Research in practice: Theory/Methodology/Methods

This research aims to refine and develop theoretical and methodological knowledge in the health sciences by building upon social scientific and historical approaches.

Key Insights

  • An unavoidable tension exists between the mission, form, and scale of ethnography as conducted to develop basic and applied knowledge, between the traditional and contemporaneous forms of ethnography. Fruitful import of ethnography into the health sciences must deal with these tensions.

  • There is very limited evidence to support the existence of a Hawthorne Effect in healthcare observational research, for two likely reasons: healthcare workers are used to being observed; and healthcare work is often so fast-paced that routine over-rides the need to safe face.

  • To avoid observer effects—defined as research participants’ altered behaviour in response to being observed—healthcare researchers conducting observations should conduct sustained observation, compare their views with those of participants, establish rapport, record and evaluate their interactions with participants, consider limiting participants’ awareness of the specific research question.

  • Access to research sites is partly dependent on the type of research scholars want to undertake. Health professions education researchers in the paradigmatic margins, those who conduct more critical research, may struggle more with finding clinical partners and research sites in clinical settings.

  • Ethical issues surrounding new forms of data collection methods—including visual methods of many kinds—need close inspection and deep introspection by investigators.

  • Visual methods may hold great potential to disrupt what we value and teach in health professions education, by centering the learner and patients.

  • Neo-institutional theory and the concept of decoupling may help scholars investigate the gap between what policies and procedures say, what people do, and the outcomes of clinical and educational practices.

  • Ethnography is a powerful method to understand culture, context, teamwork, and the richness of clinical reality.

Articles or Chapters

Paradis E and Varpio L. April 2018. “Difficult but important questions about the ethics of qualitative research.” Perspectives on Medical Education 7(2): 65-66. Visit Site

Paradis E. October 2017. “When I say… decoupling”. Medical Education. 51(10):992-3. doi: 10.1111/medu.13248. Download

Paradis E and G Sutkin. January 2017. “Beyond a good story: from Hawthorne effect to reactivity in health professions education research” Medical Education. 51(1), 31-39. doi: 10.1111/medu.13122 Download

Paradis E, O’Brien B, Nimmons L, Martimianakis MA and G Bandiera. May 2016. “Design: selection of data collection methods”. Journal of Graduate Medical Education. 8(2): 263-4. doi: 10.4300/JGME-D-16-00098.1. Visit Site

Paradis E. 2016. “The tools of the qualitative research trade.” Academic Medicine. 91(12). doi: 10.1097/ACM.0000000000001393 Visit Site

Paradis E and PJ Leake. 2016. “Visual data in health professions education: time to consider their use, ethics and aims.” Perspectives on Medical Education 5(4): 193-4. Visit Site

Paradis E. 2015. “Unanswered questions on access from the margins.” Medical Education. 49(2): 145-6. Visit Site

Leslie M, Paradis E, Gropper MA, Reeves S and S Kitto. 2014. “Applying ethnography to the study of context in healthcare quality and safety.” BMJ Quality and Safety. 23(2): 99-105. doi:10.1136/bmjqs-2013-002335 Download


Myles Leslie, U Calgary

Lara Varpio, USUHS

Gary Sutkin, UMissouri KC


Students and Research Assistants

Madison Brydges

Patricia (Patti) Leake

Gussje Bressers