Embryonic stem cell - Dissertation Example

?Running Head: STEM CELL RESEARCH Stem Cell Research CHAPTER 3 METHODOLOGY Embryonic stemcell research is not a new phenomenon in the field of medical research. However, no other research has triggered the same global concerns on ethical, political, medical, and social issues. With lack of imminent findings and insufficient information on the potential therapeutic benefits of embryonic stem cell research, controversies on viability of such studies have immediate impact on the work of scientists and researchers. The proposed qualitative case study has the purpose to explore bioethical factors and political/social controversy on stem cell research with the aim to identify and explore the potential impact stem cell research has on behavior and attitudes of health care professionals with the focus on three medical facilities. As the government cut funding for embryonic stem cell research initiatives, scientists must rely on private funding to continue their studies (Stake, 2010). The objective of this case study is to document and understand diverse aspects of researcher’s experiences in clinical research within embryonic stem cell research domain. Overall, the study aims to evaluate bioethical discourse among health care professionals, to assess current knowledge of the scientists on stem cell research, and to explore how the bioethical concerns of the medical fraternity may shape the attitudes of stem cell researchers. Qualitative case-study and semi-structured interviews, as elements of qualitative research framework, are widely used by researchers in medical settings when the purpose of the study is to assess opinions, gain ideas, and generate information that is not reflected through quantitative methodology. Population, sampling, and data collection procedures and rationale are thoroughly discussed. Internal and external validity are outlined and data analysis tools are evaluated. The chapter concludes with a brief summary of the key points. Research Method and Design Appropriateness With a wide range of research methods available, the researchers have an opportunity to rely on the method that perfectly suits the research objectives and goals. This study relies on qualitative research framework for a number of reasons. While the distinction between qualitative and quantitative research is significant, the investigation of ideas, beliefs, and perceptions does not require statistical survey or controlled experiment to obtain reliable results. As Stake (2010) noted, “Perhaps the most important methodological differences between qualitative and quantitative are two-fold: the difference between (1) aiming for explanation and (2) aiming for understanding, and the difference between (1) a personal role and (2) impersonal role for the researcher” (p. 19). Within qualitative research framework, the researcher has a personal role and is actively engaged in the process of data collection though direct interaction with the study participants. While quantitative research aims to explain the phenomena by looking at statistics, qualitative research is more beneficial for the study on embryonic stem cell research debate because it seeks to enhance understanding of the issue through the eyes of stem cell researchers within specific clinical/research settings. Advantages of qualitative research are many. Qualitative method was chosen for this study because first and foremost data will be obtained in the natural setting, as the researcher will visit three clinical/research facilities for a face-to-face interview; this will enable the researcher to obtain detailed information about study participants and the place; thus, being involved in actual experiences of the participants. Qualitative research also rests on interactive and humanistic methods (Rossman and Rallis, 2003), which benefit the current study that will aim to explore bioethical debate through the perceptions of individuals who have extensive knowledge in the field under investigation. Further, the researcher is able to modify/refine the research questions and interview elements as new details appear in the process of data collection. Qualitative research is purely interpretive, as the researcher analyzes data for categories and draws conclusions theoretically (Denzin and Lincoln, 2005). Qualitative research has a number of weaknesses. In particular, qualitative research is subjective and personal (Stake, 2010). It may lead to more questions than new answers and the ethical risks are substantial. At the same time, subjectivity is not always a failing as it is essential for understanding human thoughts and activities that have not been previously assessed by any other research (Drisko, 2008). In such a way, qualitative research weaknesses are transformed into strengths, if the research is aimed at discovery of new knowledge (Yin, 2009). Taking into account the current bioethical debate on embryonic stem cell research and uncertainties regarding its application, qualitative research design is more effective in gathering primary information (opinions of the scientists working in research/clinical settings) compared to quantitative framework, which is limited to and based on previous findings (Siedman, 2006). Qualitative research is more suitable when the objective is to study episodic, evolving phenomena (Yin, 2009). The phenomenon under investigation is evolving because of changing political, social, and economic factors. Embryonic stem cell research is a relatively young direction in medical research. Consequently, qualitative research is well-suited to explore the opinions of the clinicians and researchers working in the field of embryonic stem cell research today in order to draw conclusions on the current situation (Siedman, 2006). Thus, qualitative research is a legitimate method of conducting inquiry, and according to a number of authors (Marshall and Rossman, 1995; Coffey and Atkinson, 1996), may be found in a variety of forms such as: ethnography, enthnomethodology, field study, oral history, phenomenology, participant and non-participant observation, ethology, natural history and case study. Of these methods, the case study approach is the most appropriate for this project. In Case study research: Design and methods, R.K. Yin (1988) states: In general, case studies are the preferred strategy when "how" or "why" questions are being posed, when the investigator has little control over events, and when the focus is on a contemporary phenomenon within some real-life context (p. 13). And, Keen and Packwood (1995) state: The methods used in case studies may be qualitative or quantitative, depending on circumstances. Case studies using qualitative methods are most valuable when the question being posed requires an investigation of a real life intervention in detail, where the focus is on how and why the intervention succeeds or fails, where the general context will influence the outcome and where researchers asking the questions will have no control over events. As a result, the number of relevant variables will be far greater than can be controlled for, so that experimental approaches are simply not appropriate (p. 445). Furthermore, to allow categorization of data obtained through qualitative case study framework, a semi-structured interview technique was chosen. As Silverman (2009) noted, the major problem with qualitative studies is over-reliance on observations. While qualitative researchers attempt to address this concern by establishing quantifiable, standardized observation schedules, observations are less effective than interviewing because the perceptions of the observer are more influential when notes are based on personal interpretation or observation compared to record of opinions and ideas expressed by study participants (Daymon & Holloway, 2002). Thus, interviewing is more reliable than observation, at least in the context of the given study. Population Study participants will be stem cell researchers working in cancer research environment, educational research facility and/or transplant center. This population will be chosen for the proposed study for a number of reasons. As discussed in the introductory chapter, stem cell research raises a bioethical concern in the medical realms. This concern led to the cut off of funding for embryonic stem cell research (Marshall and Rossman, 2010). Uncertain therapeutic application of embryonic stem cell research findings is another limiting factor. Due to these political and social factors, researchers and clinicians are affected not only in the speed of the changes in research direction, but also with the changing attitudes of society and community. To investigate bioethical issues surrounding stem cell research in terms of their impact on the clinical environment, it appears reasonable to focus research on clinical field representatives. In addition to scientists working with embryonic stem cells, the study population will include physicians, registered nurses, nurse managers, and research assistants working in healthcare facilities. This group of participants is also affected by bioethical issues surrounding stem cell research. Their participation will enable in obtaining a critical insight into perceived barriers, myths, and cultural beliefs that prevent health professionals from further research in clinical research environment. These participants are engaged in stem cell research or closely-related fields on a daily basis and they possess sufficient knowledge on bioethical issues. Thus, the researcher will be able to obtain information from those people who are immersed into the field of embryonic stem cell research. The final group of study participants will include representatives of educational research facility, which is chosen to support practical experience of researchers and scientists with theoretical issues. While scientists conduct experiments, educators are exposed to the theoretical side of the debate. By teaching students and aspiring researchers on stem cell research essentials, educators transmit their views and beliefs to the audiences. Gaining their insight into the issue, will help in making conclusions about the future trends by looking at the beliefs spread of educators. The target sample size of this study is 10 - 15 participants. Therefore, sample would consist of 7-10 stem cell researchers and 3-5 educators from all three facilities. Sampling The study will be bound with the location of the representative sample, which is Seattle, Washington. This area is selected as the site for data collection because of the presence of an extensive cancer research center, major educational university, and a large transplant center. Basing on the literature review, therapeutic application of embryonic stem cell research findings is rather unclear due to many unanswered questions. Therefore, to gain as broad as possible insight into the phenomenon, it will be vital to obtain data from the following three locations: 1) research center in order to gather information from the scientists in terms of their opinions and ideas on embryonic stem cell research ethics, 2) educational university in order to explore the theoretical side of the question, and 3) transplant center in order to compare the shared ideas of other study participants with the thoughts provided by medical personnel who had a chance to use embryonic stem cell research in practice. As Yin (2011) emphasized, site selection should be purposeful. The proposed method will suit this requirement. The sampling technique will be purposeful and strictly aimed at recruiting health professionals working in stem cell research field. Age, gender, and other demographic characteristics will be included in the selection criteria since they are very important for the purpose of this research. Contact information about the employees at three centers discussed in previous paragraphs is publicly available. To recruit study participants, the researcher will send an email inviting them to participate in this study. In addition, the invitation will be followed with a personal phone call to confirm agreement to participate and set the date for the interview. It is expected that there will be about 3 to 5 interviews conducted at each facility; this will however depend on whether or not information will be saturated. Due to qualitative focus of this study and a small number of experts in the studied field, a sample study of 10-15 representatives will be sufficient to serve the objectives of the proposed study. This sample size will be sufficient because purposeful sampling in qualitative inquiry, unlike probability sampling in quantitative research, allows to select information-rich cases from which a researcher can learn about issues of central importance to the purpose of the research in an in-depth way (Patton, 1990). Procedure Participants who will be interested to take part in this study will be given an explanation of the nature of the project and the purpose of the study. Interviews will be scheduled at a convenient time and place. A follow-up letter to each subject will provide an explanation of the details of the interview format, the duration of the interview and confirmation of confidentiality and anonymity. Participants will be informed that the interview would be audio taped, and that the investigator might also take notes during the course of the interview. Participants will also be informed that they would complete a brief demographic questionnaire at the beginning of the interview session. Prior to starting the interview, rapport will be established by engaging in conversation with the participant about their home or their employment. The consent form will be read and discussed, and the participants will be encouraged to ask any pertinent questions prior to signing the consent indicating willingness to participate in the study. Demographic data will be collected prior to starting the interview. Protection of Human Subjects To ensure the protection of human participants, the Institutional Review Board Committee will assess and approve the application to study and explore bioethical factors and political/social controversy on stem cell research by interviewing health professionals working in stem cell research field prior to data collection. Participant confidentiality will be maintained through referring to each subject by number rather than name on the audiotapes and interview transcriptions, and all data materials will be secured in a locked filing cabinet. Furthermore, these materials will be kept for five years. Thereafter, all information will be shredded or deleted. Additionally, each participant will be given a consent form to sign prior to participation in the study describing the purpose of the study, potential risks and benefits, confidentiality, and the right to discontinue participation in the study at any time. In the event that participation in this study causes any emotional distress, the participants will be provided a referral list for therapeutic assistance. In case participants have any further questions or concerns about the study they will be allowed to contact the researcher through an email/or phone. Furthermore, each participant will be allowed to review the findings of this study upon its completion. Addressing Personal Bias In a qualitative case study, the researcher as interviewer is the primary instrument in the research process (Creswell, 1998). The interviewer becomes part of the participants' shared experience due to the subjective process of qualitative research. Therefore, it is critical that the interviewer's personal biases and experiences be set aside to ensure objectivity and accuracy of the research process. Once these biases and experiences are set aside, the researcher analyzes the data solely from the participants' responses. Therefore, prior to conducting the study, the researcher will seek a peer review of the study's format and content for feedback and recommendations. These candidates will review the interview questions and format. Furthermore, a pilot study will be conducted with two participants for further feedback on the study's content and format. The pilot study will be conducted in the same format as the final study to assess the study's verification and dependability (Creswell, 1998). All the suggestions and feedbacks from peer reviews and pilot study will be considered and revisions will be made accordingly. Data Collection The data will be obtained from stem cell researchers working in cancer research environment, educators from an educational research facility and/or transplant center. Data will be collected using a semi-structured, open-ended interview questionnaire. During the preliminary review of the literature, no tool or guide that met the needs of this study is identified. Therefore, the semi­ structured interview guide will be developed by the researcher. The questions will be open-ended to encourage participants to discuss their experiences. Using the semi-structured interview questionnaire will allow all participants to be asked the same questions. Additional individual probing questions will be asked to clarify information or to gain information that is more detailed relative to specific responses. The questions will not always be asked in the particular words of the questionnaire, or in a particular order. While the researcher will establish the general direction of the conversation, the researcher will purse the topics raised by the interviewee. Reflective listening, clarification, and prompting skills will be utilized as needed to facilitate the discussion. Participants will be able to freely discuss their ideas and experiences with minimal influence from the interviewer. The interviews will be recorded via audiotape and will approximately take 30 to 90 minutes. Data Analysis Once data will be collected, the audiotaped interviews will be listened to once to familiarize the researcher with the data. The interviews will be listened to a second time and the researcher will transcribe verbatim. Each transcript will be assigned a number corresponding with the order in which the interviews will be conducted. The interviews will be listened to a third time while cross- checking with the transcript to verify the accuracy of the transcription. Creswell (1998) outlines four steps in data analysis. First, all of the data is read in its entirety. Next, the researcher extracts critical statements from the descriptions. Third, these extracted statements are formulated into meanings, which are then clustered into themes. Lastly, these themes are developed into narrative descriptions. In this study, transcripts will be analyzed and coded through a process called content analysis for the purpose of developing interpretive themes. Hancock (2002) describes content analysis as a procedure for coding and classifying verbal data for the purpose of categorization and interpretation. Due to the uniformity of the participants' responses to the semi-structured interview questions, an exact replica of these steps will be difficult. Therefore, a modified data analysis that will maintain the essence of the Hancock (2002) analysis will be employed to develop the themes in this study. First, each transcript will be read. Next, each response will be listed per interview question. Third, horizontalization will occur when the responses will be read through again to find trends and ideas that can be categorized. Fourth, each category will be studied to determine if they are linked by some means. If so, the linked categories will become themes. Furthermore, the narrative essence of the participants' experience will be used to provide rich, thick descriptions of the identified themes by selecting quotations that exemplify the experiences of all of the participants (Creswell, 1998). During this process, it will become apparent that the participants' responses are collapsing around common areas related to the interview questions. As a result, this process will permit all of the data to be arranged into several uniform topic areas that will correspond with the interview questions. From this point on, one comprehensive document will be utilized in the data analysis eliminating step six in the Hancock (2002) guideline. Trustworthiness (Validity and Reliability) Qualitative research is subjective in nature therefore the quantitative terms of validity and reliability are not applicable. Instead the term trustworthiness is used to represent qualitative research authenticity. Trustworthiness is measured in credibility, transferability, dependability, and confirmability (Creswell, 1998). Credibility Credibility is the extent to which others can replicate the study (Creswell, 1998). To obtain credibility, the participants' experiences must be accurately described so that the depth and complexities of their descriptions reflect validity. This study will enhance creditability by the researcher by spending time with the participants during the interview. Additionally, credibility will be further established by triangulation which Creswell (1998) describes as the "use of multiple and different sources, methods, investigators, and theories to provide corroborating evidence" (p. 202). Triangulation will obtained by utilizing a peer review and pilot study to review the study's process and provide feedback for improvements prior to conducting the study. Additionally, the researcher will be continually engage dissertation committee throughout the research process to further enhance the creditability of the study. Transferability Transferability refers to the generalizability of the research findings to other populations and contexts. Thick description is necessary to ensure that the findings are transferable between the researcher and those being studied (Creswell, 1998). In this study, rich, thick descriptions will be obtained through the use of participant quotations allowing the study to reflect whether or not the results can be transferred to other contexts. Additionally, these rich, descriptive quotes will support the findings of emerging themes. Dependability Dependability accounts for results being subject to changes in the conditions and design of the study through the use of accurate documentation during the data collection process (Creswell, 1998). This study will enhance dependability through the process of listening to the audiotape interviews multiple times, verbatim transcription of the interviews, and reviewing the transcripts multiple times. Confirmability Confirmability is established through an auditing of the research process. The study's data can be tracked to their original sources and the findings are not biased. By employing participants who personally experienced the phenomenon authenticity will be obtained. This study will also utilize peer and dissertation committee review to ensure the accuracy and authenticity of the findings. Moreover, verbatim transcriptions of the interviews will enhance the study's confirmability. Summary This chapter presented the methodology used in this study. A brief introduction was provided, followed by a description of the study settings and the sample population. The methods of data collection were described in detail, including how the study population was recruited, and the information contained in the consent form. The manner in which the participants human rights were protected were described thoroughly. Finally, the method of data collection was outlined, followed by the method of data analyses and trustworthiness of the data. Reference Coffey, A, & Atkinson, P. 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