paulsen, E., Higgins, J. P., & Green, S. (2011). Appendix A: guide to the contents of a cochrane methodology protocol and review. In: J. P. T., Higgins & S. Green (Eds.). Cochrane handbook for systematic reviews of interventions. (5.1.0 version). The Cochrane Collaboration. Retrieved May 8th, 2021 from: www.handbook.cochrane.org.

Coogan, J., Dancey, C., & Attree, E. (2005). WebCT: A useful support tool for undergraduates – a Q methodological study. Psychology Teaching and Learning, 5(1), 61-66. https://doi.org/10.2304/plat.2005.5.1.61.

Couto, M., Farate, C., Ramos, S., & Fleming, M. (2011). A metodologia Q nas ciências sociais e humanas: O resgate da subjectividade na investigação empírica. Psicologia, 25(2), 7-21. https://doi.org/10.17575/rpsicol.v25i2.285.

Cox, J.L., Seaman, C.E., Hyde, S., Freire, K.M., & Mansfield, J. (2020). Co-designing multidisciplinary telehealth education for online learning. Health Education, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/HE-10-2020-0098.

Creswell, J. W. & Clark, V. L. P. (2010). Designing and conducting mixed methods research. Sage Publications.

Cross, R. M. (2005). Exploring attitudes: The case for Q methodology. Health Education Research, 20(2), 206–213. https://doi.org/10.1093/her/cyg121.

Danielson, S. (2009a). Q Method and surveys: Three ways to combine Q and R. Field Methods, 21(3), 219-237. https://doi.org/10.1177/1525822X09332082.

Danielson, S. (2009b). Recognizing common ground: A reply to Steven R. Brown. Field Methods, 21(3), 242-243. https://doi.org/10.1177/1525822X09332083.

Dune, T., Mengesha, Z., Buscemi, V., & Perz, J. (2019). Jumping the methodological fence: Q methodology. In: P. Liamputtong (Ed.) Handbook of research methods in health social sciences. Springer, Singapore. https://doi.org/10.1007/978-981-10-2779-6_101-1.

Dziopa, F. & Ahern, K. (2001). A systematic literature review of the applications of Q-technique and its methodology. Methodology: European Journal of Research Methods for the Behavioral and Social Sciences, 7(2), 39-55. https://doi.org/10.1027/1614-2241/a000021.

Eden, S., Donaldson, A., & Walker, G. (2005). Structuring Subjectivities? Using Q Methodology in Human Geography. Area, 37(4), 413-422. Retrieved from http://www.jstor.org/stable/20004480.

Franco de Sá, R., Nogueira, J., & De Almeida Guerra, V. (2019). Traditional and complementary medicine as health promotion technology in Brazil. Health Promotion International, 34(1), i74-i81. https://doi.org/10.1093/heapro/day087.

Galvao, M. C., Pluye, P., & Ricarte, I. (2017). Métodos de pesquisa mistos e revisões de literatura mistas: conceitos, construção e critérios de avaliação. InCID: Revista de Ciência da Informação e Documentação, 8(2), 4-24. https://doi.org/10.11606/issn.2178-2075.v8i2p4-24.

Ha, E. H. (2014). Attitudes toward video-assisted debriefing after simulation in undergraduate nursing students: An application of Q methodology. Nurse Education Today, 34(6), 978–984. https://doi.org/10.1016/j.nedt.2014.01.003.

Ha, E. H. (2015). Attitudes toward clinical practice in undergraduate nursing students: A Q methodology study. Nurse Education Today, 35(6), 733–739. https://doi.org/10.1016/j.nedt.2015.01.013.

Ha, E. H. (2016). Undergraduate nursing students' subjective attitudes to curriculum for simulation-based objective structured clinical examination. Nurse Education Today, 36, 11-17. https://doi.org/10.1016/j.nedt.2015.05.018.

Hays, R. (2018). Establishing a new medical school: A contemporary approach to personalizing medical education. Medical Teacher, 40(10), 990-995. https://doi.org/10.1080/0142159X.2018.1487048.

Hill, S. R., Mason, H., Poole, M., Vale, L., Robinson, L., & SEED team (2017). What is important at the end of life for people with dementia? The views of people with dementia and their carers. International Journal of Geriatric Psychiatry, 32(9), 1037–1045. https://doi.org/10.1002/gps.4564.

Hislop, J., Mason, H., Parr, J. R., Vale, L., & Colver, A. (2016). Views of young people with chronic conditions on transition from pediatric to adult health services. The Journal of Adolescent Health, 59(3), 345–353. https://doi.org/10.1016/j.jadohealth.2016.04.004.

Hodges, C., Moore, S., Lockee, B., Trust, T., & Bond, A. (2020). The difference between emergency remote teaching and online learning. Educause Review, Washington. Retrieved from https://er.educause.edu/articles/2020/3/the-difference-between-emergency-remote-teaching-and-online-learning.

Kampen, J. K. & Tamás, P. (2014). Overly ambitious: Contributions and current status of Q Methodology. Quality & Quantity: International Journal of Methodology, 48(6), 3109–3126. https://doi.org/10.1007/s11135-013-9944-z.

Landeen, J., Pierazzo, J., Akhtar-Danesh, N., Baxter, P., van Eijk, S., & Evers, C. (2015). Exploring student and faculty perceptions of clinical simulation: A Q-sort study. The Journal of Nursing Education, 54(9), 485–491. https://doi.org/10.3928/01484834-20150814-02.

Lim, E., Wynaden, D., Baughman, F., & Heslop, K. (2021). Realising the potential of Q methodology in nursing research. Collegian, 28(2), 236-243. https://doi.org/10.1016/j.colegn.2020.08.004.

Mason, H., Collins, M., McHugh, N., Godwin, J., Van Exel, J., Donaldson, C., & Baker, R. (2018). Is "end of life" a special case? Connecting Q with survey methods to measure societal support for views on the value of life-extending treatments. Health Economics, 27(5), 819–831. https://doi.org/10.1002/hec.3640.

McHugh, N., Baker, R. M., Mason, H., Williamson, L., van Exel, J., Deogaonkar, R., Collins, M., & Donaldson, C. (2015). Extending life for people with a terminal illness: A moral right and an expensive death? Exploring societal perspectives. BMC Medical Ethics, 16(1), 14. https://doi.org/10.1186/s12910-015-0008-x.

Miller, A. M., Wilbur, J., Dedhiya, S., Talashek, M. L., & Mrtek, R. (1998). Interpersonal styles of nurse practitioner students during simulated patient encounters. Clinical Excellence for Nurse Practitioners: The International Journal of NPACE, 2(3), 166–171. https://pubmed.ncbi.nlm.nih.gov/12675086/.

Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med, 6(7), e1000097. https://doi.org/10.1371/journal.pmed.1000097.

Munn, Z., Stern, C., Aromataris, E., Lockwood, C., & Jordan, Z. (2018). What kind of systematic review should I conduct? A proposed typology and guidance for systematic reviewers in the medical and health sciences. BMC Medical Research Methodology, 18(5). https://doi.org/10.1186/s12874-017-0468-4.

Novaes, A. (2016). Metodologia Q: Uma estratégia investigativa para o estudo das singularidades. In: A. Novaes, L. P. Villas Bôas, & Ens, R. T. (Eds.). Formação e trabalho docente: Relações pedagógicas e profissionalidade: pesquisas com a técnica Q, Champagnat/PUCPRESS, Curitiba, Fundação Carlos Chagas, São Paulo, 15-30.

Novaes, A. (2020). Professor é uma pessoa: Constituição de subjetividades docentes na periferia de São Paulo [Teacher is a Person: The Construction of Teaching Subjectivities in the Periphery of São Paulo]. Novos estudos CEBRAP, 39(1), 59-79. Retrieved from https://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-33002020000100059.

Organização Pan-Americana da Saúde (2018). Relatório 30 anos de SUS, que SUS para 2030? [Report 30 years of SUS, which SUS for 2030?]. Brasília, DF, Brasil, OPAS. Retrieved from https://iris.paho.org/handle/10665.2/49663.

Ouzzani, M., Hammady, H., Fedorowicz, Z., & Elmagarmid, A. (2016). Rayyan - a web and mobile app for systematic reviews. Systematic Reviews, 5(210). https://doi.org/10.1186/s13643-016-0384-4.

Paige, J. B. & Morin, K. H. (2015a). Using Q-methodology to reveal nurse educators’ perspectives about simulation design. Clinical Simulation in Nursing, 11(1), 11–19. https://doi.org/10.1016/j.ecns.2014.09.010.

Paige, J. B. & Morin, K. H. (2015b). Diversity of nursing student views about simulation design: A Q-methodological study. The Journal of Nursing Education, 54(5), 249–260. https://doi.org/10.3928/01484834-20150417-02.

Petit dit Dariel, O., Wharrad, H., & Windle, R. (2013). Exploring the underlying factors influencing e-learning adoption in nurse education. Journal of Advanced Nursing, 69(6), 1289–1300. https://doi.org/10.1111/j.1365-2648.2012.06120.x.

Pluye, P., Robert, E., Cargo, M., Bartlett, G., O’Cathain, A., Griffiths, F., Boardman, F., Gagnon, M. P., & Rousseau, M. C. (2011). Proposal: A mixed methods appraisal tool for systematic mixed studies reviews. Retrieved from http://mixedmethodsappraisaltoolpublic.pbworks.com.

Qurtas, D.S. & Shabila, N.P. (2020). Using Q-methodology to understand the perspectives and practical experiences of dermatologists about treatment difficulties of cutaneous leishmaniasis. BMC Infectious Diseases, 20(645). https://doi.org/10.1186/s12879-020-05365-0.

Ramlo, S. (2016). Mixed method lessons learned from 80 years of Q methodology. Journal of Mixed Methods Research, 10(1), 28-45. https://doi.org/10.1177/1558689815610998.

Ramlo, S.E. (2019). Divergent viewpoints about the statistical stage of a mixed method: qualitative versus quantitative orientations. International Journal of Research & Method in Education, 43(1), 93-111. https://doi.org/10.1080/1743727X.2019.1626365.

Roberts, J. K., Hargett, C. W., Nagler, A., Jakoi, E., & Lehrich, R. W. (2015). Exploring student preferences with a Q-sort: The development of an individualized renal physiology curriculum. Advances in Physiology Education, 39(3), 149–157. https://doi.org/10.1152/advan.00028.2015.

Roberts, J. K., Chudgar, S. M., Engle, D., McClain, E. K., Jakoi, E., Berkoben, M., & Lehrich, R. W. (2018). Digital chalk-talk videos improve knowledge and satisfaction in renal physiology. Advances in Physiology Education, 42(1), 146–151. https://doi.org/10.1152/advan.00131.2017.

Rocha, J. S. Y., & Sampaio, S.S. (2020). La educación online en Brasil: avances y desafíos. RISTI (Porto), E32(1), 524-531. Retrieved from http://www.risti.xyz/issues/ristie32.pdf.

Sampson, D. G. & Karagiannidis, C. (2002). Personalised learning: Educational, technological and standardisation perspective. Interactive Educational Multimedia, 4, 24-39. Retrieved from https://revistes.ub.edu/index.php/IEM/article/view/11738.

Sandelowski, M. & Barroso, J. (2003). Creating metasummaries of qualitative findings. Nursing Research, 52(4), 226–233. https://doi.org/10.1097/00006199-200307000-00004.

Santaella, L. (2013). Desafios da ubiquidade para a educação. Ensino Superior Unicamp. Retrieved from https://www.revistaensinosuperior.gr.unicamp.br/artigos/desafios-da-ubiquidade-para-a-educacao.

Santos S. R. & Schor, N. (2003). Vivências da maternidade na adolescência precoce. Revista de Saúde Pública, 37(1), 15-23. https://doi.org/10.1590/S0034-89102003000100005.

Serralta, F. B., Nunes, M. L. T., & Eizirik, C. L. (2007). Development of a portuguese version of the psychotherapy process Q-set. Revista de Psiquiatria do Rio Grande do Sul, 29(1), 44-55. http://dx.doi.org/10.1590/S0101-81082007000100011.

Simons, J. (2013). An introduction to Q methodology. Nurse Researcher, 20(3), 28–32. https://doi.org/10.7748/nr2013.01.20.3.28.c9494.

Stenner, P. & Stainton-Rogers, R (2004). Q methodology and qualiquantology: The example of discriminating between emotions. In: Z. Todd, B. Nerlich, S. McKeon & D. D. Clarke, (Eds.), Mixing Methods in Psychology The integration of qualitative and quantitative methods in theory and practice, Psychology Press, Taylor & Francis e-Library, Hove and New York, 99-118.

Stephenson, W. (1935). Technique of factor analysis. Nature, 136, 297. https://doi.org/10.1038/136297b0

Tamim, S.R. & Grant, M.M. (2016). Exploring how health professionals create eHealth and mHealth education interventions. Education Tech Research Dev, 64(6), 1053–1081. https://doi.org/10.1007/s11423-016-9447-4.

Valaitis, R., Akhtar-Danesh, N., Eva, K., Levinson, A., & Wainman, B. (2007). Pragmatists, positive communicators, and shy enthusiasts: Three viewpoints on Web conferencing in health sciences education. Journal of Medical Internet Research, 9(5), e39. https://doi.org/10.2196/jmir.9.5.e39.

Van Exel, N.J. & de Graaf, G. (2005). Q methodology: A sneak preview. Retrieved from: https://qmethod.org/portfolio/van-exel-and-de-graaf-a-q-methodology-sneak-preview/.

Vidal, E.I.O. & Fukushima, F.B. (2021). A arte e a ciência de escrever um artigo científico de revisão [The art and science of writing a scientific review article]. Cadernos de Saúde Pública, 37(4), e00063121. https://doi.org/10.1590/0102-311x00063121.

Watts, S. & Stenner, P. (2012). Doing Q methodological research: Theory, method and interpretation. SAGE Publications Ltd.

Webler, T., Danielson, S., & Tuler, S. (2009). Using Q method to reveal social perspectives in environmental research. Social and Environmental Research Institute, Greenfield MA. Retrieved from https://www.researchgate.net/publication/273697977_Using_Q_Method_to_Reveal_Social_Perspectives_in_Environmental_Research.

World Health Organization. (2019). WHO guideline: Recommendations on digital interventions for health system strengthening. Retrieved from: https://www.who.int/reproductivehealth/publications/digital-interventions-health-system-strengthening/en/.

Yau, S.Y., Babovič, M., Liu, G.R.J. et al. (2021). Differing viewpoints around healthcare professions’ education research priorities: A Q-methodology approach. Advances in Health Sciences Education, 26, 975–999. https://doi.org/10.1007/s10459-021-10030-5.

Yeun, E. J., Bang, H. Y., Ryoo, E. N., & Ha, E. H. (2014). Attitudes toward simulation-based learning in nursing students: An application of Q methodology. Nurse Education Today, 34(7), 1062–1068. https://doi.org/10.1016/j.nedt.2014.02.008.

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16/08/2021

How to Cite

SAMPAIO, S. dos S.; FERREIRA , J. B. B. .; BALDONI, N. R. .; DONADELI, J. M. .; FERNANDES, M. N. de F. .; SANTOS, M. dos; GALVÃO, M. C. B. .; ROCHA, J. S. Y.; SANTOS, A. M. P. .; FORSTER, A. C. . Q method in research on health professions education and digital technologies: a systematic review. Research, Society and Development, [S. l.], v. 10, n. 10, p. e471101019154, 2021. DOI: 10.33448/rsd-v10i10.19154. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/19154. Acesso em: 27 oct. 2021.

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Health Sciences