Journal of Nursing Education

Educational Innovations 

Q-Methodology: An Alternative Design for Undergraduate Nursing Honors Research

Desiree Hensel, PhD, RN, CNE

Abstract

Background:

Undergraduate research is a high-impact educational practice that fosters deep learning. Study design is an important factor to consider when planning for student success.

Method:

Q-methodology uses statistical principles to study subjectivity and can be successfully used by undergraduate nursing students to build research skills and foster deep learning.

Results:

Authentic assessments evidencing attainment of the desired learning outcomes in student studies include well-written literature reviews, successful institutional review board submissions, completed projects, and dissemination of findings.

Conclusion:

Q-studies solve many design challenges faced by novice researchers leading to doable and meaningful undergraduate projects. [J Nurs Educ. 2016;55(11):659–662.]

Abstract

Background:

Undergraduate research is a high-impact educational practice that fosters deep learning. Study design is an important factor to consider when planning for student success.

Method:

Q-methodology uses statistical principles to study subjectivity and can be successfully used by undergraduate nursing students to build research skills and foster deep learning.

Results:

Authentic assessments evidencing attainment of the desired learning outcomes in student studies include well-written literature reviews, successful institutional review board submissions, completed projects, and dissemination of findings.

Conclusion:

Q-studies solve many design challenges faced by novice researchers leading to doable and meaningful undergraduate projects. [J Nurs Educ. 2016;55(11):659–662.]

Undergraduate research is a high-impact educational practice that promotes the type of deep learning that experts believe is necessary for career readiness in the 21st century (Kuh, 2008; National Research Council, 2012). Such deep learning is considered especially necessary to prepare nurses for practice in the current complex health care environment (Benner, Sutphen, Leonard, & Day, 2009). More than a required nursing research course, undergraduate research is defined as “an inquiry or investigation conducted by an undergraduate student that makes an original intellectual or creative contribution to the discipline” (Council for Undergraduate Research, 2012, p. 2). Studies that meet this definition for undergraduate research are most typically undertaken as enrichment opportunities in baccalaureate programs. When nursing students engage in undergraduate research, they begin to form a scholarly identity while acquiring writing, presentation, and critical thinking skills that enhance their professional development and careers (Antior & Pugh, 2015; Burkhart & Hall, 2015; Kain, Hepworth, Bogossian, & McTaggart, 2014; Vessey & DeMarco, 2008). One study found that participating in undergraduate research helped students to stand out from their peers and gain confidence that carried over into their first nursing position (Antior & Pugh, 2015).

Models for undergraduate nursing research include honors programs, paid or nonpaid research assistantships, research partnerships, summer intensives, or combinations of these approaches (Kain et al., 2014; Reitmaier Koehler, Reveling Smith, Davies, & Mangan-Danckwart, 2015; Vessey & DeMarco, 2008). Our campus uses an honors model for undergraduate research. The over-arching program goal is to socialize students to the scholarly role as they develop research skills. Students who meet a minimal grade point average self-select to participate. Congruency with research interests and faculty willingness to act as mentors guide the placement of students. After being accepted into the program, students complete two sequential 3-credit hour independent study courses. The first course, Honors Proposal, involves completing a literature review, creating a study protocol, and submitting a proposal to the institutional review board (IRB). The second course, Honors Research, includes conducting the research, analyzing the data, and preparing the findings for dissemination. Students who complete the program graduate with departmental honors. Success of the program is measured in terms of achievement of student learning outcomes and mentor satisfaction. Well-written literature reviews, successful IRB submissions, completed projects, and dissemination of findings all serve as authentic assessments of the attainment of research skills. Willingness to continue as a mentor is the major indicator of faculty satisfaction.

Students gain enthusiasm for research when they begin to see the impact of their work, but they can easily become frustrated by the time and energy it takes to conduct research while navigating through processes such as IRB submissions and data analysis (Warkentin, Popik, Usick, & Farley, 2014). Time and energy are also barriers for faculty mentors who must maintain their scholarly productivity while balancing high teaching loads and service commitments (Koehler et al., 2015). Faculty may be more inclined to support student studies that lead to presentations or publications (Burkhart & Hall, 2015; Vessey & DeMarco, 2008; Wheeler, Hardie, Schell, & Plowfield, 2008), but independent studies undertaken in honors courses are often too small of scale to make a significant contributions to the discipline (Koehler et al., 2015).

The challenge becomes one of finding meaningful projects that are also doable by undergraduates in terms of time and skill level. Study design is arguably one of the most important factors to consider when planning a successful undergraduate honors project. Experimental studies require higher levels of IRB approval and participant recruitment can be lengthy. Descriptive studies require reliable instruments and frequently need large sample sizes that students may have difficulty obtaining. Qualitative studies use small sample sizes, but data analysis can be complex and require extensive faculty time commitments. Q-methodology offers a flexible alternative to traditional research methods in undergraduate research projects.

About Q-Methodology

Q-methodology was created by William Stephenson (1935) as a way to objectively study subjectivity by using specific data collection techniques and an alternative approach to factor analysis. Q-methodology studies (i.e., Q-studies) use by-person factor analysis to find shared viewpoints and capture the lived experience (Brown, 1980; 1996; Watts & Stenner, 2012). Stephenson (1977) described factors derived from Q-methodology as being operant because they do not rely critically on test construction, although they are obtained through mathematical processes.

Q-studies begin by capturing the flow of communication about a given topic, referred to as the concourse (Simons, 2013; Watts & Stenner, 2012). Populating the concourse is conducted by gathering belief, attitude, or opinion statements about a topic and is considered the most involved aspect of a Q-study (Simons, 2013). The researcher next selects a subset of statements that represents the concourse, known as the Q-sample, refines them, and presents the sample to study participants (Paige & Morin, 2016). Study data are gathered through a process known as sorting, where participants rank-order their levels of agreement or disagreement with each statement. It is through the sorting process that participants tell their story (Simons, 2013). Results are recorded on a sorting sheet. The researcher is then able to apply statistical principles either through manual calculations or with the use of software to identify groups of individuals with like beliefs, referred to as factors (Brown, 1980; Watts & Stenner, 2012). Final steps in a Q-study involve interpreting the factors.

Using Q for Undergraduate Studies

Q-studies combine some of the best features of qualitative and quantitative methods (Brown, 1996). When not bound by known data collection tools, students have more flexibility to scientifically explore attitudes about topics that hold importance to them (Sylvester, 2013). Like qualitative studies, Q-methodology can be used to explore phenomena that are relatively new in the literature and supply rich data with fairly small sample sizes. Through the sorting process, participants assign meaning to statements and the lived experience is revealed (Brown, 1996; Simons, 2013). Like quantitative studies, data analysis can be completed with a statistical program (Watts & Stenner, 2012). In fact, one of the most popular programs, PQ Method is freely available from http://schmolck.userweb.mwn.de/qmethod/downpqwin.htm. This software gives pages of data, but most important is the factors scores, given both as Z-scores and Q-sort scores, because it helps the researcher understand to what extent each statement helps characterize the factor (Brown, 1996).

Q-methodology holds specific promise in nursing research because it can be used to identify the patient's viewpoint—a key factor in evidence-based practice (Simons, 2013). Q-studies allow for the study of diverse ideas and beliefs while offering enough structure to support novice researcher success. The Table delineates suggested faculty and student responsibilities for conducting a Q-study as an honors research project. Students have collected statements for ordering, recruited study participants, and completed initial data analysis through a standardized three-step process in a fairly independent manner. In the author's experience, faculty assistance has been most needed with helping students find a final solution and interpreting the implications of the findings.


Sample Undergraduate Student and Faculty Responsibilities in Q-Methodology Studies

Table:

Sample Undergraduate Student and Faculty Responsibilities in Q-Methodology Studies

From a learning perspective, conducting Q-studies helps students gain a wide variety of what the National Research Council (2012) considers to be transferable skills. Students develop the analytical skills necessary to perform quantitative studies, as well as the interpretive skills needed for qualitative research. Through the process of synthesizing the concourse, students gain skills in inquiry and a broader knowledge of human diversity. Completing the data analysis strengthens students' mathematical reasoning and quantitative literacy. Another advantage of using Q-methodology for undergraduate research is that even if students design less than ideal Q-samples, the active engagement of the participant in the sorting process can still yield useful results that help researchers understand the lived experience (Rogers, 1995). The same is not typically true of results obtained from poorly designed questionnaires. Despite the advantages, Q-methodology is not routinely taught in nursing research. Thus, the greatest barrier to using Q-methodology with undergraduates may be lack faculty familiarity with the method.

Program Outcomes

To date, the author has sponsored six honors students on five different Q-study projects. Four are completed and one is in progress. Students have won awards, presented their projects in national forums, and published their work in peer-reviewed journals. Enhanced faculty–student relations and gains in the author's scholarly productivity have increased the author's personal academic role satisfaction. Below are examples of two Q-studies completed by undergraduate students.

Study 1: Exploring Student Attitudes

After reviewing the evaluations of a large-scale poverty simulation, the instructors determined that they needed a better understanding of the students' beliefs surrounding individuals living in poverty. An honors student helped with this exploration by creating a Q-sample of 30 statements about poverty from the de-identified poverty simulation evaluations, a focus group, and student blogs (Work, Hensel, & Decker, 2015). The student recruited 23 participants in the second, third, and final year of study from the two campuses of the baccalaureate nursing program. Three viewpoints were identified: (a) tending to believe that poverty was linked to individual behavior, (b) seeing societal reasons for poverty with a strong need to help the poor, and (c) a more neutral perspective that did not blame the individual for his or her circumstances but were also not as compelled to champion the person's cause. The information gained in that study helped faculty understand that a variety of teaching approaches was needed to address the different student perspectives. This information was ultimately used to design a tiered approach to poverty education.

Study 2: Understanding Health Care Team Members Perceptions

Two honor students with career aspirations to become certified registered nurse anesthetists (CRNAs) were familiar with barriers to autonomous practice arising from legal issues and safety concerns but identified a gap in the literature on coworker attitudes toward CRNA practice (Cooper, Craney, & Hensel, 2015). The students worked together to obtain statements for sorting from blogs and focus groups. Twenty-four Q-sorts were completed by technicians, RNs, and physicians from four different surgical practice sites. Three distinct viewpoints emerged: favoring unrestricted practice, favoring supervision, and favoring anesthesiologist practice. This study highlighted the problem that nurses do not always support other nurses in expanded roles and provided direction for future studies on understanding preferences for restricted practice in surgical team members other than physicians.

Conclusion

Undergraduate honors research helps create entry-level nurses with a unique skill set that distinguishes them from their peers, but logistics may limit student and faculty participation. Q-studies solve many design challenges faced by novice researchers leading to doable and meaningful projects that also promote deep learning. Student success with conducting Q-studies has led to improved satisfaction with the mentoring process for undergraduate nursing honors research.

References

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Sample Undergraduate Student and Faculty Responsibilities in Q-Methodology Studies

Student ResponsibilitiesFaculty Mentor Responsibilities
Identify potential projectRefine project
Complete literature review and proposalSuggest resources and provide feedback
Populate concourse and create Q-sampleHelp edit and finalize Q-sample
Seek expert reviewComplete trial sort
Create study materialsApprove final study materials
Complete human subjects training and draft IRB proposalSubmit IRB proposal
Recruit study participants and collect dataStore any identifiable data
Review software tutorialsDemonstrate software
Do data entry and complete initial analysisHelp with finding final solution
Interpret factorsHelp with interpreting factor implications
Conduct follow-up interviews as neededSuggest dissemination venues
Write manuscript first draftContribute to manuscript
Submit final manuscriptApprove final draft and help with submission
Do first round of manuscript revisionsHelp with revisions
Authors

Dr. Hensel is Associate Professor, Indiana University School of Nursing, Bloomington, Indiana.

The author has disclosed no potential conflicts of interest, financial or otherwise.

Address correspondence to Desiree Hensel, PhD, RN, CNE, Associate Professor, Indiana University School of Nursing, 1033 East 3rd Street, NU400, Bloomington, IN 47405; e-mail: dehensel@iu.edu.

Received: May 02, 2016
Accepted: July 13, 2016

10.3928/01484834-20161011-10

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