Author: Lynne S. Nemeth

Analysis Processes

To develop a pilot process for the evaluation of my data, I analyzed nine of the interviews first (as these were the first interviews transcribed). This was very helpful as I had to present a poster for Student Research Day. I wanted to get a sense of how I was setting up the analyses, to make sure I was on track. I developed the goal of creating a conceptual framework as the product of my research; and this needed to be evaluated to see if indeed I was coming up with concepts that could be related to a process.

Using the existing codes, I reviewed the categories with the highest numbers of citations and reviewed this data to create some new concepts out of the codes. This provided the opportunity to work with preliminary ideas and then start transforming the raw data. One of my nursing faculty members had some time to spend with me, and reviewed the coding with me to ensure that the work was credible and that the codes I developed made sense. Together we refined some key concepts and themes, and I worked to map the concepts out so a flow diagram or process of change could be visualized.

Shared Leadership for Practice Change

Upon viewing this flow diagram, I felt ready to talk about this work as the pilot study of the analytic process that I would use for the dissertation. Visual representation of the concepts looked credible and I had direct quotes to confirm that the concepts were grounded in the data. I presented this early framework at Student Research Day very successfully, and I was awarded the first place prize for PhD posters in my category (plus a cash prize!) This gave me confidence with the direction I was proceeding in, and I felt ready to continue to code the remaining interviews. My poster prize afforded me with the funds to pay a transcriptionist for the work I needed completed. Next, I presented the poster (as a work in progress) at a primary care research meeting (North American Primary Care Research Group) and at a nursing research meeting (Southern Nursing Research Society) in the student section, to get some ideas from conference participants. I found the input extremely useful to the remaining process that needed to be undertaken.

I continued with the coding process and completed the rest of the interviews, then added other materials which were gathered in the process of the research evaluation of the parent study. This included site visit notes and impressions related to the practices that were visited. There was also quantitative data regarding the changes in practice that were occurring in relation to the use of the clinical guidelines that were being implemented related to primary and secondary prevention of cardiovascular disease and stroke. All of the data was considered within the multi-method analysis of the PPRNet-TRIP II project which was simultaneously underway and was informing my impressions about how these practices were achieving changes in practice.

To develop the final conceptual framework, I developed a plan to have a weekend immersion in the data with two of my dissertation committee members. This took some time to arrange, but as I was being guided in an important new process of analysis, I wanted to make sure it was the best and most credible qualitative analysis that could be done. One of my mentors came in from California and the other from New Jersey. We convened the analysis at my home, sitting on rocking chairs on the front porch to read some of the transcripts aloud to fully immerse and crystallize the meaning of these interviews. The process of immersion and crystallization was used to refine the theoretical concepts that were established in the early conceptual model. Immersion and crystallization is a process whereby the individual can open up new insights through induction of a self-reflective, interpretive cycle (Borkan, 1999). Through iterative processes of immersion and crystallization with the data, creative and intuitive ideas flowed enabling the construction of new meanings that extended earlier explanations. As these new concepts were considered, critical insights emerged. Immersion in the data provided a means to re-live the experience that generated the data, with a fresh perspective.

This analytic process provided the opportunity to reflect, revise and re-consider the original framework and help differentiate the concepts more fully. I redrafted the conceptual framework and the three of us were in agreement with the revised conceptual framework. Crystallization of the concepts in a group process provided a sense of intellectual honesty that helps to validate the findings. For each of the concepts, a series of quotes from the participants elucidated the meanings and perspectives related to each concept which are provided in the final manuscript.

The final conceptual framework is shown in the final manuscript -http://www.implementationscience.com/content/3/1/3/figure/F1.

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