This chapter describes the study on which this book is based. The purpose of this chapter is not to detail and critique the research approach used. Instead, I have selectively explored elements of the study to enable the rigour of the work to be judged. Therefore, I will outline the research method and sampling approach, and then describe the data collection methods that I used in the field.
A second, and important function of this chapter is to give the reader insight into the challenges that I experienced when researching in the social world of clinical practice. Through this, I hope that both social scientists and health care practitioners can share and understand some of my experiences. To this end, I do not engage in academic debate about the data analysis model adopted. Instead, I spend a substantial amount of time exploring the complexity of data collection in the field, and on the nature of fieldwork ethics in a clinical setting.
From the outset of the study, it was clear to me that to appreciate clinical decision making, I had to understand how nurses and doctors work in a clinical area. To achieve this, I chose an ethnographic research approach as defined by Atkinson and Hammersley. In this, ethnography is:
a strong emphasis on exploring the particular phenomena, rather than setting out to test hypotheses about them; a tendency to work primarily with 'unstructured data', that is, data that have not been coded at the point of data collection in terms of a closed set of analytic categor ies; investigation of a small number of cases …; analysis of data that involves explicit interpretation of the meanings and functions of human actions, the product of which mainly takes the form of verbal descriptions, with quantification and statistical analysis playing a subordinate role at most.
(Atkinson and Hammersley 1994, p. 248)
In ethnography, in order to explore the phenomena and the alternate realities that exist, thick description of the culture occurs through data that are collected in the field and described in depth, and over time (Geertz 1973). In order to achieve this, I used three specific data sources of cultural information: cultural