Skip to content

Unit 1: Qualitative Thinking

NEURO_QUAL Podcast Qualitative Thinking

🎧 Click here to listen to Charlie, Brandon and Santhani introduce Unit One, and the idea of thinking qualitatively.

Reflection Point

Before we get started, reflect on your own motivation to find out more about qualitative research.
What do you instinctively think about this approach to research?

1.1 Unit Introduction

Welcome to Unit One. In this first unit, we explore the philosophical position of qualitative inquiry. While decisions made within a study are often pragmatic ones, researchers should also understand the theoretical and philosophical basis for their research.1 This understanding is important because all research has some philosophical basis; while this can often be hidden or taken for granted in quantitative research,2 it is important to make it explicit in qualitative research for reasons this unit will explain. This philosophy influences every part of the research process, including question development, data collection, analysis and even dissemination.

Unit Content: Qualitative Thinking

  • What is research philosophy?
  • Why is philosophy important?
  • Components of research paradigms
  • An introduction to interpretivism and constructionism

1.2 What is research philosophy?

A research philosophy or [paradigm] is a set of beliefs about how a phenomenon of interest should be examined3; these are often categorised into paradigms of [positivism] which underpins most quantitative research, [interpretivism] which is commonly used in qualitative inquiry, and [pragmatism] which is often used by those who wish to combine both quantitative and qualitative research approaches (known as mixed methods). However, there are many other paradigms including social constructionism/constructivism, critical realism, critical theory and feminist research.

For a useful introduction to qualitative research philosophies see Nicholls, D. (2017) Qualitative Research. Part 1: Philosophies, International Journal of Therapy and Rehabilitation, 24(1), pp.26-33 and Berryman, D.R. (2019) Ontology, Epistemology, Methodology, and Methods: Information for Librarian Researchers, Medical Reference Services Quarterly, 38:3, 271-279, DOI: 10.1080/02763869.2019.1623614

It is unfortunate, then, that researchers often fail to make paradigms and their associated beliefs explicit – or worse, they may be unaware that these beliefs have an effect on the study and its findings. In a pragmatic sense, researchers may be drawn to qualitative methods simply because they want more detailed information, and they may not be overly concerned with what influences their decision making in the research process. It is not uncommon for qualitative manuscripts to use a simple phrase such as ‘we conducted a qualitative study’ while offering nothing else about the thinking that drove the study to be conducted in the way it was. This lack of detail oversimplifies the process and product of qualitative inquiry.

Key Points: What is research philosophy?

  • A set of beliefs about how a study should be designed.
  • Positivism, interpretivism and pragmatism are the most commonly used paradigms, but the qualitative field also includes social constructionism/constructivism, critical realism, critical theory, feminism, and many more.
  • Philosophy is commonly hidden or poorly reported in manuscripts.

1.3 Methodological choice

It is important to understand that qualitative research extends beyond the collection of qualitative data and the use of associated techniques4 to the application of those techniques within a qualitative [paradigm]. As explained briefly in 1.2, a paradigm is a set of beliefs guiding the researchers about how the study should be conducted. The distinction between qualitative research that is or is not situated within a qualitative paradigm has been referred to as ‘small q’ and ‘Big Q’: studies that tend to focus more on data collection techniques and narrow research questions are ‘[small q]’; in contrast, qualitative studies that are situated within qualitative paradigms are considered [‘Big Q’] because they tend to fully embrace the qualitative beliefs that characterise this approach and may examine broader, more complex research questions.45

However, the classification of studies as either ‘small q’ or ‘Big Q’ is too binary to fully reflect the heterogeneity within the field of qualitative inquiry; in addition, this classification suggests an unhelpful hierarchy. Nevertheless, it can be useful to be able to distinguish studies that use qualitative techniques but are not concerned with qualitative thinking and do not necessarily situate their study within the qualitative paradigm. An example of this may be examining patients’ views whilst participating in a randomised control trial.4 In contrast, there are studies that engage fully with qualitative paradigms and use this to inform study design, advance the analytical process and shape the research findings. In the context of mixed methods trials, adopting theoretically informed qualitative approaches can shed more light on vital contextual factors that influence trial results.6

1.4 Why is philosophy important?

Philosophy is important because it encompasses ideas about how knowledge is created and drives key decisions when conducting research. The aim of all research is to generate new knowledge, therefore, researchers need to understand the context in which that knowledge is generated. But while it may be easier to focus on research procedures – such as sampling, data collection and analysis – it is the underpinning research philosophy that determines how those procedures should be conducted that informs the [trustworthiness] of the results. Decisions about how research methods should be actioned are therefore rooted in particular ideas about the construction of knowledge. 1

To illustrate this point, all research has a ‘human factor’. In quantitative research, the researchers choose which data to collect, which statistical tests to use and the causal inference that explains the statistical association; all are inherently human choices and subject to associated biases. Furthermore, where a researcher is present to collect the quantitative data, this can influence the findings by the way in which questions are asked or explained. The same is true for qualitative research; however, what makes some people more cautious about qualitative analysis is that there are no statistical calculations to ground interpretation of the findings. Therefore, the human factor has a very explicit influence on determining what is and what is not important in qualitative data analysis. In the absence of statistical tests, the researcher is required to show their own ‘working out’ and defend why a finding is important. This is why the values, preferences and experiences of the researcher (known as [axiology]) are so central to all qualitative research. When the philosophical foundations of a study are given due consideration, it strengthens the research design and increases the quality of the outcomes. 7

Key Points: Why is philosophy important?

  • Decisions regarding study methods are all based on particular ideas about reality and how knowledge is constructed.
  • The human factor influencing qualitative inquiry is substantial.
  • Axiology pertains to the values of the researcher influencing the study.
  • Qualitative manuscripts should report details of their research philosophy.

1.5 Components of research paradigms

Ontology, epistemology and methodology are the three dimensions of research paradigms.

[Ontology] refers to the study of ‘being’, the nature of existence and what can be known about the world. Therefore, ontology is what we consider to be truth and reality within the context of the subject matter under investigation. In qualitative inquiry, reality is usually considered multiple (i.e. different people experience different realities) and context specific (i.e. individual contexts will always shape how reality is experienced).

[Epistemology] is the nature of knowledge and how that knowledge can be gained. In qualitative inquiry, knowledge is considered personal, subjective and unique.

[Methodology] refers to the fundamental assumptions that guide decision making about how the study should be carried out. The fundamental assumptions of qualitative methodology are explored in more detail in Unit Two.

Understanding these principles enables qualitative researchers to identify appropriate research questions and design appropriate ways to address them. This fit between the question and the solution is known as methodological congruence.8

According to Denzin and Lincoln (1994, p. 38), 'ontology' questions what is the real world and what can be known about it; 'epistemology' questions the relationship between the knower and what can be known; and 'methodology' questions how researchers can go about finding out what they believe can be known. Thus the researcher's ontology directs the epistemology and subsequently the methodology, and the paradigm provides a framework or a lens through which to view or accomplish an investigation.9

Key Points: Components of research paradigms

  • Ontology, epistemology and methodology are the three dimensions of research paradigms.
  • Ontology is what we consider to be truth and reality.
  • Epistemology is the nature of knowledge and how that knowledge can be gained.
  • Methodology refers to the fundamental assumptions that guide decision making.

1.6 An introduction to interpretivisim and constructionism

While there are many different paradigms within the field of qualitative inquiry, by far the most used are interpretivism and social constructionism/constructivism.

Many researchers treat social constructionism/constructivism as interchangeable terms. While these are related, they are different: constructivism is a perspective that examines how individual realities are made by said individuals; social constructionism, on the other hand, assumes people create their own social reality which is a product of collective processes.

The associated philosophies direct our attention to other ways of learning than direct observation, as would be the case with a realist perspective. If we accept that people understand the world around them through their perception of events and experiences and the meaning they attribute to these, then it will help us to know more about their world if we can come to understand their interpretation of events and experiences – this is known as the [emic] perspective. From this position, we may also believe that reality is a product of social processes (i.e. context, time, culture) that human beings construct.1 While many paradigms within the qualitative field do hold similar views, there are differences. For example, a constructionist does not focus on the individual’s perception of reality but how their reality is constructed. These are subtle but important differences which will lead to different research questions and different research methods.

Key Points: An introduction to interpretivisim and constructionism

  • The most common paradigms in qualitative inquiry are interpretivism and social constructionism/constructivism.
  • The emic perspective is considered the ‘insider view’.
  • Characteristics of interpretivism: subjectivity, lived experience, multiple realities, understanding, meaning, close involvement.
  • Characteristics of social constructionism: social world, constructed reality, collective generation of meaning, culture, sense making.

1.7 The qualitative lens

Consider the three examples below about the impact of head injury on families. How do these different examples help us to understand this phenomenon?

1 2 3
“Results showed that while the group [families affected by traumatic brain injury] did not differ greatly in family functioning from a normative group, a significant proportion showed unhealthy functioning across most FAD [Family Assessment Device] subscales. Both TBI participants and their relatives showed elevated rates of anxiety and depression.”10 (p.306) [Mother] “… I said yeah because… it’s completely changed… everything… how it was… your future… everything how we were looking forward to… life… on… you know… as life was going to be a completely different world to what it is now… and we just had to kind of like… all of a sudden go… it’s like a bump [slaps hands]… stop… and then it’s like... this pond of ripples …” 11 (p.855) Water droplet picture

In the first example, the presence of a known variable is measured in a specific population. From this, we can determine that family carers are an at-risk population. In the second example, we learn something different. Here, we are not measuring a known variable, but instead we are drawn into a relative’s lived experience, and through this we are given a glimpse of that person’s life and what it is like to live with the consequences of head injury. In the third example, an image is used to portray the impact of traumatic brain injury (TBI) on the family system as it sends ripples out in all directions affecting everyone’s lives. Such metaphors demand active reflection, in which the viewer attempts to make sense of its meaning. As such, images can be compelling in many ways and increase the communicative power of qualitative research.

Key Points: The qualitative lens

  • Qualitative and quantitative inquiry contribute different perspectives to the evidence base.
  • Qualitative findings draw the reader inside the world of the participant.
  • The communication of experience can be powerful and evocative.

Reflection Point

Having completed this unit, how do you think qualitative research can contribute to the neurosurgical evidence base?

1.8 Unit summary

In this unit, we introduced the thinking behind qualitative research, its philosophical position and component parts of ontology, epistemology and methodology. The importance of this philosophy was explained and that more explicit discussion of how these beliefs inform the research process would improve qualitative studies and the manuscripts reporting them. The paradigms of interpretivism and constructionism/constructivism were introduced, but awareness of other paradigms was also raised. Finally, the qualitative lens was represented by comparing examples from qualitative and quantitative research. The next unit will explore qualitative design in more detail, the methodology’s core characteristics and what are appropriate qualitative research questions.


  1. Holloway I, Galvin K. Qualitative research in nursing and healthcare. 4th edition. ed. Chichester, West Sussex, UK ; Ames, Iowa: John Wiley & Sons Inc. 2017. 

  2. Coyle A. Introduction to qualitative psychological research. In: Lyons E, Coyle A, eds. Analysing qualitative data in psychology. London: Sage 2007. 

  3. Denzin NK, Lincoln YS. The SAGE handbook of qualitative research. 3rd ed. ed. Thousand Oaks ; London: Sage Publications 2005. 

  4. Clarke V, Braun V. Successful qualitative research: A practical guide for beginners. London: Sage 2013. 

  5. Kidder LH, Fine M. Qualitaitve and quantitative methods: When stories converge. New Directions for Program Evaluation 1987;35:57-75. 

  6. Camlin CS, Seeley J. Qualitative research on community experiences in large HIV research trials: what have we learned? J Int AIDS Soc 2018;21 Suppl 7:e25173. doi: 10.1002/jia2.25173 [published Online First: 2018/10/20] 

  7. Halcomb L. How an understanding of paradigms can improve the quality of nursing research. Nurse Researcher 2018;25(4):6. doi: 10.7748/nr.25.4.6.s2 

  8. Whiffin CJ. Choose Your Methodology: Little Quick Fix. 1st ed 2021. 

  9. Welford C, Murphy K, Casey D. Demystifying nursing research terminology. Part 1. Nurse Res 2011;18(4):38-43. doi: 10.7748/nr2011. [published Online First: 2011/08/23] 

  10. Ponsford J, Schonberger M. Family functioning and emotional state two and five years after traumatic brain injury. J Int Neuropsychol Soc 2010;16(2):306-17. doi: 10.1017/S1355617709991342 [published Online First: 2010/02/05] 

  11. Whiffin CJ, Bailey C, Ellis-Hill C, et al. Narratives of family transition during the first year post-head injury: perspectives of the non-injured members. Journal of advanced nursing 2015;71(4):849-59. doi: 10.1111/jan.12551 [published Online First: 2014/10/24]