Abstract
Abstract
Introduction
As realist methodology is still evolving, there is a paucity of guidance on how to conduct theory driven interviews. Novice realist researchers can therefore struggle to collect interview data that can make a meaningful contribution to refining their initial programme theory (IPT). In addition, researchers often face challenges when trying to conduct interviews with healthcare staff due to their busy work schedules.
In this case study of team interventions in acute hospital contexts, we explore the benefits of using the Critical Incident Technique (CIT) in order to build and refine an IPT.
Methods
The five steps of the CIT were mapped against realist methods guidance and adapted into an interview framework. Specifications to identify an incident as “critical” were agreed. We embedded probes in the interview framework to confirm, refine and/or refute previous theories synthesised from the literature and to extrapolate new theories.
Seventeen key informants were interviewed and recordings were transcribed and imported for analysis into NViVo software. Using RAMESES guidelines, Context-Mechanism-Outcomes configurations were extrapolated from a total of 31 incidents.
Results
We found that the CIT facilitated construction of an interview format that allowed KIs to reflect on specific positive or negative team interventions. We demonstrate how the CIT strengthened initial programme theory development as it facilitated the reporting of the specifics of team interventions and the contexts and mechanisms characteristic of those experiences. As new data emerged, it was possible to evolve previous theories synthesised from the literature as well as to explore new theories.
Conclusions
Utilising a CIT framework paid significant dividends in terms of the relevance and usefulness of the data for refining the IPT. Adapting the CIT questioning technique helped to focus the KIs on the specifics relating to an incident allowing the interviewers to concentrate on probes to explore theories during the interview process. The CIT interview format therefore achieved its purpose and the interview framework developed can be adapted for other research topics for use within realist methodology
Key words: Critical Incident Interview, Realist, Programme Theory, Team, Intervention, Hospital, Methods
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