Ethnography

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Ethnography (ethnos = people and graphein = writing) is the genre of writing that presents varying degrees of qualitative and quantitative descriptions of human social phenomena, based on fieldwork. Ethnography presents the results of a holistic research method founded on the idea that a system's properties cannot necessarily be accurately understood independently of each other. The genre has both formal and historical connections to travel writing and colonial office reports. [1]

Brief History

[2]: Parcitipant observation has been considered the domain of anthropologists. It's orgins are traced to Malinowski's fieldwork among Trobriand Islanders in 1914. Radcliff-Brown later saw the idea of the function of an instritution "within a social structure". Durkeim asserted that "social facts are external to individuals and exert pressure on them. Anthropology was established "as a reconized field of study" in the 1840's in American and Europe as ethnology. The use of the questionnaire was utilized on a French naval expedition to Austrailia in 1800-1803 and later became a common tool of ethnologists in the 1800's. The Royal Anthropological Society's Notes and Quieries on Anthropology was one of the first major questionnaire stiudies, published in six editions from 1874 to 1951. In the US L. H. Morgan's "Circular" was issued through the Smithsonian in 1862. Henry R. Schoolcraft was one of the first Americans to publish ethnographic style information. The Smithsonian Institution was a big supporter of anthropological research stated in 1846. Later the Bureau of Ethnology in 1879 began to gather information on Indians. Frank Boas, a German researcher did much to further ethnography in the late 1800'.s He and his students dominated the field in the early 1900's in America.

Malinowski did much of the early definition of the science of participant observation in the early 1900's. He was first to "clearly articulate" the methodology of fieldwork. He advocated the use of charts and tables in analysis. He advocated using descriptsions of everyday action to understand societies. Radcliff-Brown furthered the tradition. Most early US work was with American Indians. Margaret Mead advocated the use of participant observation


Principal use

An ethnography is especially useful for gaining an understanding of the complexities of a particular, intact culture. It allows considerable flexibility in the choice of methods used to obtain information about the culture [3].

Advantages [4][5]:

  • Deeper, more nuanced understandings
  • More ecological validity
    • Represent what’s really going on in some everyday setting
    • What’s meaningful to people
      • (disconnect between e.g., survey questions... and how people think about things)
  • Respect for complexity of human activity
  • Design for human needs; reflect users’ own issues and everyday problems
  • Cheaper to do it right the first time
    • considering the cost of launching a new product
  • Can see things people wouldn’t think to report
  • Can ask questions at moment of interesting activity


Shortcomings [4][5]:

Can only study a limited number of people, who are willing to have you around

  • Seeing the world in a single grain of sand
    • comparative work needed
    • build from multiple cases
  • Ethnography in a mobile, distributed world
    • it’s easier when the natives sit still, but we have to modify our methods and perspectives...


Examples in Informatics:

Example case of use of ethnography for understanding Informational needs of life scientists:

Abstract of [6]:

Designing information resources that actually meet the information needs of individuals requires detailed knowledge of these needs. This poses a challenge for developers. Because the meaning of particular terms can vary by field, professional knowledge differs to some extent in different disciplines, and the questions that people ask assume a certain amount of unarticulated background knowledge, understanding the information needs of life scientists is not a trivial undertaking. One source of help in meeting this challenge is ethnography, a set of research methods and an associated conceptual stance developed and used by anthropologists for investigating uncontrolled real-world settings. Drawing on the author's experience in using ethnographic techniques to study clinicians' information needs, this paper describes why such research is necessary, why it requires particular research methods, what an ethnographic perspective has added to the study of information needs, and what this broader approach has revealed about the types of information sought by clinicians in the course of their daily practice.


Example case of use of ethnography for understanding Physicians, Patients in the context of EHRs

Abstract of [7]:

PURPOSE: Little is known about the effects of the electronic health record (EHR) on physician-patient encounters. The objectives of this study were to identify the factors that influence the manner by which physicians use the EHR with patients.

METHODS: This ethnographic study included 4 qualitative components: 80 hours of participant observation in 4 primary care offices in the Pacific Northwest; individual interviews with 52 patients, 12 office staff members, 23 physicians, and 1 nurse-practitioner; videotaped reviews of 29 clinical encounters; and 5 focus-group interviews with physicians and computer advocates. The main outcome measures were factors that influence how physicians use the EHR. Researchers qualitatively derived these factors through serial reviews of data.RESULTS: This study identified 14 factors that influence how EHRs are used and perceived in medical practice today. These factors were categorized into 4 thematic domains: (1) spatial--effect of the physical presence and location of EHRs on interactions between physicians and patients; (2) relational--perceptions of physicians and patients about the EHR and how those perceptions affected its use; (3) educational--issues of developing physicians' proficiency with and improving patients' understandings about EHR use; and (4) structural--institutional and technological forces that influence how physicians perceived their use of EHR.CONCLUSIONS: This study found that the introduction of EHRs into practice influences multiple cognitive and social dimensions of the clinical encounter. It brings into focus important questions that through further inquiry can determine how to make best use of the EHR to enhance therapeutic relationships.


Outline

Ethnography is a form of research focusing on the sociology of meaning through close field observation of socio-cultural phenomena. It starts with selection of a culture, review of the literature pertaining to the culture, and identification of variables of interest -- typically variables perceived as significant by members of the culture. The ethnographer then goes about gaining entrance, which in turn sets the stage for cultural immersion of the ethnographer in the culture. It is not unusual for ethnographers to live in the culture for months or even years. The middle stages of the ethnographic method involve gaining informants, using them to gain yet more informants in a chaining process, and gathering of data in the form of observational transcripts and interview recordings. Data analysis and theory development come at the end, though theories may emerge from cultural immersion and theory-articulation by members of the culture.

References

  1. http://en.wikipedia.org/wiki/Ethnography
  2. http://faculty.babson.edu/krollag/org_site/org_theory/Scott_articles/ellen_ethhis.html
  3. Leedy and Ormrod. “Practical Research: Planning and Design”, 8th edition, Chapter 7
  4. argus-acia.com/acia_event/slides/bonnie_nardi.ppt
  5. www2.sims.berkeley.edu/academics/courses/is204/f03/is204-03-part2/ethnography.ppt –
  6. Forsythe DE. Using ethnography to investigate life scientists' information needs. [Journal Article] Bulletin of the Medical Library Association. 86(3):402-9, 1998 Jul.
  7. Ventres W. Kooienga S. Vuckovic N. Marlin R. Nygren P. Stewart V. Physicians, patients, and the electronic health record: an ethnographic analysis. [Journal Article. Research Support, Non-U.S. Gov't] Annals of Family Medicine. 4(2):124-31, 2006 Mar-Apr.







Ethnography

Executive Summary of HIDA Evaluation of HIS by Ethnographic and Human Factors Engineering

In order to improve the implementation process of HIS, HIDA will be employing extensive ethnographic and workflow analysis prior to rollout of any HIS product by our clients. Recent literature(1) suggests that such an analysis may contribute greatly to improved success of such rollouts.

The ethnographic analysis is a qualitative research method focusing on close field observation of sociocultural phenomena.

History: In the past, ethnography has been used in cultural anthropology to look at the everyday behaviors of groups with a common culture, beginning with such social scientists as Malinowski or Mead in the early 1920’s.

In this case, we will be looking at the hospital settings where the HIS will be deployed. The analysis will involve direct(participant) observations of all physician, nursing , pharmacy, ancillary personnel, dietary, housekeeping and administrative personnel and anyone else involved in the day-to-day operations of each area of the hospital, on a shiftwide basis. In addition, key representatives of each group identified by the ethnographer will be interviewed for a more thorough understanding of current work interactions with others on the team, and how HIS could enhance that interaction.

A workflow analysis will be constructed based on the observations and interviews of the ethnographic analysis. The effort to enhance this workflow with HIS will be evaluated first by storyboard prior to HIS rollout, with an attempt to modify HIS to fit to personnel workflow.

Advantages: Long term observation of the various areas of the hospital areas in which the HIS is to be deployed should give HIDA distinct advantages in understanding the workflow of the personnel to be using the HIS, their interactions, and well as ways in which the user/tool dyad can be enhanced.

Shortcomings: The shortcomings of participant observation can involve some ethical dilemmas (relationships that can influence research findings, perceptions of the researcher that can influence findings,etc)(2)

Examples in Medical Informatics: Work of the POET group at OHSU: http://www.ohsu.edu/academic/dmice/research/cpoe/index.php

Bibliography:

1. Chan,W, “Increasing the success of physician order entry through human factors engineering,” J of Healthcare Information Management 2002, 16(1):71-9.

2. Fine, G. A. , “Ten lies of ethnography”, Journal of Contemporary Ethnography, 1993, 22, p. 267-294.

Sandy Mendel