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Critical Analysis – Types, Examples and Writing Guide

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Critical Analysis

Definition:

Critical analysis is a process of examining a piece of work or an idea in a systematic, objective, and analytical way. It involves breaking down complex ideas, concepts, or arguments into smaller, more manageable parts to understand them better.

Types of Critical Analysis

Types of Critical Analysis are as follows:

Literary Analysis

This type of analysis focuses on analyzing and interpreting works of literature , such as novels, poetry, plays, etc. The analysis involves examining the literary devices used in the work, such as symbolism, imagery, and metaphor, and how they contribute to the overall meaning of the work.

Film Analysis

This type of analysis involves examining and interpreting films, including their themes, cinematography, editing, and sound. Film analysis can also include evaluating the director’s style and how it contributes to the overall message of the film.

Art Analysis

This type of analysis involves examining and interpreting works of art , such as paintings, sculptures, and installations. The analysis involves examining the elements of the artwork, such as color, composition, and technique, and how they contribute to the overall meaning of the work.

Cultural Analysis

This type of analysis involves examining and interpreting cultural artifacts , such as advertisements, popular music, and social media posts. The analysis involves examining the cultural context of the artifact and how it reflects and shapes cultural values, beliefs, and norms.

Historical Analysis

This type of analysis involves examining and interpreting historical documents , such as diaries, letters, and government records. The analysis involves examining the historical context of the document and how it reflects the social, political, and cultural attitudes of the time.

Philosophical Analysis

This type of analysis involves examining and interpreting philosophical texts and ideas, such as the works of philosophers and their arguments. The analysis involves evaluating the logical consistency of the arguments and assessing the validity and soundness of the conclusions.

Scientific Analysis

This type of analysis involves examining and interpreting scientific research studies and their findings. The analysis involves evaluating the methods used in the study, the data collected, and the conclusions drawn, and assessing their reliability and validity.

Critical Discourse Analysis

This type of analysis involves examining and interpreting language use in social and political contexts. The analysis involves evaluating the power dynamics and social relationships conveyed through language use and how they shape discourse and social reality.

Comparative Analysis

This type of analysis involves examining and interpreting multiple texts or works of art and comparing them to each other. The analysis involves evaluating the similarities and differences between the texts and how they contribute to understanding the themes and meanings conveyed.

Critical Analysis Format

Critical Analysis Format is as follows:

I. Introduction

• Provide a brief overview of the text, object, or event being analyzed
• Explain the purpose of the analysis and its significance
• Provide background information on the context and relevant historical or cultural factors

II. Description

• Provide a detailed description of the text, object, or event being analyzed
• Identify key themes, ideas, and arguments presented
• Describe the author or creator’s style, tone, and use of language or visual elements

III. Analysis

• Analyze the text, object, or event using critical thinking skills
• Identify the main strengths and weaknesses of the argument or presentation
• Evaluate the reliability and validity of the evidence presented
• Assess any assumptions or biases that may be present in the text, object, or event
• Consider the implications of the argument or presentation for different audiences and contexts

IV. Evaluation

• Provide an overall evaluation of the text, object, or event based on the analysis
• Assess the effectiveness of the argument or presentation in achieving its intended purpose
• Identify any limitations or gaps in the argument or presentation
• Consider any alternative viewpoints or interpretations that could be presented
• Summarize the main points of the analysis and evaluation
• Reiterate the significance of the text, object, or event and its relevance to broader issues or debates
• Provide any recommendations for further research or future developments in the field.

VI. Example

• Provide an example or two to support your analysis and evaluation
• Use quotes or specific details from the text, object, or event to support your claims
• Analyze the example(s) using critical thinking skills and explain how they relate to your overall argument

VII. Conclusion

• Reiterate your thesis statement and summarize your main points
• Provide a final evaluation of the text, object, or event based on your analysis
• Offer recommendations for future research or further developments in the field
• End with a thought-provoking statement or question that encourages the reader to think more deeply about the topic

How to Write Critical Analysis

Writing a critical analysis involves evaluating and interpreting a text, such as a book, article, or film, and expressing your opinion about its quality and significance. Here are some steps you can follow to write a critical analysis:

• Read and re-read the text: Before you begin writing, make sure you have a good understanding of the text. Read it several times and take notes on the key points, themes, and arguments.
• Identify the author’s purpose and audience: Consider why the author wrote the text and who the intended audience is. This can help you evaluate whether the author achieved their goals and whether the text is effective in reaching its audience.
• Analyze the structure and style: Look at the organization of the text and the author’s writing style. Consider how these elements contribute to the overall meaning of the text.
• Evaluate the content : Analyze the author’s arguments, evidence, and conclusions. Consider whether they are logical, convincing, and supported by the evidence presented in the text.
• Consider the context: Think about the historical, cultural, and social context in which the text was written. This can help you understand the author’s perspective and the significance of the text.
• Develop your thesis statement : Based on your analysis, develop a clear and concise thesis statement that summarizes your overall evaluation of the text.
• Support your thesis: Use evidence from the text to support your thesis statement. This can include direct quotes, paraphrases, and examples from the text.
• Write the introduction, body, and conclusion : Organize your analysis into an introduction that provides context and presents your thesis, a body that presents your evidence and analysis, and a conclusion that summarizes your main points and restates your thesis.
• Revise and edit: After you have written your analysis, revise and edit it to ensure that your writing is clear, concise, and well-organized. Check for spelling and grammar errors, and make sure that your analysis is logically sound and supported by evidence.

When to Write Critical Analysis

You may want to write a critical analysis in the following situations:

• Academic Assignments: If you are a student, you may be assigned to write a critical analysis as a part of your coursework. This could include analyzing a piece of literature, a historical event, or a scientific paper.
• Journalism and Media: As a journalist or media person, you may need to write a critical analysis of current events, political speeches, or media coverage.
• Personal Interest: If you are interested in a particular topic, you may want to write a critical analysis to gain a deeper understanding of it. For example, you may want to analyze the themes and motifs in a novel or film that you enjoyed.
• Professional Development : Professionals such as writers, scholars, and researchers often write critical analyses to gain insights into their field of study or work.

Critical Analysis Example

An Example of Critical Analysis Could be as follow:

Research Topic:

The Impact of Online Learning on Student Performance

Introduction:

The introduction of the research topic is clear and provides an overview of the issue. However, it could benefit from providing more background information on the prevalence of online learning and its potential impact on student performance.

Literature Review:

The literature review is comprehensive and well-structured. It covers a broad range of studies that have examined the relationship between online learning and student performance. However, it could benefit from including more recent studies and providing a more critical analysis of the existing literature.

Research Methods:

The research methods are clearly described and appropriate for the research question. The study uses a quasi-experimental design to compare the performance of students who took an online course with those who took the same course in a traditional classroom setting. However, the study may benefit from using a randomized controlled trial design to reduce potential confounding factors.

The results are presented in a clear and concise manner. The study finds that students who took the online course performed similarly to those who took the traditional course. However, the study only measures performance on one course and may not be generalizable to other courses or contexts.

Discussion :

The discussion section provides a thorough analysis of the study’s findings. The authors acknowledge the limitations of the study and provide suggestions for future research. However, they could benefit from discussing potential mechanisms underlying the relationship between online learning and student performance.

Conclusion :

The conclusion summarizes the main findings of the study and provides some implications for future research and practice. However, it could benefit from providing more specific recommendations for implementing online learning programs in educational settings.

Purpose of Critical Analysis

There are several purposes of critical analysis, including:

• To identify and evaluate arguments : Critical analysis helps to identify the main arguments in a piece of writing or speech and evaluate their strengths and weaknesses. This enables the reader to form their own opinion and make informed decisions.
• To assess evidence : Critical analysis involves examining the evidence presented in a text or speech and evaluating its quality and relevance to the argument. This helps to determine the credibility of the claims being made.
• To recognize biases and assumptions : Critical analysis helps to identify any biases or assumptions that may be present in the argument, and evaluate how these affect the credibility of the argument.
• To develop critical thinking skills: Critical analysis helps to develop the ability to think critically, evaluate information objectively, and make reasoned judgments based on evidence.
• To improve communication skills: Critical analysis involves carefully reading and listening to information, evaluating it, and expressing one’s own opinion in a clear and concise manner. This helps to improve communication skills and the ability to express ideas effectively.

Importance of Critical Analysis

Here are some specific reasons why critical analysis is important:

• Helps to identify biases: Critical analysis helps individuals to recognize their own biases and assumptions, as well as the biases of others. By being aware of biases, individuals can better evaluate the credibility and reliability of information.
• Enhances problem-solving skills : Critical analysis encourages individuals to question assumptions and consider multiple perspectives, which can lead to creative problem-solving and innovation.
• Promotes better decision-making: By carefully evaluating evidence and arguments, critical analysis can help individuals make more informed and effective decisions.
• Facilitates understanding: Critical analysis helps individuals to understand complex issues and ideas by breaking them down into smaller parts and evaluating them separately.
• Fosters intellectual growth : Engaging in critical analysis challenges individuals to think deeply and critically, which can lead to intellectual growth and development.

Advantages of Critical Analysis

Some advantages of critical analysis include:

• Improved decision-making: Critical analysis helps individuals make informed decisions by evaluating all available information and considering various perspectives.
• Enhanced problem-solving skills : Critical analysis requires individuals to identify and analyze the root cause of a problem, which can help develop effective solutions.
• Increased creativity : Critical analysis encourages individuals to think outside the box and consider alternative solutions to problems, which can lead to more creative and innovative ideas.
• Improved communication : Critical analysis helps individuals communicate their ideas and opinions more effectively by providing logical and coherent arguments.
• Reduced bias: Critical analysis requires individuals to evaluate information objectively, which can help reduce personal biases and subjective opinions.
• Better understanding of complex issues : Critical analysis helps individuals to understand complex issues by breaking them down into smaller parts, examining each part and understanding how they fit together.
• Greater self-awareness: Critical analysis helps individuals to recognize their own biases, assumptions, and limitations, which can lead to personal growth and development.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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Writing a Critical Analysis

What is in this guide, definitions, putting it together, tips and examples of critques.

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This guide is meant to help you understand the basics of writing a critical analysis. A critical analysis is an argument about a particular piece of media. There are typically two parts: (1) identify and explain the argument the author is making, and (2), provide your own argument about that argument. Your instructor may have very specific requirements on how you are to write your critical analysis, so make sure you read your assignment carefully.

Critical Analysis

A deep approach to your understanding of a piece of media by relating new knowledge to what you already know.

Part 1: Introduction

• Identify the work being criticized.
• Present thesis - argument about the work.
• Preview your argument - what are the steps you will take to prove your argument.

Part 2: Summarize

• Provide a short summary of the work.
• Present only what is needed to know to understand your argument.

Part 3: Your Argument

• This is the bulk of your paper.
• Provide "sub-arguments" to prove your main argument.
• Use scholarly articles to back up your argument(s).

Part 4: Conclusion

• Reflect on  how  you have proven your argument.
• Point out the  importance  of your argument.
• Comment on the potential for further research or analysis.
• Cornell University Library Tips for writing a critical appraisal and analysis of a scholarly article.
• Queen's University Library How to Critique an Article (Psychology)
• University of Illinois, Springfield An example of a summary and an evaluation of a research article. This extended example shows the different ways a student can critique and write about an article
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Tools for Critical Appraisal of Studies

“The purpose of critical appraisal is to determine the scientific merit of a research report and its applicability to clinical decision making.” 1 Conducting a critical appraisal of a study is imperative to any well executed evidence review, but the process can be time consuming and difficult. 2 The critical appraisal process requires “a methodological approach coupled with the right tools and skills to match these methods is essential for finding meaningful results.” 3 In short, it is a method of differentiating good research from bad research.

Critical Appraisal by Study Design (featured tools)

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• Diagnostic Accuracy
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• Tool Repository
• AMSTAR 2 The original AMSTAR was developed to assess the risk of bias in systematic reviews that included only randomized controlled trials. AMSTAR 2 was published in 2017 and allows researchers to “identify high quality systematic reviews, including those based on non-randomised studies of healthcare interventions.” 4 more... less... AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews)
• ROBIS ROBIS is a tool designed specifically to assess the risk of bias in systematic reviews. “The tool is completed in three phases: (1) assess relevance(optional), (2) identify concerns with the review process, and (3) judge risk of bias in the review. Signaling questions are included to help assess specific concerns about potential biases with the review.” 5 more... less... ROBIS (Risk of Bias in Systematic Reviews)
• BMJ Framework for Assessing Systematic Reviews This framework provides a checklist that is used to evaluate the quality of a systematic review.
• CASP Checklist for Systematic Reviews This CASP checklist is not a scoring system, but rather a method of appraising systematic reviews by considering: 1. Are the results of the study valid? 2. What are the results? 3. Will the results help locally? more... less... CASP (Critical Appraisal Skills Programme)
• CEBM Systematic Reviews Critical Appraisal Sheet The CEBM’s critical appraisal sheets are designed to help you appraise the reliability, importance, and applicability of clinical evidence. more... less... CEBM (Centre for Evidence-Based Medicine)
• JBI Critical Appraisal Tools, Checklist for Systematic Reviews JBI Critical Appraisal Tools help you assess the methodological quality of a study and to determine the extent to which study has addressed the possibility of bias in its design, conduct and analysis.
• NHLBI Study Quality Assessment of Systematic Reviews and Meta-Analyses The NHLBI’s quality assessment tools were designed to assist reviewers in focusing on concepts that are key for critical appraisal of the internal validity of a study. more... less... NHLBI (National Heart, Lung, and Blood Institute)
• RoB 2 RoB 2 “provides a framework for assessing the risk of bias in a single estimate of an intervention effect reported from a randomized trial,” rather than the entire trial. 6 more... less... RoB 2 (revised tool to assess Risk of Bias in randomized trials)
• CASP Randomised Controlled Trials Checklist This CASP checklist considers various aspects of an RCT that require critical appraisal: 1. Is the basic study design valid for a randomized controlled trial? 2. Was the study methodologically sound? 3. What are the results? 4. Will the results help locally? more... less... CASP (Critical Appraisal Skills Programme)
• CONSORT Statement The CONSORT checklist includes 25 items to determine the quality of randomized controlled trials. “Critical appraisal of the quality of clinical trials is possible only if the design, conduct, and analysis of RCTs are thoroughly and accurately described in the report.” 7 more... less... CONSORT (Consolidated Standards of Reporting Trials)
• NHLBI Study Quality Assessment of Controlled Intervention Studies The NHLBI’s quality assessment tools were designed to assist reviewers in focusing on concepts that are key for critical appraisal of the internal validity of a study. more... less... NHLBI (National Heart, Lung, and Blood Institute)
• JBI Critical Appraisal Tools Checklist for Randomized Controlled Trials JBI Critical Appraisal Tools help you assess the methodological quality of a study and to determine the extent to which study has addressed the possibility of bias in its design, conduct and analysis.
• ROBINS-I ROBINS-I is a “tool for evaluating risk of bias in estimates of the comparative effectiveness… of interventions from studies that did not use randomization to allocate units… to comparison groups.” 8 more... less... ROBINS-I (Risk Of Bias in Non-randomized Studies – of Interventions)
• NOS This tool is used primarily to evaluate and appraise case-control or cohort studies. more... less... NOS (Newcastle-Ottawa Scale)
• AXIS Cross-sectional studies are frequently used as an evidence base for diagnostic testing, risk factors for disease, and prevalence studies. “The AXIS tool focuses mainly on the presented [study] methods and results.” 9 more... less... AXIS (Appraisal tool for Cross-Sectional Studies)
• NHLBI Study Quality Assessment Tools for Non-Randomized Studies The NHLBI’s quality assessment tools were designed to assist reviewers in focusing on concepts that are key for critical appraisal of the internal validity of a study. • Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies • Quality Assessment of Case-Control Studies • Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group • Quality Assessment Tool for Case Series Studies more... less... NHLBI (National Heart, Lung, and Blood Institute)
• Case Series Studies Quality Appraisal Checklist Developed by the Institute of Health Economics (Canada), the checklist is comprised of 20 questions to assess “the robustness of the evidence of uncontrolled, [case series] studies.” 10
• Methodological Quality and Synthesis of Case Series and Case Reports In this paper, Dr. Murad and colleagues “present a framework for appraisal, synthesis and application of evidence derived from case reports and case series.” 11
• MINORS The MINORS instrument contains 12 items and was developed for evaluating the quality of observational or non-randomized studies. 12 This tool may be of particular interest to researchers who would like to critically appraise surgical studies. more... less... MINORS (Methodological Index for Non-Randomized Studies)
• JBI Critical Appraisal Tools for Non-Randomized Trials JBI Critical Appraisal Tools help you assess the methodological quality of a study and to determine the extent to which study has addressed the possibility of bias in its design, conduct and analysis. • Checklist for Analytical Cross Sectional Studies • Checklist for Case Control Studies • Checklist for Case Reports • Checklist for Case Series • Checklist for Cohort Studies
• QUADAS-2 The QUADAS-2 tool “is designed to assess the quality of primary diagnostic accuracy studies… [it] consists of 4 key domains that discuss patient selection, index test, reference standard, and flow of patients through the study and timing of the index tests and reference standard.” 13 more... less... QUADAS-2 (a revised tool for the Quality Assessment of Diagnostic Accuracy Studies)
• JBI Critical Appraisal Tools Checklist for Diagnostic Test Accuracy Studies JBI Critical Appraisal Tools help you assess the methodological quality of a study and to determine the extent to which study has addressed the possibility of bias in its design, conduct and analysis.
• STARD 2015 The authors of the standards note that “[e]ssential elements of [diagnostic accuracy] study methods are often poorly described and sometimes completely omitted, making both critical appraisal and replication difficult, if not impossible.”10 The Standards for the Reporting of Diagnostic Accuracy Studies was developed “to help… improve completeness and transparency in reporting of diagnostic accuracy studies.” 14 more... less... STARD 2015 (Standards for the Reporting of Diagnostic Accuracy Studies)
• CASP Diagnostic Study Checklist This CASP checklist considers various aspects of diagnostic test studies including: 1. Are the results of the study valid? 2. What were the results? 3. Will the results help locally? more... less... CASP (Critical Appraisal Skills Programme)
• CEBM Diagnostic Critical Appraisal Sheet The CEBM’s critical appraisal sheets are designed to help you appraise the reliability, importance, and applicability of clinical evidence. more... less... CEBM (Centre for Evidence-Based Medicine)
• SYRCLE’s RoB “[I]mplementation of [SYRCLE’s RoB tool] will facilitate and improve critical appraisal of evidence from animal studies. This may… enhance the efficiency of translating animal research into clinical practice and increase awareness of the necessity of improving the methodological quality of animal studies.” 15 more... less... SYRCLE’s RoB (SYstematic Review Center for Laboratory animal Experimentation’s Risk of Bias)
• ARRIVE 2.0 “The [ARRIVE 2.0] guidelines are a checklist of information to include in a manuscript to ensure that publications [on in vivo animal studies] contain enough information to add to the knowledge base.” 16 more... less... ARRIVE 2.0 (Animal Research: Reporting of In Vivo Experiments)
• Critical Appraisal of Studies Using Laboratory Animal Models This article provides “an approach to critically appraising papers based on the results of laboratory animal experiments,” and discusses various “bias domains” in the literature that critical appraisal can identify. 17
• CEBM Critical Appraisal of Qualitative Studies Sheet The CEBM’s critical appraisal sheets are designed to help you appraise the reliability, importance and applicability of clinical evidence. more... less... CEBM (Centre for Evidence-Based Medicine)
• CASP Qualitative Studies Checklist This CASP checklist considers various aspects of qualitative research studies including: 1. Are the results of the study valid? 2. What were the results? 3. Will the results help locally? more... less... CASP (Critical Appraisal Skills Programme)
• Quality Assessment and Risk of Bias Tool Repository Created by librarians at Duke University, this extensive listing contains over 100 commonly used risk of bias tools that may be sorted by study type.
• Latitudes Network A library of risk of bias tools for use in evidence syntheses that provides selection help and training videos.

References & Recommended Reading

1.     Kolaski, K., Logan, L. R., & Ioannidis, J. P. (2024). Guidance to best tools and practices for systematic reviews .  British Journal of Pharmacology ,  181 (1), 180-210

2.    Portney LG.  Foundations of clinical research : applications to evidence-based practice.  Fourth edition. ed. Philadelphia: F A Davis; 2020.

3.     Fowkes FG, Fulton PM.  Critical appraisal of published research: introductory guidelines.   BMJ (Clinical research ed).  1991;302(6785):1136-1140.

4.     Singh S.  Critical appraisal skills programme.   Journal of Pharmacology and Pharmacotherapeutics.  2013;4(1):76-77.

5.     Shea BJ, Reeves BC, Wells G, et al.  AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both.   BMJ (Clinical research ed).  2017;358:j4008.

6.     Whiting P, Savovic J, Higgins JPT, et al.  ROBIS: A new tool to assess risk of bias in systematic reviews was developed.   Journal of clinical epidemiology.  2016;69:225-234.

7.     Sterne JAC, Savovic J, Page MJ, et al.  RoB 2: a revised tool for assessing risk of bias in randomised trials.  BMJ (Clinical research ed).  2019;366:l4898.

8.     Moher D, Hopewell S, Schulz KF, et al.  CONSORT 2010 Explanation and Elaboration: Updated guidelines for reporting parallel group randomised trials.  Journal of clinical epidemiology.  2010;63(8):e1-37.

9.     Sterne JA, Hernan MA, Reeves BC, et al.  ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions.  BMJ (Clinical research ed).  2016;355:i4919.

10.     Downes MJ, Brennan ML, Williams HC, Dean RS.  Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS).   BMJ open.  2016;6(12):e011458.

11.   Guo B, Moga C, Harstall C, Schopflocher D.  A principal component analysis is conducted for a case series quality appraisal checklist.   Journal of clinical epidemiology.  2016;69:199-207.e192.

12.   Murad MH, Sultan S, Haffar S, Bazerbachi F.  Methodological quality and synthesis of case series and case reports.  BMJ evidence-based medicine.  2018;23(2):60-63.

13.   Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J.  Methodological index for non-randomized studies (MINORS): development and validation of a new instrument.   ANZ journal of surgery.  2003;73(9):712-716.

14.   Whiting PF, Rutjes AWS, Westwood ME, et al.  QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies.   Annals of internal medicine.  2011;155(8):529-536.

15.   Bossuyt PM, Reitsma JB, Bruns DE, et al.  STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies.   BMJ (Clinical research ed).  2015;351:h5527.

16.   Hooijmans CR, Rovers MM, de Vries RBM, Leenaars M, Ritskes-Hoitinga M, Langendam MW.  SYRCLE's risk of bias tool for animal studies.   BMC medical research methodology.  2014;14:43.

17.   Percie du Sert N, Ahluwalia A, Alam S, et al.  Reporting animal research: Explanation and elaboration for the ARRIVE guidelines 2.0.  PLoS biology.  2020;18(7):e3000411.

18.   O'Connor AM, Sargeant JM.  Critical appraisal of studies using laboratory animal models.   ILAR journal.  2014;55(3):405-417.

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An Introduction to Critical Approaches

• First Online: 29 September 2022

Cite this chapter

• Robert E. White   ORCID: orcid.org/0000-0002-8045-164X 3 &
• Karyn Cooper 4  

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As can be understood from the previous chapter, in qualitative research, words are used as data rather than numerical representations (Miles & Huberman, 1994). All qualitative methods rely on linguistic information rather than on statistical evidence. As such, they tend to employ meaning-based (as opposed to numerical-based) data analysis (Polkinghorne, 1983). Thus, qualitative research utilizes data in the form of text, which, in turn, serves to furnish a detailed analysis of a situation, a case, a subject or an event through original analysis (Creswell, 2013). In qualitative research, data is usually collected and analyzed on fewer participants and situations (Patton, 2014) than is commonly found in quantitative research practices. The previous chapter introduced a short history of qualitative research as it relates to quantitative research endeavours. The current chapter devotes itself to a discussion of a number of approaches to qualitative research, specifically the critical approach.

The reliance on personal experience is the main building block, the main distinction of qualitative research. Not so much feelings, not so much how do we feel about things, but what is the experience as felt, as told, as manifest in the things that we do. Robert Stake, University of Illinois, Urbana-Champaign.

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Blumer, H. (1969). Symbolic interactionism: Perspective and method . University of California Press.

Google Scholar  

Butler, T. (1998). Towards a hermeneutic method for interpretive research in information systems. Journal of Information Technology, 13 (4), 285–300.

Article   Google Scholar  

Collins, H. (2010). Creative research: The theory and practice of research for the creative industries . AVA Publications.

Comte, A. (1908). A general view of positivism (Trans. J. A. Bridges). Routledge.

Cooper, K., & White, R. E. (2012). Qualitative research in the post-modern era: Contexts of qualitative research . Springer.

Book   Google Scholar  

Creswell, J. W. (2013). Research design: Qualitative, quantitative, and mixed methods approaches (4th ed.). Sage.

Crossman, A. (2017). What is positivism in sociology? Background and theory of positivism . Retrieved October 25, 2017 from https://www.thoughtco.com/positivism-sociology-3026456

Fairclough, N. (2010). Critical discourse analysis: The critical study of language . Prentice Hall.

Feyerabend, P. (1975). Against method: Outline of an anarchistic theory of knowledge . New Left Books.

Goldkuhl, G. (2012). Pragmatism vs. interpretivism in qualitative information systems research. European Journal of Information Systems, 21 (2), 135–146.

Henning, E., Van Rensburg, W., & Smit, B. (2004). Finding your way in qualitative research . Van Schaik Publishers.

Horgan, J. (1993). Profile: Paul Karl Feyerabend—The worst enemy of science. Scientific American, 268 (5), 36–37.

Krippendorff, K. H. (2003). Content analysis: An introduction to its methodology . Sage.

Marx, K. (1867/2012). Das kapital: A critique of political economy . Regnery Publishing.

Miles, M. B., & Huberman, M. A. (1994). Qualitative data analysis: An expanded source book (2nd ed.). Sage.

Myers, M., & Avison, D. (2002). An introduction to qualitative research in information systems. In M. Myers & D. Avison (Eds.), Qualitative research in information systems: A reader . Sage.

Chapter   Google Scholar  

Ong, Y. S. (2016). Reexamining education research methodologies—Collaborative rather than competitive. Bulgarian Journal of Science & Education Policy, 10 (1), 124–141.

Orbe, M. P., & Kinefuchi, E. (2008). Crash under investigation: Engaging complications of complicity, coherence, and implicature through critical analysis. Critical Studies in Media Communication, 25 (2), 135–156. https://doi.org/10.1080/15295030802032275

Orlikowski, W. J., & Baroudi, J. J. (1991). Studying information technology in organizations: Research approaches and assumptions. Information Systems Research, 2 (1), 1–28.

Patton, M. Q. (2014). Qualitative research & evaluation methods: Integrating theory & practice (4th ed.). Sage.

Polkinghorne, D. (1983). Methodology for the human sciences . Human Sciences Press.

Popper, K. R. (1979). Objective knowledge: An evolutionary approach . Oxford University Press.

Shusterman, R. (2004). Pragmatism and East-Asian thought. Metaphilosophy, 35 (1/2), 13–43.

Thomas, V. G., & Madison, A. (2010). Integration of social justice into the teaching of evaluation. American Journal of Evaluation, 31 (4), 570–583. https://doi.org/10.1177/1098214010368426

Trauth, E. M. (Ed.). (2001). Qualitative research in IS: Issues and trends . Idea Group.

Willis, J. W. (2007). Foundations of qualitative research: Interpretive and critical approaches . Sage.

Wilson, W. J. (1987). The truly disadvantaged: The inner city, the underclass, and public policy . University of Chicago Press.

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Robert E. White

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Transformative Potentials of Critical Educational Inquiry

Emma Simmons

The foundational questions to critical work are: Who/what is helped/privileged/legitimated? Who/what is harmed/oppressed/disqualified?

(Cannella & Lincoln, 2009, p. 54)

Critical inquiry has been criticized for creating illusions of justice and being unable to transform the situations of the oppressed. Critics have voiced concerns for the paradoxical nature of critical inquiry, arguing that by providing alternative understandings of social phenomena, critical inquirers send a message that the oppressed are partly responsible for their situations due to their lack of “ appropriate” knowledge. In this article, we discuss the transformative potentials of critical educational inquiry. We use five contexts of qualitative research, namely, autobiographical, historical, political, postmodern, and philosophical to explore the possibilities of critical inquiry in educational research. We also use an article by Deborah Hicks (2005) to exemplify how critical research may be transformative and empowering by involving the researched in a process of inquiry characterized by negotiation and reciprocity.

critical inquiry, educational research, contexts of qualitative research, empowerment

Introduction

Critical theory generally refers to the theoretical traditions developed by a number of scholars affiliated with the Institute of Social Research at the University of Frankfurt in the mid-twentieth century. This group of scholars, including Max Horkheimer, Theodor Adorno, and Herbert Marcuse, situated this inquiry within German philosophical, social, and political thoughts and traditions. Very soon, the life and work of these scholars were heavily influenced by the devastation of World War I, along with resulting economic crises and political instability. They believed that reinterpretations of society were necessary, during an infamous period in history, when various forms of injustice and subjugation were shaping their world. Unfortunately, only a decade after the establishment of the Frankfurt School, the Nazis overtook Germany in body and mind. The leading scholars of the Frankfurt School decided (or were forced) to move to the United States. However, they were shocked by many aspects of American culture, especially the unquestioned acceptance of empirical practices of American social science research. In 1953, Horkheimer and Adorno decided to return to Germany in order to revitalize the Institute of Social Research, but Marcuse chose to stay in the United States and continue his work in social science research and theorization (Kincheloe & McLaren, 2011).

All members of the Frankfurt School championed a vision of a more just society, in which people have not only an equal access to desirable things but also control over the economic, political and cultural aspects of their lives. They argued that the oppressed and exploited people would be emancipated only if they were empowered to transform their situations by themselves. This theoretical tradition is called “critical” because the promoters of this theory “saw the route to emancipation as being a kind of self-conscious critique which problematizes all social relations, in particular those of and within the discursive practices of power, especially technical rationalism” (Tripp, 1992, p. 13).

Although frequently referenced in social science literature, critical theory has also been misinterpreted, misunderstood and accused of being patriarchal and re-inscribing old power structures. For example, Elizabeth Ellsworth (1989) famously questioned the ability of critical theory to empower the oppressed and transform their situations. To avoid confusion in our discussion, we conceptualize critical theory as a framework to understand “issues of power and justice and the ways that the economy; matters of race, class, and gender; ideologies; discourses; education; religion and other social institutions; and cultural dynamics interact to construct a social system” (Kincheloe & McLaren, 2011, p. 288).

Because of its emancipatory nature, critical theory is different from traditional empiricist theories in three important ways (Schwandt, 2007). First, it is a self-reflective, democratic discourse in the sense that it relinquishes normative and accepted understandings of the social order and adopts a lens of critical reconsideration. Second, unlike the empiricist tradition in which the theorist is disinterested in and detached from the research subjects, critical inquiry is closely related to praxis [i.e., action + reflection = word = work = praxis] (for details, see Freire, 1970). Third, critical inquiry “employs the method of immanent critique, working from within categories of existing thought in order to radicalize those categories, reveal their internal contradictions and shortcomings, and demonstrate their unrecognized possibilities” (Schwandt, 2007, p. 55). Therefore, when research is carried out from the perspectives of critical theory, it aims to identify various forms of power and “seeks in its analyses to plumb the archaeology of taken-for-granted perspectives to understand how unjust and oppressive social conditions came to be reified as historical ‘givens’” (Cannella & Lincoln, 2009, p. 54).

The critical theory tradition has been taken into the field of education by a number of scholars, “but most notably by Paulo Freire in his work with oppressed minorities which gave rise to the term critical pedagogy , meaning teaching-learning from within the principles of critical theory” (Tripp, 1992, p. 13). Other scholars, such as Michael Apple, Henry Giroux, Joe Kincheloe and Peter McLaren have taken up critical theory to unpack politics of education, epistemological violence, control of teachers and learners, commodification of knowledge, and how schools reproduce social, economic, political, and cultural inequalities. In addition to identifying these oppressive roles of education, they have also provided the language of possibility .

In this article, we explore critical inquiry through five contexts, namely, autobiographical, historical, political, postmodern, and philosophical. Karyn Cooper and Robert White (2012) propose these five contexts as “a theoretical framework for conducting, understanding, and interpreting qualitative research” (p. 23). Throughout our exploration, we use Deborah Hicks’ (2005) article “Cultural hauntings: Girlhood fictions from working-poor America” as an example of reflexive, advocacy-centred critical inquiry. In this article, Hicks delineates links between third and fourth-grade girls’ fascination with horror fiction, layered dimensions of their voice and identity, and the complexities of growing up in a predominantly white working-poor community. Using the five contexts of qualitative research (Cooper & White, 2012) as a theoretical framework with reference to Hicks (2005), as an example of critical inquiry, we present our analysis of and insights into the possibilities for and realities for empowerment in critical education research.

Autobiographical Context

One of the over-arching aims of critical inquiry is to include various perspectives in academia and to acknowledge that the stories and voices of particular groups have long been underrepresented in conversation of research. Critical inquiry has paved the way for, and continues to incorporate, the lenses of feminist theory, critical race theory and class analyses, among others, and ultimately seeks to challenge the canonical frames of academia that have allowed for only one reality. The autobiographical context provides a step forward in that challenge, and many practitioners of critical inquiry have used the autobiographical context both to inform their larger critiques and also to situate themselves within the larger discourse. Race and gender theorists such as Gloria Anzaldua (1987), bell hooks (1994), and Beverly Daniel Tatum (1997) weave their autobiographies throughout their critical analyses in order to establish the inextricability between their lived experience and their perspective regarding the world around them.

As described in Cooper and White (2012), the autobiographical context is a way to highlight the researcher’s own perspective in order to better establish a connection between researcher, researched and reader, as well as to contextualize the research produced. Without an autobiographical context, the researcher and, in fact, the research itself would be disembodied and without a human source. As a reader, one would be unable to understand both the insights and the blind spots that the researcher brings to an investigation without an understanding of the author’s preconceived ideologies and experiences: “To use a metaphor, viewing a work of art without contextualizing it in terms of our knowledge about the artist tends to limit our understanding of the painting itself” (Cooper & White, 2012, p. 33). Before theorists in the latter half of the 20 th century began to call into question the positionalities within the academy, the autobiography of the researcher was hidden, leading to an inability to trust the work produced, and an “othering” of the subject.

Referencing William Pinar, Cooper and White (2012) highlight the use of autobiography in research, noting that it need not be a self-indulgent exercise. Pinar demonstrates, through his method of currere, that autobiography is a part of a larger context. His four steps allow researchers to incorporate their lived experiences into their larger research and, in fact, study themselves in order to ask and understand the question, “What do I make of what I have been made?” (Cooper & White, 2012, p. 34). As critical inquiry attempts to inspire new ways of thinking, it simultaneously follows the steps that Pinar lays out—regressive, progressive, analytical, and synthetical. These steps give us the opportunity first to look back on our formative experiences, then forward to where we desire to go. The third step looks at our present, while being informed by our past and future and, fourth, we bring all three pieces together in order to understand our ways of understanding (Pinar, 1975).

Hicks’ (2005) relies heavily on the autobiographical context to perform her critical inquiry. Within her analysis, she interweaves her own autobiography, as well as those of her students. Hicks’ voice as the researcher and author is never lost within her writing; her choices, observations and interactions are always deeply embedded within her work. In fact, the writing/research process and the choices she has made within that are all reflective of her positionality, and she makes no secret of that. In so doing, she avoids the problem of the researcher’s gaze which, gone unmentioned, can affect the ways in which the reader sees the subjects of the research, ultimately skewing the reader’s response and, perhaps in turn, any action taken as a result of her research. As Cooper and White (2012) discuss, by being autobiographically expository, one ensures that both researcher and reader are using the same tools to understand and view the subjects of the research. By revealing our subjectivity, we actually allow more space for our reader to be objective.

In addition to being honest about her own autobiography, we would also argue that Hicks presents what functions almost as an autobiography of the community where she conducted her research. More than simply contextualizing her students’ narratives, the way in which she describes the setting of the classroom leads the reader to feel as if the place is in and of itself. She describes its position on the economic margins of the city by stating that the middle-class “might drive through on the way to something else, noting in passing the ghostly frames of abandoned warehouses or the thick, gray smoke churned out from one of the few working factories” (p. 172).

While this contextualization also has its place in discussions of both the historical and political context, it is raised here as well. Hicks regards the space that her subjects live in with her particular eye and mindset, and gives a specific meaning to both their autobiographies and the very act of contextualization. In doing so, Hicks provides her individual subjects with more of a universality, a way to posit that narrative need not be insular and without academic merit. The research question, as stated by Hicks, is “what was it like to grow up as a girl in contemporary working-poor America?” (p. 172). Thus, her focus on the economic and structural context of her subjects is vital to the larger underpinnings of her research, for which horror novels become merely a vehicle and not the point, in themselves.

The third modality in which we see the autobiographical context at play is, of course, in the narratives of the girls themselves. Hicks uses bell hooks (1994), Myles Horton (1990) and Paulo Freire (1970) as a framework, all three of whom centered both their pedagogies and their scholarship within a context of dialogue so the human aspect of each of the girls’ experiences is vital to the analysis that Hicks is attempting to construct. We learn about these girls through our understanding of their community and through their understandings of and interactions with the books that Hicks posits as “subversive” texts (p. 174). As Hicks describes their reactions to the texts, their previous experience with different genres and the choices that they make, we are able to understand the girls both as individuals, and within their larger contexts.

In Inquiry and Reflection, Diane Dubose Brunner (1994) talks about representations of student experience in various forms of media (pp. 153-186), a topic that is also tackled quite often by both bell hooks and Henry Giroux. By investigating how these girls read different texts, Hicks provides us a new reading of the girls themselves. Brunner talks about the way in which language has been used to describe students, especially along class lines, in television, film and literature, as well as the ways in which students, themselves, have been depicted as using (or conversely, failing to use) language. Hicks’ framing of her larger point of inquiry, the ways in which language and linguistic practices are both reflective and constructive of their material and cultural lives is an investigation into the very way that fictional depictions of youth in educational spaces disembodies them from their contexts, a process described by Brunner (1994). By focusing on the autobiography and narrative experience of herself, her students, and their teacher, Hicks is able to re-contextualize these experiences.

Historical Context

Moving through the five contexts of critical inquiry, we arrive at the historical context. Cooper and White (2012) open their discussion of the historical context with the African proverb, “Until the lion has his own historian, the hunter will always be the hero” (p. 52). This proverb is central to the ideas of a critical, historical analysis. Without questioning, “Whose history is it?” we are unable to look critically at the stories that we have taken as truth (p. 52). Denzin and Lincoln (2005) do just this by going through what they depict as the eight moments of qualitative research. They move from the traditional, through modernist, blurred genres, crisis of representation, and finally, the triple crisis. As they move through these moments, we see the history of qualitative research in varying complexities itself, as it is opened to new voices, new ways of knowing, seeing and understanding.

There are, of course, numerous scholars who aim to illustrate both a critical and historical understanding of their subjects. One such scholar, whose work seems of particular relevance to Hicks’ content and analysis, is David Roediger (1993). By developing a history of American racial construction through the paradigm of whiteness, Roediger takes both a critical and historical look at the ways in which our understanding of self, power, poverty and privilege are informed by the history of racial construction, as well as the history of labour in the United States. As Hicks discusses the working poor character of the town that her work is centered in, Roediger’s (1993) analysis of how labour history and the history of slavery becomes particularly critical to our understandings of the intersections of whiteness and working class identities, as posited by Hicks (2005).

Gloria Ladson-Billings (1995, 1999) also captures a historical context in her analyses of education and race, uniting the contexts of critical race theory and critical pedagogy. By tracing notions of racial segregation and looking at cultural deprivation, Ladson-Billings is able to reclaim the ways that we look at modern schooling and the ways that we talk about racial disparities in education. In so doing, the historical perspective in critical inquiry acts as a counter-argument to sometimes dangerous modes of thinking, such as the “deficit” model of education. Hicks continues this tradition by highlighting the voices of subjects schooled within a working class context, as well as by demonstrating positive examples of engaged learning.

Many of Hicks’ methodological and writing strategies demonstrate a strong connection to the historical context. Firstly, she contextualizes the geographic location based on historical understanding. She discusses its physical make-up, position within the larger urban space and, also, demographic profiles within a historical context. The critical inquiry piece here is that neighborhoods do not simply arise, just as residents are not divorced from their space—neighborhoods themselves do not exist separately from the forces that construct them (Hicks, 2005). She specifically mentions factors such as factory closings that occurred long before her students were born, largely as a means to highlight the ways in which communities live under the economic shadows of what came before. It is clear within a historical context that events do not just happen and dissipate; they continue to have an effect on what comes after them.

Hicks is also able to engage with the historical context by extending her study over a year-long period (She even goes so far as to refer to her data as a “history” (p. 173)). By looking at the girls over a period of time, she engages with notions of change. The other way in which she engages with the historical context is by situating her methodology and theoretical framework within a trajectory of study, wherein she cites the work of Gee (2004) and other practitioners of new literacy studies. In so doing, she draws a historical lens over her specific research, as well as engaging in a larger theoretical conversation.

Political Context

Within critical theory, it is impossible to create barriers between the political, postmodern, and philosophical contexts. Like the postmodern world we live in, they are liquid, and flow into each other at different times of the research and inquiry process. First and foremost, we currently live in the postmodern era and, thus, all contemporary research is firmly rooted within that particular framework. Secondly, if, as Pinar (1978) claims, all intellectual acts are inherently political, then any act of research by an individual or institution is, of course, political as well. Finally, thoughtful considerations of philosophy hold these concepts together and, through the philosophical context, dialogue and discourse are created to enable change. Nonetheless, the political aspect of critical theory is interwoven into all four contexts and must always be present in any research that aims to be called “critical.”

The Frankfurt School, notably Max Horkheimer, is central in exploring the political context of critical theory. Horkheimer (1972) states in his pivotal work, Critical Theory , that there cannot be many defined criteria for critical theory, as it is a product of its political, social, cultural, and economic contexts and is, thus, continually changing; however, he argues that critical theory must always contain the unfaltering “concern for the abolition of social injustice” (p. 242), a sentiment echoed by scholars such as Giroux (2004) and Lather (1986).

Lather (1986), in particular, argues that researchers should employ critical theory in order to avoid the “rape model” of research—namely, objectifying and “othering” one’s research subject. Critical theory can help researchers and institutions build and maintain “a more collaborative approach...to empower the researched, to build emancipatory theory, and to move toward the establishment of data credibility within praxis-oriented, advocacy research” (Lather, 1986, p. 272). Essentially, the goal of critical theory should be to encourage and facilitate emancipatory change for the oppressed, marginalized and misunderstood. For example, in her article, Hicks investigates—and eventually advocates for—the typically “hidden face of poverty” or the hidden “white” face of poverty. Intrigued and surprised by the “predominant Whiteness of the neighbourhood” (p. 171), where she situates her research, Hicks draws attention to an often overlooked area in urban poverty research.

The change called for in critical inquiry can be demonstrated through the realization of agency, which is central to the political context, and to critical inquiry as well: “the political contexts at work within society impact upon one’s sense of agency” (Cooper & White, 2012, p. 72). In Hicks’ article, her goal (though flawed by her own middle-class biases and preconceptions of the working-poor) was to investigate the experience of girlhood in working-poor America, and how the school language practices—mainly reading novels—were “layered within their cultural and material lives” (p. 172). Though her research began with a more observational rather than advocacy focus, Hicks accomplished the praxis-oriented research that is often advocated by Lather (1986) and other critical researchers and theorists. When one student, Brandy, voiced her newfound confidence and proclaimed that “We can start to control this [their situation] by just sitting down and talking” (p. 184), she demonstrated that she had begun to realize her agency—the first step towards the change that critical theory champions.

The students in Hicks’ research also struggled with “juggling the tension and ambiguity of their class differences in a middle-class school culture” (p. 173). This is clearly evident in Hicks’ demonstration of her own middle-class cultural capital, when she attempts to begin the course with a text that the girls simply did not relate to, involving a cultural capital (Bourdieu, 1985) that rested outside of their realm of experience. Instead, the girls chose to focus on a type of text that was familiar to them: horror paperbacks. This shift in the types of literature that the students gravitated towards raises some critical questions: Are students in working-poor, urban neighbourhoods only capable of consuming simple, seemingly “low brow” texts? Should educators push those students beyond their comfortable reading environment into something more literary?

It is here that the true task of critical inquiry begins to take shape: “Literary” for whom, exactly? Why are these texts considered to be “low brow?” Why do we feel the need to teach certain accepted texts within the English classroom? While not specifically stating that these questions entered her research, Hicks displays in her article her engagement with these issues, as she questions her own cultural capital and decides to investigate, instead, the possibilities that lay within the horror paperbacks for unveiling the layered meanings of her students’ identities.

By taking this critical approach, Hicks’ grounds herself in the realm of critical pedagogy for political and social change—after reflecting on and altering her preconceptions of the cultural awareness and capital of her students, she provided them with a forum to be heard and to express their own cultural hauntings. Bauman (1997) claims that “the key to a problem as large as social justice lies in a problem as (ostensibly) small-scale as the primal moral act of taking up responsibility for the other nearby” (p. 70)—while Hicks may not have solved the issue of social justice, her research and willingness to speak and listen to these young girls illustrates her commitment to this group in working-poor America.

Postmodern Context

Critical theory argues that, in our postmodern society, normative assumptions and dominant perspectives of politics, culture and society often remain unquestioned. Horkheimer (1972) proposes that we re-evaluate our interactions and place within society a renewed consciousness that is “dominated at every turn by a concern for reasonable conditions of life” (pp. 198-199). Of course, the critical researcher must question and define what is meant by “reasonable conditions of life;” the researcher must also focus on how that is attainable for each individual. For many theorists, the key lies in the search for individual and collective agency. For example, once the young girls in Hicks’ class developed and discovered their personal stories and voices, they were able to create a larger, collaborative agency that, potentially, could be heard outside of their small, working-poor neighbourhood classroom.

Central to the postmodern context is the move from a producer to a consumer society, and the power dynamics that occur as a result—a concept encountered by many critical theorists and researchers. Foucault (1982) claims that, for society to progress to a more equitable and open society, we are in desperate need of a “new economy of power relations” (p. 779). However, as Giroux (2004) notes, it is important to remember that, within our capitalist, postmodern society, power does not disappear but, rather, becomes reworked, replayed and restaged; perhaps that reworking of power can result from the turn from consumer to producer.

Bauman also voices his concern for our movement from a producer society to a consumer society and notes that, “if unchecked, [it] will spell dire consequences for humanity” (quoted in Cooper & White, 2012, p. 86). He further explains that the concept of choice, and the deceptively simple ability to choose, is yet another crucial component of our postmodern condition, rooted in the dichotomy of producer and consumer. Surrounded by menial daily choices of what espresso drink to purchase, television program to fit into our schedule or Twitter account to follow, it is clear that our postmodern society values choice. Bauman would argue, however, that these are quick, meaningless choices that require little to no responsibility once the choice has been made, but it is these choices that create and shape our identities, only to be “adopted and discarded like a change of costume” (1997, p. 88).

In Hicks’ article, her students began as consumers. They were drawn to the paperback horrors because of their distribution and saturation within the media, from television programs such as Goosebumps , as well as other film interpretations of the genre. However, once they began creating the same horror texts that they originally consumed and became producers, they found their voices and became individuals with their own sense of agency and the awareness of their autobiographical situation within their postmodern, political world.

Even so, Hicks’ students do not have the same choices as many of their middle-class counterparts. Our consumer-driven society emphasizes the constant need for choice, yet so many fail to have the privilege of choice. Indeed, the word “fail” might seem insensitive and severe but, in a consumer-driven society, members of the working-poor have neither the ability nor the means to choose and participate in material culture. In her article, Hicks observes that her students fail to meet the material standards of the dominant, middle-class culture and, therefore, their ability to live within the consumer, postmodern world is gone; there are no jobs left in their area and, so, the “material possibilities” have disappeared for the youth in this working-poor neighbourhood (p. 170). In addition to their attempted participation in the middle-class consumer culture, the young girls also continuously struggle with “juggling the tension and ambiguity of their class differences in a middle-class school culture” (p. 173). If material possibilities are valued in identity construction in a postmodern consumer society, then the students’ inability to obtain them means a negation of individuality and agency and, thus, the potential for collective action and change.

Philosophical Context

The girls in Hicks’ summer school reading group may have juggled tensions and struggled with expression, but they certainly took matters into their own hands when they decided to circulate horror paperbacks amongst themselves. Hicks’ article illustrates a difference between education and schooling, and these young girls in working-poor America used the horror paperbacks as a means of creating their own form of education. Postmodern critical philosopher Maxine Greene (1988) notes the philosophical differences between schooling and education, and argues that “Education...encourages individuals to grow and to become, while schooling constrains students to become servants of a technocratic society” (Cooper & White, 2012, p. 106). This is particularly crucial to coming to an understanding of the dynamic nature of critical theory and, thus, critical pedagogy. Schooling, in Hicks’ situation, relied on a middle-class cultural capital that was not in the same sphere of experience as the education that the girls created for themselves, based on their interests and understandings. They began reading these texts as a self-created peer reading group and it was from this form of education, on the periphery of a middle-class school culture and environment, that the educator, Hicks, noticed the potential in exploring (and further complicating) the layered meanings of the girls’ identities.

Greene (1988) also states that imagination is central to developing one’s particular perspective and realizing one’s individual agency.

It takes imagination to become aware that a search is possible, and there are analogies here to the kind of learning we want to stimulate...it takes imagination on the part of the young people to perceive openings through which they can move. (Cooper & White, 2012, p. 110)

Greene’s (1988) emphasis on imagination paving the path to freedom is central to understanding the philosophical context of critical inquiry and also the philosophical context of Hick’s research. During a discussion of The Wizard of Oz, Hicks asked her students if, given the choice, they would choose to stay in Oz or go back to Kansas. One student, Shannon, imagines her escape from her current situation in a heartbreaking revelation:

I would choose Oz because it’s a beautiful land and up there you don’t hear no gunshots. And you don’t walk on glass and don’t hear people hollering and screaming at you like you do here. (Hicks, 2005, p. 183)

Shannon might not have made a plan of action for escaping her reality, but her imagination in this one instance displays her awareness of her political, social and economic situation, and her desire to escape. Picturing a better place—even one that is imaginary—could have been Shannon’s first step into plucking herself from her reality and escaping into a new one of change and autonomy (Greene, 1988).

Critics often blame critical inquiry for its emphasis on the language of critique, rather than the language of possibility. For example, Elizabeth Ellsworth (1989) expresses her doubt in critical inquiry’s empowering and transformative powers. She argues that “the discourse of critical pedagogy is based on rationalist assumptions that give rise to repressive myths,” and critical pedagogues “perpetuate relations of domination in their classrooms” (p. 297). Like Ellsworth, Viviane Robinson (1992) argues that there is a paradox at the heart of critical inquiry’s endeavours for emancipation. When critical researchers offer alternative understandings of subjects’ situations, their offer has two “arrogant” claims:

a) subjects’ (mis)understandings are at least in part responsible for the situation they find unacceptable; and (b) the alternative understandings offered by the critical social scientist, if acted on, would result in outcomes that are more effective and fulfilling than those currently experienced. (p. 346)

Nonetheless, critical inquiry is, by its nature, self-critical, and critical theorists assert that, while these may be potential issues, true critical inquiry inherently addresses these problems. Rather than criticizing the nature of critical inquiry, Canella and Lincoln (2009) identify three issues that may marginalize and disempower critical inquiry, thus impacting its reception amongst academic and general populations. First, a high level of abstraction and use of difficult language keep the work of critical inquiry away from broader audiences. Second, political forces often attack diversity and discredit critique. Finally, the rise of neoliberalism and hyper-capitalism suppress critical inquiry and privileges evidence-based, positivistic research.

In this article, we have used the five contexts for qualitative research (Cooper & White, 2012) to understand the possibilities for empowerment in critical educational research. In our analysis, Hicks’ (2005) article has provided examples of how teachers can adopt responsive and dialogic pedagogies that “start with close readings of students’ lives and voices” (p. 188). Through her constant reflective, self-critical, and participatory methodology, Hicks avoids the potential pitfalls of critical inquiry and, instead, epitomizes the language of possibility in critical inquiry. Thus, the five contexts of Cooper and White (2012) exemplified through Hicks (2005) illustrate the emancipatory potentials of critical educational research by engaging “the researched in a democratized process of inquiry characterized by negotiation, reciprocity, [and] empowerment” (Lather, 1986, p. 257).

Anzaldua, G. E. (1987). Borderlands/La Frontera: The new Mestiza  4th ed., San Francisco, CA: Aunt Lute Books .

Bauman, Z. (1997). Postmodernity and its discontents . Cambridge, UK: Polity Press.

Bauman, Z. (2005). Work, consumerism and the new poor . Maidenhead, England: Open University Press.

Bourdieu, P. (1985). The forms of capital. In J. G. Richardson (Ed.), Handbook of theory and research for the sociology of education (pp. 241-258). New York: Greenwood.

Brunner, D. D. (1994).  Inquiry and reflection: Framing narrative practice in education . Albany, NY: SUNY Press.

Cannella, G. S., & Lincoln, Y. S. (2009). Deploying qualitative methods for critical social purposes. In N. K. Denzin & M. D. Giardina (Eds.), Qualitative inquiry and social justice (pp. 53-72). Walnut Creek, CA: Left Coast Press.

Cooper, K. & White, R. E. (2012). Qualitative research in the post-modern era: Contexts of qualitative research . New York: Springer.

Denzin, N. K. & Lincoln, Y. S. (2005). Introduction: The discipline and practice of qualitative research. In N. K. Denzin & Y. S. Lincoln (Eds.), The Sage handbook of qualitative research, 3 rd Ed. (pp. 1-32). Thousand Oaks, CA: Sage.

Ellsworth, E. (1989). Why doesn’t this feel empowering? Working through the repressive myths of critical pedagogy. Harvard Educational Review, 59 (3), 297-324.

Foucault, M. (1982). The subject and power. Critical Inquiry, 8 (4), 777-795.

Freire, P. (1970). Pedagogy of the oppressed . New York: Seabury Press.

Gee. J. P. (2004).  Situated language and learning: A critique of traditional schooling . London: Routledge.

Giroux, H. (1988). Critical theory amid the politics of culture and voice: Rethinking the discourse of educational research. In R. Sherman & R. Webb (Eds.), Qualitative research in education: Focus and methods (pp. 190–210). New York: Palmer.

Giroux, H. A. (2000). Postmodern education and disposable youth. In P. P. Trifonas (Ed.), Revolutionary pedagogies: Cultural politics, instituting education, and the discourse of theory (pp. 174-195). New York: Routledge.

Giroux, H. A. (2004). Critical pedagogy and the postmodern/modern divide: Towards a pedagogy of democratization. Teacher Education Quarterly, 31 (1), 31-47.

Greene, M. (1988). The dialectic of freedom . New York: Teachers College Press.

Hicks, D. (2005). Cultural hauntings: Girlhood fictions from working-poor America. Qualitative Inquiry, 11 (2), 170-190.

hooks, b. (1994). Teaching to transgress: Education as the practice of freedom. New York: Routledge.

Horkheimer, M. (1972). Critical theory . Toronto: Herder and Herder.

Horton, M. & Freire, P. (1990). We Make the Road by Walking: Conversations on Education and Social Change. (Edited by B. Bell, J. Gaventa & J. Peters). Philadelphia, PA: Temple University Press.

Kincheloe, J. L., & McLaren, P. (2005). Rethinking critical theory and qualitative research. In N. Denzin and Y. Lincoln (Eds.), The handbook of qualitative research (pp. 279–313). Thousand Oaks, CA: Sage Publications.

Kincheloe, J. L., & McLaren, P. (2011). Rethinking critical theory and qualitative research. In K. Hayes et al., (Eds.), Key work in critical pedagogy: Joe L. Kincheloe (pp. 285-326). Rotterdam: Sense Publishers.

Ladson-Billings, G. J. (1995). But that’s just good teaching! The case for culturally relevant pedagogy. Theory into Practice, 34 (3), 159-165.

Ladson-Billings, G. J. (1999). Preparing teachers for diverse student populations: A critical race theory perspective. Review of Research in Education, 24 , 211-247.

Lather, P. (1986). Research as praxis. Harvard Educational Review, 56 (3), 257-277.

Pinar, W. F. (1975). Currere: toward reconceptualization. Curriculum theorizing: The reconceptualists , 396-414.

Pinar, W. F. (1978). The reconceptualization of curriculum studies. In D. J. Flinders and S. J. Thornton (Eds.), The curriculum studies reader (pp. 149-157). New York: Routledge Falmer.

Robinson, V. M. J. (1992). Doing critical social science: dilemmas of control. International Journal of Qualitative Studies in Education, 5 (4), 345-359.

Roediger, D. (1993). Race and the working-class past in the United States: Multiple identities and the future of labor history. International Review of Social History, 38 , 127-143.

Schwandt, T. A. (2007). The Sage dictionary of qualitative inquiry . Thousand Oaks, CA: Sage Publications.

Tatum, B. D. (1997). “Why are all the Black kids sitting together in the. cafeteria?” And other conversations about race. New York: Basic Books.

Tripp, D. (1992). Critical theory and educational research. Issues in Educational Research , 2(1), 13-23.

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White, R.E., Cooper, K. (2022). An Introduction to Critical Approaches. In: Qualitative Research in the Post-Modern Era. Springer, Cham. https://doi.org/10.1007/978-3-030-85124-8_2

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9 Critical Approaches to Qualitative Research

Kum-Kum Bhavnani, Department of Sociology, University of California at Santa Barbara

Peter Chua, Department of Sociology, San José State University

Dana Collins, Department of Sociology, California State University, Fullerton

• Published: 04 August 2014
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This chapter reflects on critical strategies in qualitative research. It examines the meanings and debates associated with the term “critical,” in particular, contrasting liberal and dialectical notions and practices in relation to social analysis and qualitative research. The chapter also explores how critical social research may be synonymous with critical ethnography in relation to issues of power, positionality, representation, and the production of situated knowledges. It uses Bhavnani’s framework to draw on Dana Collins’ research as a specific case to suggest how the notion of the “critical” relates to ethnographic research practices: ensuring feminist and queer accountability, resisting reinscription, and integrating lived experience.

Qualitative research is now ubiquitous and fairly well-respected throughout the human sciences. That Oxford University Press is producing this much-needed volume is further testament to that notion, and one which we applaud. However, although there are different approaches to conducting qualitative research, what is often not addressed are the philosophical notions underlying such research. And that is where the “critical” enters. Indeed, “critical,” used as an adjective and applied, within the academy, to methods of research is also a familiar phrase. The question is, therefore: what does “critical” mean, and how might it be translated such that present and future researchers could draw on some of its fundamentals as they plan their research studies in relation to progressive political activism?

The popularity of critical research is not predictable. Although the 1960s and early 1970s did offer a number of publications that engaged with critical research traditions (e.g., Gouldner, 1970 ), and the 1990s also led to a resurgence of interest in this area (e.g., Harvey, 1990 ; Thomas, 1993 ), it is now two decades since explicit discussions of critical research have been widely discussed within the social sciences (see Smith, 1999 ; Madison, 2012 , as exceptions).

In this chapter, we first outline meanings associated with “critical.” We then suggest that the narratives of critical ethnography are best suited for an overview chapter such as this. We consider critical ethnography to be virtually synonymous with critical social research as we discuss it in this chapter. In the final section of our chapter, we discuss Dana Collins’ specific research studies to suggest how her approach embraces the notion of “critical” ( Collins, 2005 ; 2007 ; 2009 ).

The “Critical” in Critical Approaches

“Critical” is used in many ways. In everyday use, the term can refer, among other definitions, to an assessment that points out flaws and mistakes (“a critical approach to the design”), or to being close to a crisis (“a critical illness”). On the positive side, it can refer to a close reading (“a critical assessment of Rosa Luxembourg’s writings”) or as being essential (“critical for effective educational strategies”). A final definition is that the word can be used to either denote considerable praise (“the playwright’s work was critically acclaimed”) or to indicate a particular turning point (“this is a critical time to vote”). It is this last definition that is closest to our approach as we reflect on “critical” in the context of qualitative research. That is, drawing from the writings of Marx, the Frankfurt School, and others (see Delanty, 2005 ; Marx, 1845/1976 ; Strydom, 2011 ), we suggest that critical approaches to qualitative methods do not signify only a particular way of thinking about the methods we use in our research studies, but that “critical approaches” also signify a turning point in how we think about the conduct of research across the human sciences, including its dialectical relations to the progressive and systematic transformation of social relations and social institutions.

The most straightforward notion of “critical” in this context is that it refers to (at the least) or insists (at its strongest) that research—and all ways by which knowledge is created—is firmly grounded within an understanding of social structures (social inequalities), power relationships (power inequalities), and the agency of human beings (an engagement with the fact that human beings actively think about their worlds). Critical approaches are most frequently associated with Marxist, feminist, and antiracist, indigenous, and Third World perspectives. At its most succinct, therefore, we argue that “critical” in this context refers to issues of epistemology, power, micropolitics, and resistance.

What does this mean, both theoretically and for how we conduct our research? Most would agree that whereas qualitative research does not, by definition, insist on a nonpositivist way of examining the social world, for critical approaches to be truly critical, an antipositivist approach is the sine qua non of critical research. Furthermore, it is evident as we survey critical empirical research that issues of reflexive and subjective techniques in data collection and the researcher’s relationship with research subjects also frame both the practices and the theories associated with research.

The following section begins by drawing attention to developments and debates involving the more restricted use the term critical as related to Marxism and then explores the ramifications for varying attempts to conduct critical qualitative research.

The Critical Debates

Karl Marx, Friedrich Engels, and their contemporaries (see Engels, 1877/1969 ; Harvey, 1996 ; Lenin, 1915/1977 ; Mao, 1990 ; Ollman, 2003 ) developed dialectical materialist notions of critique and “critical” that were substantively different from prior notions. They incorporated these dialectical materialist notions to develop Marxist theories and politics.

Dialectical materialism refers to an outlook on reality that emphasizes the importance of process and change that are inherent to things (such as objects, phenomena, and situations), as well as of the importance of human practices in making change. Significantly, human struggle over existing conditions and contradictions in things creates not only new conditions, but also new contradictions. This outlook serves as an analytical tool over idealist and old-fashioned materialist worldviews and as a source of strength for exploited peoples in their struggle against ruling elites and classes. It emphasizes that correct ideas, knowledge, and theoretical abstractions are established initially, and perhaps inevitably, through practice.

Dialectical materialism may be used to examine two aspects of the research process and the production of academic knowledge. The first aspect involves the writing process as it is carried out among multiple authors. At the drafting phase, the authors craft their distinct ideas into textual form. Contradictions in ideas are bound to exist in the draft. In doing revisions, some contradictions may become intensified and remain unresolved, yet, most frequently (and hopefully!), many are addressed in the form of clearer, more solid, and coherent arguments, thus resolving the earlier contradictions in the text. Yet, new struggles and contradictions emerge. The synthesis of ideas and argument in the final manuscript may again, however, engage in new struggles with the prevailing arguments being discussed.

The second aspect involves the relationship and interaction between the researcher and the interviewee. As their relationship begins, contradictions and differences usually exist between them, for instance, in terms of their prior experiences and knowledge, their material interests in the research project, and their communication skills in being persuasive and forging consent. The struggle of these initial contradictions could result in new conditions and contradictions. For example, this could lead to

the establishment of quality rapport between them, allowing the interview to be completed while the researcher maintains control over the situation;

the abrupt end of the interview due to the interviewee refusing and asserting her or his right to comply with the interview process; or

an explicit set of negotiations that address the unevenness in power relations between them, along with an invitation for both to be part of the research team and to collaborate in the collection and analysis of data and in the forging of new theories and knowledges.

In the first possibility, the prevailing power relations in interviews remain but shift to beneath the surface of the relationship, under the guise of “rapport.” In the second possibility, power relations in the interview process and initial contradictions are heightened, resulting in new conditions and contradictions that the researcher and research participant have to address, jointly and singly. In the third possibility, the research subject is transformed into a researcher as well, and the relationship between the two is transformed into a more active co-learning and co-teaching relationship. Still, new conflicts and contradictions may emerge as the research process continues to unfold. 1 In short, dialectical materialism stresses the analysis of change in the essence (1), practice (2), and struggle (3). Such analyses are at the root of how change may be imagined within the practices of social research.

Dialectical materialism, which forms the basis of the concept of “critical,” emphasizes the need to engage with power, inequality, and social relations in the arenas of the social, political, economic, cultural, and ideological. Based on this status, it is argued that an analysis of societies and ways of life demands a more comprehensive approach, one that does not view society and social institutions merely as a singular unit of analysis but rather as ones that are replete with history. Dialectical materialism directs its criticism against prevailing views or hegemonies, and, within the context of academic endeavors, engages in debates against positivism and neo-Kantian forms of social inquiry. It is this basis of “critical” that defines it in the context of research as a deep questioning of science, objectivity, and rationality. Thus, the meaning of the term “critical,” based on the idea of “critique,” emerges from the practice and application of dialectical materialism.

Historical materialism emerges from and is based on dialectical materialism. That is, any application of the dialectic to material realities is historical materialism. For example, any study of human society, its history, its development, and its process of change demands a dialectical approach rooted in historical materialism. This involves delving deeper into past and present social phenomena to thereby determine how people change the essence of social phenomena, and, simultaneously, transform their contradictions.

Dialectical materialism regards positivism as a crude and naïve endeavor to seek knowledge and explain phenomena and as one that assumes it is the task of social researchers to determine the laws of social relationships by relying solely on observations (i.e., by assuming there is a primacy of external conditions and actions). In addition, positivism separates the subject (the seemingly unbiased, detached observer) and object (the phenomenon/a under consideration) of study. Dialectical materialism overcomes the shortcomings of positivism by offering a holistic understanding of (a) the essence of phenomena; (b) the processes of internal changes, the handling of contradictions, and the development of knowledge; (c) the unity of the subject and object in the making of correct ideas; and (d) the role of practice and politics in knowledge creation.

Dialectical materialism directs its criticism against dominant standpoints. These standpoints can offer a simplistic form of idealism and philosophical materialism. Within the context of academic endeavors, the methods of dialectical materialism engage in debates against positivism and neo-Kantian forms of social inquiry. This approach challenges assertions that science, objectivity, and rationality are the sine qua non of research and that skepticism and liberalism are the only appropriate analytical positionings by which a research project can be defined as “critical.”

For instance, Auguste Comte and Emile Durkheim, in developing sociological positivism, argued for a new science to study society, one that adopted the methods of the natural sciences, such as skeptical empiricism and the practices of induction. In adopting these methods, approaches relying on early positivism sought to craft knowledge based on seemingly affirmative verification rather than being based on judgmental evaluation and transformative distinctions.

Positivism and dialectical materialism were both developed in response to Kantian and idealist philosophy. In the context of the European Enlightenment, in the late 1700s, Immanuel Kant inaugurated the philosophy of critique. Positivism challenged Kant’s philosophy of critique as the basis for the theory of knowledge.

Kant developed his notion of critique to highlight the workings of human reason and judgment, to illuminate its limitations, and to consolidate its application in order to secure a stable foundation for morality, religion, and metaphysical concerns. Politically, Kantian philosophy provided justification for both a traditionalism derived from earlier periods and a liberalism developed during the ascendance of the Enlightenment.

Kant sought to settle philosophical disputes between a narrow notion of empiricism (that relies on pure observation, perception, and experience as the basis for knowledge) and a narrow notion of rationalism (that relies on pure reason and concepts as the basis for knowledge). He argued that the essence (termed “thing-in-itself”) is unknowable, countering David Hume’s skeptical empiricism, and he was convinced that there is no knowledge outside of innate conceptual categories. For Kant, “concepts without perceptions are empty; perceptions without concepts are blind” (1781/1965, pp. A 51/B 75).

The method of dialectical materialism challenges Kant’s idealism for (what is claimed to be) its faulty assertion that correct ideas and knowing about the “thing-in-itself” can only emerge from innate conceptual categories, ones that are universal and transcendental. In Kantian philosophy, there is no reality (out there) to be known. Rather, it is the experience of reality itself that provides for human reason and consciousness.

Dialectical materialism overcomes Kant’s idealism with its recognition of the existence of concrete phenomena, outside and independent of human reason. Dialectical materialism stresses that social reality and concrete phenomena reflect on and determine the content of human consciousness (and also, we would argue, vice versa). Dialectical materialism also emphasizes the role of practice and politics in knowledge development, instead of merely centering the primacy of ideas and the meanings of objects.

In sum, the core debate against positivism centers on the practices of science. Dialectical materialism regards positivist approaches as crude and naïve endeavors that seek to determine unchangeable laws of nature, rely solely on observations and “sense experience” of phenomena as the basis for knowledge, highlight the primacy of external conditions and actions to explain phenomena, and separate the subject from the object of study. That is, dialectical materialism views positivism as a form of mechanical, as distinct from historical, materialism.

This abridged account of dialectical materialism and the critiques it offers of Kantian idealism and sociological positivism can allow for the formation of a preliminary set of criteria for what may constitute the “critical.” We argue that qualitative research may be critical if it makes clear conceptually and analytically:

The essence and root cause of any social phenomena (e.g., youth and politics);

The relationship between the essence of the social phenomena under consideration to the general social totality (such as how youth and their views of politics are related to wider systems within society, such as education, age, exploitation);

The contradictions within this social phenomenon (such as how young people are expressing their discontent),

and, therefore,

How to conduct more reflexive practices that interrelate data generation, data analysis, and political engagement that challenge existing relations of power.

Contemporary debates between neo-Kantian idealists and dialectical materialists have often been friendly regarding the direction for carving out what is meant by a critical project in qualitative social research. These debates bring to the fore issues of politics, ethics, research design, and the collection and analysis of data. They have also prompted a variety of ways in which “critical” may be used in relation to qualitative research. For the purposes of this chapter, we suggest four substantial ways in which “critical” is used in the context of qualitative research: (a) critical as a form of liberalism, (b) critical as a counterdisciplinary perspective, (c) critical as an expansion of politics, and (d) critical as a professionalized research endeavor and perspective.

Critical as a form of Kantian liberalism is one of the more conventional uses of the term in qualitative research. This use of critical is generally contrasted against the dogmatism of positivist approaches within social scientific research. Yet, to use critical in this way means that we embrace a liberalism that ends up promoting idealism in outlook and pluralism in practice. That is, Kantian liberalism presents itself as a “critical” and novel analysis by combining eclectic ideas and theories while not making known its political stand and its material interests. As a result, it supports prevailing modes of thinking that emphasize abstraction over concrete reality, and it succumbs to relativistist and pragmatist practices in research, such as “anything goes” in collecting data. In terms of methods, this use of “critical” promotes looseness and leniency in ethics and data collection and analysis, often without a structured accountability to the many constituencies that underlie all social research. Furthermore, the use of, for example, phrases such as “critical spaces,” when applied to social research, may be better understood as a celebration of method above theory and meta-theory and an engagement with some (of the often rather) excessive approaches to reflexivity and meta-reflexivity. In sum, this understanding of “critical” lacks appropriate structures of ethics and accountability and often tends to reject dialectic materialism.

The second use of “critical” in regards to qualitative research proposes a more analytical disagreement with conventional scholarly disciplines and, in so doing, seeks to take up counterdisciplinary positions ( Burawoy, 1998 ; 2003 ; Carroll, 2004 ; Smith, 2007 ). There are two main strands in this use of “critical.” One strand argues that “critical” is a means of exposing the weaknesses of conventional academic disciplines such as anthropology, political science, psychology, and sociology. At the same time, this strand maintains the viability of these core social science disciplines. For instance, academic feminists have continually highlighted the masculinist and heterosexist bias in what is considered top-tier scholarship and the need for these disciplines to be more inclusive in terms of perspectives and methodological techniques (e.g., Fonow & Cook, 1991 ; Harding, 1991 ; Ray, 2006 ). Yet such an approach may not inevitably focus on the fundamental problems, such as a neglect of the study of power inequalities (e.g., Boserup 1970 ; and see examples in Reinharz & Davidman, 1992 ). This second strand seeks to carve out interdisciplinary and multidisciplinary fields such as women studies, cultural studies, and area studies to overcome the paradigmatic and fundamental crises within core disciplines ( Bhavnani, Foran, & Kurian, 2003 ; March, 1995 ; Mohanty, 2003 ). Many of these interdisciplinary and multidisciplinary fields have often been more historical and qualitative in their approaches, seeking to go beyond positivist limitations and present a more nuanced and thorough analysis. However, even these multi-, inter-, and antidisciplinary fields have an uneven impact on dominant and conventional knowledge.

Moreover, both strands have not been able to overcome the increasing corporatization and neoliberalization of academic institutions. This issue addresses the increasing restructuring of public education into a private domain, one that relies on privatized practices and funding of both teaching and research. The neoliberalization of the academy is found in the ties of academic research to corporate grants, individualized career advancement, excessive publishing demands and citation indices, and the use of outsourcing for transcription, interviewing, online education, and private research spaces that are “rented” by public institutions, to name a few. These neoliberal conditions of research usually push out those critical researchers who attempt to avoid such exploitative avenues for research, writing, and collaboration. This use of “critical,” however, does expose that critical research is taking shape within contemporary processes of neoliberalism and the increasing privatization of the academy ( Giroux, 2009 ; Greenwood, 2012 ; Pavlidis, 2012 ).

The third and less familiar approach is to view “critical” as invigorating politics through the practices of feminist, antiracist, and participatory action research. This approach, for example, highlights the importance of analyzing power in research, as in terms of the conduct of inquiry, in political usefulness, and in affecting relations of power and material relations. Yet this view of “critical” is dogmatic because this approach demands that every research study meet all criteria of criticality comprehensively and perfectly.

A final use of “critical” emerges from the many scholarly and professionalized approaches that engage with the politics of academic knowledge construction while making visible the limits of positivism. “Critical” is used here as a means to focus primarily on revitalizing scholarship and research endeavors. However, we argue that even this use of “critical” ossifies the separation of the making of specialized knowledge from an active engagement to transform social life. Such a separation is antithetical to dialectical materialism. Often, this fourth form of the term “critical” is based on the logics of the Frankfurt School of critical theory (such as that of Adorno [1973] , Habermas [1985] , and Marcuse [1968] ) and other Western neo-Marxisms (from Lukacs [1971] and Gramsci [1971] to Negri [1999] ). Critical ethnographers and other critical social researchers, drawing from this tradition, often develop public intellectual persona by writing and talking about politics through scholarly and popular forms of publishing and speaking presentations and are even seen to take part in political mobilizations. Yet they can also shy away from infusing their research with a deep engagement in political processes outside the academy.

Later in this chapter, we discuss how to avoid some of the pitfalls of these four types of “critical,” but suffice it to say, in short, that it is the politics and the explicit situatedness of research projects that can permit research to remain “critical.”

Is Critical Ethnography the Same as Critical Research?

George Marcus (1998) argues that the ethnographer is a midwife who, through words, gives birth to what is happening in the lives of the oppressed. Beverley Skeggs (1994) has proposed that ethnography is, in itself, “a theory of the research process,” and Asad (1973) offered the now-classic critique of anthropology as the colonial encounter. However, although many approaches to and definitions of ethnography abound, it is the case that they all agree on one aspect: namely, that ethnographies offer an “insider’s” perspective on the social phenomena under consideration. It is often suggested that the best ethnographies, whether defined as critical or not, offer detailed descriptions of how people see, and inhabit, their social worlds and cultures (e.g., Behar, 1993 ; Ho, 2009 ; Kondo, 1990 ; Zinn, 1979 ).

It is evident from our argument so far that we do not think of ethnographic approaches to knowledge construction as being, in and of themselves, critical. This is because an ethnographic study, although not in opposition to critical ethnography or to critical research in general, has practices rooted in social anthropology. Therefore, its assumptions are often in line with anthropological assumptions (see Harvey [1990] for a recounting of some of these assumptions). Concepts such as “insider” versus “outsider,” “going native,” “gaining access,” and even conceptualizations of a homogenized and/or exoticized “field” that is out there ready to be examined by research remain as significant lenses of methodological conceptualization in much ethnographic research.

Despite, or perhaps because of, the move to reflexivity in ethnographic research, there remain enduring assumptions about best practices. As a result, a certain fetishization of research methods transpires, one that is often epitomized as reflexivity. In this instance, ethnographic and qualitative research become an ideal set of practices for extracting information. In sum, “best research practices,” as ways to extract information, reproduce core power dynamics of racism, gender, class, imperialism, and heteronormativity, which, in turn, reproduce the oppressive dynamics of noncritical qualitative research.

Furthermore, when presenting research merely as reflexive research, it is the case that the researcher can lose sight of the broader social structural and historical materialist context. In addition, a static notion of reflexivity can lead to the researcher not looking outward to assess the wider interconnections among the micropolitics of the research. That is, reflexivity is a dialectic among the researcher, the research process, and the analysis ( Jordan & Yeomans, 1995 ), but it is often presented simply as a series of apparently unchangeable/essential facets of the researcher. Our final point is that for theory to be critical in the development of research paradigms, it has to explicitly engage with lived experiences and cultures for, without that engagement, it remains as formalism (see, e.g., the work of Guenther [2009] and Kang [2010] as examples of critical qualitative research). We are very much in tune with Hesse-Biber and Leavy, who have suggested that (grounded) theory building is a “dynamic dance routine” in which “there is no one right dance, no set routine to follow. One must be open to discovery” (2006, p. 76).

An example of the limitation of conventionally reflexive research is in the area of lesbian and gay research methods that focus on the experiences of gay men and lesbians conducting qualitative research. It also offers a commentary on the role that non-normative sexuality plays in social research. By looking inward (see the earlier comment on “reflexivity”), these methodological frameworks focus on the researcher’s and participants’ lesbian/gay identifications. In so doing, this can fabricate a shared social structural positionality with research participants who have been labeled “gay” or “lesbian.” Such an approach to reflexivity overlooks the fabricated nature of positionalities and ignores the sometimes more significant divisions between researchers and participants that are expressed along the lines of race, class, gender, and nationality. Reflexivity is used only as a way to forge a connection for the exchange of information. A grave mistake is made in this rush to force similarity along the lines of how people practice non-normative sexualities ( Lewin & Leap, 1996 ; for a more successful engagement with queer intersectionality in research, see Browne & Nash, 2010 ).

The point to be made is that critical researchers should not merely ask “how does this knowledge engage with social structure?” Critical researchers, when contemplating the question “What is this?” as they set up and analyze their research, could also ask, “What could this be?” ( Carspecken, 1996 ; Degiuli, 2007 ; Denzin, 2001 ; Noblit, Flores, & Murillo, 2004 , all cited in Degiuli, 2007 ). Perhaps, borrowing from Karen O’Reilly’s thoughts on critical ethnography, one may think of critical research as “an approach that is overtly political and critical, exposing inequalities in an effort to effect change” ( Reilly, 2009 , p. 51). That is, in order for qualitative research to be critical, it must be grounded in the material relationships of history, as may be seen in the work of Carruyo (2011) , Chua (2001 ; 2006 ; 2007 ; 2012 ), Collins (2005 ; 2007 ; 2009 ), Lodhia (2010) , and Talcott (2010) .

Quantz (1992) , in his discussion of critical ethnography, suggests that five aspects are central to the discussion of critical research/ethnography: knowledge, values, society, history, and culture. So far in this chapter, we have discussed knowledge and its production, values/reflexivity and qualitative research/ethnography, society and unequal social relationships, and history as a method of historical and dialectical materialism in order to better understand social and institutional structures. What we have not discussed, however, is the notion of culture, nor, indeed, the predicament of culture ( Clifford, 1998 ): “Culture is an ongoing political struggle around the meaning given to actions of people located within unbounded asymmetrical power relations” ( Quantz, 1992 , p. 483).

Quantz elaborates by stating that culture develops as people struggle together to name their experiences (see Comaroff & Comaroff, 2012 , for a sophisticated and elegant discussion of this thinking). For example, one key task of critical research is to tease out how disempowerment is achieved, undermined, or resisted. That is, the job of the researcher is to see how the disempowerment—economic, political, cultural—of subordinated groups manifests itself within culture, and, indeed, whether the subordinated groups even recognize their disempowerment. For example, “the hand that rocks the cradle rules the world” is one example of how the material disempowerment of many groups of women is presented, in fact, as a strength of women, and yet it takes the gaze away from seeing the subordination of women by ostensibly emphasizing women’s hidden social power.

It is critical qualitative research that has to simultaneously analyze how our research can identify processes and expressions of disempowerment and can then lead to a restructuring of these relationships of disempowerment. At times, critical social researchers engage in long-term projects that involve policy advocacy and community solidarity to link community-driven research with social empowerment and community change (see Bonacich, 1998 ; Bonacich & Wilson, 2008 ; Hondagneu-Sotelo, 2007 ; Stoecker, 2012 ).

The key point is that critical qualitative research parts company with positivistic approaches because it is argued that positivism is only able to offer a superficial set of findings. Critical qualitative research hones research concepts, practices, and analyses into finer points of reference so that societal relationships may be not only understood, but also so that social power inequalities can be undermined. In short, critical social research has a Foucauldian notion of power at its very core and may thus be thought of as offering insights into people’s lived experiences ( Williams, 1976 ) as they negotiate asymmetrical societal power relations (see e.g., Novelli, 2006 ).

The Practices of Critical Qualitative Research

Within our current era of enduring global inequalities, what could constitute a truly critical approach to qualitative research? More than twenty years ago, in “Tracing the Contours” ( Bhavnani, 1993 ), it was argued that if all knowledge is historically contingent and, therefore, that the processes of knowledge production are situated, then this must apply to all research practices as well. 2 This argument was based on Haraway’s (1988) idea that the particularities of knowledge production do not lie in the characteristics of individuals. Rather, knowledge production is “about communities, not about isolated individuals” (p. 590). Building on this, Haraway discussed the significance of partiality and its relationship to objectivity. She suggested that it is the researcher’s knowledge of her own “limited location” that creates objectivity. In other words, knowing the limitations of one’s structural position as a researcher contributes to objective research because there is no objectivity that is omniscient, one from which all can be revealed (Haraway discusses this as the “god trick,” which is like “seeing everything from nowhere,” p. 582).

It is from Haraway’s insights that we develop our argument that situated knowledges are not synonymous with the static reflexivity we describe earlier. This is because, in this latter scenario, the researcher implies that all research knowledge is based on and derives from an individual’s personal historical and biographical perspectives. That is, researchers note their racial/ethnic identity, sex/gender, sexuality, age, class, and ability (i.e., biographical aspects of themselves), which are presented as essential and unchanging factors and that determine the knowledge created by the research. This has also been called “absolute relativism” ( Bhavnani, 1993 ) or “extreme relativism” ( Alcoff & Potter, 1993 ).

We suggest that the three elements central to research being “critical” are partiality, positionality, and accountability. Partiality leads to critical research interrogating prevailing representations as the research is conducted, and this builds on difference. Positionality is not about being reflexive, but about understanding the sociohistorical/political context from which research is created and thus engages with the micropolitics of a research endeavor. Accountability makes it evident that there are many constituencies to which all academic researchers are accountable—for example, their discipline, intellectual integrity, their institution and academic colleagues, the idea of rigorous scientific research, and academic freedom in research—as well as being accountable to the people with whom the research is being conducted. It is accountability that leads to a critical research project interrogating how the lived experiences and cultures of the research participants are inscribed within the research (see Stoecker, 2012 ).

What might the necessary elements be for ensuring that our research practices retain the criticality we have discussed earlier? We offer four possibilities that could form a filter through which one could decide if research is critical, using our definition of the term. First, all critical qualitative researchers should interrogate the history of ethnographic research that has led to the systematic domination of the poor; working classes; ethnic, racialized, sexual Others; women; and colonized peoples. That is, critical qualitative researchers must begin research with an understanding of how previous research, including their own, may continue to play a part in the subordination of peoples around the world, for example, by reinscribing them into predictable and stereotypical roles. Second, critical qualitative researchers should work to develop a consciousness of what might constitute critical research practices—without fetishizing methods—that challenge the system of domination often present in social research. Third, researchers who embrace critical qualitative approaches must develop comfort with the notion that they are conducting research with a purpose; that is, researchers grapple with and comprehend that critical research demands that they engage with the idea that they conduct research into research inequalities in order to undo these inequalities. Finally, critical qualitative researchers comprehend that their level of comfort can extend into the idea that research does not simply capture social realities; rather, the critical research approach is generative of narratives and knowledges. Once this last idea is accepted—namely, that knowledge is created in a research project and not merely captured—it is then a comparatively straightforward task to see the need for a researcher’s accountability for the narratives and knowledges he or she ultimately produces. In so doing, it is possible to recognize that all representations have a life of their own outside of any intentions and that representations can contribute to histories of oppression and subordination.

We propose that it is the actual practice of research, and, perhaps, even the idea of researcher as witness ( Fernandes, 2003 ), and not a notion of “best practices,” that keeps the politics of research at the center of the work we do. This includes insights into the redistribution of power, representation, and knowledge production. We suggest that critical research is work that shifts research away from the production of knowledge for knowledge’s sake and edges or nudges it toward a more transformative vision of social justice (see Burawoy, 1998 ; Choudry, 2011 ; D’Souza, 2009 ; Hussey, 2012 ; Hunter, Emerald, & Martin, 2013 ).

Thoughts from the Field

Here, based on Collins’s fieldwork, we highlight a set of critical methodological lessons that became prominent while she was conducting her field research in Malate, in the city of Manila, the Philippines, currently a tourist destination but once famous as a sex district. We define her work as a critical research practice.

Since 1999, Dana Collins has conducted urban ethnographic work in Malate, exploring gay men’s production of urban sexual place. She has been interested in the role of “desire” in urban renewal, and, in particular, how informal sexual laborers (whom she terms “gay hospitality workers,” a nomenclature drawn from their own understandings of their labor and lives) use “desire” to forge their place in a gentrifying district that is also displacing them. This displacement has involved analyzing urban tourism development, city-directed urban renewal, and gay-led gentrification, as well as informal sexual labor.

The research has involved her precarious immersion in an urban sexual field. She undertook participant observation of gay night life in the streets, as well as in private business establishments, and conducted in-depth and in-field interviews with gay business owners, city officials, conservationists, gay tourists, and gay-identified sexual laborers. In addition, she drew on insights from visual sociology and also completed extensive archival work and oral history interviewing. In all of this, she explored the collective memories of Malate as a freeing urban sexual space.

There exist multiple and shifting positionalities of power, knowledge, exchange, and resistance in her research. For one, she points out that she occupies multiple social locations as a white, lesbian-identified feminist ethnographer from a US university, one who forges complicated relationships with urban sexual space, sex workers, and both gay Filipino men and gay tourists.

A critical research practice at heart involves the shifting of epistemological foundations of social science research by addressing core questions of how we know what we know, how power shapes the practices of research, how we can better integrate research participants and communities as central producers of knowledge in our research, and how we can better conceptualize the relationship between the research we do and the social justice we are working toward in this world. 3 Such questions function as a call to action for critical researchers not only to examine the power relations present in research, but to generate new ways of researching that can confront the realities of racism, gender and class oppression, imperialism, and homophobia. This is about not only becoming better researchers, but also about seeking ways to shift the very paradigm of qualitative research and ensuring its service to social change. We have learned to use these questions as a central and ongoing part of the research we do.

Feminist and Queer Accountability to the Micropolitics of the Field

One of the primary tenets of critical qualitative research is that researchers must work with a wider understanding and application of the politics of research. For Kum-Kum Bhavnani (1993) , this means that one needs to be accountable to the micropolitics of research because such accountability destabilizes the tendency to conduct and present research from a transcendent position—the “all knowing” ethnographer, the “outsider” going in to understand the point of view of “insiders,” the attempt to (avoid) “go(ing) native,” and the researcher who aims to “gain access” at all costs and in the interests of furthering research. Micropolitics is not only the axis of inequality that shapes contemporary field relations; it is also the historical materialist relationship that constitutes the field and informs the basis of critical qualitative research. Micropolitics therefore is a critical framework that questions the essentializing and power-laden perceptions of research spaces and people because it encourages both a reflexive inquiry into the limited locations of research, and it involves the more critical practice of the researcher turning outward, to comprehend what Bhavnani calls the “interconnections” among researcher, research participants, and the social structural spaces of “the field.”

Micropolitics illuminates how all research is conducted from the limited locations of gender, race, class, sexual identification, and nationality, as well as illuminating the interconnections among all of these locations. This is not a simplistic reflexive practice of taking a moment in research to account for one’s positionality and then moving on to conduct normative field work; Bhavnani has been critical of such moments of inward inspection that lack substantial accountability to the wider micropolitics of the field. Rather, this move requires an ongoing interrogation of the limited locations of research that show how knowledge is not transcendent. Furthermore, when used reflexively, limited locations offer a more critical framework from which to practice research.

Micropolitics encouraged Collins’ attention to the limited location of a global feminist ethnographer doing research on gay male urban sexual space in Manila. For one, she moved among different positionalities throughout her research—of woman, queer-identified, white, US academic, tourist, ate (Tagalog term for older sister)—and none of these positions was either a transcendent or more authentic standpoint from which to conduct ethnographic work. So, for instance, as a white tourist, she moved easily among the gentrifying gay spaces because these spaces were increasingly designed to encourage her movement around Malate. This limited location showed the increasing establishment of white consumer space, which encouraged the movement of consumers like herself yet dissuaded the movement of the informal sexual laborers with whom she was also spending time—the gay hosts. Her limited location as a white woman researcher from a major US university meant that gay hosts sometimes shared their spaces and meanings of urban gay life with her, yet many times those particular spaces and dialogues were closed—she was not allowed into the many public sexual spaces (parks and avenues for cruising and sex late at night), yet gay hosts treated her as an audience for their many romantic stories about the boyfriends they met in the neighborhood.

Hosts emphasized that they gained much from hosting foreigners in terms of friendship, love, desire, and cultural capital. Yet they monitored the information they shared because she remained to them a US researcher who wielded the power of representation over their lives, despite her closeness with a group of five gay hosts. Hence, gay hosts often chose to remain silent about their difficult memories of sex work or any information that could frame them as one-dimensional “money boys,” as distinct from the “gay”-identified Filipino men who migrated to Malate to take part in a gay urban community.

Micropolitics challenges the authenticity of any one positionality over another; it was Collins’ movement among all of them, as well as her ongoing consideration of their social structural places, that provided her with a more critical orientation to the research. She suggests that she was not essentially a better “positioned” researcher to study “gay” life in Manila because she too is gay. Rather she found that differences of race, class, gender, and nationality tended to serve as more enduring, limited locations that influenced relationships within this research and that required ongoing critical reflexive engagement.

We want to add that a queer micropolitics of the field also offers critical insight into how identities are not stagnant but rather can be fabricated and performative during the research process. This moves researchers away from an essentialist take on their standpoint because an essentialist mind-set can lead to a search for the authentic insider and outsider. It can also lead to an essentialist social positionality that is more conducive for researching. Queer micropolitics show that research is made up of a collection of productive relations and identities. So, for example, her lesbian identification did not create a more authentic connection with gay hosts in Manila; rather, she often fabricated a shared “gay” positionality. This was a performance that served as a point of departure for her many conversations, from which she could proceed to share meanings of what it meant to be “gay” in the Manila and the United States.

Some of the productive relations that arise in research are the continuum of intimacies that develop while doing research. So, like feminists before her, she chose to develop close friendships with hosts where they genuinely loved (in a familial way) as they spoke of love. While learning about gay life in Malate, she stroked egos, offered advice, cried over broken hearts and life struggles, and built and maintained familial relations. Queer micropolitics shows, however, the limitations of such intimacies because intimacy does not equal similarity—the differing social locations of class, race, gender, and nationality meant that the experiences of urban gay life varied immensely. Thus, building such intimacies across these differences requires both the recognition and respect for boundaries that hosts constructed. She had to learn to see and know that when hosts became quiet and pulled away these were acts of self-preservation as well as acts of defiance against the many misrepresentations of their lives that had taken shape in academic research and journalistic renderings of their place in “exotic” sex districts.

A queer micropolitics also shows how research is an embodied practice: researchers are gendered, racialized, classed, and sexualized in the field. This became most apparent as she walked alone at night in the “field” and developed a keen awareness of the deeply gendered aspects of Malate’s urban spaces. For one, her embodiment was a peculiar presence because women in Manila do not walk alone at night. This includes women sex workers who publicly congregate in groups or with clients and escorts; otherwise, they are subject to police harassment. Hence, her very movement in the field as a sole woman felt like a transgression into masculine urban space because her feminine body was treated as “out-of-place” in the public spaces of the streets at night—she was flirted with, name called, followed, and sexually handled as she walked to gay bars for her research. As much as her queer location afforded her an understanding of how gender is a discursive production on the body, replete with the possibility of her being able to transcend and destabilize the gendered body as a biological “reality,” she confronted the discomfort of being read as a real woman in what became predominantly men’s spaces at night.

Yet this gendered embodiment, in part, shaped her knowledge of the district as she developed quick and knowledgeable movement through the streets, a queer micropolitical reading of urban space that arose out of this limited gender location. She was aware of the spacing of blocks, the alleys, the street lighting, and the time of night when crowds spilled out from the bars and onto the streets, allowing her to realize that a socially vibrant street life actually facilitated her movement. This queer micropolitical reading of urban space showed how both researchers and research participants do not simply exist in a neutral way in city space; rather, gender leads to our use and misuse of urban space. She has juxtaposed her experience with those of research participants in her study. The latter spoke at length about their exploratory and liberatory experiences of urban space, replete with their access to masculine sexual spaces—parks for cruising and sex, city blocks for meeting clients or picking up male sex workers, and alleys, movie theaters, and mall bathrooms for anonymous sex.

This queer micropolitical read of Malate’s gentrified space showed how very different was her access to the newly opening bars, restaurants, cafés, and lifestyle stores. Her whiteness signaled assumptions of her class location and positioned her as part of the international presence that this gentrifying space was targeting and whose movement among establishments was encouraged. She received free entry, free drinks, exceptional hospitality, and invitations to private parties, and her movements were closely monitored as she entered and exited establishments for the sake of “protecting a foreign tourist from street harassment” (interview with bar owner).

Overall, she experienced whiteness and class as equally embodied because these locations signaled her power as a “legitimate” consumer, allowing access to urban consumer sites and a privileged movement among gentrified spaces. This embodied experience of gentrified space differed from that of her gay hosts, who were often denied access to these establishments for being Filipino, young, working class, gay, and interested in foreigners. Contrarily, their bodies were constructed as a “threat” to urban renewal in the district.

Resisting Reinscription

Critical qualitative research is also concerned with the politics of representation in research. This requires a hard look at the implicit imperialisms of ethnographic work, including the tendency to go in and get out with abundant factual information, as well as the lasting impact of objectificatory research practices on fields of study. Such practices are evident in the now global rhetoric about the so-called Third World prostitute, who in both academic and journalistic renderings tends to be sensationalized and sexually Othered. This rendering is part of a long history of exoticization that has denied subjectivity and rendered invisible the lived experiences of sexual laborers around the world.

Such failed representations are part of what Kum-Kum Bhavnani (1993) has called “reinscription”—the tendency in research to freeze research participants and sites in time and space, thus rendering them both exotic and silenced. Reinscription denies agency to research participants and renders invisible the dynamic lived experiences of those same research participants. Doing research in both postcolonial and sexual spaces means that researchers must grapple with how our research participates in histories of reinscription—we both enter into and potentially contribute to a field that has been already “examined,” overstudied, and often exoticized. Thus, a critical qualitative approach is one that begins with a thorough understanding of these histories of representation so that we are not entering fields naïvely, as spaces only of exploration. Rather, we enter with knowledge of how the field has already been constituted for us through reinscription. A critical orientation has a core objective of understanding how our representations of research at all levels of the research process could contribute to exoticization by reinscribing participants and sites.

The issue of reinscription became particularly apparent when Dana Collins interviewed gay hosts and grappled with what appeared to be their elaboration of a contradictory picture of their sexual labor, as well as of their lives. In short, hosts tended to “lie,” remain silent, embellish “truths,” and articulate contradictory allusions to their life and labor in Malate. When Collins began her interviewing, she held the implicit objective of obtaining the “truth” about hosts’ lives, which she believed resided in “what they do” in the tourism industry. She was concerned with the “facts” about their lives, even though gay hosts were more likely to express their desire—desire for relations with foreigners, desire to migrate to a “gay” urban district, desire for rewarding work, and desire for community and social change. She struggled with many uncertainties about the discussions: how could they hold a range of “jobs” and attend school, yet spend most of their days and nights in Malate? How could they understand gay tourists as both boyfriends and clients? Why resist the label “sex worker” yet refer to themselves as “working boys” and claim to have “clients?” She struggled to make sense of the meanings that hosts offered even as she simultaneously felt misled concerning the “real” relations of hospitality.

Interviewing hosts about sexualized labor—as a way to produce a representation of sex work—did not facilitate the flow of candid information; hosts later expressed their view that sex work and their lives were already “overstudied.” Many researchers had previously descended on Malate to study sex work, and the district was a prime location for the outreach of HIV/AIDS organizations, some of which had breached the confidence of the gay host community. In short, Dana mistakenly started her research without the knowledge of Malate as a hyperrepresented field, and her research risked reinscribing gay hosts’ lives within that field as static and unchanging.

Importantly, those gay hosts who resisted becoming the “good research subjects” who give accurate and bountiful information, prompted a radical shift in her research framework. They told her stories about their imagined social lives, which encouraged her to rethink her commitment to researching sex work because the transformation of the discourses offered another view of the district, their work, and lives, one that offered a more visionary perspective. She began to focus less on “misinformation” and instead followed how hosts framed their lives. She treated these framings as social imaginings in which Malate features prominently in their understandings of gay identity, community, belonging, and change. In short, their social imaginings functioned as counternarratives to reinscription and offered their lived experience of urban gay place. Such imaginations expressed hope, fear, critique, and desire—in short, they present a utopic vision of identity, community, and urban change.

Integrating Lived Experience

Finally, critical qualitative research is a call to study lived experience, which is a messy, contradictory realm, but a deeply important one if we as critical researchers are truly interested in working against a history of research that has silenced those “under study” (see Weis & Fine, 2012 ). Paying attention to lived experience allows us to better engage with the contradictions mentioned earlier because lived experience is about understanding the meanings that research participants choose to share with researchers, and it is also about respecting their silences. As Kum-Kum Bhavnani (1993) has argued, silences can be as eloquent as words. Finally, integrating lived experience can take a critical qualitative project further because lived experience allows researchers to explore the epistemological relationship of the meanings and imaginings offered by research participants and to be explicit about the project of knowledge production. In other words, a central guiding question of critical qualitative research is how can research participants speak and shape epistemology, rather than solely being spoken about or being the subjects of epistemology?

Collins used hosts’ social imaginings as an epistemological contribution because their imaginings showed how hosts draw from experiences of urban gay community to articulate their desires for change, despite their simultaneous experiences of inequality and exclusion. We read social imaginings as a subjective rendering of urban place—the hosts’ social imaginings expressed their history, identity, subversive uses of urban space, and, ultimately, the symbolic reconstitution of that urban space. In this way, hosts were refiguring transnational urban space by writing themselves and their labor back into the district’s meaning, even as the global forces of tourism and urban renewal threatened to displace them.

In conclusion, we seek to highlight how critical research insists on the interplay of reflexivity, process, and practice. In particular, we encourage critical researchers to be mindful of the multiple meanings and usages of the term “critical” so that we can make more explicit our political interests and stand within our disciplines, the academy, our community, and the world. We offer dialectical materialism as a distinct mode of critical analysis that emphasizes an analysis of change in essence, practice, and struggle. We also suggest that, for researchers to be critical in their research, they should strive to take up research questions and projects that study change, contradictions, struggle, and practice in order to counter dominant interests and advance the well-being of the world’s majority. We should strive to build new research relationships—such as overcoming the faulty divides between researchers and research participants and by promoting systems of community accountability—that dialectically fuse research, political activism, and progressive social change.

Furthermore, we suggest that critical research can agitate against the homogeneity of ethnographic representation, allowing for the realities of people’s lives to come into view. Critical researchers recognize the contested fields of research; yet this requires our critical engagement with the research process, as a reflexive, empathetic, collective, self-altering, socially transformative, and embedded exercise in knowledge production. Therefore, critical research can resist imperialist research practices that are disembodied and that assume a singular social positioning. We use an imperative here to say that we must conduct research as embodied subjects who shift between multiple and limited locations. We also have to find more ways to remain accountable to our communities of research as a way to undo implicit imperialisms in social research. Critical research can work against the remnants of an objectivist and truth-seeking method that supports prevailing interests, classes, and groups while embracing research from social locations that offer situated knowledges and the possibility for greater shared understandings. Finally, critical research can engage the micropolitics of research and foreground the need for the accountability of researchers to resist reproducing epistemic violence.

This last is an idealist imagining of what should happen. However, a number of research projects have approximated closely to these goals.

Parts of our argument have appeared in some of our earlier work (e.g., Bhavnani & Talcott, 2011 ; Collins, 2009 ; 2002 ; Chua, 2001 ).

Although we, as the chapter’s three authors, do not usually use “we” in our writing as a general pronoun, it is the most direct way to offer our insights in this section.

Adorno, T. W. ( 1973 ). Negative dialectics . London: Routledge and Kegan Paul.

Google Scholar

Google Preview

Alcoff, L. , & Potter, E. (Eds.). ( 1993 ). Feminist epistemologies . New York: Routledge.

Asad, T. (Ed.). ( 1973 ). Anthropology and the colonial encounter . London: Ithaca Press.

Behar, R. ( 1993 ). Translated women: Crossing the border with Esperanza’s story . Boston: Beacon Press.

Bhavnani, K. -K. ( 1993 ). Tracing the contours: Feminist research and feminist Objectivity.   Women’s Studies International Forum , 16 (2), 95–104.

Bhavnani, K. -K. , Foran, J. , & Kurian, P. (Eds.). ( 2003 ). Feminist futures: Re-imagining women, culture, and development . London: Zed Books.

Bhavnani, K. -K. , & Talcott, M. ( 2011 ). Interconnections and configurations: Towards a global feminist ethnography. In S. N. Hesse-Biber (Ed.), Handbook of feminist research: Theory and praxis (pp. 176–186). Thousand Oaks, CA: Sage Publications.

Bonacich, E. ( 1998 ). Reflections on union activism.   Contemporary Sociology , 27 (2), 129–132.

Bonacich, E. , & Wilson, J. B. ( 2008 ). Getting the goods: Ports, labor, and logistics revolution . Cornell, NY: Cornell University Press.

Boserup, E.   1970 . Women’s Role in Economic Development . New York: St. Martin’s Press.

Browne, K. , & Nash, C. J. (Eds.). ( 2010 ). Queer methods and methodologies: Intersecting queer theories and social science research . Burlington, VA: Ashgate Publishing Company.

Burawoy, M. ( 1998 ). The extended case method.   Sociological Theory , 16 (1), 4–33.

Burawoy, M. ( 2003 ). Revisits: Outline of a theory of reflexive ethnography.   American Sociological Review , 68 , 645–679.

Carroll, W. (Ed.). ( 2004 ). Critical strategies for social research . Ontario: Canadian Scholars Press.

Carspecken, P. F. ( 1996 ). Critical Ethnography in Educational Research: A theoretical and practical guide . New York: Routledge.

Carruyo, L. ( 2011 ). Producing knowledge, protecting forests: Rural encounters with gender, ecotourism, and international aid in the Dominican Republic . Philadelphia: Penn State University Press.

Choudry, A. ( 2011 ). On knowledge, learning and research in struggle. In C. Fanelli & P. Lefebvre (Eds.), Uniting struggles: Critical social research in critical times (pp. 175– 194). Ontario: Red Quill Books.

Clifford, J. ( 1998 ). The predicament of culture: Twentieth-century ethnography, literature, and art . Cambridge, MA: Harvard University Press.

Chua, P. (2001). Condom matters and social inequalities: Inquiries into condom production, exchange, and advocacy practices . PhD. dissertation, Department of Sociology, University of California, Santa Barbara, CA.

Chua, P. ( 2006 ). Bloodshed and coercive communal peace negotiations. In R. Tolentino & S. Raymundo (Eds.), Kontra-gahum: Academics against political killings (pp. 42–57). Quezon City, Philippines: IBON Publishing.

Chua, P. ( 2007 ). Corporatizing public education in the Philippines: The case of USAID and the Ayala Foundation. In B. Lumbera , R. Guillermo , & A. Alamon (Eds.), Mula Tore Patungong Palengke: Neoliberal education in the Philippines (pp. 115–125). Quezon City, Philippines: IBON Publishing.

Chua, P. ( 2012 ). National schooling in crisis: Neoliberal policies and the 2011 justice campaign for the PGCPS Filipino overseas contract teachers.   Pingkian , 1 (1), 45–58.

Collins, D. M. (2002). Laboring districts, pleasuring sites: Hospitality, “gay” life, and the production of urban sexual space in Manila . Ph.D. dissertation, Department of Sociology, University of California, Santa Barbara, CA.

Collins, D. ( 2005 ). Identity, mobility, and urban placemaking: Exploring gay life in Manila.   Gender and Society , 19 (2), 180–198.

Collins, D. ( 2007 ). When sex work isn’t “work”: Hospitality, gay life, and the production of desiring labor.   Tourist Studies , 7 (2), 115–139.

Collins, D. ( 2009 ). “ We’re there and queer”: Homonormative mobility and lived experience among gay expatriates in Manila.   Gender and Society , 23 (4), 465–493.

Comaroff, J. , & Comaroff, J. L. ( 2012 ). Theory from the South: How Euro-America is evolving towards Africa . Boulder, CO: Paradigm Publishers.

D’Souza, R. ( 2009 ). The prison houses of knowledge: Activist scholarship and revolution in the era of globalization.   McGill Journal of Education , 44 (1), 19–38.

Degiuli, F. ( 2007 ). A job with no boundaries: Home eldercare work in Italy.   European Journal of Women’s Studies , 14 (3), 193–207.

Delanty, G. ( 2005 ). Social science: Philosophical and methodological foundations (2nd ed.). Berkshire, UK: Open University Press.

Denzin, N. K. ( 2001 ). Interpretive interactionism . Thousand Oaks, CA. Sage Publications.

Engels, F. (1877/ 1969 ). Anti-Dühring . London: Lawrence and Wishart.

Fernandes, L. ( 2003 ). Transforming feminist practice: Non-violence, social justice, and the possibilities of a spiritualized feminism . San Francisco: Aunt Lute Books.

Fonow, M. M. , & Cook, J. A. (Eds.). ( 1991 ). Beyond methodology: Feminist scholarship as lived research . Bloomington: Indiana University Press.

Giroux, H. A. ( 2009 ). Democracy’s nemesis. The rise of the corporate university.   Cultural Studies ↔ Critical Methodologies , 9 (5), 669–695.

Gouldner, A. ( 1970 ). The coming crisis of American sociology . New York: Basic Books.

Gramsci, A. ( 1971 ). Selections from the prison notebooks of Antonio Gramsci . ( Q. Hoare & G. N. Smith , Eds. & Trans.). New York: International Publishers.

Greenwood, D. J. ( 2012 ). Doing and learning action research in the neo-liberal world of contemporary higher education.   Action Research , 10 (2), 115–132.

Guenther, K. M. ( 2009 ). The impact of emotional opportunities on the emotion cultures of feminist organizations.   Gender and Society , 23 (3), 337–362.

Habermas, J. ( 1985 ). The theory of communicative action: vol. 2: Lifeword and system: A critique of functionalist reason . Boston: Beacon Press.

Haraway, D. ( 1988 ). Situated knowledges: The science question in feminism and the privilege of partial perspective.   Feminist Studies , 14 (3), 575–599.

Harding, S. ( 1991 ). Whose science? Whose knowledge? Ithaca: Cornell University Press.

Harvey, D. ( 1996 ). Justice, nature, and the geography of difference . Cambridge, MA: Blackwell Publisher.

Harvey, L. ( 1990 ). Critical social research . London: Routledge.

Hesse-Biber, S. N. , & Leavy, P. ( 2006 ). The practice of qualitative research . Thousand Oaks, CA: Sage Publications.

Ho, K. ( 2009 ). Liquidated: An Ethnography of Wall Street . Durham: Duke University Press.

Hondagneu-Sotelo, P. ( 2007 ). Domestica: Immigrant workers cleaning and caring in the shadows of affluence (2nd ed.). Berkeley: University of California Press.

Hunter, L. , Emerald, E. , & Martin, G. ( 2013 ). Participatory activist research in the globalised world . Düsseldorf: Springer.

Hussey, I. ( 2012 ). “Political activist as ethnographer” revisited.   Canadian Journal of Sociology , 37 (1), 1–23.

Jordan, S. , & Yeomans, D. ( 1995 ). Critical ethnography: Problems in contemporary theory and practice.   British Journal of Sociology of Education , 16 (3), 389–408.

Kant, I. (1781/ 1965 ). The critique of pure reason . New York: St. Martins Press.

Kang, M. ( 2010 ). The managed hand: Race, gender, and the body in beauty service work . Berkeley: University of California Press.

Kondo, D. K. ( 1990 ). Crafting selves: Power, gender, and discourses of identity in a Japanese workplace . Chicago: University of Chicago Press.

Lenin, V. I. (1915/ 1977 ). On the question of dialectics. In Collected works (vol. 38, pp. 357–361). Moscow: Progress Publishers.

Lewin, E. , & Leap, W. L. (Eds.). ( 1996 ). Out in the field: Reflections of lesbian and gay anthropologists . Champaign, IL: University of Illinois Press.

Lodhia, S. ( 2010 ). Constructing an imperfect citizen-subject: Globalization, national “security,” and violence against South Asian women.   Women’s Studies Quarterly , 38 (1), 161–177.

Lukacs, G. ( 1971 ). History and class consciousness . ( R. Livingstone ,)Trans.. Cambridge, MA: MIT Press.

Mao, Z. ( 1990 ). Lecture notes on dialectical materialism . In N. Knight (Ed.), Mao Zedong on dialectical materialism: Writings on philosophy, 1937 (pp. 84–131). Armonk, NY: M. E. Sharpe.

Madison, D. S. ( 2012 ). Critical ethnography: Method, ethics, and performance (2nd ed.). Thousand Oaks, CA: Sage Publications.

Marchand, M. H. ( 1995 ). Latin American women speak on development: Are we listening yet? In M. H. Marchand & J. L. Parpart (Eds.), Feminism/postmodernism/development (pp. 56–72). London: Routledge.

Marcus, G. E. ( 1998 ). Ethnography through thick and thin . Princeton, NJ: Princeton University Press.

Marcuse, H. ( 1968 ). Negations: Essays in critical theory . Boston: Beacon Press.

Marx, K. (1845/ 1976 ). Thesis on Feuerbach. In Marx and Engels collected works (vol. 5, pp. 3–9). New York: International Publishers.

Mohanty, C. T. ( 2003 ). Feminism without borders: Decolonizing theory, practicing solidarity . Durham, NC: Duke University Press.

Reinharz, S. , & Davidman, L. (Eds.). ( 1992 ). Feminist methods in social research . New York: Oxford University Press.

Negri, A. ( 1999 ). Insurgencies: Constituent power and the modern state . Minneapolis, MN: University of Minnesota Press.

Noblit, G. W. , Flores, S. Y. , & Murillo, E. G. ( 2004 ). Postcritical ethnography: Reinscribing critique . New York: Hampton Press.

Novelli, M. ( 2006 ). Imagining research as solidarity and grassroots globalisation: A response to Appadurai (2001).   Globalisation, Societies and Education , 4 (2), 275–286.

Ollman, B. ( 2003 ). Dance of the dialectic: Steps in Marx’s method . Champaign, IL: University of Illinois Press.

Pavlidis, P. ( 2012 ). The antinomic condition of the university: “Universal labour” beyond “academic capitalism.”   Journal for Critical Education Policy Studies , 10 (2), 139–159.

Ray, R. ( 2006 ). Is the revolution missing or are we looking in the wrong places?   Social Problems , 53 (4), 459–465.

Reilly, K. ( 2009 ). Key concepts in ethnography . London: Sage Publications.

Quantz, R. A. ( 1992 ). On critical ethnography (with some postmodern considerations). In M. S. Lecompte , W. L. Millroy , & J. Preissle (Eds.), Handbook of qualitative research in education (pp. 447–505). San Diego, CA: Academic Press.

Skeggs, B. ( 1994 ). Situating the production of feminist ethnography. In M. Maynard (Ed.), Researching women’s lives from a feminist perspective (pp. 72–81). London: Routledge.

Smith, D. ( 2007 ). Institutional ethnography: From a sociology for women to a sociology of the people. In S. N. Hesse-Biber (Ed.), Handbook of feminist research: Theory and praxis (pp. 409–416). Thousand Oaks, CA: Sage Publications.

Smith, L. T. ( 1999 ). Decolonizing methodologies . London: Zed Books.

Stoecker, R. ( 2012 ). Research methods for community change: A project based approach (2nd ed.). Thousand Oaks, CA: Sage Publications.

Strydom, P. ( 2011 ). Contemporary critical theory and methodology . London: Routledge.

Talcott, M. ( 2010 ). As neoliberal crises persist, indigenous-led movements resist: Examining the current social and political-economic conjuncture in southern Mexico. In R. A. Dello Buono & D. Fasenfest (Eds.), Social change, resistance and social practices (pp. 131–148). Boston: Brill Publishers.

Thomas, J. ( 1993 ). Doing critical ethnography . Thousand Oaks, CA: Sage Publications.

Weis, L. , & Fine, M. ( 2012 ). Critical bifocality and circuits of privilege: Expanding critical ethnographic theory and design.   Harvard Educational Review , 82 (2), 173–201.

Williams, R. ( 1976 ). Keywords: A vocabulary of culture and society . New York: Oxford University Press.

Zinn, M. B. ( 1979 ). Field research in minority communities: Ethical, methodological and political observations by an insider.   Social Problems , 27 (2), 209–219.

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The larger the nonprofit, the more likely it is run by a white man, says new Candid diversity report

Candid CEO Ann Mei Chang poses for a photo at the nonprofit’s headquarters on Wednesday, Jan. 31, 2024, in New York. Chang, CEO since 2021, believes her organization can help the philanthropic sector work more efficiently by making more data from donors and grantees available to the public.(AP Photo/Peter K. Afriyie)

Candid CEO Ann Mei Chang poses for a photo at the nonprofits’s headquarters on Wednesday, Jan. 31, 2024, in New York. Chang, CEO since 2021, believes her organization can help the philanthropic sector work more efficiently by making more data from donors and grantees available to the public. (AP Photo/Peter K. Afriyie)

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NEW YORK (AP) — White men are most likely to lead the largest, best-funded nonprofits, while women of color tend to lead the organizations with the fewest financial resources, according to a study from the nonprofit data research organization Candid.

“ The State of Diversity in the U.S. Nonprofit Sector ” report released by Candid on Thursday is the largest demographic study of the nonprofit sector, based on diversity information provided by nearly 60,000 public charities.

According to the study, white CEOs lead 74% of organizations with more than $25 million in annual revenue, with white men heading 41% of those nonprofits, despite being only about 30% of the population. Women of color, who make up about 20% of the U.S. population, lead 14% of the organizations with more than $25 million in revenue and 28% of the smallest nonprofits — those with less than $50,000 in revenue.

The Candid report provides data for nonprofits who have complained for years that minority-led nonprofits attract fewer donations, government resources and sales, even after the racial reckoning following the murder of George Floyd and promises from funders of all sizes seeking change. Many groups argue that when the leadership of a charity comes from the community it is serving, its needs are met more effectively. According to a report from the Ms. Foundation for Women and the consulting group Strength in Numbers, less than 1% of the $67 billion that foundations donated in 2017 was earmarked specifically for minority women and girls.

“Our mission is to use data to help make the whole sector more efficient, effective and equitable,” Candid CEO Ann Mei Chang told The Associated Press. “We think that data is a force for good and can help everybody trying to do good, to do good better.”

The report’s findings are based on data gathered from the Demographics via Candid initiative, where nonprofits voluntarily report the diversity numbers of their organizations. Cathleen Clerkin, Candid’s associate vice president of research, said authors of the report compared its findings to other sector-wide data and found them to be consistent.

Because the diversity information was self-reported, Clerkin said Candid studied whether nonprofits would be more likely to share their information because they were more diverse, but found that was not the case. What was more likely to determine whether a nonprofit reported its diversity information was how much they depended on outside donations, said Clerkin, adding that Candid hopes the report will encourage more charities to provide its organization’s information.

The report found that environmental and animal welfare groups were least likely to have diverse leadership, with 88% having a white CEO. Nearly three-quarters of religious nonprofits had white CEOs, according to the report.

Portia Allen-Kyle, chief of staff and interim head of external affairs at the racial justice nonprofit Color of Change, said the report’s findings were not surprising. “The backsliding of Black leadership and other underrepresented populations is exactly what we unfortunately expect to see in an era of attacks on the tools of Black power like affirmative action, like DEI (diversity, equity and inclusion), et cetera,” she said. ”It’s a nonprofit space where disproportionately white leaders disproportionately receive resources from these white, ultrawealthy donors, while Black leaders from the most impacted communities are expected to often turn water into wine, using nothing but pennies on the dollar.”

Allen-Kyle said the fact that the report also finds that women of color are overrepresented as leaders of the smallest charities is also not a surprise. “With these small nonprofits, especially with advocacy, Black women are going to be doing this work regardless and they’re doing it on nothing and whether or not they get paid because they believe in it,” she said.

The report also found that Latinos were underrepresented as nonprofit CEOs in nearly every state.

“We have been talking about that for decades,” said Frankie Miranda, president and CEO of the Hispanic Federation, which supports Latino communities and nonprofits. “It’s the reason the Hispanic Federation was created in 1990 — to advocate for Latino-led, Latino-serving providers because we were not part of the conversation when decision-making around funding and support was happening.”

That has led to Hispanic Federation becoming one of the nation’s largest grantmakers for Latino nonprofits. However, even though its findings are not unexpected, the Candid study is still extraordinarily valuable, Miranda said.

“This study will validate our argument,” he said. “This is critically important for us to be able to say, ‘Here’s the proof.’ It’s proof for major donors that you need to do better when it comes to diversity within your organization. Your institution needs to have the cultural competency to understand the importance of investing in our organizations, the importance of getting to know these organizations. They know how to serve these communities.”

Associated Press coverage of philanthropy and nonprofits receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content. For all of AP’s philanthropy coverage, visit https://apnews.com/hub/philanthropy .

Video games can have a positive impact on children—if designed with the right features, says new study

New research finds that digital games can contribute to the well-being of children, but game producers must design games to support positive outcomes.

Video games can contribute to and support the well-being of children if they are designed with the needs of children in mind, according to new research from UNICEF Innocenti and collaborating institutions, including New York University.

The report, the second in the Responsible Innovation in Technology for Children (RITEC) project, establishes that digital gaming companies and game designers can and should support the well-being of children through the games they produce and demonstrates that digital play has a particularly positive impact on children’s autonomy, competence, creativity, and identity when it responds to their deep interests, needs and desires. The project was co-founded by UNICEF and the LEGO Group and is funded by the LEGO Foundation.

NYU Steinhardt Professor Jan L. Plass led one of three studies appearing in the report. To understand the effect of digital play on children’s well-being, Plass and his colleagues implemented a 10-week intervention involving digital games including Lego Builder’s Journey and Rocket League with 255 children ages 8 through 12 years old. Among their findings, US children with a greater need for belonging relayed more positive feelings toward their social and parental relationships and an improved sense of autonomy. In Chile, children reported greater autonomy and improved parental relationships. In South Africa, the digital play generally supported well-being for all children.

“Many parents are concerned about screen time for their children, and this is the first study investigating the effect of digital play on well-being for this age group in the US, Chile, and South Africa,” said Plass, founding director of the Consortium for Research and Evaluation of Advanced Technology in Education (CREATE) Lab at NYU.

In addition to the experimental research led by Plass, observational research was conducted in the homes of 50 families over a 14-month period with children ages 6 through 12 in Australia, Cyprus, South Africa, and the UK. Lab-based research measured heart rate, eye tracking, facial expressions, and galvanic skin response (changes in sweat gland activity) of 69 children, ages 7 though 12, playing digital games in Australia.

The three studies found that games can support children’s senses of autonomy, competence, creativity, and identity, as well as help them regulate emotions and build relationships. But in order to support one or more of these aspects of well-being, games should consider certain features. For example, to support children’s sense of autonomy, a game could put them in control, allow them to make decisions about gameplay and encourage them to develop their own strategies to progress. Or to support creativity, a game could allow children to freely explore and solve problems or create their own characters or narratives.

“For decades, people have often assumed that playing video games is somehow bad for children, undermining their well-being. But our new study paints a far more complex picture—one in which these games can actually contribute to children’s well-being and positively support them as they grow up,” said Bo Viktor Nylund, director of UNICEF Innocenti.

Anna Rafferty, vice president of Digital Consumer Engagement, the LEGO Group, said: “This exciting research from UNICEF and leading academics shows that safe and inclusive digital play can have a profoundly positive impact on children’s lives. We’re proud to be partnering with like-minded organisations to understand how digital experiences can be designed in a way that puts children’s well-being first. These findings will empower responsible businesses to create a digital future where children are safe, nurtured and equipped to thrive.”

“The finding that digital play can enhance child well-being and meet children’s psychological needs, such as the need for connections to others, is especially important at a time when we are concerned about children’s mental health,” added Plass.

Said Nylund: “This research helps us understand not only how video games can impact the well-being of children, but also helps the producers and designers of these games understand what elements they can include to support children. We hope they will consider these findings as they design the games our children will be playing in the future.”

Also included in the RITEC project is the Joan Ganz Cooney Center; the Young & Resilient Research Centre at Western Sydney University; the Graduate Center, City University of New York; the University of Sheffield; and the Australian Centre of Excellence for the Digital Child.

The findings will be followed later this year by the launch of a guide to assist businesses to incorporate these findings into the games they design.

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'Surprisingly' high number of adults in the U.S. at risk of heart syndrome

Nearly 90% of adults over age 20 in the United States are at risk of developing heart disease , an alarming new study suggests. 

While the unexpectedly high number doesn't mean that the majority of adults in the U.S. have full-blown heart disease, it does indicate that many are at risk of developing the condition, even younger people.

Researchers identified people at high risk using a recently defined syndrome that takes into account the strong links between heart disease, obesity, diabetes and kidney disease, according to the research published Wednesday in JAMA.

The American Heart Association alerted doctors in October about cardiovascular-kidney-metabolic (CKM) syndrome , a condition which affects major organs in the body, including the brain, heart, liver and kidneys. CKM is diagnosed in stages ranging from zero — no risk factors for heart disease — to 4 — people with diagnosed heart disease plus excess body fat, metabolic risk factors such as hypertension and diabetes, or kidney disease.

For the new study, researchers analyzed almost a decade’s worth of data from more than 10,000 people who were participating in the National Health and Nutrition Examination Survey (NHANES).

“We absolutely were surprised that almost 90% of people met the criteria,” said study co-author Dr. Rahul Aggarwal, a cardiology fellow at Brigham and Women’s Hospital, Harvard Medical School, in Boston. “It was much higher than we anticipated in a database that included younger adults.”

Especially concerning was the finding that almost 50% of the NHANES participants were at stage 2 of CKM, meaning that they were at moderate risk because they had either high blood sugar, hypertension, high cholesterol or chronic kidney disease, Aggarwal said.

Just more than a quarter of the group — people listed as stage 1 — were at increased risk of developing heart disease because of being obese or overweight, having excess belly fat and fat around their organs, but didn't have specific symptoms.

The researchers found that 15% of the participants had advanced disease, a number that remained fairly constant between 2011 and 2020.  

“I think one of the biggest factors contributing to the fact that the percentage of people in advanced stages is not improving is obesity, which is very prevalent in the U.S.,” Aggarwal said, adding that 40% of people in America are obese. Another 32% are overweight based on body mass index calculations , according to the Centers for Disease Control and Prevention. 

Carrying excess pounds increases the likelihood a person will have high blood pressure, high blood sugar and high cholesterol, although some have metabolic risk factors even if they are at a healthy weight.

 Participants older than 65 were more likely to be at an advanced stage than people between 45 to 64. But being young wasn’t as protective as one might assume. Only 18% of people ages 20 through 44 were at stage zero. That is, they had no risk factors.  

The new findings show that health care providers need to be picking up on these conditions earlier “before they lead to downstream effects,” such as increased risk of heart attack, heart failure and stroke, Aggarwal said. “We need to diagnose earlier and be more aggressive at treating people.”

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Adopting lifestyle changes, such as improved diets and increased activity, can help protect against heart attack and stroke.The findings also show that “young adults, those younger than 45, are not as healthy as we thought they were,” Aggarwal said. 

Experts were also surprised by the high rates of CKM. 

“It is alarming that 90% of the population is at least stage 1 and only 10% have no risk factors,” said Dr. Sripal Bangalore, a professor of medicine and director of invasive and interventional cardiology at NYU Langone Health in New York City. 

He blames the epidemic of overweight and obesity for those numbers. 

“We have a lot of work to do to reduce the rates of overweight and obesity,” Bangalore said. “If we can do that, then hopefully we can reduce the number of people who progress to stage 2 and also move the needle down for higher stages.”

The inclusion of kidney disease in the risk assessments for cardiovascular disease makes a lot of sense, said Dr. Adriana Hung, a kidney specialist and epidemiologist and a professor of medicine at the Vanderbilt University Medical Center in Nashville, Tennessee. 

“Kidney disease magnifies cardiovascular disease,” she said. “Some studies show that a patient has as much as six times the risk of dying from cardiovascular disease if kidney disease is also present.”

The new, broader approach to heart disease is likely to help identify more people who are at risk, said Dr. Robert Rosenson, director of lipids and metabolism for the Mount Sinai Health System in New York City. 

“The main message from this study should be that many common behaviors are leading to an accumulation of diseases over one’s lifetime, which will impact quality of life and survival,” he said. 

The large numbers of people with CKM in this study are related to overweight and obesity, insulin resistance and a diet that is high in fat and salt, Rosenson added. 

People need to realize that it’s not just the heart that is being harmed by unhealthy diets and lack of exercise, he said, but that lifestyle factors also have an effect on cognition.

Linda Carroll is a regular health contributor to NBC News. She is coauthor of "The Concussion Crisis: Anatomy of a Silent Epidemic" and "Out of the Clouds: The Unlikely Horseman and the Unwanted Colt Who Conquered the Sport of Kings." 

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Study Suggests Genetics as a Cause, Not Just a Risk, for Some Alzheimer’s

People with two copies of the gene variant APOE4 are almost certain to get Alzheimer’s, say researchers, who proposed a framework under which such patients could be diagnosed years before symptoms.

By Pam Belluck

Scientists are proposing a new way of understanding the genetics of Alzheimer’s that would mean that up to a fifth of patients would be considered to have a genetically caused form of the disease.

Currently, the vast majority of Alzheimer’s cases do not have a clearly identified cause. The new designation, proposed in a study published Monday, could broaden the scope of efforts to develop treatments, including gene therapy, and affect the design of clinical trials.

It could also mean that hundreds of thousands of people in the United States alone could, if they chose, receive a diagnosis of Alzheimer’s before developing any symptoms of cognitive decline, although there currently are no treatments for people at that stage.

The new classification would make this type of Alzheimer’s one of the most common genetic disorders in the world, medical experts said.

“This reconceptualization that we’re proposing affects not a small minority of people,” said Dr. Juan Fortea, an author of the study and the director of the Sant Pau Memory Unit in Barcelona, Spain. “Sometimes we say that we don’t know the cause of Alzheimer’s disease,” but, he said, this would mean that about 15 to 20 percent of cases “can be tracked back to a cause, and the cause is in the genes.”

The idea involves a gene variant called APOE4. Scientists have long known that inheriting one copy of the variant increases the risk of developing Alzheimer’s, and that people with two copies, inherited from each parent, have vastly increased risk.

The new study , published in the journal Nature Medicine, analyzed data from over 500 people with two copies of APOE4, a significantly larger pool than in previous studies. The researchers found that almost all of those patients developed the biological pathology of Alzheimer’s, and the authors say that two copies of APOE4 should now be considered a cause of Alzheimer’s — not simply a risk factor.

The patients also developed Alzheimer’s pathology relatively young, the study found. By age 55, over 95 percent had biological markers associated with the disease. By 65, almost all had abnormal levels of a protein called amyloid that forms plaques in the brain, a hallmark of Alzheimer’s. And many started developing symptoms of cognitive decline at age 65, younger than most people without the APOE4 variant.

“The critical thing is that these individuals are often symptomatic 10 years earlier than other forms of Alzheimer’s disease,” said Dr. Reisa Sperling, a neurologist at Mass General Brigham in Boston and an author of the study.

She added, “By the time they are picked up and clinically diagnosed, because they’re often younger, they have more pathology.”

People with two copies, known as APOE4 homozygotes, make up 2 to 3 percent of the general population, but are an estimated 15 to 20 percent of people with Alzheimer’s dementia, experts said. People with one copy make up about 15 to 25 percent of the general population, and about 50 percent of Alzheimer’s dementia patients.

The most common variant is called APOE3, which seems to have a neutral effect on Alzheimer’s risk. About 75 percent of the general population has one copy of APOE3, and more than half of the general population has two copies.

Alzheimer’s experts not involved in the study said classifying the two-copy condition as genetically determined Alzheimer’s could have significant implications, including encouraging drug development beyond the field’s recent major focus on treatments that target and reduce amyloid.

Dr. Samuel Gandy, an Alzheimer’s researcher at Mount Sinai in New York, who was not involved in the study, said that patients with two copies of APOE4 faced much higher safety risks from anti-amyloid drugs.

When the Food and Drug Administration approved the anti-amyloid drug Leqembi last year, it required a black-box warning on the label saying that the medication can cause “serious and life-threatening events” such as swelling and bleeding in the brain, especially for people with two copies of APOE4. Some treatment centers decided not to offer Leqembi, an intravenous infusion, to such patients.

Dr. Gandy and other experts said that classifying these patients as having a distinct genetic form of Alzheimer’s would galvanize interest in developing drugs that are safe and effective for them and add urgency to current efforts to prevent cognitive decline in people who do not yet have symptoms.

“Rather than say we have nothing for you, let’s look for a trial,” Dr. Gandy said, adding that such patients should be included in trials at younger ages, given how early their pathology starts.

Besides trying to develop drugs, some researchers are exploring gene editing to transform APOE4 into a variant called APOE2, which appears to protect against Alzheimer’s. Another gene-therapy approach being studied involves injecting APOE2 into patients’ brains.

The new study had some limitations, including a lack of diversity that might make the findings less generalizable. Most patients in the study had European ancestry. While two copies of APOE4 also greatly increase Alzheimer’s risk in other ethnicities, the risk levels differ, said Dr. Michael Greicius, a neurologist at Stanford University School of Medicine who was not involved in the research.

“One important argument against their interpretation is that the risk of Alzheimer’s disease in APOE4 homozygotes varies substantially across different genetic ancestries,” said Dr. Greicius, who cowrote a study that found that white people with two copies of APOE4 had 13 times the risk of white people with two copies of APOE3, while Black people with two copies of APOE4 had 6.5 times the risk of Black people with two copies of APOE3.

“This has critical implications when counseling patients about their ancestry-informed genetic risk for Alzheimer’s disease,” he said, “and it also speaks to some yet-to-be-discovered genetics and biology that presumably drive this massive difference in risk.”

Under the current genetic understanding of Alzheimer’s, less than 2 percent of cases are considered genetically caused. Some of those patients inherited a mutation in one of three genes and can develop symptoms as early as their 30s or 40s. Others are people with Down syndrome, who have three copies of a chromosome containing a protein that often leads to what is called Down syndrome-associated Alzheimer’s disease .

Dr. Sperling said the genetic alterations in those cases are believed to fuel buildup of amyloid, while APOE4 is believed to interfere with clearing amyloid buildup.

Under the researchers’ proposal, having one copy of APOE4 would continue to be considered a risk factor, not enough to cause Alzheimer’s, Dr. Fortea said. It is unusual for diseases to follow that genetic pattern, called “semidominance,” with two copies of a variant causing the disease, but one copy only increasing risk, experts said.

The new recommendation will prompt questions about whether people should get tested to determine if they have the APOE4 variant.

Dr. Greicius said that until there were treatments for people with two copies of APOE4 or trials of therapies to prevent them from developing dementia, “My recommendation is if you don’t have symptoms, you should definitely not figure out your APOE status.”

He added, “It will only cause grief at this point.”

Finding ways to help these patients cannot come soon enough, Dr. Sperling said, adding, “These individuals are desperate, they’ve seen it in both of their parents often and really need therapies.”

Pam Belluck is a health and science reporter, covering a range of subjects, including reproductive health, long Covid, brain science, neurological disorders, mental health and genetics. More about Pam Belluck

The Fight Against Alzheimer’s Disease

Alzheimer’s is the most common form of dementia, but much remains unknown about this daunting disease..

How is Alzheimer’s diagnosed? What causes Alzheimer’s? We answered some common questions .

A study suggests that genetics can be a cause of Alzheimer’s , not just a risk, raising the prospect of diagnosis years before symptoms appear.

Determining whether someone has Alzheimer’s usually requires an extended diagnostic process . But new criteria could lead to a diagnosis on the basis of a simple blood test .

The F.D.A. has given full approval to the Alzheimer’s drug Leqembi. Here is what to know about i t.

Alzheimer’s can make communicating difficult. We asked experts for tips on how to talk to someone with the disease .

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A Practical Guide to Writing Quantitative and Qualitative Research Questions and Hypotheses in Scholarly Articles

Edward barroga.

1 Department of General Education, Graduate School of Nursing Science, St. Luke’s International University, Tokyo, Japan.

Glafera Janet Matanguihan

2 Department of Biological Sciences, Messiah University, Mechanicsburg, PA, USA.

The development of research questions and the subsequent hypotheses are prerequisites to defining the main research purpose and specific objectives of a study. Consequently, these objectives determine the study design and research outcome. The development of research questions is a process based on knowledge of current trends, cutting-edge studies, and technological advances in the research field. Excellent research questions are focused and require a comprehensive literature search and in-depth understanding of the problem being investigated. Initially, research questions may be written as descriptive questions which could be developed into inferential questions. These questions must be specific and concise to provide a clear foundation for developing hypotheses. Hypotheses are more formal predictions about the research outcomes. These specify the possible results that may or may not be expected regarding the relationship between groups. Thus, research questions and hypotheses clarify the main purpose and specific objectives of the study, which in turn dictate the design of the study, its direction, and outcome. Studies developed from good research questions and hypotheses will have trustworthy outcomes with wide-ranging social and health implications.

INTRODUCTION

Scientific research is usually initiated by posing evidenced-based research questions which are then explicitly restated as hypotheses. 1 , 2 The hypotheses provide directions to guide the study, solutions, explanations, and expected results. 3 , 4 Both research questions and hypotheses are essentially formulated based on conventional theories and real-world processes, which allow the inception of novel studies and the ethical testing of ideas. 5 , 6

It is crucial to have knowledge of both quantitative and qualitative research 2 as both types of research involve writing research questions and hypotheses. 7 However, these crucial elements of research are sometimes overlooked; if not overlooked, then framed without the forethought and meticulous attention it needs. Planning and careful consideration are needed when developing quantitative or qualitative research, particularly when conceptualizing research questions and hypotheses. 4

There is a continuing need to support researchers in the creation of innovative research questions and hypotheses, as well as for journal articles that carefully review these elements. 1 When research questions and hypotheses are not carefully thought of, unethical studies and poor outcomes usually ensue. Carefully formulated research questions and hypotheses define well-founded objectives, which in turn determine the appropriate design, course, and outcome of the study. This article then aims to discuss in detail the various aspects of crafting research questions and hypotheses, with the goal of guiding researchers as they develop their own. Examples from the authors and peer-reviewed scientific articles in the healthcare field are provided to illustrate key points.

DEFINITIONS AND RELATIONSHIP OF RESEARCH QUESTIONS AND HYPOTHESES

A research question is what a study aims to answer after data analysis and interpretation. The answer is written in length in the discussion section of the paper. Thus, the research question gives a preview of the different parts and variables of the study meant to address the problem posed in the research question. 1 An excellent research question clarifies the research writing while facilitating understanding of the research topic, objective, scope, and limitations of the study. 5

On the other hand, a research hypothesis is an educated statement of an expected outcome. This statement is based on background research and current knowledge. 8 , 9 The research hypothesis makes a specific prediction about a new phenomenon 10 or a formal statement on the expected relationship between an independent variable and a dependent variable. 3 , 11 It provides a tentative answer to the research question to be tested or explored. 4

Hypotheses employ reasoning to predict a theory-based outcome. 10 These can also be developed from theories by focusing on components of theories that have not yet been observed. 10 The validity of hypotheses is often based on the testability of the prediction made in a reproducible experiment. 8

Conversely, hypotheses can also be rephrased as research questions. Several hypotheses based on existing theories and knowledge may be needed to answer a research question. Developing ethical research questions and hypotheses creates a research design that has logical relationships among variables. These relationships serve as a solid foundation for the conduct of the study. 4 , 11 Haphazardly constructed research questions can result in poorly formulated hypotheses and improper study designs, leading to unreliable results. Thus, the formulations of relevant research questions and verifiable hypotheses are crucial when beginning research. 12

CHARACTERISTICS OF GOOD RESEARCH QUESTIONS AND HYPOTHESES

Excellent research questions are specific and focused. These integrate collective data and observations to confirm or refute the subsequent hypotheses. Well-constructed hypotheses are based on previous reports and verify the research context. These are realistic, in-depth, sufficiently complex, and reproducible. More importantly, these hypotheses can be addressed and tested. 13

There are several characteristics of well-developed hypotheses. Good hypotheses are 1) empirically testable 7 , 10 , 11 , 13 ; 2) backed by preliminary evidence 9 ; 3) testable by ethical research 7 , 9 ; 4) based on original ideas 9 ; 5) have evidenced-based logical reasoning 10 ; and 6) can be predicted. 11 Good hypotheses can infer ethical and positive implications, indicating the presence of a relationship or effect relevant to the research theme. 7 , 11 These are initially developed from a general theory and branch into specific hypotheses by deductive reasoning. In the absence of a theory to base the hypotheses, inductive reasoning based on specific observations or findings form more general hypotheses. 10

TYPES OF RESEARCH QUESTIONS AND HYPOTHESES

Research questions and hypotheses are developed according to the type of research, which can be broadly classified into quantitative and qualitative research. We provide a summary of the types of research questions and hypotheses under quantitative and qualitative research categories in Table 1 .

Research questions in quantitative research

In quantitative research, research questions inquire about the relationships among variables being investigated and are usually framed at the start of the study. These are precise and typically linked to the subject population, dependent and independent variables, and research design. 1 Research questions may also attempt to describe the behavior of a population in relation to one or more variables, or describe the characteristics of variables to be measured ( descriptive research questions ). 1 , 5 , 14 These questions may also aim to discover differences between groups within the context of an outcome variable ( comparative research questions ), 1 , 5 , 14 or elucidate trends and interactions among variables ( relationship research questions ). 1 , 5 We provide examples of descriptive, comparative, and relationship research questions in quantitative research in Table 2 .

Hypotheses in quantitative research

In quantitative research, hypotheses predict the expected relationships among variables. 15 Relationships among variables that can be predicted include 1) between a single dependent variable and a single independent variable ( simple hypothesis ) or 2) between two or more independent and dependent variables ( complex hypothesis ). 4 , 11 Hypotheses may also specify the expected direction to be followed and imply an intellectual commitment to a particular outcome ( directional hypothesis ) 4 . On the other hand, hypotheses may not predict the exact direction and are used in the absence of a theory, or when findings contradict previous studies ( non-directional hypothesis ). 4 In addition, hypotheses can 1) define interdependency between variables ( associative hypothesis ), 4 2) propose an effect on the dependent variable from manipulation of the independent variable ( causal hypothesis ), 4 3) state a negative relationship between two variables ( null hypothesis ), 4 , 11 , 15 4) replace the working hypothesis if rejected ( alternative hypothesis ), 15 explain the relationship of phenomena to possibly generate a theory ( working hypothesis ), 11 5) involve quantifiable variables that can be tested statistically ( statistical hypothesis ), 11 6) or express a relationship whose interlinks can be verified logically ( logical hypothesis ). 11 We provide examples of simple, complex, directional, non-directional, associative, causal, null, alternative, working, statistical, and logical hypotheses in quantitative research, as well as the definition of quantitative hypothesis-testing research in Table 3 .

Research questions in qualitative research

Unlike research questions in quantitative research, research questions in qualitative research are usually continuously reviewed and reformulated. The central question and associated subquestions are stated more than the hypotheses. 15 The central question broadly explores a complex set of factors surrounding the central phenomenon, aiming to present the varied perspectives of participants. 15

There are varied goals for which qualitative research questions are developed. These questions can function in several ways, such as to 1) identify and describe existing conditions ( contextual research question s); 2) describe a phenomenon ( descriptive research questions ); 3) assess the effectiveness of existing methods, protocols, theories, or procedures ( evaluation research questions ); 4) examine a phenomenon or analyze the reasons or relationships between subjects or phenomena ( explanatory research questions ); or 5) focus on unknown aspects of a particular topic ( exploratory research questions ). 5 In addition, some qualitative research questions provide new ideas for the development of theories and actions ( generative research questions ) or advance specific ideologies of a position ( ideological research questions ). 1 Other qualitative research questions may build on a body of existing literature and become working guidelines ( ethnographic research questions ). Research questions may also be broadly stated without specific reference to the existing literature or a typology of questions ( phenomenological research questions ), may be directed towards generating a theory of some process ( grounded theory questions ), or may address a description of the case and the emerging themes ( qualitative case study questions ). 15 We provide examples of contextual, descriptive, evaluation, explanatory, exploratory, generative, ideological, ethnographic, phenomenological, grounded theory, and qualitative case study research questions in qualitative research in Table 4 , and the definition of qualitative hypothesis-generating research in Table 5 .

Qualitative studies usually pose at least one central research question and several subquestions starting with How or What . These research questions use exploratory verbs such as explore or describe . These also focus on one central phenomenon of interest, and may mention the participants and research site. 15

Hypotheses in qualitative research

Hypotheses in qualitative research are stated in the form of a clear statement concerning the problem to be investigated. Unlike in quantitative research where hypotheses are usually developed to be tested, qualitative research can lead to both hypothesis-testing and hypothesis-generating outcomes. 2 When studies require both quantitative and qualitative research questions, this suggests an integrative process between both research methods wherein a single mixed-methods research question can be developed. 1

FRAMEWORKS FOR DEVELOPING RESEARCH QUESTIONS AND HYPOTHESES

Research questions followed by hypotheses should be developed before the start of the study. 1 , 12 , 14 It is crucial to develop feasible research questions on a topic that is interesting to both the researcher and the scientific community. This can be achieved by a meticulous review of previous and current studies to establish a novel topic. Specific areas are subsequently focused on to generate ethical research questions. The relevance of the research questions is evaluated in terms of clarity of the resulting data, specificity of the methodology, objectivity of the outcome, depth of the research, and impact of the study. 1 , 5 These aspects constitute the FINER criteria (i.e., Feasible, Interesting, Novel, Ethical, and Relevant). 1 Clarity and effectiveness are achieved if research questions meet the FINER criteria. In addition to the FINER criteria, Ratan et al. described focus, complexity, novelty, feasibility, and measurability for evaluating the effectiveness of research questions. 14

The PICOT and PEO frameworks are also used when developing research questions. 1 The following elements are addressed in these frameworks, PICOT: P-population/patients/problem, I-intervention or indicator being studied, C-comparison group, O-outcome of interest, and T-timeframe of the study; PEO: P-population being studied, E-exposure to preexisting conditions, and O-outcome of interest. 1 Research questions are also considered good if these meet the “FINERMAPS” framework: Feasible, Interesting, Novel, Ethical, Relevant, Manageable, Appropriate, Potential value/publishable, and Systematic. 14

As we indicated earlier, research questions and hypotheses that are not carefully formulated result in unethical studies or poor outcomes. To illustrate this, we provide some examples of ambiguous research question and hypotheses that result in unclear and weak research objectives in quantitative research ( Table 6 ) 16 and qualitative research ( Table 7 ) 17 , and how to transform these ambiguous research question(s) and hypothesis(es) into clear and good statements.

a These statements were composed for comparison and illustrative purposes only.

b These statements are direct quotes from Higashihara and Horiuchi. 16

a This statement is a direct quote from Shimoda et al. 17

The other statements were composed for comparison and illustrative purposes only.

CONSTRUCTING RESEARCH QUESTIONS AND HYPOTHESES

To construct effective research questions and hypotheses, it is very important to 1) clarify the background and 2) identify the research problem at the outset of the research, within a specific timeframe. 9 Then, 3) review or conduct preliminary research to collect all available knowledge about the possible research questions by studying theories and previous studies. 18 Afterwards, 4) construct research questions to investigate the research problem. Identify variables to be accessed from the research questions 4 and make operational definitions of constructs from the research problem and questions. Thereafter, 5) construct specific deductive or inductive predictions in the form of hypotheses. 4 Finally, 6) state the study aims . This general flow for constructing effective research questions and hypotheses prior to conducting research is shown in Fig. 1 .

Research questions are used more frequently in qualitative research than objectives or hypotheses. 3 These questions seek to discover, understand, explore or describe experiences by asking “What” or “How.” The questions are open-ended to elicit a description rather than to relate variables or compare groups. The questions are continually reviewed, reformulated, and changed during the qualitative study. 3 Research questions are also used more frequently in survey projects than hypotheses in experiments in quantitative research to compare variables and their relationships.

Hypotheses are constructed based on the variables identified and as an if-then statement, following the template, ‘If a specific action is taken, then a certain outcome is expected.’ At this stage, some ideas regarding expectations from the research to be conducted must be drawn. 18 Then, the variables to be manipulated (independent) and influenced (dependent) are defined. 4 Thereafter, the hypothesis is stated and refined, and reproducible data tailored to the hypothesis are identified, collected, and analyzed. 4 The hypotheses must be testable and specific, 18 and should describe the variables and their relationships, the specific group being studied, and the predicted research outcome. 18 Hypotheses construction involves a testable proposition to be deduced from theory, and independent and dependent variables to be separated and measured separately. 3 Therefore, good hypotheses must be based on good research questions constructed at the start of a study or trial. 12

In summary, research questions are constructed after establishing the background of the study. Hypotheses are then developed based on the research questions. Thus, it is crucial to have excellent research questions to generate superior hypotheses. In turn, these would determine the research objectives and the design of the study, and ultimately, the outcome of the research. 12 Algorithms for building research questions and hypotheses are shown in Fig. 2 for quantitative research and in Fig. 3 for qualitative research.

EXAMPLES OF RESEARCH QUESTIONS FROM PUBLISHED ARTICLES

• EXAMPLE 1. Descriptive research question (quantitative research)
• - Presents research variables to be assessed (distinct phenotypes and subphenotypes)
• “BACKGROUND: Since COVID-19 was identified, its clinical and biological heterogeneity has been recognized. Identifying COVID-19 phenotypes might help guide basic, clinical, and translational research efforts.
• RESEARCH QUESTION: Does the clinical spectrum of patients with COVID-19 contain distinct phenotypes and subphenotypes? ” 19
• EXAMPLE 2. Relationship research question (quantitative research)
• - Shows interactions between dependent variable (static postural control) and independent variable (peripheral visual field loss)
• “Background: Integration of visual, vestibular, and proprioceptive sensations contributes to postural control. People with peripheral visual field loss have serious postural instability. However, the directional specificity of postural stability and sensory reweighting caused by gradual peripheral visual field loss remain unclear.
• Research question: What are the effects of peripheral visual field loss on static postural control ?” 20
• EXAMPLE 3. Comparative research question (quantitative research)
• - Clarifies the difference among groups with an outcome variable (patients enrolled in COMPERA with moderate PH or severe PH in COPD) and another group without the outcome variable (patients with idiopathic pulmonary arterial hypertension (IPAH))
• “BACKGROUND: Pulmonary hypertension (PH) in COPD is a poorly investigated clinical condition.
• RESEARCH QUESTION: Which factors determine the outcome of PH in COPD?
• STUDY DESIGN AND METHODS: We analyzed the characteristics and outcome of patients enrolled in the Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA) with moderate or severe PH in COPD as defined during the 6th PH World Symposium who received medical therapy for PH and compared them with patients with idiopathic pulmonary arterial hypertension (IPAH) .” 21
• EXAMPLE 4. Exploratory research question (qualitative research)
• - Explores areas that have not been fully investigated (perspectives of families and children who receive care in clinic-based child obesity treatment) to have a deeper understanding of the research problem
• “Problem: Interventions for children with obesity lead to only modest improvements in BMI and long-term outcomes, and data are limited on the perspectives of families of children with obesity in clinic-based treatment. This scoping review seeks to answer the question: What is known about the perspectives of families and children who receive care in clinic-based child obesity treatment? This review aims to explore the scope of perspectives reported by families of children with obesity who have received individualized outpatient clinic-based obesity treatment.” 22
• EXAMPLE 5. Relationship research question (quantitative research)
• - Defines interactions between dependent variable (use of ankle strategies) and independent variable (changes in muscle tone)
• “Background: To maintain an upright standing posture against external disturbances, the human body mainly employs two types of postural control strategies: “ankle strategy” and “hip strategy.” While it has been reported that the magnitude of the disturbance alters the use of postural control strategies, it has not been elucidated how the level of muscle tone, one of the crucial parameters of bodily function, determines the use of each strategy. We have previously confirmed using forward dynamics simulations of human musculoskeletal models that an increased muscle tone promotes the use of ankle strategies. The objective of the present study was to experimentally evaluate a hypothesis: an increased muscle tone promotes the use of ankle strategies. Research question: Do changes in the muscle tone affect the use of ankle strategies ?” 23

EXAMPLES OF HYPOTHESES IN PUBLISHED ARTICLES

• EXAMPLE 1. Working hypothesis (quantitative research)
• - A hypothesis that is initially accepted for further research to produce a feasible theory
• “As fever may have benefit in shortening the duration of viral illness, it is plausible to hypothesize that the antipyretic efficacy of ibuprofen may be hindering the benefits of a fever response when taken during the early stages of COVID-19 illness .” 24
• “In conclusion, it is plausible to hypothesize that the antipyretic efficacy of ibuprofen may be hindering the benefits of a fever response . The difference in perceived safety of these agents in COVID-19 illness could be related to the more potent efficacy to reduce fever with ibuprofen compared to acetaminophen. Compelling data on the benefit of fever warrant further research and review to determine when to treat or withhold ibuprofen for early stage fever for COVID-19 and other related viral illnesses .” 24
• EXAMPLE 2. Exploratory hypothesis (qualitative research)
• - Explores particular areas deeper to clarify subjective experience and develop a formal hypothesis potentially testable in a future quantitative approach
• “We hypothesized that when thinking about a past experience of help-seeking, a self distancing prompt would cause increased help-seeking intentions and more favorable help-seeking outcome expectations .” 25
• “Conclusion
• Although a priori hypotheses were not supported, further research is warranted as results indicate the potential for using self-distancing approaches to increasing help-seeking among some people with depressive symptomatology.” 25
• EXAMPLE 3. Hypothesis-generating research to establish a framework for hypothesis testing (qualitative research)
• “We hypothesize that compassionate care is beneficial for patients (better outcomes), healthcare systems and payers (lower costs), and healthcare providers (lower burnout). ” 26
• Compassionomics is the branch of knowledge and scientific study of the effects of compassionate healthcare. Our main hypotheses are that compassionate healthcare is beneficial for (1) patients, by improving clinical outcomes, (2) healthcare systems and payers, by supporting financial sustainability, and (3) HCPs, by lowering burnout and promoting resilience and well-being. The purpose of this paper is to establish a scientific framework for testing the hypotheses above . If these hypotheses are confirmed through rigorous research, compassionomics will belong in the science of evidence-based medicine, with major implications for all healthcare domains.” 26
• EXAMPLE 4. Statistical hypothesis (quantitative research)
• - An assumption is made about the relationship among several population characteristics ( gender differences in sociodemographic and clinical characteristics of adults with ADHD ). Validity is tested by statistical experiment or analysis ( chi-square test, Students t-test, and logistic regression analysis)
• “Our research investigated gender differences in sociodemographic and clinical characteristics of adults with ADHD in a Japanese clinical sample. Due to unique Japanese cultural ideals and expectations of women's behavior that are in opposition to ADHD symptoms, we hypothesized that women with ADHD experience more difficulties and present more dysfunctions than men . We tested the following hypotheses: first, women with ADHD have more comorbidities than men with ADHD; second, women with ADHD experience more social hardships than men, such as having less full-time employment and being more likely to be divorced.” 27
• “Statistical Analysis
• ( text omitted ) Between-gender comparisons were made using the chi-squared test for categorical variables and Students t-test for continuous variables…( text omitted ). A logistic regression analysis was performed for employment status, marital status, and comorbidity to evaluate the independent effects of gender on these dependent variables.” 27

EXAMPLES OF HYPOTHESIS AS WRITTEN IN PUBLISHED ARTICLES IN RELATION TO OTHER PARTS

• EXAMPLE 1. Background, hypotheses, and aims are provided
• “Pregnant women need skilled care during pregnancy and childbirth, but that skilled care is often delayed in some countries …( text omitted ). The focused antenatal care (FANC) model of WHO recommends that nurses provide information or counseling to all pregnant women …( text omitted ). Job aids are visual support materials that provide the right kind of information using graphics and words in a simple and yet effective manner. When nurses are not highly trained or have many work details to attend to, these job aids can serve as a content reminder for the nurses and can be used for educating their patients (Jennings, Yebadokpo, Affo, & Agbogbe, 2010) ( text omitted ). Importantly, additional evidence is needed to confirm how job aids can further improve the quality of ANC counseling by health workers in maternal care …( text omitted )” 28
• “ This has led us to hypothesize that the quality of ANC counseling would be better if supported by job aids. Consequently, a better quality of ANC counseling is expected to produce higher levels of awareness concerning the danger signs of pregnancy and a more favorable impression of the caring behavior of nurses .” 28
• “This study aimed to examine the differences in the responses of pregnant women to a job aid-supported intervention during ANC visit in terms of 1) their understanding of the danger signs of pregnancy and 2) their impression of the caring behaviors of nurses to pregnant women in rural Tanzania.” 28
• EXAMPLE 2. Background, hypotheses, and aims are provided
• “We conducted a two-arm randomized controlled trial (RCT) to evaluate and compare changes in salivary cortisol and oxytocin levels of first-time pregnant women between experimental and control groups. The women in the experimental group touched and held an infant for 30 min (experimental intervention protocol), whereas those in the control group watched a DVD movie of an infant (control intervention protocol). The primary outcome was salivary cortisol level and the secondary outcome was salivary oxytocin level.” 29
• “ We hypothesize that at 30 min after touching and holding an infant, the salivary cortisol level will significantly decrease and the salivary oxytocin level will increase in the experimental group compared with the control group .” 29
• EXAMPLE 3. Background, aim, and hypothesis are provided
• “In countries where the maternal mortality ratio remains high, antenatal education to increase Birth Preparedness and Complication Readiness (BPCR) is considered one of the top priorities [1]. BPCR includes birth plans during the antenatal period, such as the birthplace, birth attendant, transportation, health facility for complications, expenses, and birth materials, as well as family coordination to achieve such birth plans. In Tanzania, although increasing, only about half of all pregnant women attend an antenatal clinic more than four times [4]. Moreover, the information provided during antenatal care (ANC) is insufficient. In the resource-poor settings, antenatal group education is a potential approach because of the limited time for individual counseling at antenatal clinics.” 30
• “This study aimed to evaluate an antenatal group education program among pregnant women and their families with respect to birth-preparedness and maternal and infant outcomes in rural villages of Tanzania.” 30
• “ The study hypothesis was if Tanzanian pregnant women and their families received a family-oriented antenatal group education, they would (1) have a higher level of BPCR, (2) attend antenatal clinic four or more times, (3) give birth in a health facility, (4) have less complications of women at birth, and (5) have less complications and deaths of infants than those who did not receive the education .” 30

Research questions and hypotheses are crucial components to any type of research, whether quantitative or qualitative. These questions should be developed at the very beginning of the study. Excellent research questions lead to superior hypotheses, which, like a compass, set the direction of research, and can often determine the successful conduct of the study. Many research studies have floundered because the development of research questions and subsequent hypotheses was not given the thought and meticulous attention needed. The development of research questions and hypotheses is an iterative process based on extensive knowledge of the literature and insightful grasp of the knowledge gap. Focused, concise, and specific research questions provide a strong foundation for constructing hypotheses which serve as formal predictions about the research outcomes. Research questions and hypotheses are crucial elements of research that should not be overlooked. They should be carefully thought of and constructed when planning research. This avoids unethical studies and poor outcomes by defining well-founded objectives that determine the design, course, and outcome of the study.

Disclosure: The authors have no potential conflicts of interest to disclose.

Author Contributions:

• Conceptualization: Barroga E, Matanguihan GJ.
• Methodology: Barroga E, Matanguihan GJ.
• Writing - original draft: Barroga E, Matanguihan GJ.
• Writing - review & editing: Barroga E, Matanguihan GJ.

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Understanding Cannabinoids and Their Medical Uses

What are cannabinoids and what do they do, how do cannabinoids work, how are cannabinoids used, current uses, side effects and safety of cannabinoids, who shouldn’t use cannabinoids, legal status of cannabinoids.

Cannabis is a term used to describe all products derived from a specific type of cannabis plant that consists of more than 500 chemicals. The two main types of cannabis are indica and sativa .

Cannabinoids are a group of chemicals or compounds found in the cannabis sativa plant. This includes tetrahydrocannabinol (THC) , cannabidiol (CBD) , and hundreds of other substances.

Cannabinoids may also be naturally present in the human body and are referred to as endocannabinoids.

Cannabinoids are commonly used to minimize symptoms associated with pain conditions such as neuropathy , rheumatoid arthritis , and chronic pain . They may also be used for a variety of other conditions, such as epilepsy and cancer-related side effects. Additional research is needed to establish and understand their appropriate use and place in therapy.

This article will define cannabinoids and discuss what the research says about them.

Getty Images | Jordan Siemens

Cannabinoids are the chemical components of cannabis. They work like messengers, interacting with the endocannabinoid system in our bodies and working on receptors that can help regulate mood, memory, appetite, and pain.

Additionally, cannabinoids activate receptors throughout the body, affecting the central nervous system and immune system.

Examples of Cannabinoids

THC and CBD are the two main types of cannabinoids. Cannabinol (CBN) is a less popular type of cannabinoid. Medications that contain cannabinoids typically include THC, CBD, or both.

THC is mainly responsible for the psychoactive (mind-altering) and intoxicating effects that are commonly associated with cannabis use. CBD is known for its potential therapeutic benefits, which range from pain relief to anxiety management.

CBD and CBN differ from THC in that they are not psychoactive, meaning they do not cause changes to the mind, mood, or mental state. Unlike THC, CBD should not cause mental impairment or a "high" feeling.

While CBD and CBN work similarly, CBD has been more widely studied. More research is needed to better understand the therapeutic potential of CBN.

Medications on the Market

The United States Food & Drug Administration (FDA) has not approved the cannabis plant itself for medical use. However, several FDA-approved medications contain individual cannabinoids.

Cannabis-related compounds are created in a lab and can be used to manufacture drug products. Cannabis-derived compounds are found naturally in the cannabis plant and can also be used to manufacture medications.

The following synthetic cannabis-related medications are currently on the market:

• Marinol, Syndros (dronabinol)
• Cesamet (nabilone)

Epidiolex (cannabidiol) is a cannabis-derived medication that is also approved by the FDA to treat very specific types of seizures. It contains a purified form of CBD.

Marinol and Syndros contain artificial THC, and Cesamet contains an artificial substance that mimics THC.

Many cannabis products remain unapproved by the FDA, and their safety and efficacy have not been studied.

Beyond THC, CBD, and CBN, researchers are exploring the potential of other cannabinoids to better understand their varying effects on health and well-being.

Are Cannabinoids and Marijuana the Same?

Cannabinoids and marijuana are closely related, but they are not the same and have some distinct differences.

Cannabinoids are the chemical compounds that make up the cannabis plant, which include THC and CBD. Cannabinoids are responsible for interacting with receptors in the body, which determine how the body responds.

Marijuana refers to the dried leaves, flowers, stems, and seeds of the cannabis plant, which includes cannabinoids as the active ingredients. Marijuana contains high levels of the cannabinoid THC, which is responsible for the mental effects of the drug.

Cannabinoids interact with the body's endocannabinoid system, which is found throughout the brain, nervous system, and other tissues in the body. This system acts as a messenger.

When cannabinoids are consumed, they send signals to the body, influencing various processes and responses. For example, some cannabinoids may trigger feelings of happiness and relaxation; others may help alleviate pain or cause drowsiness.

There are two main types of cannabinoid receptors: cannabinoid 1 receptor (CB1) and cannabinoid 2 receptor (CB2).

CB1 receptors are primarily located in the brain and central nervous system. They are responsible for the effects of cannabinoids on the mental state. CB2 receptors are found mostly on immune cells and peripheral tissues. They regulate inflammation and immune function.

Depending on the specific cannabinoid and its concentration, cannabinoids can produce a wide range of effects, including pain relief, relaxation, appetite stimulation, and mood changes.

Understanding how cannabinoids interact with the endocannabinoid system is crucial for exploring their potential therapeutic benefits and ensuring safe and effective use.

Cannabinoids are used for different purposes and are being studied for a wide range of medical uses. The majority of people who take cannabinoids use them for chronic pain and mental health conditions.

Until more research is conducted, it is important to use cannabinoids only as instructed by your healthcare provider to prevent long-term complications.

Epidiolex contains a purified form of cannabis-derived CBD. It is FDA-approved for the treatment of seizures associated with two rare forms of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome , that typically begin in early childhood.

Epidiolex can be used in people 2 years of age and older to reduce the frequency of seizures in those with either condition.

Marinol, Syndros, and Cesamet are used to treat nausea and vomiting caused by cancer chemotherapy. Marinol and Sydnros are also used to treat appetite and weight loss in people with HIV/AIDS .

Clinical studies suggest that CBD can be used to reduce anxiety and help reduce symptoms associated with mental health disorders.

In addition to the FDA-approved formulations, over-the-counter (OTC) CBD products may be easily accessible depending on location and state laws. These products are much less regulated, making it difficult to know exactly what they contain, and therefore, raises safety concerns.

Studied Uses

Some promising areas of research for cannabinoid use include:

• Sleep problems
• Post-traumatic stress disorder (PTSD)
• Movement disorders

Cannabinoids are generally well tolerated with minimal known risks; however, like most drug products, there are some side effects and safety concerns associated with their use.

It is unknown what makes someone more likely to experience negative effects, but factors such as genetics and personality may play a role.

It is recommended that cannabinoids be taken by mouth rather than inhaled. Smoking cannabinoid products used for medical purposes can increase exposure to gene-altering and cancer-causing substances.

You are more likely to experience serious side effects associated with cannabinoid use if you are taking higher doses.

Side Effects

Side effects associated with THC are different than CBD. In general, dizziness and fatigue are the most common adverse events people using THC or a combination of THC and CBD experience.

THC use may negatively affect memory and lead to decreased ability to engage in activities that require hand-eye coordination. CBD, on the other hand, has shown benefit in reducing the negative mental effects of THC when they are used together.

The severity of side effects usually correlates to the dose, meaning that as the dose of cannabinoids increases, so does the likelihood of side effects.

The most common side effects associated with THC when used alone include:

• Drowsiness and fatigue
• Nausea/vomiting
• Cognitive effects such as elevated mood (euphoria) and confusion
• Problems with balance and coordination

The most common side effects associated with CBD use include:

• Decreased appetite
• Upper respiratory tract infection
• Elevated liver enzymes

Research studies show that even though side effects may occur in those using cannabinoids, there is no major concern for serious side effects when they are used as directed.

Drug Interactions

Cannabinoids do have several potential drug interactions, and these should be taken into consideration when determining if treatment is appropriate.

There is a risk of drug–drug interactions between some cannabinoids and the following medications:

• Anticholinergic medications (such as amitriptyline)
• Benzodiazepines
• Specific types of medications to treat cancer ( such as Keytruda )

Alcohol should also be avoided and not used at the same time as cannabinoids.

More studies are needed to evaluate potential drug interactions further. It is important to consult with a healthcare provider before use, especially if you are taking other medications.

What Are Synthetic Cannabinoids?

Synthetic cannabinoids are similar to the compounds found in the cannabis plant. They are "man-made" products usually created in a lab and often intended to mimic the effects of cannabinoids.

Examples of synthetic cannabinoids on the market include Syndros and Marinol (dronabinol), which contain synthetic THC, and Cesamet (nabilone), which contains a synthetic THC-like substance.

Some synthetic cannabinoids have medical uses, but in other cases, they are illegally made and distributed. The use of unregulated synthetic cannabinoids can cause severe side effects and potential health risks, including long-term health complications and death.

You should avoid cannabinoid use if you:

• Are under 25 years of age
• Have liver disease, including Hepatitis C
• Are pregnant or breastfeeding
• Have a personal or family history of psychosis or schizophrenia
• Have a history of substance abuse disorder

The health risks and concerns associated with cannabinoid use in these populations may vary, but in some cases, the benefits may outweigh the risks. You should consult with your healthcare provider to determine if cannabinoid use is safe and appropriate.

The legal status of cannabinoids, particularly THC and CBD, is a complex and evolving topic, as laws and regulations can vary greatly across the United States. Of note, it is technically illegal under federal law.

In some states, cannabinoids are strictly regulated by the law, and in other states, cannabinoids may be legal for medical use, recreational use, or both.

There are protocols in place for cannabinoid use in research. Researchers must work with the FDA to submit the proper applications and documentation.

Depending on the particular state, whether or not CBD products are legal depends on whether it is hemp-derived or cannabis-derived. Regardless of the source, products containing THC or CBD cannot be sold legally as dietary supplements.

It is important to be aware of the laws regarding cannabinoid use in your state and places you may travel to.

Cannabinoids are found in the cannabis sativa plant and include hundreds of compounds, including the two most common types, THC and CBD.

Cannabinoids can help regulate mood, memory, appetite, and pain. THC is mainly responsible for the mind-altering effects that are commonly associated with cannabis use. CBD is known for its therapeutic benefits without impacting the mental state or causing a high.

Despite conflicting federal and state regulations for cannabinoids, there are a few cannabinoid-containing medications approved by the FDA. The legal status of cannabinoids is constantly evolving as laws change and new research becomes available.

Understanding cannabinoids and their effects is crucial for navigating the complex landscape of cannabis-based therapies and supplements.

Discuss the risks and benefits of cannabinoid use with your healthcare provider to help determine whether a cannabinoid-based therapy may be an appropriate treatment option for you.

National Center for Complementary and Integrative Health. Cannabis (marijuana) and cannabinoids: what you need to know .

Atakan Z. Cannabis, a complex plant: different compounds and different effects on individuals . Ther Adv Psychopharmacol . 2012;2(6):241-254. doi:10.1177/2045125312457586

Bridgeman MB, Abazia DT. Medicinal cannabis: history, pharmacology, and implications for the acute care setting . P&T. 2017;42(3):180-188.

Gottschling S, Ayonrinde O, Bhaskar A, et al. Safety considerations in cannabinoid-based medicine . Int J Gen Med . 2020;13:1317-1333. doi:10.2147/IJGM.S275049

National Cancer Institute. Cannabis and cannabinoids (PDQ®)–health professional version .

Centers for Disease Control and Prevention. Health effects of marijuana .

U.S. Food & Drug Administration. FDA and cannabis: research and drug approval process .

National Institute on Drug Abuse. Cannabis (marijuana) drug facts .

National Institute on Drug Abuse. Synthetic cannabinoids .

U.S. Food & Drug Administration. FDA regulation of cannabis and cannabis-derived products, including cannabidiol (CBD) .

Department of Justice/Drug Enforcement Administration. Marijuana/cannabis .

Centers for Disease Control and Prevention. CBD: what you need to know .

By T'Keyah Bazin, PharmD T'Keyah Bazin, PharmD, is a clinical pharmacist and experienced health content writer. She received her Doctor of Pharmacy degree from the University of Mississippi School of Pharmacy.

Patients love telehealth—physicians are not so sure

IRL or URL? Many physicians and patients used to see medical care as something best done in-person (in real life, or IRL). But the pandemic has spurred a massive transition to virtual (or URL) care. According to our recent surveys of consumers and physicians, opinions are split on what happens next (see sidebar, “Our methodology”). As the pandemic evolves, consumers still prefer the convenience of digital engagement and virtual-care options, according to our recent McKinsey Consumer Health Insights Survey. This preference could help more patients access care, while also helping providers to grow.

Our methodology

To help our clients understand responses to COVID-19, McKinsey launched a research effort to gather insights from physicians into how the pandemic is affecting their ability to provide care, their financial situation, and their level of stress, as well as what kind of support would interest them. Nationwide surveys were conducted online in 2020 from April 27–May 5 (538 respondents), July 22–27 (150 respondents), and September 22–27 (303 respondents), as well as from March 25–April 5, 2021 (379 respondents).

The participants were US physicians in a variety of practice types and sizes, and a range of employment types. The specialties included general practice and family practice; cardiology; orthopedics, sports medicine and musculoskeletal; dermatology; general surgery; obstetrics and gynecology; oncology; ophthalmology; otorhinolaryngology and ENT; pediatrics; plastic surgery; physical medicine and rehabilitation; psychiatry and behavioral health; emergency medicine; and urology. These surveys built on a prior one of 1,008 primary-care, cardiology, and orthopedic-surgery physicians in April 2019.

To provide timely insights on the reported behaviors, concerns, and desired support of adult consumers (18 years and older) in response to COVID-19, McKinsey launched consumer surveys in 2020 (March 16–17, March 27–29, April 11–13, April 25–27, May 15–18, June 4–8, July 11–14, September 5–7, October 22–26, and November 20–December 6) and 2021 (January 4–11, February 8–12, March 15–22, April 24–May 2, June 4–13, and August 13–23). These surveys represent the stated perspectives of consumers and are not meant to indicate or predict their actual future behavior. (In these surveys, we asked consumers about “Coronavirus/COVID-19,” given the general public’s colloquial use of coronavirus to refer to COVID-19.)

Many digital start-ups and tech and retail giants are rising to the occasion, but our most recent (2021) McKinsey Physician Survey indicates that physicians may prefer a return to pre-COVID-19 norms. In this article, we explore the trends creating disconnects between consumers and physicians and share ideas on how providers could offer digital services that work not only for them but also for patients. Bottom line: a seamless IRL/URL offering could retain patients while delivering high-quality care. Everybody benefits.

The rise of telehealth

These materials reflect general insight based on currently available information, which has not been independently verified and is inherently uncertain. Future results may differ materially from any statements of expectation, forecasts, or projections. These materials are not a guarantee of results and cannot be relied upon. These materials do not constitute legal, medical, policy, or other regulated advice and do not contain all the information needed to determine a future course of action.

At the onset of the COVID-19 pandemic, both physicians and patients embraced telehealth: in April 2020, the number of virtual visits was a stunning 78 times higher than it had been two months earlier, accounting for nearly one-third of outpatient visits. In May 2021, 88 percent of consumers said that they had used telehealth services at some point since the COVID-19 pandemic began. Physicians also felt dramatically more comfortable with virtual care. Eighty-three percent of those surveyed in the 2021 McKinsey Physician Survey offered virtual services, compared with only 13 percent in 2019. 1 See sidebar on methodology; McKinsey Physician Surveys conducted nationally in five waves between May 2019 and April 2021; May 1, 2019, n = 1,008; May 5, 2020, n = 500; July 2, 2020, n = 150; September 27, 2020, n = 500; April 5, 2021, n = 379.

However, as of mid-2021, consumers’ embrace of telehealth appeared to have dimmed a bit  from its early COVID-19 peak: utilization was down to 38 times pre-COVID-19 levels. Also, more physicians were offering telehealth but recommending in-person care when possible in 2021, which could suggest that physicians are gravitating away from URL and would prefer a return to IRL care delivery (Exhibit 1).

Three trends from the late-stage pandemic

As COVID-19 continues, three emerging trends could set the stage for the next few years.

The number of virtual-first players keeps growing, and physicians struggle to keep up

The growth (and valuations) of virtual-first care providers suggest that demand by patients is persistent and growing. Teladoc increased the number of its visits by 156 percent in 2020, and its revenues jumped by 107 percent year over year. Amwell increased its supply of providers by 950 percent in 2020. 2 “Teladoc Health reports fourth-quarter and full-year 2020 results,” Teledoc Health, February 24, 2021; “Amwell announces results for the fourth quarter and full year 2020,” Amwell, March 24, 2021. By contrast, only 45 percent of physicians have been able to invest in telehealth during the pandemic, and only 16 percent have invested in other digital tools. Just 41 percent believe that they have the technology to deliver telehealth seamlessly. 3 McKinsey Physician Survey, April 5, 2021.

Some workflows, for example, require physicians to log into disparate systems that do not integrate seamlessly with an electronic health record (EHR). Audiovisual failures during virtual appointments continue to occur. To make these models work, providers may need to determine how to design operational workflows to make IRL/URL care as seamless as possible for both providers and patients. The workflows and care team models may need to vary, depending on the physician’s specialty and the amount of time they plan to devote to URL versus IRL care.

Patient–physician relationships are shifting

In McKinsey’s April 2021 Physician Survey, 58 percent of the respondents reported that they had lost patients to other physicians or to other health systems since the start of the COVID-19 pandemic. Corroborating those findings, our August 2021 survey of consumers showed that of those who had a primary-care physician (PCP), 15 percent had switched in the past year. Thirty-five percent of all consumers reported seeing a new healthcare provider who was not their regular PCP or specialist in the past year. Among consumers who had switched PCPs, 35 percent cited one or more reasons related to the patient experience—the desire for a PCP who better understood their needs (15 percent of respondents), a better experience (10 percent), or more convenient appointments (6 percent). Just half (50 percent) of consumers with a PCP say they are very satisfied. What’s more, Medicare regulations now give patients more ownership over their health data, and that could make it easier for them to switch physicians. 4 “Policies and technology for interoperability and burden reduction,” Centers for Medicare & Medicaid Services, December 9, 2021.

Physicians and patients see telehealth differently

Our surveys show that doctors and patients have starkly different opinions about telehealth and broader digital engagement (Exhibit 2). Take convenience: while two-thirds of physicians and 60 percent of patients said they agreed that virtual health is more convenient than in-person care for patients, only 36 percent of physicians find it more convenient for themselves.

This perception may be leading physicians to rethink telehealth. Most said they expect to return to a primarily in-person delivery model over the next year. Sixty-two percent said they recommend in-person over virtual care to patients. Physicians also expect telehealth to account for one-third less of their visits a year from now than it does today.

These physicians may be underestimating patient demand. Forty percent of patients in May 2021 said they believe they will continue to use telehealth in the pandemic’s aftermath. 5 McKinsey Consumer Health Insights Survey , May 7, 2021.

In November 2021, 55 percent of patients said they were more satisfied with telehealth/virtual care visits than with in-person appointments. 6 McKinsey Consumer Health Insights Survey , November 19, 2021. Thirty-five percent of consumers are currently using other digital services, such as ordering prescriptions online and home delivery. Of these, 42 percent started using these services during the pandemic and plan to keep using them, and an additional 15 percent are interested in starting digital services. 7 McKinsey Consumer Health Insights Survey , June 24, 2021.

Convenience is not the only concern. Physicians also worry about reimbursement. At the height of the COVID-19 pandemic in the United States, the Centers for Medicare & Medicaid Services (CMS) and several other payers switched to at-parity (equal) reimbursement for virtual and in-person visits. More than half of physician respondents said that if virtual rates were 15 percent lower than in-person rates, they would be less likely to offer telehealth. Telehealth takes investment: traditional providers may need time to transition their capital and operating expenses to deliver virtual care at a cost lower than that of IRL.

Four critical actions for providers to consider

Providers may want to define their IRL/URL care strategy to identify the appropriate places for various types of care—balancing clinical appropriateness with the preferences of physicians and patients.

Determine the most clinically appropriate setting

Clinical appropriateness may be the most crucial variable for deciding how and where to increase the utilization of telehealth. Almost half of physicians said they regard telehealth as appropriate for treatment of ongoing chronic conditions, and 38 percent said they believe it is appropriate when patients have an acute change in health—increases of 26 and 17 percentage points, respectively, since May 2019.

However, physicians remain conservative in their view of telehealth’s effectiveness compared with in-person care. Their opinions vary by visit type (Exhibit 3). Health systems may consider asking their frontline clinical-care delivery teams to determine the clinically appropriate setting for each type of care, taking into account whether physicians are confident that they can deliver equally high-quality care for both IRL and URL appointments.

Assess patient wants and needs in relevant markets and segments

Patient demand for telehealth remains high, but expectations appear to vary by age and income group, payer status, and type of care. Our survey shows that younger people (under the age of 55 ), people in higher income brackets (annual household income of $100,000 or more), and people with individual or employer-sponsored group insurance are more likely to use telehealth (Exhibit 4). Patient demand also is higher for virtual mental and behavioral health. Sixty-two percent of mental-health patients completed their most recent appointments virtually, but only 20 percent of patients logged in to see their primary-care provider, gynecologist, or pediatrician.

To meet market demand effectively, it may be crucial to base care delivery models on a deep understanding of the market, with a range of both IRL and URL options to meet the needs of multiple patient segments.

Partner with physicians to define a new operating model

Many physicians are turning away from the virtual operating model: 62 percent recommended in-person care in April 2021, up five percentage points since September 2020. As physicians evaluate their processes for 2022, 46 percent said they prefer to offer, at most, a couple of hours of virtual care each day. Twenty-nine percent would like to offer none at all—up ten percentage points from September 2020. Just 11 percent would dedicate one full day a week to telehealth, and almost none would want to offer virtual care full time (Exhibit 5).

To adapt to these views, care providers can try to meet the needs and the expectations of physicians. They could offer highly virtualized schedules to physicians who prefer telehealth, while allowing other physicians to remain in-person only. Matching the preferences of physicians may create the best experience both for them and for patients. Greater flexibility and greater control over decisions about when and how much virtual care to offer may also help address chronic physician burnout issues (Exhibit 6). Digital-first solutions (for example, online scheduling, digital registration, and virtual communications with providers) could also increase the reach of in-person-only care providers to the 60 percent of consumers interested in using these digital solutions after the pandemic abates.

Communicate clearly to patients and others

Physicians consistently emerge as the most trusted source of clinical information by patients: 90 percent consider providers  trustworthy for healthcare-related issues. 8 McKinsey Consumer Survey, May 2020. Providers could play a pivotal role in counseling patients on the importance of continuity of care, as well as what can be done safely and effectively by IRL and URL, respectively. The goal is to help patients receive the care that they need in a timely manner and in the most clinically appropriate setting.

Potential benefits to providers

The strategic, purposeful design of a hybrid IRL/URL healthcare delivery model that respects the preferences of patients and physicians and offers virtual care when it is appropriate clinically may allow healthcare providers to participate in the near term, retain clinical talent, offer better value-based care, and differentiate themselves strategically for the future.

Telehealth and broader digital engagement tools have enjoyed persistent patient demand throughout the pandemic. That demand may persist well after it. Investment in digital health companies has grown rapidly—reaching $21.6 billion in 2020, a 103 percent year-over-year increase—which also suggests that this approach to medicine has staying power. 9 Q4 and annual 2020 digital health (healthcare IT) funding and M&A report , Executive Summary, Digital Health Funding and M&A, Mercom Capital Group.

That level of demand offers the potential for growth when physicians can meet it. If only new entrants fully meet consumer demand, traditional providers who do not offer URL options may risk losing market share over time as a result of patients’ initial visit and downstream care decisions. What’s more, as healthcare reimbursement continues to move toward value, virtual-delivery options could become a strategic differentiator that helps providers better manage costs. 10 Brian W. Powers, MD, et al., “Association between primary care payment model and telemedicine use for Medicare Advantage enrollees during the COVID-19 pandemic,” JAMA Network , July 16, 2021.

In all likelihood, one of the critical steps in the process will be engaging physicians in the design of new virtual-care models—for example, determining clinical appropriateness, how and where physicians prefer to deliver care, and the workflows that will maximize their productivity. This has the added benefit of potentially also addressing the problem of physician burnout by offering a range of options for how and where clinicians practice.

Most important, virtual care can offer an opportunity to improve outcomes for patients meaningfully by delivering timely care to those who might otherwise delay it or who live in areas with provider shortages. In addition, patients’ most trusted advisers on care decisions are physicians, so virtual care gives them a meaningful opportunity to help patients access the care they need in a way that both parties may find convenient and appropriate. 11 “Public & physician trust in the U.S. healthcare system,” ABIM Foundation, surveys conducted on December 29, 2020 and February 5, 2021.

Physicians are evaluating a variety of factors for delivering care to patients during and, eventually, after the COVID-19 pandemic. The strategic, purposeful design of a hybrid IRL/URL healthcare delivery model offers a triple unlock: improving the value of healthcare while better meeting consumer demand and improving physicians’ engagement. The full unlock is not easy—it requires deep engagement and cooperation between administrators, clinicians, and frontline staff, as well as focused investment. But it will yield dividends for patients and providers alike in the long run.

Jenny Cordina is a partner in McKinsey’s Detroit office,  Jennifer Fowkes is a partner in the Washington, DC, office,  Rupal Malani, MD , is a partner in the Cleveland office, and  Laura Medford-Davis, MD , is an associate partner in the Houston office.

The article was edited by Elizabeth Newman, an executive editor in the Chicago office.

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