IDG Update #3:Qualitative Interviewing in the time of COVID
By: Midori Matthew
Hello, Kernel Network! My name is Midori Matthew, and I am the Graduate Research Assistant on the ‘Physician’s Experience and Bioethics’ project regarding physician’s perceived moral differences between the provision of medical assistance in dying and withdrawal of life-sustaining treatment. The scope of my role has been to manage the scheduling of physician interviews, co-facilitate interviews with clinicians with one of the primary investigators Dr. Bonner, and to maintain an open line of communication with our participants while I transcribe our data and establish codes/recurring themes. It has been both enlightening and enriching to be in the thick of this project, particularly as it relates to a bioethical and public health matter so pertinent to the times – especially now that Bill C-7 has been passed by Canada’s Senate. For context, C-7 proposes to expand access to medical assistance in dying further by allowing people whose natural deaths do not fall under the ‘reasonably foreseeable’ criteria to request assisted death.
As of mid-December 2020, we have completed Phase 2 of the project. From October to December, we were able to interview 22 physicians across Canada (surpassing our original goal of 20) spanning many different specializations and backgrounds, including, but not limited to: family medicine, palliative care, obstetrics and gynecology, internal medicine, and psychiatry. The national scope and cross-disciplinary backgrounds of these physicians provided us with a wealth of depth and diversity in lived experiences and personal bioethical opinions in the provision of medical assistance in dying (MAID) and withdrawal of life-sustaining treatment. Our sample also included several who are not involved in the provision of MAID as well as many who are. With each interview that we conducted, we learned a great deal about the nuances and clinical and philosophical complexities that physicians face in their everyday lives and practice in the provision of end-of-life-care.
For those who are somewhat unfamiliar with the ins-and-outs of qualitative interviewing, this was quite a large sample size (which we deem to be a success), and, thus, quite a bit of work! In non-COVID affected circumstances, the original plan was to meet our interviewees in-person in a private location of their choice. However, given the nature of the pandemic and respecting the safety of both ourselves and our participants, we made the necessary arrangements to undertake all of our interviews virtually via Microsoft Teams. While qualitative interviewing poses many foreseeable challenges such as building appropriate rapport with participants, having a reliable recording device, and ensuring that questions are open-ended enough to allow the participant to take questions in a direction they see fit; interviewing in the time of COVID provided us with some interesting challenges. Foremost, internet connection is something we take for granted during our own down-time, but as Murphy’s Law would have it, it was often difficult to ensure that myself, Dr. Bonner, and our participant all had adequate connectivity! For us, the repercussions of this issue meant that questions often needed to be re-asked, video recordings sporadically cut out some words or sentences, and it was much harder to establish the rapport we often take for granted in face-to-face contact via non-verbal cues or pauses, which was significantly harder to gauge over video chat. As well, for clinicians who were not familiar with video chat and recording software, there were initial adaptivity pains in troubleshooting email receipts, invitation links working adequately, and navigating differences in time zones that were not necessarily reflected on the software.
Now that this phase of the project is complete, the next step involves qualitative research’s most notorious aspect: transcription of all 22 interviews (which is precisely as daunting, if not more, than it sounds!). When it comes to the average rate of transcription, for every 1 hour of audio, the average person takes approximately 4 hours to fully transcribe it. So, while this stage is a little temporally onerous, it will provide us with accurate and precise accounts (including non-verbal cues, at least those of which that could be detected on video) that we can work with to undertake coding and thematic analysis of responses to our questions. We look forward to being able to provide the next update ~ until then, stay safe!
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