Abstract
In 2006, I wrote an editorial for this journal entitled ‘Integrating mixed-methods research into healthcare’. At that time, almost two decades ago, I pointed out that mixed-methods research was not a new phenomenon, despite a surge in popularity and visibility. Since then, many authors have attempted to evaluate the state of play in relation to the use and misuse of mixed methods as applied to healthcare research. Methodological pluralism, paradigmatic contests, the benefits and limitations of one method over another, the superiority of quantitative approaches, integration versus triangulation, are just some of the many debates that continue to ensue in this field. In that editorial, I commented that such debates could keep researchers ad writers in work for some time, and that mixed-methods research was not ‘about creating a new academic industry; simply, it is about finding the best approach to answering a question in the most robust manner’ (2006: 181). Well, the industriousness continues, however, the question of the value of mixed-methods research in delivering contextually focused, outcome based, what I think of as relevant and impactful research, in clinical settings remains.
The authors of this socio-ecological scoping review remind us of some of the challenges of developing and implementing mixed-methods research in the clinical setting, and the importance of generating clinically applicable findings; this has never been in doubt, perhaps though we do need periodic reminders. Whilst I am not convinced that the traditional hierarchy of evidence that is described as ‘often relied upon’ in the paper is in fact heavily relied upon, or still the dominant discourse, what is key, is the point made by the authors around the potential of MMR to advance contextual knowledge. The social context of mixed-methods research is indeed highly influential, but isn’t it in all research? Even in the Lab? So what makes the context of mixed-methods research peculiar or different. Amongst the discussion, one specific context is proposed by the authors that captured my attention. To paraphrase, researchers anticipating pushback on their choice of methodology, work harder at providing a rationale for using it. This may be accurate, but I have some disquiet. How much of this working harder to provide a rationale and expecting pushback reflects the social context of nursing writ large. Is it possible that additional justification and persuasion that is apparently required (real or perceived) hides a deeper contextual narrative? A tricky question to answer I know. So are research questions! There is a parallel here.
As I have written elsewhere, questions matter. The art of asking good questions is essential to the success of relevant and impactful research. Carefully crafted contextually focused questions should always precede the choice of methodological approach in healthcare research. Carefully crafted thought through questions also elicit and create context and often get under the values and judgements behind both the questioner and the questioned, the researcher and the researched. This scoping review elicits and rehearses many of the relevant issues concerning the value and impact of mixed-methods research in creating evidence-based nursing. My question to the reader is, ‘Does it sufficiently question and challenge the historical and social contexts within which the questions themselves are asked?’.