(Page 40 of 40) - Identity Types and Organizational Contexts: An Inquiry into Physicians in Organizations authored by Real, Kevin., Bramson, Rachel. and Poole, Marshall.

Identity types

Pseudonym for the names of two adjacent communities

After interviewing approximately 12-15 physicians, a preliminary analysis of the data was undertaken by the first author in order to provide knowledge that might inform future

data collection as well as gain insight into the revision and formation of research questions. There were two primary outcomes of this preliminary analysis: we became more aware
of issues that would arise in later interviews, so the first author was provided with the ability to intelligently probe after hearing certain issues discussed. Secondly, we revised the
research questions, specifically adding a set of research questions related to the current environment in medicine because of all the attention focused on it in the interviews. Even
though no direct questions were asked about this matter, a number of responses were directed into this area so new research questions were added to the study. Finally, all
materials related to this analysis were physically put away in order to prevent this preliminary analysis from unduly influencing the primary data analysis.

A number of specific steps were taken that there is simply not enough space to detail in the text. The first author unitized the data by dividing it into discrete units of

information that could stand alone and would later serve as the basis for defining categories. Secondly, this unitizing was checked by the third author and another experienced
researcher. Third, these units were transferred from the full-length transcripts onto 5x8 cards in order to sort the data into distinct categories based on “feels/like and looks/like”
(Lincoln & Guba, 1985). In all, there were 1,305 cards in the data set. Fourth, after analyzing seven interviews, the data was audited by the second author, a practicing physician.
This first audit consisted of a complete review of five full interviews. The physician-auditor was not only able to recognize certain meanings attached to what physicians were
saying in the interviews not previously grasped, but added insight into the naming of categories. A second audit of one more completed interview occurred after the coding of
fourteen interviews. Fifth, the next step in the data analysis was the sorting of data into larger thematic units or themes. It has been noted above that this process is analyzing data
inductively in search of themes, but any themes arrived at are derived from the data itself guided by theory, prior conceptualization and experience (especially in the case of the
physician data-auditor). After sorting the data into thematic units, a third audit of the data was conducted in which the physician-auditor went over all of the completed analysis:
where the data had been unitized, categorized, printed out on cards, and sorted into thematic units related to specific research questions. The physician-auditor reviewed categories
within three basic research questions to determine if the categories belonged within specific thematic units and if the specific thematic unit was viable. This work with the data
auditor was directed toward satisfying methodological rigor by establishing trustworthiness (Lincoln & Guba, 1985) and, prior to the writing up of any findings, resulted in four
distinct analyses of the data.

An important aspect of qualitative research is establishing the trustworthiness of both the data and the data analysis. Included in these are member checking, which

were utilized in order to gain a degree of “interpretive validation” (Lindlof, 1995, p. 241). In an immediate sense, member checks were performed during interviews by asking and
checking with physicians to clarify any obvious confusion that can typically arise in the course of an interview. Moreover, one Clinic physician, in a follow-up member check,
indicated the veracity of the findings but vehemently disagreed with what Group and Solo physicians had to say about the Clinic. That is, he agreed that these sentiments existed in
the community, but he believed them to be incorrect. A second means of establishing trustworthiness is transferability, which is intended to provide readers enough information to
allow them to decide whether the findings of this study are applicable elsewhere (Lincoln &Guba, 1985). In qualitative research, transferability is used instead of generalizability
and the applicability of research findings is decided, not by the researcher, but by potential “appliers” (Lincoln & Guba, 1985; Lindlof, 1995), who may be researchers and
physicians interested in the areas covered in this study. The key element is providing sufficient information for the reader to make a reasonable determination. The third and
fourth means of establishing trustworthiness are dependability and confirmability, which attest to how reliable and verifiable the data and data analyses are in a given study
(Lincoln &Guba, 1985). These are grouped together here because the primary means of establishing these was through the use of a data auditor (Lincoln &Guba, 1985). In this
study, care was taken not only to allow for a clear audit trail from the unitized data back to the original data, but also to provide for an audit of the data analysis as reported in the
section on data analysis.

A thorough representation of this interpretive schema is not possible due to page constraints. And while this has been constructed from the data in a larger study, out of respect

for the blind review process, we withhold the cite.

Ample raw interview data can be found in the larger study, which is not cited out of respect for the blind review process.

The first number indicates the code number for the physician and the second number indicates the card number from the data.