2-2 Defining Research Objectives and Formulating Research Questions

Overview

Research ideas in health professions education are everywhere. What are the different approaches to curricular design? Why choose one assessment method over another? Just how does problem-based learning (PBL) work? And yet getting from an idea to a research question which will advance our understanding and add to the conversation in the health professions education is an art and a science. An art to understanding what will spark the interest of the community, and a science to know how to craft the question in a way that focuses on describing, justifying or clarifying.

Good research questions consider carefully the scope of what is being studied – too broad and hard to find meaning – too narrow and hard to apply. Good research questions often lend themselves to a methodology – or are aligned with a methodology – that is best suited to the type and manner of question being posed. Finally, good questions do not shy away from the context in which they emerged. Like distinctive characters in a movie plot, they are uncompromising in their specificity. Rather than being afraid of bias, good research questions  make explicit the assumptions on which they are based and defend against misinterpretation through systematization. This chapter will introduce you to the types of research questions. We will explore how bias is inherent in all research questions, but can be mitigated. Finally, we look at how research questions help decide on methodologies, as they are most effective at advancing the conversation when the methods match or align with the question in a way that leads to clarity, discovery or novelty!

Vignette

What a challenging first year of residency! Xyla moved to a new centre to start her internal medicine and feels that she has developed a new sense of self, and new professional identity as a result of the journey. She wonders how much the shift in cultural context contributed to her new identity formation – what a great idea for a research project. But how to get from this idea to a researchable idea? What kind of questions is she asking anyway? Is this a descriptive, justification or clarifying question? Is there relevant theory? She has experience doing survey research in the past, should she simply adapt this approach?

Deeper Dive into this Concept

Writing a concise and specific research question is well worth the effort. Coming up with a single sentence may not seem like a big endeavour, but it can be really challenging to find a question that contributes to the conversation in the literature. A great question is right where the action is at – the proximal zone of development for the field. It challenges convention but is well situated within the existing conversation. If you are in Xyla’s position, and want to explore something new, make sure that you have started with understanding where the field is currently. Search the literature systematically, read carefully and thoroughly to understand the current conversations, before trying to craft your research question. For your research question to incite conversation within the field, it should build on what others have done, and highlight an important gap in the literature which has not been previously addressed. It is important to think about gaps both theoretically and practically to be meaningful. Does repeating a study for internal residents that was already done with a wider group of residents really address a gap? It might be, especially if there is a theoretical reason to consider internal medicine residents unique, and especially if that theoretical reason is intertwined with the construct being studied. For example, the link between supervision and entrustment is well established, but when the tasks are cognitive – such as in internal medicine – what the terms direct and indirect supervision mean are less clear, but this is highly relevant for the construct of entrustment. Here the gap relates to the construct of interest and represents a meaningful rationale for exploration.

Once you have identified a gap, consider whether you can formulate a research question which will inform that gap. How will you learn something and convince others that you have learned something about that gap? Here, consider the different types of questions – are you taking a descriptive approach? A justification approach? A clarification approach? For more information on these different types of questions, read the article by Cook et al. listed in the suggested readings list (1).

Next consider the language that you are using.  Words are important. It is worth spending time to carefully consider what terms you are using. Are these the dominant terms within the literature? Are these the terms most likely to help advance our understanding of the gap? Are these terms specific and focused enough to be practically researchable? Do you want to explore workplace-based assessment or entrustable professional activity assessment? The difference in terminology sets the stage for your entire research endeavour.

Then, after you have settled on the language, recognize that there is a balance between being concise and thorough – not losing a reader in a detailed, run-on research question, but being sufficiently clear to be a research question and not just an objective or aim. Many will include the context, the population and the methodology in their research question. This is  similar to including the Population, Intervention, Control and Outcome present in many clinical research questions. Finally, consider whether not your research question should be divided into smaller questions, especially if you are referencing multiple methodologies or populations. Research questions that are too broad often end up in complex methods, and results which are hard to interpret.

It is helpful to share your question with your study team and reflect on it. The following are some questions that may guide you through thinking about your research question:

• Is this answerable?
• Does this address the gap that you have highlighted in the literature?
• Is the specificity and context provided sufficient to predict the methods?
• Will this add to the conversation in the literature?
• Will it hold meaning?
• Will it have impact? (See Chapter 3-4 for more thinking around this topic.)

You can also review some of the literature on how to generate good research questions that are listed in the reference list below (2-4)

Also, please listen to the following podcast featuring Drs. Larkin Larmarche & Teresa Chan on the topic of research questions. Some of the papers mentioned in this podcast are available below.

Vignette Conclusion

Xyla starts by deciding to read up on the literature. She realizes that there are many theoretical frameworks around professional identity. She connects with an author of a previous paper, and discusses her ideas. She opts to explore the role of cultural context in professional identity setting by studying those who train in different cultures, using transformative learning theory as a framework to help her clarification question.

1. Cook DA, Bordage G, Schmidt HG. Description, justification and clarification: a framework for classifying the purposes of research in medical education. Medical education. 2008 Feb;42(2):128-33. Get it Mac | See on Medical Education

2. Eva, K. W. (2008). On the limits of systematicity. Medical Education, 42(9), 852–853. Get it Mac | See on Medical Education

3. Dine CJ, Shea JA, Kogan JR. Generating good research questions in health professions education. Academic Medicine. 2016 Dec1;91(12):e8. Get it Mac | See on Academic Medicine

4. O’Brien BC, Ruddick VJ, Young JQ. Generating research questions appropriate for qualitative studies in health professions education. Academic Medicine. 2016 Dec 1;91(12):e16. Get it Mac | See on Academic Medicine

5. Monte AA, Libby AM. Introduction to the Specific Aims Page of a Grant Proposal. Academic Emergency Medicine. 2018 Sep;25(9):1042-7. Get it Mac | See on Academic Emergency Medicine

About the Authors

name: Matt Sibbald

institution: McMaster University

Matthew Sibbald (he/him) is an Associate Professor of Medicine, McMaster University and Interventional Cardiologist at Hamilton Health Sciences and Niagara Health System. He is also the Associate Dean of the Michael G. DeGroote School of Medicine Undergraduate Medical Education Program.

name: Sarah Blissett

institution: Schulich School of Medicine & Dentistry, Western University

Sarah Blissett (she/her) is an Assistant Professor, Department of Medicine (Division of Cardiology) at Western University. She is also a researcher within the Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University.