rigour in qualitative research lincoln and guba

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Critical Analysis of Strategies for Determining Rigor in Qualitative Inquiry

Affiliation.

1 University of Utah, Salt Lake City, Utah, USA [email protected].
PMID: 26184336
DOI: 10.1177/1049732315588501

Criteria for determining the trustworthiness of qualitative research were introduced by Guba and Lincoln in the 1980s when they replaced terminology for achieving rigor, reliability, validity, and generalizability with dependability, credibility, and transferability. Strategies for achieving trustworthiness were also introduced. This landmark contribution to qualitative research remains in use today, with only minor modifications in format. Despite the significance of this contribution over the past four decades, the strategies recommended to achieve trustworthiness have not been critically examined. Recommendations for where, why, and how to use these strategies have not been developed, and how well they achieve their intended goal has not been examined. We do not know, for example, what impact these strategies have on the completed research. In this article, I critique these strategies. I recommend that qualitative researchers return to the terminology of social sciences, using rigor, reliability, validity, and generalizability. I then make recommendations for the appropriate use of the strategies recommended to achieve rigor: prolonged engagement, persistent observation, and thick, rich description; inter-rater reliability, negative case analysis; peer review or debriefing; clarifying researcher bias; member checking; external audits; and triangulation.

Keywords: credibility; dependability; generalizability; qualitative; reliability; rigor; transferability; trustworthiness; validity.

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Application of Guba and Lincoln's parallel criteria to assess trustworthiness of qualitative research on indigenous social protection systems

Qualitative Research Journal

ISSN : 1443-9883

Article publication date: 7 March 2023

Issue publication date: 12 June 2023

This paper illustrates how Guba and Lincoln's parallel criteria for establishing trustworthiness, can be adapted and applied to qualitative research on indigenous social protection systems. It provides insights for social protection researchers, exploring plausible qualitative research rigor evaluation criteria, on plausible alternatives.

Design/methodology/approach

The paper draws on qualitative evidence from a larger ethnographic study on the dynamics of indigenous social protection systems in Nigeria. It illustrates the systematic application of Guba and Lincoln's parallel criteria.

Available evidence from the study shows that Guba and Lincoln's parallel criteria is viable for establishing trustworthiness of qualitative research on indigenous social protection systems. The criteria can facilitate credible and reliable research outcomes in research on improving social protection policy and practice.

Research limitations/implications

Qualitative inquiries that draw on Guba and Lincoln's parallel criteria as evaluation criteria for trustworthiness can complement quantitative research on social protection. This makes it imperative to incorporate both, in social protection research for a holistic system. How this can be done is beyond the scope of this paper but needs to be explored by future research.

Originality/value

Contrary to the use of Guba and Lincoln's parallel criteria in qualitative research in other contexts, the use of the criteria has not been carefully examined in qualitative research on indigenous social protection systems. This paper is an attempt to fill this gap.

Qualitative research
Social protection

Trustworthiness

Credibility

Enworo, O.C. (2023), "Application of Guba and Lincoln's parallel criteria to assess trustworthiness of qualitative research on indigenous social protection systems", Qualitative Research Journal , Vol. 23 No. 4, pp. 372-384. https://doi.org/10.1108/QRJ-08-2022-0116

Emerald Publishing Limited

Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcode

Introduction

The importance of evaluation of the quality of a research cannot be overemphasized. Without rigor, argue Morse et al. (2002) , research is worthless, becomes fiction and loses its utility. In like manner, a research that lacks trustworthiness portends harmful consequences if adopted for policy purposes ( Tierney and Clemens, 2010 ). Just as in quantitative research, qualitative research has criteria that can be used to evaluate the quality of the research ( Liamputtong, 2019 ). Indeed, the different models and emphasis on standards for legitimation of qualitative research and the quality of qualitative research evaluation generally (see Onwuegbuzie et al. , 2012 ) attest to the importance attached to trustworthiness of research.

Qualitative research is often seen to be rigorous if it is reliable and valid ( Creswell, 2013 ; Morse et al. , 2002 ; Morse 2015a , b ; 2018 ). In reality, however, the debate on rigor, including suggestions about its constituent elements, is alive and at the forefront of qualitative scholarship, often resulting in a plethora of terms and criteria that undermines rather than clarify the concept ( Johnson and Rasulova, 2016 ; Morse et al. , 2002 ; Morse, 2018 ).

As for the related concept, trustworthiness, some background information is vital for clarity. Guba and Lincoln settled the debate for qualitative rigor by introducing a new perspective, new criteria and a new language for qualitative rigor in the 1980s. Prior to that time, quantitative researchers devalued qualitative research for the latter's methods considered to lack rigor and incapable of generating valid results ( Morse, 2018 ). Lincoln and Guba's (1986) idea of scientific rigor comprise two components: parallel criteria of trustworthiness and unique criteria of authenticity. The first was referred to as “parallel criteria” because, as Lincoln and Guba (1986, p. 76 ) explained, “given a dearth of knowledge about how to apply rigor in the naturalistic paradigm, using conventional criteria as analogs or metaphoric counterparts was a possible and useful place to begin”, which is also why the term trustworthiness was used as a parallel term to rigor, such that the basis of the latter include credibility as an analog to internal validity, transferability as an analog to external validity, dependability as an analog to reliability and confirmability as an analog to objectivity. However, the second component of rigor in Lincoln and Guba's (1986) expanded idea of the term is the “authenticity criteria”, but being beyond the scope of the current paper, this is not delved into.

The development recounted above notwithstanding, the lack of clarity among qualitative researchers in the use of the concept of rigor prompted Morse (2015a, p. 1213 ) to suggest a return to the terminology of mainstream social science, “using rigor (rather than trustworthiness) and replacing dependability, credibility, and transferability with the more generally used reliability, validity , and generalizability .” A major implication of the foregoing is the connection between rigor, trustworthiness and the nature of meaning making in qualitative inquiry. For example, the language that describes, and the meanings attached to the terminology for establishing and assessing rigor in qualitative research vary from that of traditional positivist studies ( Tucket, 2005 ). Thus, meaning making is a vital but complex element in qualitative research and lapses in this regard ultimately make aspects of rigor and trustworthiness to suffer ( James and Mulcahy, 1999 ; Krauss, 2005 ).

The components of Lincoln and Guba's (1986) “parallel criteria” also referred to as “the Four-Dimensions Criteria” or the acronym FDC ( Forero et al. , 2018, p. 2 ), namely, credibility, dependability, confirmability and transferability, are elaborated below.

Credibility addresses whether the findings and judgments made by the researcher can be trusted and the extent to which they provide comprehensive and sensible interpretations of the data ( Lincoln and Guba, 1986 cited in Hanson et al. , 2019 ). The purpose is to establish confidence that the results (from the perspective of the participants) are true, credible and believable and can be achieved through prolonged engagement, persistent observation, triangulation, peer debriefing, negative case analysis, referential adequacy and member checks ( Guba and Lincoln, 1989 ; Forero et al. , 2018 ). Basically, dependability is the ability, to the extent that all conditions are equal, to obtain the same results if the study were to be repeated ( Morse, 2015a ). As such, the research process should be logical and transparent such that the process and procedures can be auditable and traced, ensuring coherence across the methods and findings ( Hanson et al. , 2019 ). Dependability is attainable through credibility, triangulation, splitting data and duplicating the analysis and use of audit trail ( Guba and Lincoln, 1989 ). According to Liamputtong (2019, p. 20 ), “Confirmability attempts to show that the findings and the interpretations of the findings do not derive from the imagination of the researchers but are clearly linked to the data.” The purpose is to extend the confidence that the results of a study would be confirmed or corroborated by other researchers ( Forero et al. , 2018 ). The strategies to achieve this include triangulation and the audit trail ( Guba and Lincoln, 1989 ). The underlying intention behind transferability is to extend the degree to which the results of a qualitative inquiry can be generalized or transferred to other contexts or settings ( Forero et al. , 2018 ; Liamputtong, 2019 ). Based on Guba and Lincoln's criteria, the strategies to achieve this include thick description, purposive sampling and reflexivity. Furthermore, credibility and the three other criteria, can also be addressed through the researcher's reflexive journal or reflexivity ( Lincoln and Guba, 1985 ).

Criticisms to Guba and Lincoln's (1989) argument abound (a few are highlighted in Morse et al. , 2002 ). However, such criticisms have also been addressed, for instance, in the article, RSVP: we are pleased to accept your invitation ( Lincoln and Guba, 1994 ). In fact, the paradigmatic shift heralded by Guba and Lincoln can be seen as work-in-progress, the relevance of which in contemporary scholarship is not in doubt ( Morse, 2015a ; Lincoln et al. , 2018 ).

Moving on, research on indigenous social protection systems known variously with terms like “informal” “traditional”, “community-based” and “non-state” systems – as the neglected half of formal social protection in Africa has only gained attention in recent years ( Patel et al. , 2012 ; Dafuleya, 2018 ; Noyoo and Boon, 2018 ; Mokomane et al. , 2021 ). For example, researchers and policy-makers from Southern and Western Africa assembled in 2016, at an International Workshop in Johannesburg, South Africa and deliberated on the state of these indigenous systems, contending that they should constitute an important basis for the formulation of public policies in Africa. In Nigeria, social protection only gained prominence and sense of direction in terms of a clearly defined policy framework at the institutional level with the ratification of a National Social Protection Policy [NSPP] in 2017 ( Ministry of Budget and National Planning, 2017 ). Yet, in the NSPP, indigenous social protection systems are given a peripheral position – unsurprisingly, as is the case in most African countries, on the grounds that they are fragile, rapidly declining, not as strong or effective as before, only effective in managing idiosyncratic risks as opposed to covariate shocks and apparently providing only short-term solutions, among others ( Balgah and Buchenrieder, 2010 ; Dafuleya, 2018 ). Thus, these systems are not well understood in relation to social protection in Nigeria ( World Bank, 2019 ).

The foregoing, among others, explains the dearth of empirical research on indigenous social protection systems. Moreover, whereas the subject matter lies within the interpretive (constructivist) paradigm, in Nigeria, only few studies have explored the roles of indigenous social protection systems whether in managing idiosyncratic (micro) risks or covariate (community-wide) shocks, using purely qualitative methods ( Fabiyi and Oloukoi, 2013 ; Izugbara, 2017 ). Even where qualitative methods have been used in whole or in part for research on social protection, ensuring and evaluating trustworthiness has most often been either completely overlooked or scantily done (see for example, Aiyede et al. , 2015 ; Surajo et al. , 2019 ). The concern with quality of qualitative research on social protection is relevant in view of the adverse ripple effects of shocks from one region to others – if not curbed.

In this article, I show how Guba and Lincoln's parallel criteria for establishing trustworthiness, also known as the “Four-Dimensions Criteria” (subsequently referred to as FDC) was adapted and applied in an ethnographic study of indigenous social protection systems in Nigeria. By so doing, I not only justify the importance of qualitative research using ethnographic methods in particular, for social protection research, generally, but go ahead to show why the FDC is a viable qualitative research tool for research on indigenous social protection systems in particular. Both for methodology and policy, the paper offers an opportunity for tool development in terms of appropriate recognition and allocation of resources by policy-makers and research funders into wider use of ethnographic methods of qualitative research in social protection research (see also Loh, 2013 ). This novel application of the FDC to research on indigenous social protection systems will also serve as a guide to researchers in other developing countries for similar future studies.

These criteria have been used in other contexts of qualitative research in education ( Lincoln and Guba, 1986 ), qualitative health research ( Tuckett, 2005 ; Morse, 2015a ; Forero et al. , 2018 ), impact evaluation research in development consultancy ( Johnson and Rasulova, 2016 ) and research on international marketing ( Singh et al. , 2021 ), among others; but this is the first time it has been used in the study of indigenous social protection systems.

In the next section, the study methodology is presented. Subsequently, the study findings which involve detailed explanation on the application of the FDC to the study in question are presented. In the last section, methodological issues arising from these findings and their policy implications are discussed further with pointers on possible areas of improvements.

Methodology

In this paper, I discuss the application of Guba and Lincoln's (1989) parallel criteria for ensuring trustworthiness in a wider study which explores the dynamics of indigenous social protection systems vis-à-vis formal systems in handling covariate shocks (emphasis on floods) in Southeast Nigeria. Following the examples of Tuckett (2005) , Morse (2015a) and Forero et al. (2018) , I adapted the criteria point by point by selecting those strategies that applied to the present study systematically. Indeed, the beauty of Guba and Lincoln's criteria is that the range of strategies may be adapted across each of the four quality criteria by investigators to suit their qualitative inquiry ( Shenton, 2004 ; Korstjens and Moser, 2018 ).

However, the full study adopted an ethnographic qualitative research design, using in-depth interviews (IDIs), focus group discussions (FGDs) and participant observations. This was justified on the grounds that the phenomena of study lie within the interpretive paradigm. Two communities – Umueze-Anam and Nzam, respectively, in Anambra state in Southeast Nigeria were selected purposively for the study for their rural location, agrarian livelihood, linguistic diversity, minority status and history of marginalization and vulnerability by their location in the lowlands of the Niger River to perennial flood disasters. Furthermore, study participants comprised three categories: key informants that comprised 7 relevant staff of state ministries and entities most relevant to social protection in the state; extremely poor –using United Nations Development Programme (2019) and Oxford Poverty and Human Development Initiative (2019) measures and vulnerable community members (e.g. persons with severe physical disability and poor aged) numbering 38 in all and; 11 indigenous community-based associations. On completion of the data collection, the audio-recordings of all interviews and group discussions were fully transcribed. Thereafter, data were analyzed using Braun et al. ’s (2019, p. 852 ) “six-phase” reflexive thematic analysis (TA) approach.

In addition, ethical approval for the study was obtained from the Faculty of Humanities Research Ethics Committee, University of Pretoria. Next, the study findings with respect to the stated objectives are discussed.

A detailed description of each of the components of the FDC including application of particular strategies in the study is provided in this section.

For this criterion, the following strategies were applied thus:

Prolonged engagement

For the present study, I spent two months in each of the two study sites. Most of the initial key informant interviews were held prior to travelling to the fieldwork sites, while two sessions were held concurrently in the course of the fieldwork in the second community which is semi-urban and had better access road to the state capital where the key informant interviews were held. Without doubt, both for observations and interviews, this strategy gave participants time to know the researcher better through participation in community life and events which increased their trust and intimacy, spurring them to provide richer data through the numerous revelations. Thus, through prolonged engagement with the locals, I gradually transformed from an “outsider” … to more of an “insider” whom participants were comfortable to initiate small talks with ( Hung and Min, 2020, p. 117 ). Prolonged engagement at a site is “to test biases and perceptions of both inquirer and respondents and to provide time to identify salient characteristics of both the context and the problem” ( Guba and Lincoln, 1982, p. 377 ; Lincoln and Guba, 1986 ).

Persistent observation

In this study observations entailed attending the meetings, events or activities of selected community associations. It was a channel to gather more data in natural settings about indigenous social protection systems since it was not feasible to get a practical understanding of certain group practices through the FGDs. The aim was to identify the patterns of these associations, their functions, generally, including extent of inclusion of vulnerable groups, and particularly in relation to dealing with floods, thereby identify the opportunities these indigenous systems present with regards to handling the problem of floods vis-à-vis formal social protection systems. The indigenous community-based social protection systems in the two study sites involved include the following: Town unions (TUs), which are community development associations; social clubs, which are mutual aid associations; age grades which serve as community support networks; rotating savings and credit associations (ROSCAs) which are also mutual aid associations and; indigenous women's organizations, comprising married women. I was a participant-observer in most events, except that of TUs and married women's organizations.

Generally, each observation lasted between 2 and 10 hours, often with breaks in-between. Both for the participant observation sessions and the complete observer sessions, no notes were taken at the spot. First, this would be difficult, for example during the farm work and burial ceremonies. Again, it could alter the behavior of those being observed. Instead, I recorded events observed, mostly later in the day at my rented apartment, after leaving the site. A field note for recording of events was used to document field observations, intuitions and clarifications. Mott (2022) applied this strategy as well in her ethnographic study, based on the argument that it would hinder ability to build rapport and deep relationships with the people who the author encountered. In addition, the number of observations made in each community was limited by the number of community-based associations' events. The relevance of the persistent observation strategy lies in the “in-depth pursuit” of those elements identified to be salient through prolonged engagement ( Lincoln and Guba, 1986, p. 77 ), to gain a high degree of acquaintance with pervasive qualities and salient characteristics and be able to eliminate those which are irrelevant ( Guba and Lincoln, 1982 ).

Debriefing which is an opportunity to present one's findings, is intended to prevent bias and aid conceptual development of the study and is particularly useful for new investigators ( Morse, 2015a ). This can be achieved through various methods ( Onwuegbuzie et al. , 2008 ). I benefitted from this strategy. After data collection, debriefing sessions were held with the project supervisor and later, with other scholars in my department. After receiving an extensive explanation and verifying a sample of the transcripts of the interviews and other texts (as referential adequacy materials) I received in the course of the study, the project supervisor made practical suggestions based on experience as a seasoned researcher. Other colleagues also made vital suggestions on how the work may be improved. These inputs improved the quality of the research report.

Collection of referential adequacy materials 2

Referential adequacy materials refer to materials collected during the study and archived without analysis, but which can later be utilized by the inquirer or others, to test interpretations made from other analyzed data ( Guba and Lincoln, 1982 ). During the data collection for this study, I collected additional relevant documents from government agencies and a community leader in one of the communities. These include newsletters, policy documents, periodicals and books about the study areas. The documents contain additional information in relation to the context of the study and were utilized later to confirm the accuracy of the interpretations made from the analyzed data. These materials were kept for future reference (see Forero et al. , 2018, p. 6 for a similar practice in a qualitative study).

Dependability

The strategies that applied to this study are discussed as follows:

Rich description

By the term thick (or rich) description, Guba and Lincoln (1982) meant providing enough information about a research context and is a fundamental feature of a qualitative inquiry ( Goodwin and Horowitz, 2002 ). This includes being clear about the purpose of the project and about the type of questions and data that will best meet the research goal ( See Morse, 2018 ). Having complied with these requirements right from the proposal stage during which greater transparency and logic were imbued into the research, the data collection instruments were appropriate and enabled participants the opportunity to provide in-depth responses relevant to the research question (see Hanson et al. , 2019 ). Throughout the designing of the instruments, there was continual reflection on the questions: “What assurances can we offer to policy studies, methodologies, and academic research … Are we even asking the right questions?” ( Wolgemuth et al. , 2018, p. 7 ). In this regard, the Faculty of Humanities Research Ethics Committee, University of Pretoria was very instrumental, throughout the entire process of ethical clearance for the study through pointing out aspects of the research that needed further elaboration or clarification. It was this process that facilitated the proper research method-related choices, including selection of an adequate and appropriate sample, which in turn guaranteed theoretical saturation as argued below, all contributing to empirical data generated, fulfilling the requirements of being rich ( Morse, 2015a ). The rich description strategy is further reflected in the application of some of the principles of micro-interlocutor analysis including frequency data for themes that emerged from members of focus groups (see Onwuegbuzie et al. , 2009 ). Therefore, the same results can be obtained if the study were to be repeated.

Member checks

As a tool for establishing dependability, member checks answers the question: “Does the researcher understand/interpret the participant correctly?” ( Morse, 2015a , p. 1219). If the researcher do not understand events accurately, the analysis will be “ unstable and the results cannot be repeated ” to get the same results ( Morse, 2015a, p. 1219 ). Hence, to avoid this loophole, I conducted member checking in the process of data collection to check data between participants in the manner suggested by Morse (2015a, p. 1218 ) thus: “some people tell me [so and so]. Do you see it from that angle?” This was not done with the original participants but with others, i.e. subsequent respondents both among the government officials and among members of the selected communities, particularly in the in-depth interviews. This strategy determined normative patterns of behavior and ensured that the findings reflect the full depth and scope of the participants' experiences and perspectives hence; dependability was achieved (see Morse, 2015a ; Morse, 2018 ; Hanson et al. , 2019 ). In addition, it facilitated full participation by respondents in the research process, enabling them co-construct the research outcomes together with me, the researcher ( Livari, 2017 ).

Confirmability

The strategies that are applicable to this study are triangulation and reflexivity ( Guba and Lincoln, 1982 ). These are explained here.

Triangulation

In this study, I applied the within-methods triangulation in which two or more approaches are combined in one method ( Flick, 2018 ). Practically, individual in-depth interviews, group interviews and observations were combined in an ethnographic approach (See Flick, 2018, p. 795 ). This method of triangulation may enhance credibility as it is used to expand understanding ( Morse, 2015a ). Data source triangulation ( Creswell, 2013 ; Flick, 2018 ; Vogl et al. , 2019 ) was also applied such that the sources of the data were different categories of vulnerable populations, government establishments and different groups that constitute indigenous social protection systems in two different study settings with different socio-cultural features. Triangulation is particularly relevant for studying social problems, in this case flooding, and social justice for the vulnerable ( Flick, 2018 ). Therefore, triangulation offered a broad source of data for a holistic understanding of social protection in Nigeria generally, and how indigenous social protection systems in particular handled covariate shocks. Hence, the results of the study can be trusted. Generally, the use of a single technique does not guarantee that a qualitative study is rigorous ( Hanson et al. , 2019 ).

Reflexivity

Guba and Lincoln (1982, p. 379 ) defines practicing reflexivity as “attempting to uncover one's underlying epistemological assumptions, reasons for formulating the study in a particular way, and heretofore implicit assumptions, biases or prejudices about the context or problem.” They suggested keeping a reflexive journal in the field as the most appropriate means for the practice of reflexivity. For the purposes of this study, I actually kept a reflexive journal and applied reflexivity as a way of clarifying researcher bias in the study. For instance, I had anticipated massive rural-urban migration of working-age persons occasioned by the menace of flood in the first study site but this was not the case. Careful documentation of some of the assumptions and efforts to avoid biases and prejudices arising from the insider-outsider status dichotomy on my part contributed to the overall success in the field. This was reflected for instance, in the scheduling of the interviews to suit the participants given the nature of their livelihood and the way I applied probes during interviews as well as participation in the daily activities of the communities during the participant observations. To further show that the findings of the study do not derive from my imagination, quotations that support the findings are provided in the transcripts as suggested by Hanson et al. (2019) .

Transferability

To avoid repetition, I followed the example of Forero et al. (2018) by adapting and applying the strategy on sampling with the argument that this can increase transferability (See also Hanson et al. , 2019, p. 1017 ).

Sampling techniques (purposive and snowball sampling)

The sampling technique applied in this study has the potential to extend the degree to which the results of the study can be transferred to other contexts or settings. For instance, key informants for the study were selected through purposive sampling and comprised of staff of ministries and entities most relevant to formal social protection in Anambra state and who had also acquired in-depth knowledge of indigenous social protection systems in the state both as residents and in the course of their official duties.

Similarly, through the use of snowball sampling, I was able to access the most relevant individuals who comprised the extremely poor and most vulnerable and groups which comprised functional indigenous social protection systems, in relation to social protection in the study areas. Thus, the most appropriate participants formed the sample for the study. Actually, the peculiarity of such persons makes them accessible mostly through networks. Community-based associations were eleven (11) in numbers and selected on the basis of the provision of social protection or assistance to their members. Such associations were indigenous arrangements based on their communal cultural values and members of such groups selected [purposively] as participants in the group discussions were predominantly poor farmers who had lived and worked in the community for at least 10 years and experienced major flooding disasters in the community.

To further ensure that the results of this qualitative inquiry can be transferred to other contexts or settings, effort was made to achieve saturation. Theoretical saturation was achieved thus: I conducted 7 in-depth interviews with key informants, 36 in-depth interviews with different categories of vulnerable community members in the two study sites and 11 FGDs, based on constant reviewing of the findings so far made in the field, through the content of statements made during concurrent data collection and analysis with emphasis on the themes that stood out in response to the research questions for the study and how this linked to the theoretical framework for the study and literature. In the process, I observed that there was enough in-depth data showing the patterns, categories and variety of the phenomena under study (see also Morse, 2015b ; Moser and Korstjens, 2018 ). At that point, I considered whether sampling might be ended because of saturation. However, 2 more interviews were carried out to confirm that saturation has been reached, bringing the total number of in-depth interviews with the vulnerable to 38. Also, as inherent in the design of the study, I used multiple groups to assess if the themes that emerged from one group also emerged from other groups in a sort of across-group saturation check (See Onwuegbuzie et al. , 2009 ).

It became clear that no new analytical information was emanating and the findings provided maximum information on the subject matter of the research. Therefore, sampling was ended and the sample size considered sufficient (see Malterud et al. , 2016 ; Moser and Korstjens, 2018 ). Theoretical saturation was, therefore, reached. Theoretical saturation was applied in this research because it was an ethnographic qualitative inquiry as opposed to code or meaning saturation which would have been the case in health sciences and public health research ( Hennink et al ., 2017 , 2019 ). All in all, the information power of the sample took priority over the size ( Malterud et al. , 2016 ). Understandings and applications of saturation in qualitative researches vary ( Morse, 2015b ; Malterud et al. , 2016 ; Saunders et al. , 2018 ; Sebele-Mpofu, 2020 ), yet, are guided by parameters like study purpose, population, sampling strategy, data quality and researcher's skill ( Morse, 2015b ; Hennink et al. , 2017 ). Thus, researchers need to be clear on the type of saturation they claim to have achieved because saturation is not unidimensional; it can be assessed (or achieved) at different levels, either by individual constructs or by overall study saturation ( Hennink et al. , 2017 ).

The application of the criteria is summed up in Table 1 below.

To recapitulate, over the years, Guba and Lincoln's parallel criteria for evaluating rigor, termed trustworthiness in qualitative research remains one of the most extensively used. This criteria, also referred to as the Four-Dimensions Criteria (FDC) consists of credibility, dependability, confirmability and transferability to be respectively equivalent to quantitative criteria of internal validity, reliability, objectivity and external validity or generalizability.

Given the dearth of research on indigenous social protection in the context of a recently developed social protection policy in Nigeria, the specific objective of this article was to show the applicability of Guba and Lincoln's parallel criteria for establishing trustworthiness in qualitative research on social protection, drawing empirical data from a wider qualitative inquiry in Southeast Nigeria. The criteria were applied following the examples of Tuckett (2005) , Morse (2015a) and Forero et al. (2018) by adapting the criteria point by point, selecting those strategies that applied to the present study systematically. Being closely engaged with their cases, qualitative researchers typically adapt existing theories or make new conceptual distinctions or theoretical arguments to accommodate new data ( Goodwin and Horowitz, 2002 ). This is the first time the FDC has been applied in this manner in a study of [indigenous] social protection systems. It will among other things, provide guidance to researchers and policy-makers.

On the basis of ethnographic fieldwork data from the study sites, the paper indicated how the four components of the FDC and particular strategies under each component were successfully applied to the study in question and concludes that these criteria increased trustworthiness. As has been correctly observed by Daniel (2018) , while trustworthiness enhances the understanding and interpretation of research findings and enables others to establish a level of confidence in the quality of an investigation, establishing trustworthiness in qualitative does not imply subscribing to one unified ontology, or embracing a universal epistemology, but rather demonstrating an acceptable degree of integrity in the process and outcome of the study. It is this acceptable level of integrity in the process and outcome of the study in question, that I have demonstrated in this paper.

In all, based on qualitative (ethnographic) data that informed this paper, the argument is that social protection researchers can engage in more rigorous qualitative research process to facilitate trustworthiness of their research using Guba and Lincoln's parallel criteria as enunciated above. In addition, the criteria hold great potential for social policy given the purpose of each of the strategies adopted for this particular inquiry as explained in Table 1 . In their study of regulatory practices in the private health care sector of Bangladesh, Rahman and Caulley (2007) inculcated some of Guba and Lincoln's criteria and found qualitative research methods to be appropriate for doing health research and evaluation, as it provided a platform to gain in-depth insights into policy issues. Thus, based on the application of the FDC to assess rigor of qualitative research as used for this study, some issues in the current social protection policy and programmes linked to methodology are discussed with an elaboration of the wider implications.

First, I argue that formal social welfare in most of Africa, and Nigeria in particular, remains an elite project devoid of norms of equality and solidarity vital for holistic development. This is reflected, for example, in the relegating of the potentials of indigenous social protection systems. Appropriate mainstreaming of indigenous social protection systems into the social protection space in Nigeria and other African countries is needed to widen social protection coverage which is vital for poverty reduction. This is where the role of qualitative inquiries that draw on the FDC as evaluation criteria for trustworthiness becomes relevant to support the quantitative data dominated social protection research space – which often fails to dig-up social phenomena only amenable to certain qualitative strategies. Thus, linking formal and indigenous social protection systems is vital but should be done in such a way to facilitate research designs that embeds the FDC into qualitative research methods. This could form a topic for further exploration by researchers.

Methodologically, the one-off cross-sectional survey using questionnaires or in-depth interview guides that is mostly adopted in most social protection research has shown limitations in terms of shallow understanding of people's subjective wellbeing and dimensions of social vulnerabilities and how to properly target and select beneficiaries for formal social assistance. Often, faulty assumptions about programme success have been made by using purely quantitative research methods or faulty qualitative research methods, with adverse impact on social policies and programmes. This further underscores the relevance of the methodology advocated for in this paper.

A research that lacks trustworthiness portends harmful consequences if adopted for policy purposes as pointed out by Tierney and Clemens (2010) . Guba and Lincoln's parallel criteria for establishing trustworthiness are plausible for qualitative research on social protection, and indigenous social protection systems in particular, in countries with low human development outcomes similar to Nigeria. Recognition of this fact and prioritizing research funding in that regard can guarantee sustainable development.

Criteria	Purpose	Original strategies	Strategies applied in this study to achieve trustworthiness
Credibility	To show that the research process was done with integrity and the final results of the study can be trusted	Prolonged engagement	Prolonged engagement
		Persistent observation	Persistent observation
		Triangulation	See confirmability below
		Peer debriefing	Debriefing
		Negative case analysis	Not applicable
		Referential adequacy	Collection of referential adequacy materials
		Member checks (process and terminal)	(See dependability below)
Dependability	To show that the research was sound in all ramifications and the outcome will be similar should it be repeated	Use of “overlapping methods” (triangulation)	Rich description
		“Stepwise replication” (splitting data and duplicating the analysis)	Member checks (process, not terminal)
		“Inquiry audit” or audit trail	Not applicable
Confirmability	To show confidence in the fact that the research findings are based on data generated and are verifiable	Triangulation	Triangulation
		Reflexivity	Reflexivity
		Audit trail	Not applicable
Transferability	To show that findings from the study can be transferred to other contexts or settings	Thick description is essential for “someone interested” to transfer the original findings to another context, or individuals	Sampling techniques
Transferability			Saturation

Source(s): (adapted based on Guba and Lincoln, 1989 )

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Acknowledgements

The author gratefully acknowledges the guidance and support of Prof. Zitha Mokomane, his doctoral thesis supervisor at the University of Pretoria.

Disclosure statement: No potential conflict of interest was reported by the author.

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Published: 17 February 2018

Application of four-dimension criteria to assess rigour of qualitative research in emergency medicine

Roberto Forero ORCID: orcid.org/0000-0001-6031-6590 1 ,
Shizar Nahidi 1 ,
Josephine De Costa 1 ,
Mohammed Mohsin 2 , 3 ,
Gerry Fitzgerald 4 , 5 ,
Nick Gibson 6 ,
Sally McCarthy 5 , 7 &
Patrick Aboagye-Sarfo 8

BMC Health Services Research volume 18 , Article number: 120 ( 2018 ) Cite this article

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The main objective of this methodological manuscript was to illustrate the role of using qualitative research in emergency settings. We outline rigorous criteria applied to a qualitative study assessing perceptions and experiences of staff working in Australian emergency departments.

We used an integrated mixed-methodology framework to identify different perspectives and experiences of emergency department staff during the implementation of a time target government policy. The qualitative study comprised interviews from 119 participants across 16 hospitals. The interviews were conducted in 2015–2016 and the data were managed using NVivo version 11. We conducted the analysis in three stages, namely: conceptual framework, comparison and contrast and hypothesis development. We concluded with the implementation of the four-dimension criteria (credibility, dependability, confirmability and transferability) to assess the robustness of the study,

We adapted four-dimension criteria to assess the rigour of a large-scale qualitative research in the emergency department context. The criteria comprised strategies such as building the research team; preparing data collection guidelines; defining and obtaining adequate participation; reaching data saturation and ensuring high levels of consistency and inter-coder agreement.

Based on the findings, the proposed framework satisfied the four-dimension criteria and generated potential qualitative research applications to emergency medicine research. We have added a methodological contribution to the ongoing debate about rigour in qualitative research which we hope will guide future studies in this topic in emergency care research. It also provided recommendations for conducting future mixed-methods studies. Future papers on this series will use the results from qualitative data and the empirical findings from longitudinal data linkage to further identify factors associated with ED performance; they will be reported separately.

Peer Review reports

Qualitative research methods have been used in emergency settings in a variety of ways to address important problems that cannot be explored in another way, such as attitudes, preferences and reasons for presenting to the emergency department (ED) versus other type of clinical services (i.e., general practice) [ 1 , 2 , 3 , 4 ].

The methodological contribution of this research is part of the ongoing debate of scientific rigour in emergency care, such as the importance of qualitative research in evidence-based medicine, its contribution to tool development and policy evaluation [ 2 , 3 , 5 , 6 , 7 ]. For instance, the Four-Hour Rule and the National Emergency Access Target (4HR/NEAT) was an important policy implemented in Australia to reduce EDs crowding and boarding (access block) [ 8 , 9 , 10 , 11 , 12 , 13 ]. This policy generated the right conditions for using mixed methods to investigate the impact of 4HR/NEAT policy implementation on people attending, working or managing this type of problems in emergency departments [ 2 , 3 , 5 , 6 , 7 , 14 , 15 , 16 , 17 ].

The rationale of our study was to address the perennial question of how to assess and establish methodological robustness in these types of studies. For that reason, we conducted this mixed method study to explore the impact of the 4HR/NEAT in 16 metropolitan hospitals in four Australian states and territories, namely: Western Australia (WA), Queensland (QLD), New South Wales (NSW), and the Australian Capital Territory (ACT) [ 18 , 19 ].

The main objectives of the qualitative component was to understand the personal, professional and organisational perspectives reported by ED staff during the implementation of 4HR/NEAT, and to explore their perceptions and experiences associated with the implementation of the policy in their local environment.

This is part of an Australian National Health and Medical Research Council (NH&MRC) Partnership project to assess the impact of the 4HR/NEAT on Australian EDs. It is intended to complement the quantitative streams of a large data-linkage/dynamic modelling study using a mixed-methods approach to understand the impact of the implementation of the four-hour rule policy.

Methodological rigour

This section describes the qualitative methods to assess the rigour of the qualitative study. Researchers conducting quantitative studies use conventional terms such as internal validity, reliability, objectivity and external validity [ 17 ]. In establishing trustworthiness, Lincoln and Guba created stringent criteria in qualitative research, known as credibility, dependability, confirmability and transferability [ 17 , 18 , 19 , 20 ]. This is referred in this article as “the Four-Dimensions Criteria” (FDC). Other studies have used different variations of these categories to stablish rigour [ 18 , 19 ]. In our case, we adapted the criteria point by point by selecting those strategies that applied to our study systematically. Table 1 illustrates which strategies were adapted in our study.

Study procedure

We carefully planned and conducted a series of semi-structured interviews based on the four-dimension criteria (credibility, dependability, confirmability and transferability) to assess and ensure the robustness of the study. These criteria have been used in other contexts of qualitative health research; but this is the first time it has been used in the emergency setting [ 20 , 21 , 22 , 23 , 24 , 25 , 26 ].

Sampling and recruitment

We employed a combination of stratified purposive sampling (quota sampling), criterion-based and maximum variation sampling strategies to recruit potential participants [ 27 , 28 ]. The hospitals selected for the main longitudinal quantitative data linkage study, were also purposively selected in this qualitative component.

We targeted potential individuals from four groups, namely: ED Directors, ED physicians, ED nurses, and data/admin staff. The investigators identified local site coordinators who arranged the recruitment in each of the participating 16 hospitals (6 in NSW, 4 in QLD, 4 in WA and 2 in the ACT) and facilitated on-site access to the research team. These coordinators provided a list of potential participants for each professional group. By using this list, participants within each group were selected through purposive sampling technique. We initially planned to recruit at least one ED director, two ED physicians, two ED nurses and one data/admin staff per hospital. Invitation emails were circulated by the site coordinators to all potential participants who were asked to contact the main investigators if they required more information.

We also employed criterion-based purposive sampling to ensure that those with experience relating to 4HR/NEAT were eligible. For ethical on-site restrictions, the primary condition of the inclusion criteria was that eligible participants needed to be working in the ED during the period that the 4HR/NEAT policy was implemented. Those who were not working in that ED during the implementation period were not eligible to participate, even if they had previous working experience in other EDs.

We used maximum variation sampling to ensure that the sample reflects a diverse group in terms of skill level, professional experience and policy implementation [ 28 ]. We included study participants irrespective of whether their role/position was changed (for example, if they received a promotion during their term of service in ED).

In summary, over a period of 7 months (August 2015 to March 2016), we identified all the potential participants (124) and conducted 119 interviews (5 were unable to participate due to workload availability). The overall sample comprised a cohort of people working in different roles across 16 hospitals. Table 2 presents the demographic and professional characteristics of the participants.

Data collection

We employed a semi-structured interview technique. Six experienced investigators (3 in NSW, 1 in ACT, 1 in QLD and 1 in WA) conducted the interviews (117 face-to-face on site and 2 by telephone). We used an integrated interview protocol which consisted of a demographically-oriented question and six open-ended questions about different aspects of the 4HR/NEAT policy (see Additional file 1 : Appendix 1).

With the participant’s permission, interviews were audio-recorded. All the hospitals provided a quiet interview room that ensured privacy and confidentiality for participants and investigators.

All the interviews were transcribed verbatim by a professional transcriber with reference to a standardised transcription protocol [ 29 ]. The data analysis team followed a stepwise process for data cleaning, and de-identification. Transcripts were imported to qualitative data analysis software NVivo version 11 for management and coding [ 30 ].

Data analysis

The analyses were carried out in three stages. In the first stage, we identified key concepts using content analysis and a mind-mapping process from the research protocol and developed a conceptual framework to organise the data [ 31 ]. The analysis team reviewed and coded a selected number of transcripts, then juxtaposed the codes against the domains incorporated in the interview protocol as indicated in the three stages of analysis with the conceptual framework (Fig. 1 ).

Conceptual framework with the three stages of analysis used for the analysis of the qualitative data

In this stage, two cycles of coding were conducted: in the first one, all the transcripts were revised and initially coded, key concepts were identified throughout the full data set. The second cycle comprised an in-depth exploration and creation of additional categories to generate the codebook (see Additional file 2 : Appendix 2). This codebook was a summary document encompassing all the concepts identified as primary and subsequent levels. It presented hierarchical categorisation of key concepts developed from the domains indicated in Fig. 1 .

A summarised list of key concepts and their definitions are presented in Table 3 . We show the total number of interviews for each of the key concepts, and the number of times (i.e., total citations) a concept appeared in the whole dataset.

The second stage of analysis compared and contrasted the experiences, perspectives and actions of participants by role and location. The third and final stage of analysis aimed to generate theory-driven hypotheses and provided an in-depth understanding of the impact of the policy. At this stage, the research team explored different theoretical perspectives such as the carousel model and models of care approach [ 16 , 32 , 33 , 34 ]. We also used iterative sampling to reach saturation and interpret the findings.

Ethics approval and consent to participate

Ethics approval was obtained for all participating hospitals and the qualitative methods are based on the original research protocol approved by the funding organisations [ 18 ].

This section described the FDC and provided a detailed description of the strategies used in the analysis. It was adapted from the FDC methodology described by Lincoln and Guba [ 23 , 24 , 25 , 26 ] as the framework to ensure a high level of rigour in qualitative research. In Table 1 , we have provided examples of how the process was implemented for each criterion and techniques to ensure compliance with the purpose of FDC.

Credibility

Prolonged and varied engagement with each setting.

All the investigators had the opportunity to have a continued engagement with each ED during the data collection process. They received a supporting material package, comprising background information about the project; consent forms and the interview protocol (see Additional file 1 : Appendix 1). They were introduced to each setting by the local coordinator and had the chance to meet the ED directors and potential participants, They also identified local issues and salient characteristics of each site, and had time to get acquainted with the study’s participants. This process allowed the investigators to check their personal perspectives and predispositions, and enhance their familiarity with the study setting. This strategy also allowed participants to become familiar with the project and the research team.

Interviewing process and techniques

In order to increase credibility of the data collected and of the subsequent results, we took a further step of calibrating the level of awareness and knowledge of the research protocol. The research team conducted training sessions, teleconferences, induction meetings and pilot interviews with the local coordinators. Each of the interviewers conducted one or two pilot interviews to refine the overall process using the interview protocol, time-management and the overall running of the interviews.

The semi-structured interview procedure also allowed focus and flexibility during the interviews. The interview protocol (Additional file 1 : Appendix 1) included several prompts that allowed the expansion of answers and the opportunity for requesting more information, if required.

Establishing investigators’ authority

In relation to credibility, Miles and Huberman [ 35 ] expanded the concept to the trustworthiness of investigators’ authority as ‘human instruments’ and recommended the research team should present the following characteristics:

Familiarity with phenomenon and research context : In our study, the research team had several years’ experience in the development and implementation of 4HR/NEAT in Australian EDs and extensive ED-based research experience and track records conducting this type of work.

Investigative skills: Investigators who were involved in data collections had three or more years’ experience in conducting qualitative data collection, specifically individual interview techniques.

Theoretical knowledge and skills in conceptualising large datasets: Investigators had post-graduate experience in qualitative data analysis and using NVivo software to manage and qualitative research skills to code and interpret large amounts of qualitative data.

Ability to take a multidisciplinary approach: The multidisciplinary background of the team in public health, nursing, emergency medicine, health promotion, social sciences, epidemiology and health services research, enabled us to explore different theoretical perspectives and using an eclectic approach to interpret the findings.

These characteristics ensured that the data collection and content were consistent across states and participating hospitals.

Collection of referential adequacy materials

In accordance with Guba’s recommendation to collect any additional relevant resources, investigators maintained a separate set of materials from on-site data collection which included documents and field notes that provided additional information in relation to the context of the study, its findings and interpretation of results. These materials were collected and used during the different levels of data analysis and kept for future reference and secure storage of confidential material [ 26 ].

Peer debriefing

We conducted several sessions of peer debriefing with some of the Project Management Committee (PMC) members. They were asked at different stages throughout the analysis to reflect and cast their views on the conceptual analysis framework, the key concepts identified during the first level of analysis and eventually the whole set of findings (see Fig. 1 ). We also have reported and discussed preliminary methods and general findings at several scientific meetings of the Australasian College for Emergency Medicine.

Dependability

Rich description of the study protocol.

This study was developed from the early stages through a systematic search of the existing literature about the four-hour rule and time-target care delivery in ED. Detailed draft of the study protocol was delivered in consultation with the PMC. After incorporating all the comments, a final draft was generated for the purpose of obtaining the required ethics approvals for each ED setting in different states and territories.

To maintain consistency, we documented all the changes and revisions to the research protocol, and kept a trackable record of when and how changes were implemented.

Establishing an audit trail

Steps were taken to keep a track record of the data collection process [ 24 ]: we have had sustained communication within the research team to ensure the interviewers were abiding by an agreed-upon protocol to recruit participants. As indicated before, we provided the investigators with a supporting material package. We also instructed the interviewers on how to securely transfer the data to the transcriber. The data-analysis team systematically reviewed the transcripts against the audio files for accuracy and clarifications provided by the transcriber.

All the steps in coding the data and identification of key concepts were agreed upon by the research team. The progress of the data analysis was monitored on a weekly basis. Any modifications of the coding system were discussed and verified by the team to ensure correct and consistent interpretation throughout the analysis.

The codebook (see Additional file 2 : Appendix 2) was revised and updated during the cycles of coding. Utilisation of the mind-mapping process described above helped to verify consistency and allowed to determine how precise the participants’ original information was preserved in the coding [ 31 ].

As required by relevant Australian legislation [ 36 ], we maintained complete records of the correspondence and minutes of meetings, as well as all qualitative data files in NVivo and Excel on the administrative organisation’s secure drive. Back-up files were kept in a secure external storage device, for future access if required.

Stepwise replication—measuring the inter-coders’ agreement

To assess the interpretative rigour of the analysis, we applied inter-coder agreement to control the coding accuracy and monitor inter-coder reliability among the research team throughout the analysis stage [ 37 ]. This step was crucially important in the study given the changes of staff that our team experienced during the analysis stage. At the initial stages of coding, we tested the inter-coder agreement using the following protocol:

Step 1 – Two data analysts and principal investigator coded six interviews, separately.

Step 2 – The team discussed the interpretation of the emerging key concepts, and resolved any coding discrepancies.

Step 3 – The initial codebook was composed and used for developing the respective conceptual framework.

Step 4 – The inter-coder agreement was calculated and found a weighted Kappa coefficient of 0.765 which indicates a very good agreement (76.5%) of the data.

With the addition of a new analyst to the team, we applied another round of inter-coder agreement assessment. We followed the same steps to ensure the inter-coder reliability along the trajectory of data analysis, except for step 3—a priori codebook was used as a benchmark to compare and contrast the codes developed by the new analyst. The calculated Kappa coefficient 0.822 indicates a very good agreement of the data (See Table 4 ).

Confirmability

Reflexivity.

The analysis was conducted by the research team who brought different perspectives to the data interpretation. To appreciate the collective interpretation of the findings, each investigator used a separate reflexive journal to record the issues about sensitive topics or any potential ethical issues that might have affected the data analysis. These were discussed in the weekly meetings.

After completion of the data collection, reflection and feedback from all the investigators conducting the interviews were sought in both written and verbal format.

Triangulation

To assess the confirmability and credibility of the findings, the following four triangulation processes were considered: methodological, data source, investigators and theoretical triangulation.

Methodological triangulation is in the process of being implemented using the mixed methods approach with linked data from our 16 hospitals.

Data source triangulation was achieved by using several groups of ED staff working in different states/territories and performing different roles. This triangulation offered a broad source of data that contributed to gain a holistic understanding of the impact of 4HR/NEAT on EDs across Australia. We expect to use data triangulation with linked-data in future secondary analysis.

Investigators triangulation was obtained by consensus decision making though collaboration, discussion and participation of the team holding different perspectives. We also used the investigators’ field notes, memos and reflexive journals as a form of triangulation to validate the data collected. This approach enabled us to balance out the potential bias of individual investigators and enabling the research team to reach a satisfactory consensus level.

Theoretical triangulation was achieved by using and exploring different theoretical perspectives such as the carousel model and models of care approach [ 16 , 32 , 33 , 34 ]. that could be applied in the context of the study to generate hypotheses and theory driven codes [ 16 , 32 , 38 ].

Transferability

Purposive sampling to form a nominated sample.

As outlined in the methods section, we used a combination of three purposive sampling techniques to make sure that the selected participants were representative of the variety of views of ED staff across settings. This representativeness was critical for conducting comparative analysis across different groups.

Data saturation

We employed two methods to ensure data saturation was reached, namely: operational and theoretical. The operational method was used to quantify the number of new codes per interview over time. It indicates that the majority of codes were identified in the first interviews, followed by a decreasing frequency of codes identified from other interviews.

Theoretical saturation and iterative sampling were achieved through regular meetings where progress of coding and identification of variations in each of the key concepts were reported and discussed. We also used iterative sampling to reach saturation and interpret the findings. We continued this iterative process until no new codes emerged from the dataset and all the variations of an observed phenomenon were identified [ 39 ] (Fig. 2 ).

Data saturation gain per interview added based on the chronological order of data collection in the hospitals. Y axis = number of new codes, X axis = number of interviews over time

Scientific rigour in qualitative research assessing trustworthiness is not new. Qualitative researchers have used rigour criteria widely [ 40 , 41 , 42 ]. The novelty of the method described in this article rests on the systematic application of these criteria in a large-scale qualitative study in the context of emergency medicine.

According to the FDC, similar findings should be obtained if the process is repeated with the same cohort of participants in the same settings and organisational context. By employing the FDC and the proposed strategies, we could enhance the dependability of the findings. As indicated in the literature, qualitative research has many times been questioned in history for its validity and credibility [ 3 , 20 , 43 , 44 ].

Nevertheless, if the work is done properly, based on the suggested tools and techniques, any qualitative work can become a solid piece of evidence. This study suggests that emergency medicine researchers can improve their qualitative research if conducted according to the suggested criteria. The triangulation and reflexivity strategies helped us to minimise the investigators’ bias, and affirm that the findings were objective and accurately reflect the participants’ perspectives and experiences. Abiding by a consistent method of data collection (e.g., interview protocol) and conducting the analysis with a team of investigators, helped us minimise the risk of interpretation bias.

Employing several purposive sampling techniques enabled us to have a diverse range of opinions and experiences which at the same time enhanced the credibility of the findings. We expect that the outcomes of this study will show a high degree of applicability, because any resultant hypotheses may be transferable across similar settings in emergency care. The systematic quantification of data saturation at this scale of qualitative data has not been demonstrated in the emergency medicine literature before.

As indicated, the objective of this study was to contribute to the ongoing debate about rigour in qualitative research by using our mixed methods study as an example. In relation to innovative application of mixed-methods, the findings from this qualitative component can be used to explain specific findings from the quantitative component of the study. For example, different trends of 4HR/NEAT performance can be explained by variations in staff relationships across states (see key concept 1, Table 3 ). In addition, some experiences from doctors and nurses may explain variability of performance indicators across participating hospitals. The robustness of the qualitative data will allow us to generate hypotheses that in turn can be tested in future research.

Careful planning is essential in any type of research project which includes the importance of allocating sufficient resources both human and financial. It is also required to organise precise arrangements for building the research team; preparing data collection guidelines; defining and obtaining adequate participation. This may allow other researchers in emergency care to replicate the use of the FDC in the future.

This study has several limitations. Some limitations of the qualitative component include recall bias or lack of reliable information collected about interventions conducted in the past (before the implementation of the policy). As Weber and colleagues [ 45 ] point out, conducting interviews with clinicians at a single point in time may be affected by recall bias. Moreover, ED staff may have left the organisation or have progressed in their careers (from junior to senior clinical roles, i.e. junior nursing staff or junior medical officers, registrars, etc.), so obtaining information about pre/during/post-4HR/NEAT was a difficult undertaking. Although the use of criterion-based and maximum-variation sampling techniques minimised this effect, we could not guarantee that the sampling techniques could have reached out all those who might be eligible to participate.

In terms of recruitment, we could not select potential participants who were not working in that particular ED during the implementation, even if they had previous working experience in other hospital EDs. This is a limitation because people who participated in previous hospitals during the intervention could not provide valuable input to the overall project.

In addition, one would claim that the findings could have been ‘ED-biased’ due to the fact that we did not interview the staff or administrators outside the ED. Unfortunately, interviews outside the ED were beyond the resources and scope of the project.

With respect to the rigour criteria, we could not carry out a systematic member checking as we did not have the required resources for such an expensive follow-up. Nevertheless, we have taken extensive measures to ensure confirmation of the integrity of the data.

Conclusions

The FDC presented in this manuscript provides an important and systematic approach to achieve trustworthy qualitative findings. As indicated before, qualitative research credentials have been questioned. However, if the work is done properly based on the suggested tools and techniques described in this manuscript, any work can become a very notable piece of evidence. This study concludes that the FDC is effective; any investigator in emergency medicine research can improve their qualitative research if conducted accordingly.

Important indicators such as saturation levels and inter-coder reliability should be considered in all types of qualitative projects. One important aspect is that by using FDC we can demonstrate that qualitative research is not less rigorous than quantitative methods.

We also conclude that the FDC is a valid framework to be used in qualitative research in the emergency medicine context. We recommend that future research in emergency care should consider the FDC to achieve trustworthy qualitative findings. We can conclude that our method confirms the credibility (validity) and dependability (reliability) of the analysis which are a true reflection of the perspectives reported by the group of participants across different states/territories.

We can also conclude that our method confirms the objectivity of the analyses and reduces the risk for interpretation bias. We encourage adherence to practical frameworks and strategies like those presented in this manuscript.

Finally, we have highlighted the importance of allocating sufficient resources. This is essential if other researchers in emergency care would like to replicate the use of the FDC in the future.

Following papers in this series will use the empirical findings from longitudinal data linkage analyses and the results from the qualitative study to further identify factors associated with ED performance before and after the implementation of the 4HR/NEAT.

Abbreviations

Four Hour Rule/National Emergency Access Target

Australian Capital Territory

Emergency department(s)

Four-Dimensions Criteria

Health Research Ethics Committee

New South Wales

Project Management Committee

Western Australia

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Acknowledgements

We acknowledge Brydan Lenne who was employed in the preliminary stages of the project, for ethics application preparation and ethics submissions, and her contribution in the planning stages, data collection of the qualitative analysis and preliminary coding of the conceptual framework is appreciated. Fenglian Xu, who was also employed in the initial stages of the project in the data linkage component. Jenine Beekhuyzen, CEO Adroit Research, for consultancy and advice on qualitative aspects of the manuscript and Liz Brownlee, owner/manager Bostock Transcripts services for the transcription of the interviews. Brydan Lenne, Karlene Dickens; Cecily Scutt and Tracey Hawkins who conducted the interviews across states. We also thank Anna Holdgate, Michael Golding, Michael Hession, Amith Shetty, Drew Richardson, Daniel Fatovich, David Mountain, Nick Gibson, Sam Toloo, Conrad Loten, John Burke and Vijai Joseph who acted as site contacts on each State/Territory. We also thank all the participants for their contribution in time and information provided. A full acknowledgment of all investigators and partner organisations is enclosed as an attachment (see Additional file 3 : Appendix 3).

This project was funded by the Australian National Health and Medical Research Council (NH&MRC) Partnership Grant No APP1029492 with cash contributions from the following organisations: Department of Health of Western Australia, Australasian College for Emergency Medicine, Ministry of Health of NSW and the Emergency Care Institute, NSW Agency for Clinical Innovation, and Emergency Medicine Foundation, Queensland.

Availability of data and materials

All data generated or analysed during this study are included in this published article and its supplementary information files have been included in the appendix. No individual data will be available.

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RF, GF, SMC made substantial contributions to conception, design and funding of the study. RF, SN, NG, SMC with acquisition of data. RF, SN, JDC for the analysis and interpretation of data. RF, SN, JDC, MM, GF, NG, SMC and PA were involved in drafting the manuscript and revising it critically for important intellectual content and gave final approval of the version to be published. All authors have participated sufficiently in the work to take public responsibility for appropriate portions of the content; and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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As indicated in the background, our study received ethics approval from the respective Human Research Ethics Committees of Western Australian Department of Health (DBL.201403.07), Cancer Institute NSW (HREC/14/CIPHS/30), ACT Department of Health (ETH.3.14.054) and Queensland Health (HREC/14/QGC/30) as well as governance approval from the 16 participating hospitals. All participants received information about the project; received an invitation to participate and signed a consent form and agreed to allow an audio recording to be conducted.

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Additional files

Additional file 1:.

Appendix 1. Interview form. Text. (PDF 445 kb)

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Appendix 2. Codebook NVIVO. Text code. (PDF 335 kb)

Additional file 3:

Appendix 3. Acknowledgements. Text. (PDF 104 kb)

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Forero, R., Nahidi, S., De Costa, J. et al. Application of four-dimension criteria to assess rigour of qualitative research in emergency medicine. BMC Health Serv Res 18 , 120 (2018). https://doi.org/10.1186/s12913-018-2915-2

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Application of four-dimension criteria to assess rigour of qualitative research in emergency medicine

Roberto forero.

1 The Simpson Centre for Health Services Research, South Western Sydney Clinical School and the Ingham Institute for Applied Research, Liverpool Hospital, UNSW, Liverpool, NSW 1871 Australia

Shizar Nahidi

Josephine de costa, mohammed mohsin.

2 Psychiatry Research and Teaching Unit, Liverpool Hospital, NSW Health, Sydney, Australia

3 School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia

Gerry Fitzgerald

4 School - Public Health and Social Work, Queensland University of Technology (QUT), Brisbane, Qld Australia

5 Australasian College for Emergency Medicine (ACEM), Melbourne, VIC Australia

Nick Gibson

6 School of Nursing and Midwifery, Edith Cowan University (ECU), Perth, WA Australia

Sally McCarthy

7 Emergency Care Institute (ECI), NSW Agency for Clinical Innovation (ACI), Sydney, Australia

Patrick Aboagye-Sarfo

8 Clinical Support Directorate, System Policy & Planning Division, Department of Health WA, Perth, WA Australia

Associated Data

Electronic supplementary material

The online version of this article (10.1186/s12913-018-2915-2) contains supplementary material, which is available to authorized users.

The methodological contribution of this research is part of the ongoing debate of scientific rigour in emergency care, such as the importance of qualitative research in evidence-based medicine, its contribution to tool development and policy evaluation [ 2 , 3 , 5 – 7 ]. For instance, the Four-Hour Rule and the National Emergency Access Target (4HR/NEAT) was an important policy implemented in Australia to reduce EDs crowding and boarding (access block) [ 8 – 13 ]. This policy generated the right conditions for using mixed methods to investigate the impact of 4HR/NEAT policy implementation on people attending, working or managing this type of problems in emergency departments [ 2 , 3 , 5 – 7 , 14 – 17 ].

Methodological rigour

This section describes the qualitative methods to assess the rigour of the qualitative study. Researchers conducting quantitative studies use conventional terms such as internal validity, reliability, objectivity and external validity [ 17 ]. In establishing trustworthiness, Lincoln and Guba created stringent criteria in qualitative research, known as credibility, dependability, confirmability and transferability [ 17 – 20 ]. This is referred in this article as “the Four-Dimensions Criteria” (FDC). Other studies have used different variations of these categories to stablish rigour [ 18 , 19 ]. In our case, we adapted the criteria point by point by selecting those strategies that applied to our study systematically. Table 1 illustrates which strategies were adapted in our study.

Key FDC strategies adapted from Lincoln and Guba [ 23 ]

Rigour Criteria	Purpose	Original Strategies	Strategies applied in our study to achieve rigour
Credibility	To establish confidence that the results (from the perspective of the participants) are true, credible and believable.	• Prolonged and varied engagement with each setting	• Interviewers spent an average of 6–8 weeks per site to engage with ED and participants.
		• Interviewing process and techniques	• Interview protocol tested at two induction meetings and using 1–2 pilot interviews.
		• Establishing investigators’ authority	• We ensured the investigators had the required knowledge and research skills to perform their roles.
		• Collection of referential adequacy materials	• We asked interviewers to send all the field notes to the research office for analysis and storage.
		• Peer debriefing	• We had regular debriefing sessions with key members of Project Management Committee/Australasian College of Emergency Medicine.
Dependability	To ensure the findings of this qualitative inquiry are repeatable if the inquiry occurred within the same cohort of participants, coders and context.	• Rich description of the study methods	• We prepared detailed drafts of the study protocol throughout the study.
		• Establishing an audit trail	• We developed a detailed track record of the data collection process.
		• Stepwise replication of the data	• We measured coding accuracy and inter-coders’ reliability of the research team.
Confirmability	To extend the confidence that the results would be confirmed or corroborated by other researchers.	• Reflexivity	• We implemented reflexive journals and weekly investigators meetings.
Confirmability		• Triangulation	• We applied several triangulation techniques (methodological, data source, investigators and theoretical).
Transferability	To extend the degree to which the results can be generalized or transferred to other contexts or settings.	• Purposeful sampling to form a nominated sample	• We used a combination of three purposive sampling techniques.
Transferability		• Data saturation	• We quantified operational and theoretical data saturation.

Study procedure

Sampling and recruitment

Demographic and professional characteristics of the staff participated in the study

Characteristics	Number of participants ( = 119)	% of total participants
Gender
Male	57	48
Female	62	52
Role in the ED
ED Directors (ED Dir/Deputy Dir/Acting Dir)	21	18
ED Physicians (Staff Spec, Registrars)	43	36
ED Nurses (NUMs, CNCs, Nurse Coordinator)	44	37
Data or Administrator (data managers, admin)	11	9
Time of service in ED (years)
Mean	13.5
Range	3–33
Median	12
State/territory of service
NSW/ACT	52	44
QLD	37	31
WA	30	25

Dir represents ‘Director’, NUM Nursing unit manager, CNC Clinical nurse consultant

Data collection

With the participant’s permission, interviews were audio-recorded. All the hospitals provided a quiet interview room that ensured privacy and confidentiality for participants and investigators.

Data analysis

An external file that holds a picture, illustration, etc.
Object name is 12913_2018_2915_Fig1_HTML.jpg

Conceptual framework with the three stages of analysis used for the analysis of the qualitative data

Summary of key concepts, their definition, total number of citations and total number of interviews

	Key concepts	Definition of key concepts based on participants’ information	Interviews	Total citations
1	Relationships	Discussion of interactions between ED staff and staff from elsewhere in the hospital, and how these relationships affected and were affected by 4HR/NEAT.	119	5308
2	Characteristics of care in EDs pre- and post-4HR/NEAT	Participants discussed about the characteristics of care in ED before after 4HR/NEAT, and how 4HR/NEAT have changed these characteristics along its implementation.	119	1920
3	Staffing and 4HR/NEAT	Participants’ references to the impact and influence of 4HR/NEAT on staffing. These include creating new roles, changing/shuffling the responsibilities, issues around staff shortage and supply after 4HR/NEAT, etc.	113	1457
4	Recommendations	Participants expressed and explained a number of recommendations based on their experience with 4HR/NEAT implementation. These were suggested to be taken on board if other hospitals/organisations intended to adopt and implement time targets.	113	1070
5	Access block	Interactions and relationships reported in relation to 4HR/NEAT performance and access block as a principal factor associated with ED overcrowding.	109	910
6	4HR/NEAT introduction & management	Concepts and descriptions relevant to the introduction of 4HR/NEAT into hospitals and how this was managed.	106	880
7	External factors	Participants described a number of factors on which ED has had no control. It included all the factors imposed to ED from the department of health or the hospital executives (e.g., budget cut and changes to the hospital services that influenced ED operation).	95	868
8	Changes to ED related to 4HR/NEAT	All the references and explanations relating to the changes that were brought in as a result of 4HR/NEAT implementation.	115	565
9	4HR/NEAT performance	References how participants thought their hospital performed in terms of meeting the 4HR/NEAT target.	103	429
10	Medical education and training	Participants’ explanation of how and to what extent 4HR/NEAT have had an influence on medical education and training of ED staff.	46	206

Citations refer to the number of times a coded term was counted in NVivo

The second stage of analysis compared and contrasted the experiences, perspectives and actions of participants by role and location. The third and final stage of analysis aimed to generate theory-driven hypotheses and provided an in-depth understanding of the impact of the policy. At this stage, the research team explored different theoretical perspectives such as the carousel model and models of care approach [ 16 , 32 – 34 ]. We also used iterative sampling to reach saturation and interpret the findings.

Ethics approval and consent to participate

Ethics approval was obtained for all participating hospitals and the qualitative methods are based on the original research protocol approved by the funding organisations [ 18 ].

This section described the FDC and provided a detailed description of the strategies used in the analysis. It was adapted from the FDC methodology described by Lincoln and Guba [ 23 – 26 ] as the framework to ensure a high level of rigour in qualitative research. In Table Table1, 1 , we have provided examples of how the process was implemented for each criterion and techniques to ensure compliance with the purpose of FDC.

Credibility

Prolonged and varied engagement with each setting.

Interviewing process and techniques

Establishing investigators’ authority

Familiarity with phenomenon and research context : In our study, the research team had several years’ experience in the development and implementation of 4HR/NEAT in Australian EDs and extensive ED-based research experience and track records conducting this type of work.
Investigative skills: Investigators who were involved in data collections had three or more years’ experience in conducting qualitative data collection, specifically individual interview techniques.
Theoretical knowledge and skills in conceptualising large datasets: Investigators had post-graduate experience in qualitative data analysis and using NVivo software to manage and qualitative research skills to code and interpret large amounts of qualitative data.
Ability to take a multidisciplinary approach: The multidisciplinary background of the team in public health, nursing, emergency medicine, health promotion, social sciences, epidemiology and health services research, enabled us to explore different theoretical perspectives and using an eclectic approach to interpret the findings.

These characteristics ensured that the data collection and content were consistent across states and participating hospitals.

Collection of referential adequacy materials

Peer debriefing

We conducted several sessions of peer debriefing with some of the Project Management Committee (PMC) members. They were asked at different stages throughout the analysis to reflect and cast their views on the conceptual analysis framework, the key concepts identified during the first level of analysis and eventually the whole set of findings (see Fig. Fig.1). 1 ). We also have reported and discussed preliminary methods and general findings at several scientific meetings of the Australasian College for Emergency Medicine.

Dependability

Rich description of the study protocol.

To maintain consistency, we documented all the changes and revisions to the research protocol, and kept a trackable record of when and how changes were implemented.

Establishing an audit trail

Stepwise replication—measuring the inter-coders’ agreement

Step 1 – Two data analysts and principal investigator coded six interviews, separately.
Step 2 – The team discussed the interpretation of the emerging key concepts, and resolved any coding discrepancies.
Step 3 – The initial codebook was composed and used for developing the respective conceptual framework.
Step 4 – The inter-coder agreement was calculated and found a weighted Kappa coefficient of 0.765 which indicates a very good agreement (76.5%) of the data.

Inter-coder analysis using Cohen’s Kappa coefficients

	Key concepts	1st team of coders (initial stage)		2nd team of coders (later stage)
	Key concepts	Kappa (unweighted)	Kappa (weighted)	Kappa (unweighted)	Kappa (weighted)
1	Relationships	0.772		0.806
2	Characteristics of care in EDs pre- and post-4HR/NEAT	0.825		0.720
3	Staffing and 4HR/NEAT	0.978		0.794
4	Recommendations	0.772		0.875
5	Access block	0.909		0.948
6	4HR/NEAT introduction and management	0.786		0.810
7	External factors	0.710		0.874
8	Changes to ED related to 4HR/NEAT	0.792		0.815
9	4HR/NEAT performance	0.912		0.700
10	Medical education and training	0.789		0.855
Overall Kappa		–		–

Confirmability

Reflexivity.

After completion of the data collection, reflection and feedback from all the investigators conducting the interviews were sought in both written and verbal format.

Triangulation

To assess the confirmability and credibility of the findings, the following four triangulation processes were considered: methodological, data source, investigators and theoretical triangulation.

Methodological triangulation is in the process of being implemented using the mixed methods approach with linked data from our 16 hospitals.

Theoretical triangulation was achieved by using and exploring different theoretical perspectives such as the carousel model and models of care approach [ 16 , 32 – 34 ]. that could be applied in the context of the study to generate hypotheses and theory driven codes [ 16 , 32 , 38 ].

Transferability

Purposive sampling to form a nominated sample.

Data saturation

An external file that holds a picture, illustration, etc.
Object name is 12913_2018_2915_Fig2_HTML.jpg

Data saturation gain per interview added based on the chronological order of data collection in the hospitals. Y axis = number of new codes, X axis = number of interviews over time

Scientific rigour in qualitative research assessing trustworthiness is not new. Qualitative researchers have used rigour criteria widely [ 40 – 42 ]. The novelty of the method described in this article rests on the systematic application of these criteria in a large-scale qualitative study in the context of emergency medicine.

As indicated, the objective of this study was to contribute to the ongoing debate about rigour in qualitative research by using our mixed methods study as an example. In relation to innovative application of mixed-methods, the findings from this qualitative component can be used to explain specific findings from the quantitative component of the study. For example, different trends of 4HR/NEAT performance can be explained by variations in staff relationships across states (see key concept 1, Table Table3). 3 ). In addition, some experiences from doctors and nurses may explain variability of performance indicators across participating hospitals. The robustness of the qualitative data will allow us to generate hypotheses that in turn can be tested in future research.

Conclusions

Finally, we have highlighted the importance of allocating sufficient resources. This is essential if other researchers in emergency care would like to replicate the use of the FDC in the future.

Additional files

Appendix 1. Interview form. Text. (PDF 445 kb)

Appendix 2. Codebook NVIVO. Text code. (PDF 335 kb)

Appendix 3. Acknowledgements. Text. (PDF 104 kb)

Acknowledgements

Availability of data and materials

Abbreviations.

4HR/NEAT	Four Hour Rule/National Emergency Access Target
ACT	Australian Capital Territory
ED/EDs	Emergency department(s)
FDC	Four-Dimensions Criteria
HREC	Health Research Ethics Committee
NSW	New South Wales
PMC	Project Management Committee
QLD	Queensland
WA	Western Australia

Authors’ contributions

Consent for publication

All the data used from the interviews were de-identified for the analysis. No individual details, images or recordings, were used apart from the de-identified transcription.

Competing interests

RF is an Associate Editor of the Journal. No other authors have declared any competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Lincoln & Guba's (1985) trustworthiness criteria & techniques for establishing them

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Why was Novgorod a unique city in medieval Russia?

As the most prominent and powerful city of northwestern Rus in the Middle Ages, and being very popular with European merchants, Novgorod was unlike any other settlement in the lands of the Eastern Slavs during that era.

Traditionally, medieval Russian cities grew around the main fortress, which was the political and religious heart of the community. Novgorod, however, emerged from a union of three settlements inhabited by different Slavic tribes. For them, it became a “new city” – this is how “Novgorod” is literally translated from Russian ( Novy – “new”, and gorod – “city”).

In the 14th and 15th centuries, during its heyday as a commercial and political power, the city of Novgorod was officially known as Gospodin Velikiy Novgorod – literally “The Great Master Novgorod”. The city was almost an empire, controlling vast lands from the Baltic Sea in the west to the Ural Mountains in the east, and from the White Sea in the north to the upper Volga in the south. After Kiev, it was the second most powerful city in medieval Rus.

Commerce: Making Novgorod great

Novgorod market in the 17th century

International commerce was the foundation of Novgorod's prosperity, which truly made it great and powerful. The local craftsmen – weavers and tanners, jewelers and glass blowers, potters and foundry workers, gunsmiths and locksmiths – were famous throughout the Russian lands. But Novgorod also did a brisk trade with Western Europe via the Baltic Sea trade routes.

By the end of the 13th century, merchants from the Hanseatic League developed strong trade relations with Novgorod. The Hanseatic League was the largest trade association of merchants from major German cities situated along the Baltic and North seas, but it also maintained four representative offices outside of the German-speaking world – in Novgorod, Bruges, Bergen and London.

Guests from over the sea, Nikolai Rerikh, 1901

The German merchants came to Novgorod to make wholesale purchases, and deals were concluded at the Hanseatic League's representative office. However, a merchant from any other Russian city couldn't enter the office's territory and make deals there.

European merchants were eager to come to Novgorod to sell prized luxury goods such as wine, expensive fabrics, ornamental stones, and precious metals. In return, Novgorod sold fine and precious furs such as squirrel, weasel, and sable. Novgorod also massively exported honey, leather, wax (which Europe needed to make church candles), and walrus ivory.

Boyar republic

Velikiy Novgorod

Novgorod’s political system was unique among the myriad of city-states and principalities of medieval Rus; it was ruled by a small circle of boyar families that owned huge fiefdoms both near the city and in remote northern lands. The title of boyar in Novgorod was hereditary, a fact that distinguished the city from the rest of Russia, where the title of boyar usually was bestowed upon military commanders who were close to the Rurikid princes. The fact that Novgorod was ruled solely by locally-born aristocracy was actually a prominent feature in the principality’s unique form of republican government.

Liberty in princes

Yaroslav the Wise, Nikolai Rerikh, 1941-1942

Restriction of the rights of the princes began in Novgorod during the lifetime of Yaroslav the Wise (978 – 1054), who agreed to give special privileges to the Novgorod boyars vis-a-vis the prince in exchange for support in the struggle for control of Kiev. Novgorod did not develop a separate princely dynasty after the death of Yaroslav, because the city was at the source of the trade route "from the Varangians to the Greeks” and was closely connected with Kiev. When he died in 1054, Yaroslav the Wise bequeathed Kiev and Novgorod to his eldest son. As a result, the princely line that ruled Kiev usually chose a prince to rule in Novgorod, or Novgorod had the same prince as Kiev did.

In 1136, a rebellion in Novgorod led to the expulsion of the prince. From then on, the Novgorodians invited princes themselves and concluded a temporary agreement with them, according to which they could not interfere in the affairs of city management, change the highest officials and acquire lands on the outskirts of the Novgorod republic. In case of any violation of the agreement, the prince was expelled from the city, and the Veche selected a new candidate. Such changes more than once had a serious impact on the life of all the principalities of Rus.

Despite such treatment of the princes, all the major figures of Kievan Rus, who were the builders of the future united Russian state – from Vladimir the Great to Vladimir Monomakh – reigned in Novgorod before ascending the throne in Kiev. Symbolically, Novgorod was also the first place where Rurik reigned in Russia.

The most literate city in Russia

Birch bark letter #1

On July 26, 1951, archaeological excavations in Novgorod found the first letter written on birch bark, with a discernible text carved on the surface. In total, more than 1100 such letters were found in Novgorod and about 100 in other cities of medieval Russia.

The analysis of Novgorod’s birch-bark letters allowed scholars to reconstruct the everyday life of the city and its inhabitants over the course of the 11th to the 15th centuries, which was the golden era of the Novgorod Republic.

The texts on birch bark testify to widespread literacy among the people of Novgorod who wrote to each other often and on a variety of matters, where they discussed household affairs, commercial transactions, as well as court decisions and simply the local gossip. Both men and women were literate, which was unheard of for Western Europe at this time.

READ MORE: How did single women survive in Tsarist Russia?

The birch-barks showed that the position of women in Novgorod society was quite prominent, and they conducted their own affairs, concluded commercial transactions, dispatched their husbands orders, as well as appeared in court, including on financial issues; and in general were actively engaged in economic activity.

Among the letters there were also touching declarations of love, such as the famous letter written by an unknown young woman in the 12th century: "I sent to you three times. What evil do you have against me that you did not come to me?" Another birch-bark letter contains one of the first records of Russian cursing.

Novgorod's heroes, its tragic fall and legacy today

Sadko, Ilya Repin, 1876

Novgorod’s political structure and the nature of its economy created special cultural and real heroes. Unlike the characters of the Russian bylinas who spend their time lying on the stove and waiting for an opportunity to stand up for the fatherland, Novgorod's main hero, Sadko, who is a handsome man, as well as gusli player and merchant, is relentless in his pursuit of money and fame. He successfully swindles the sea tsar and wraps him around his finger, and once he is rich, he swears to buy up all Novgorod’s goods. In some versions of the legend he even succeeds.

Another atypical Novgorod hero, one not from a bylina but rather someone from real history, was the leader of the local resistance against Moscow. Marfa Boretskaya (or Marfa Posadnitsa because Marfa's second husband was a posadnik) came from an influential boyar family and owned vast tracts of land that were already in her family’s possession, as well as those lands that she inherited after the death of her first husband.

The taking away of the Novgorod Veche bell. Marfa Posadnitsa. 1889

When in the 15th century the Grand Prince of Moscow, Ivan III, began to unite the Russian lands by conquering other cities, Marfa entered into negotiations with the Lithuanian Grand Duke to propose a merger with Novgorod on the condition that it maintains its rights of autonomy.

READ MORE: How Russians executed... bells

Having learned about the negotiations, Ivan III declared war on Novgorod, and in 1478 the republic ceased to exist. As a sign of the abolition of Novgorod’s Veche, the famous bell was taken to Moscow, and the most promised townspeople were repressed. Marfa's lands were confiscated, and she herself soon died.

Nevertheless, while Novgorod has long disappeared from the map as an independent political entity, its legacy resonates today in the modern era. At the dawn of Russian history Novogorod accepted Rurik to reign, thereby laying the foundation of Russian statehood. Also, the city and its republican form of government showed that the path to rigid centralization and the absolute power of the Grand Prince was not the only possible political path for Russia.

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Novgorod “la grande”, cuna de rusia.

Posted on junio 19, 2015 by oscarnunezcrespo

El Kremlin (ciudadela) de Novgorod

PRESENTACIÓN

Novgorod, “Ciudad Nueva” (llamada también Veliki Novgorod “Gran Ciudad Nueva”, para diferenciarla de la otra población con un nombre similar, Nizhni Novgorod, que se halla al este de Moscú) es una histórica ciudad rusa, capital del oblast (distrito, región) del mismo nombre, y situada, de Norte a Sur, entre San Petersburgo por un lado y Tver y Moscú por otro, y de Oeste a Este, entre el oblast de Pskov y los países bálticos, de un lado, y el oblast de Vologda y los territorios del Mar Blanco.

FUENTES DE AGUA DULCE

Por Veliky Novgorod pasa el río Volkhov, justo al poco nacer del cercano lago Ilmen.

HISTORIA REMOTA

Aunque las crónicas mencionan Novgorod como fundada hacia 862, el resultado de las excavaciones retrasan esta fecha en un siglo, tal vez debido a una interpolación posterior en los textos para dar más solera a la ciudad. Lo que sí existió en la zona fue una fortaleza varenga (vikinga), el Gorodishche , donde el líder varengo Rurik estableció su base de operaciones. La Ciudad propiamente dicha nace en el siglo X.

Novgorod se convirtió en el centro neurálgico de un nuevo grupo étnico, nacido de la asimilación por eslavos (la Urheimat eslava debió estar aproximadamente en Galitzia y Volinia) de pueblos de lengua báltica y de lengua finesa, a los que los escandinavos dieron nombre (Rus, por Rurik) y se convirtieron en su aristocracia.

ALTA EDAD MEDIA

Catedral de Santa Sofía de Novgorod

En 882, el sucesor de Rurik, Oleg de Novgorod, conquistó Kiev y fundó el estado de la Rusia de Kiev. En torno a la vieja forzaleza, nace el Novgorov urbano y se convierte pronto, por su influencia cultural, política y económica en la segunda ciudad más importante de la Rus de Kiev. De acuerdo con la costumbre, el hijo mayor del rey de Kiev, el príncipe heredero, era enviado a Novgorod a “entrenarse” gobernando el Principado. Cuando el rey no tenía tal hijo, Novgorod era gobernado por posadniks (alcaldes), como los legendarios Gostomysl, Dobrynya, Konstantin, y Ostromir.

De todos los príncipes, destaca la memoria de Yaroslav el Sabio, quien fue Príncipe de Novgorod de 1010 a 1019, mientras su padre, Vladimir el Grande, era Príncipe de Kiev. Yaroslav promulgó el primer código escrito de leyes entre los eslavos orientales (la Russkaya Pravda ) y otorgó a la ciudad una serie de fueros (privilegios, libertades). Su hijo, Vladimir, promovió la construcción de la gran Catedral de Santa Sofía que aún se mantiene hasta hoy.

De cara al exterior, Novgorod tuvo importantes relaciones con Noruega (nada menos que 4 reyes noruegos se exiliaron allí huyendo de revueltas en su país). Tras la muerte en 1030 y canonización de uno de ellos , San Olaf de Noruega (quien además era cuñado del ya mencionado príncipe Yaroslav I el Sabio), se erigió en Novgorod la Iglesia de San Olaf, que existió hasta el siglo XIV.

También hubo fluidas relaciones con comerciantes del Norte de Alemania.

LA REPÚBLICA DE NOVGOROD

En 1136, el príncipe Vsevolod Mstislavich fue destituido por los ciudadanos, hecho que se considera el nacimiento de la república de Novgorod. Al mismo tiempo, los lazos con Kiev se sueltan cada vez más durante el siglo XII. La Ciudad nombró y destituyó a muchos príncipes en los dos siglos siguientes, pues la monarquía no llegó a ser oficialmente abolida (pero tenían poca importancia política). La Ciudad-estado controló buena parte del Noreste de Europa, desde Pskov hasta los montes Urales, siendo uno de los estados más extensos de la Europa de su tiempo, aunque su densidad de población hacia el Este y el Norte fue escasa.

Una de las figuras más importantes en Novgorod fue el posadnik , o alcalde, un alto cargo elegido por la Asamblea Pública (llamada el Veche ) de entre los miembros locales de los boyardos (la aristocracia). El tysyatsky , o «hombre de los mil», originalmente el jefe de la milicia ciudadana (quien más tarde adquirió funciones judiciales y comerciales), fue también elegido por el Veche. Otro importante alto cargo local fue el Arzobispo de Novgorod, quien compartía poder con los boyardos. Los Arzobispos, a su vez, eran también elegidos por el Veche, aunque a veces lo eran por sorteo, y justo después de su elección el metropolitano los consagraba.

Es poco más lo que se sabe sobre la estructura de gobierno. Los boyardos y el arzobispo gobernaron juntos la Ciudad, pero se ignoran los límites de las competencias de cada uno. El príncipe, aunque su poder fue reducido, era representado por su namestnik , o lugarteniente, y todavía representava importantes funciones como jefe de estado, comandante militar, legislador y jurista.

En el siglo XIII, Novgorod tuvo un importante comercio con la Liga Hanseática, aún sin pertenecer a ella.

Culturalmente, Novgorod prosperó durante el medievo, el hallazgo arqueológico de grandes cantidades de textos escritos por plebeyos (escribiendo en ruso medieval y no en el Eslavo Eclesiástico -lengua arcaizante equivalente al latín dentro de la iglesia ortodoxa rusa-) sobre cortezas de abedul demuestran el alto grado de alfabetización entre los ciudadanos. Asimismo, el Códice de Novgorod , el libro eslavo más antiguo escrito fuera de los Balcanes , y la inscripción más antigua en una lengua finesa fueron desenterrados en Novgorod.

NOVGOROV SE SALVA DE LA INVASIÓN MONGOL Y RECHAZA ATAQUES OCCIDENTALES

Novgorod se libró de la conquista por los mongoles durante su invasión de Rus. El ejército mongol dio la vuelta a 200 kilómetros de la ciudad, no por su fuerza militar, sinó por temor a quedarse empantanados en las marismas cercanas. Aún así, quedo sometida al tributo que, en nombre del khan mongol, recaudaba el príncipe moscovita Alexander Nevski (actuando como poder colaboracionista local). Un episodio, en el que Nevski arranca la nariz a varios funcionarios de Novgorod que se resistían a pagar tributo al invasor, generó una fuerte enemistad entre Novgorod (como símbolo de una Rusia 100% europea de ciudadanos libres ) y Moscú (un poder despótico semi-asiático de siervos). Con la decadencia del poder mongol, los moscovitas se van independizando y enfrentándose a sus antiguos amos (batalla de Kulikovo en 1380), pero ésto no cambia lo anterior: Moscú , con ínfulas de ser la tercera Roma y la sucesora de Constantinopla, es en realidad un nuevo khanato y empieza su afán expansionista hacia el Este, pero también contra el Oeste.

Mientras, Novgorod rechaza con éxito los insolidarios y oportunistas ataques de cruzados suecos, daneses y alemanes, con la excusa de ser cismáticos, de haber roto con Roma, pero son rechazados (los suecos en 1260 y la Orden Teutónica en 1262).

MOSCOVIA CONQUISTA NOVGOROD A SANGRE Y FUEGO

En los siglos XIV y XV, Novgorod lucha por su supervivencia frente a una Moscovia expansionista que resulta imparable, y su dependencia alimentaria de Moscú empeora las cosas. Tras la decisiva derrota novgorodiana en la Batalla de Shelón (1471), Ivan III anexionó a la fuerza la Ciudad al Gran Ducado de Moscú en 1478. La Veche fue disuelta y una buena parte de la población de la Ciudad fue masacrada o deportada.

Tras la anexión, Novgorod se convirtió en la tercera mayor ciudad de Moscovia (30.000 habitantes hacia 1550) hasta la hambruna de1560 y la Masacre de 1570, en la que Ivan el Terrible saqueó la ciudad, asesinó a miles de sus habitantes y deportó a su nobleza a Moscú, Yaroslavl y otros lugares. Boris Godunov, el usurpador previo al ascenso de los Romanov, permitió su recuperación.

HISTORIA POSTERIOR

Durante el Período Tumultuoso (a comienzos del siglo XVII) Novgorod fue ocupada por los suecos en 1611, y devuelta a Moscovia seis años después por el Tratado de Stolbovo. Se empezó a recuperar hacia finales de ese siglo, cuando se construyen la Catedral de la Señal y el monasterio de Vyazhischi.

En 1727, Novgorod se convirtió en el centro administrativo del Gobernorato de Novgorod del Imperio Ruso. Entre 1927 y 1944, la ciudad formó parte del Oblast de Leningrado, para después ser la capital de su propio Oblast, creado después de esa fecha.

En 1862, Novgorod sale momentáneamente de su tranquilidad provinciana al inaugurar el Zar Alejandro II Romanov el monumento al “Milenario de Rusia”.

Cuadro representando la inaguración

El 15 de Agosto de 1941, durante la Segunda Guerra Mundial, la ciudad fue ocupada por la Wehrmacht, hasta que fue recuperada por el Ejército Rojo el 19 de Enero de 1944. Con frecuencia, los voluntarios españoles de la División Azul, destinados en el sector de Leningrado, visitaban Novgorod durante sus permisos. Durante la guerra, la mayoría de sus monumentos históricos fueron destruidos, pero fueron restaurados aquellos situados en la zona central en la posguerra.

En 1992, los principales monumentos de la Ciudad y sus alrededores fueron declarados Patrimonio de la Humanidad por la Unesco.

NOMBRE OFICIAL DE LA CIUDAD

Hasta el año 1478 (fecha de la brutal conquista moscovita) la ciudad era llamada Gospodín Veliki Nóvgorod, ‘ Señor Nóvgorod el Grande’ ). Luego, hasta 1999 su nombre oficial era Nóvgorod . En esa fecha, adquirió su nombre actual, que es una reposición parcial del original.

POBLACIÓN Y GOBIERNO MUNICIPAL

Según el censo de 2010, la ciudad tenía unos 218,717 habitantes en su área municipal de 90 km2 . Su actual alcalde (aunque en el momento de escribir ésto, está a punto de ser forzado a dimitir) aún es Yuri Bobryshev .

TRANSPORTE PÚBLICO INTERURBANO
La autopista federal M10 lleva a Moscú y San Petersburgo
Conexiones ferroviarias con Moscú, San Petersburgo, Minsk (Belarus) y Murmansk
Línea de autobuses a San Petersburgo y otras ciudades
El aeropuerto de Yurievo, que servía a Novgorod, fue cerrado al trafico aéreo en los años 90. Se ha convertido el antiguo aeropuerto militar de Kretschewizy en el nuevo aeropuerto civil de la ciudad (inagurado en 2010). El de Pulkovo en San Petersburgo es el aeropuerto internacional más cercano.
TRANSPORTE LOCAL

Consiste en una serie de líneas de autobús y en 5 líneas de trolebús. La frecuencia de paso es de un autobús o trolebús cada 5 minutos aproximadamente.

ECONOMÍA DE SU REGIÓN (OBLAST )

El producto regional bruto de la región de Novgorod es 87.600.000.000 rublos, que es aproximadamente el 0,3 por ciento de producto Interior bruto de toda Rusia . Aproximadamente el 91,8 por ciento se destina a la industria de la transformación, de los cuales 31.1 por ciento en la industria química , el 20,1 por ciento a la producción de alimentos y el 12,3 por ciento a la industria de transformación de la madera . 7.9 por ciento hace que el campo de la energía (electricidad y la producción de gas y distribución de agua) y 0,3 por ciento de la extracción de materias primas (arcilla, piedra caliza, arena de cuarzo, turba). Otras industrias son la ingeniería mecánica , industria de la pulpa y el papel , la metalurgia ferrosa y la industria de combustible . La tasa de desempleo es del 1,2 por ciento , más baja que la media de Rusia (2 por ciento).

Nóvgorod es la sede de uno de los mayores productores de fertilizantes en el mundo, el grupo Akron . La empresa alemana Pfleiderer, que se especializa en la producción de materiales a base de madera, desde 2006 opera una planta en Nóvgorod, adquirida por IKEA (Swedspan) de 2012.

PARQUES, JARDINES Y PLAYAS
Parque del Kremlin
Playa fluvial del Kremlin, en el Volkhov
VIDA CULTURAL Y OCIO

Novgorod tiene dos salas de cine : la «Novgorod» y el «Kinozentr» con tres salas.

Además, cuenta con tres teatros : el Teatro Dramático Fyodor Dostoyevsky , fundado en 1853, la Ciudad Teatro para Niños y Jóvenes «Malyi», fundada en 1990, y el Teatro Folclórico «Kudesy» , que celebra cada año alrededor de 2.700 conciertos, con más de 400.000 espectadores.

También existe una orquesta filarmónica en la ciudad .

Sede de la Filarmónica

En Novgorod hay una estación de televisión local «Novgorod Oblast Television”

«El Almirante» , es el más importante club nocturno (macrodiscoteca) de Novgorod.

PUNTOS DE INTERÉS TURÍSTICO

El Kremlin, con la catedral de santa Sofía y otros edificios antiguos dentro de su perímetro

La Corte de Yaroslav (Dvorishche) es un conjunto arquitectónico construido en los siglos X-XI a las orillas del río Volkhov. Fue una gran barriada formada por casas residenciales, iglesias y una amplia plaza en el centro. En la plaza se reunían los miembros de la Asamblea de ciudadanos de Nóvgorod. Además, aquí se situaba la corte del príncipe, donde posteriormente se construyó la Catedral de San Nicolás (comienzos del siglo XII) .

Actualmente, en el territorio de la Corte de Yaroslav, a parte de esta catedral, se conservan varias iglesias, como la Iglesia de San Juan Bautista , la Iglesia de Mujeres Mirróforas , la Iglesia de Santa Paraskeva, la Iglesia de Procopio, la Iglesia de San Jorge, la Iglesia de la Asunción, y también el conjunto arquitectónico del Mercado y una arcada de piedra blanca. Durante la época soviética, prácticamente todos los edificios de viviendas fueron destruidos, y la mayoría de las iglesias ahora sólo son museo. El único edificio civil conservado hasta nuestros días es el Palacio de Catalina II , construido en el siglo XVIII. Se organizan visitas guiadas por la Corte de Yaroslav, que se conecta con el Kremlin de Nóvgorod en el lado opuesto del río mediante el Puente Peatonal .

El Mercado Antiguo en la Corte de Yaroslav

Monumento al Milenario de Rusia (monumento erigido en 1862 a instancias del Zar Alejandro II, conmemorando los 1000 años del estado ruso)

Una imagen del monumento

Catedral de Santa Sofía, dentro del Kremlin y construida en 1065 (con su impresionante campanario de 1439 y su Museo de las Campanas en el interior).

Catedral de Santa Sofía

Palacio de las Facetas, vestigio del antiguo Palacio del Arzobispo , un raro ejemplo de arquitectura gótica, construida con ladrillo en 1433 en colaboración con los maestros alemanes. También situada intramuros del Kremlin.

Catedral de Nuestra Señora del Signo , construida entre 1682-1688
Catedral de San Nicolás
Iglesia de la Natividad de la Virgen del Monasterio de San Antonio (del siglo XII, erigida sobre un antiguo templo pagano dedicado a Perun). A orillas del lago.
La Iglesia de la Natividad de la Virgen
Monasterio de San Jorge (Yuriev)
Museo de la Torre Kokui (una de las torres del Kremlin, habilitada como Museo)

Torre Kokui

Museo de Bellas Artes (edificio de estilo neoclásico en el límite de la ciudad nueva con la zona de las murallas del Kremlim)

Iglesia del Salvador en la colina Nereditsa (siglo XII)
Iglesia de Teodoro Stratilates sobre el Arroyo (de 1361, conserva pinturas del la época, obra de Teófano el Griego )
Museo Vitoslavitsy de Arquitectura Popular en Madera (un conjunto de 20 construcciones tradicionales en madera procedentes de toda Rusia y reinstaladas a las afueras de la ciudad)

Uno de los edificios que se pueden ver en el Museo

Monasterio del Espíritu Santo (siglo XII)
Gorodishe de Rurik

El Gorodishe de Rurik (residencia de este príncipe vikingo en el siglo IX)

PARA SABER MÁS

http://visitnovgorod.es/

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Construction of the rigour equivalents and qualitative and quantitative
Achieving rigour in qualitative research: an examination of tensions in the international development sector Susan Johnson and Saltanat Rasulova Qualitative
1: Lincoln and Guba's naturalistic criteria (source Spencer et al 2003
1. Five scientific paradigms of qualitative research (Guba & Lincoln
Guba & Lincoln
Rigor in qualitative research

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A Review of the Quality Indicators of Rigor in Qualitative Research
A Review of the Quality Indicators of Rigor in Qualitative ...
Application of Guba and Lincoln's parallel criteria to assess
Conclusion. To recapitulate, over the years, Guba and Lincoln's parallel criteria for evaluating rigor, termed trustworthiness in qualitative research remains one of the most extensively used. This criteria, also referred to as the Four-Dimensions Criteria (FDC) consists of credibility, dependability, confirmability and transferability to be respectively equivalent to quantitative criteria of ...
Critical Analysis of Strategies for Determining Rigor in Qualitative
Abstract. Criteria for determining the trustworthiness of qualitative research were introduced by Guba and Lincoln in the 1980s when they replaced terminology for achieving rigor, reliability, validity, and generalizability with dependability, credibility, and transferability. Strategies for achieving trustworthiness were also introduced.
Ensuring Rigor in Qualitative Data Analysis: A Design Research Approach
To ensure the research process was trustworthy, Guba and Lincoln's (1989) criteria for ensuring rigor in qualitative research were addressed by employing the following strategies. For the purpose of credibility and to affirm the research measured a design researchers understanding of and approach to research, Charmaz, well-established methods ...
Application of Guba and Lincoln's parallel criteria to assess
Application of Guba and Lincoln's parallel criteria to assess ...
Rigor in Qualitative Social Work Research
may be used in qualitative research. Indeed, as Seale (1999, 2002) suggested, we come to see research more as a craft skill in which practitioners make "local" (or project-specific) decisions to enhance the quality of the end product. Together, the criteria proposed by Lincoln and Guba (1985) and revised by Lincoln (1995) have
Application of four-dimension criteria to assess rigour of qualitative
Methodological rigour. This section describes the qualitative methods to assess the rigour of the qualitative study. Researchers conducting quantitative studies use conventional terms such as internal validity, reliability, objectivity and external validity [].In establishing trustworthiness, Lincoln and Guba created stringent criteria in qualitative research, known as credibility ...
Application of Guba and Lincoln's parallel criteria to assess
Purpose This paper illustrates how Guba and Lincoln's parallel criteria for establishing trustworthiness, can be adapted and applied to qualitative research on indigenous social protection systems.
RWJF
Lincoln and Guba's Evaluative Criteria
PDF Lincoln and Guba'S Quality Criteria for Trustworthiness
articles - lincoln and guba's quality criteria for trustworthiness
PDF But is it rigorous? Trustworthiness and authenticity in naturalistic
The emergence of a new paradigm of inquiry (naturalistic) has, unsurprisingly enough, led to a demand for rigorous criteria that meet traditional standards of inquiry. Two sets are suggested, one of which, the "trmstwmthiness" criteria, parallels conventional criteria, while the second, "authenticity" criteria, is implied directly by ...
Searching for rigour in the reporting of mixed methods population
Although the discussion regarding rigour in qualitative research is ongoing, Lincoln and Guba's [ 21] criteria of credibility, transferability, dependability and confirmability are considered the 'gold standard' ([ 22], p. 179, [ 12], p. 527). Given the differences between assessing rigour in quantitative and qualitative methodologies ...
Application of four-dimension criteria to assess rigour of qualitative
Application of four-dimension criteria to assess rigour ...
Lincoln & Guba's (1985) trustworthiness criteria & techniques for
Lincoln & Guba's (1985) trustworthiness criteria ...
Validity in Qualitative Evaluation: Linking Purposes, Paradigms, and
Peer debriefing is a form of external evaluation of the qualitative research process. Lincoln and Guba (1985, p. 308) describe the role of the peer reviewer as the "devil's advocate.". It is a person who asks difficult questions about the procedures, meanings, interpretations, and conclusions of the investigation.
Veliky Novgorod Region: Why you need to see the jewel in Russia's
Krestetsky stitching is a traditional Russian pattern - a folk craft that was born and developed in this area since the 1860-s. In Soviet times a small factory producing original unique linen ...
Why was Novgorod a unique city in medieval Russia?
Novgorod's political system was unique among the myriad of city-states and principalities of medieval Rus; it was ruled by a small circle of boyar families that owned huge fiefdoms both near the ...
Critical Analysis of Strategies for Determining Rigor in Qualitative
Abstract. Criteria for determining the trustworthiness of qualitative research were introduced by Guba and Lincoln in the 1980s when they replaced terminology for achieving rigor, reliability, validity, and generalizability with dependability, credibility, and transferability. Strategies for achieving trustworthiness were also introduced.
Prodotti dell'Arca del Gusto in Novgorod oblast
Prodotti dell'Arca del Gusto in Novgorod oblast - Save the Biodiversity, Save the Planet
A Review of the Quality Indicators of Rigor in Qualitative Research
Attributes of rigor and quality and suggested best practices for qualitative research design as they relate to the steps of designing, conducting, and reporting qualitative research in health professions educational scholarship are presented. A research question must be clear and focused and supported by a strong conceptual framework, both of which contribute to the selection of appropriate ...
NOVGOROD "LA GRANDE", CUNA DE RUSIA
En 882, el sucesor de Rurik, Oleg de Novgorod, conquistó Kiev y fundó el estado de la Rusia de Kiev. En torno a la vieja forzaleza, nace el Novgorov urbano y se convierte pronto, por su influencia cultural, política y económica en la segunda ciudad más importante de la Rus de Kiev.
Critical analysis of strategies for determining rigor in qualitative
Criteria for determining the trustworthiness of qualitative research were introduced by Guba and Lincoln in the 1980s when they replaced terminology for achieving rigor, reliability, validity, and generalizability with dependability, credibility, and transferability. Strategies for achieving trustworthiness were also introduced. This landmark contribution to qualitative research remains in use ...

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Application of Guba and Lincoln's parallel criteria to assess trustworthiness of qualitative research on indigenous social protection systems

Design/methodology/approach

Research limitations/implications

Originality/value

Credibility

Introduction

Methodology

Prolonged engagement

Persistent observation

Collection of referential adequacy materials 2

Dependability

Rich description

Member checks

Confirmability

Triangulation

Reflexivity

Transferability

Sampling techniques (purposive and snowball sampling)

Acknowledgements

Corresponding author

Report an issue or find answers to frequently asked questions

Application of four-dimension criteria to assess rigour of qualitative research in emergency medicine

Methodological rigour

Study procedure

Sampling and recruitment

Data collection

Data analysis

Ethics approval and consent to participate

Credibility

Interviewing process and techniques

Establishing investigators’ authority

Collection of referential adequacy materials

Peer debriefing

Dependability

Establishing an audit trail

Stepwise replication—measuring the inter-coders’ agreement

Confirmability

Triangulation

Transferability

Data saturation

Conclusions

Abbreviations

Acknowledgements

Availability of data and materials

Author information

Contributions

Corresponding author

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Consent for publication

Competing interests

Publisher’s Note

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BMC Health Services Research

Application of four-dimension criteria to assess rigour of qualitative research in emergency medicine

Shizar Nahidi

Gerry Fitzgerald

Nick Gibson

Sally McCarthy

Patrick Aboagye-Sarfo

Associated Data

Methodological rigour

Study procedure

Sampling and recruitment

Data collection

Data analysis

Ethics approval and consent to participate

Credibility

Interviewing process and techniques

Establishing investigators’ authority

Collection of referential adequacy materials