Qualitative Research: Standards, Challenges, and Implications for Health Design


Objective: This Methods column describes the existing reporting standards for qualitative research, their application to health design research, and the challenges to implementation. Intended for both researchers and practitioners, this article provides multiple perspectives on both reporting and evaluating high-quality qualitative research. Background: Two popular reporting standards exist for reporting qualitative research—the Consolidated Criteria for Reporting Qualitative Research (COREQ) and the Standards for Reporting Qualitative Research (SRQR). Though compiled using similar procedures, they differ in their criteria and the methods to which they apply. Creating and applying reporting criteria is inherently difficult due to the undefined and fluctuating nature of quali- tative research when compared to quantitative studies. Conclusions: Qualitative research is expansive and occasionally controversial, spanning many different methods of inquiry and epistemo- logical approaches. A “one-size-fits-all” standard for reporting qualitative research can be restrictive, but COREQ and SRQR both serve as valuable tools for developing responsible qualitative research proposals, effectively communicating research decisions, and evaluating submissions. Ultimately, tai- loring a set of standards specific to health design research and its frequently used methods would ensure quality research and aid reviewers in their evaluations.

Keywords: Research methodology, qualitative research, SRQR, COREQ 

In healthcare, practitioners and researchers alike employ qualitative studies to describe experiences, environments, and relationships, including those that may be otherwise difficult to capture using quantitative methods. Interviews and focus groups are key components of participatory design studies, while field observations and document analysis are frequently used during facility evaluations. In a review of scientific nursing journals, one of every five studies involved qualitative methods (Yarcheski, Mahon, & Yarcheski, 2012). 

Though the evidence-based design has its roots in quantitative data, it has been increasingly common to approach healthcare design issues from a mixed-methods perspective (O’Cathain,2009). As one example, quantitative patient data can be used to test a particular hypothesis while a narrative observation corroborates the results and provides the context required for effective translational research. The Journal of the American Medical Association’s Evidence-Based Medicine Working Group proposed four essential aspects of qualitative analysis relevant participants, suitable methods, comprehensive data collection, and appropriate analysis (Giacomini & Cook, 2000). 

No recommendations are made, however, to ensure researchers have adequately communicated these research decisions to potential reviewers or practitioners. Adhering to a set of criteria for reporting research is crucial to improving the overall quality of a research discipline. Reporting standards can be as much a tool for the researcher as for the evaluator and practitioner. While this has been customary in quantitative studies since the 1990s, it was only recently that reporting recommendations were made for qualitative research.

Existing Reporting Standards for Qualitative Research 

Standards often take the form of a checklist to be completed with a journal submission, allowing reviewers to quickly identify methodological issues and ensure adequate reporting. The now-ubiquitous Quality of Reporting of Meta-analyses (QUOROM) and Consolidated Standards of Reporting Trials (CONSORT) guidelines for randomized controlled trials were established for quantitative researchers in 1997 and 2001, respectively, but it was not for another decade qualitative research guidelines were widely adopted.

Challenges Qualitative studies can be categorized into several traditions, including narrative research, phenomenology, grounded theory, ethnographic studies, and case studies (Creswell, 2012). With such a breadth of principles and methods within each type of inquiry, a “one-size-fits-all” reporting standard may be restrictive. What may be a notable characteristic in a strictly narrative study may be less relevant in an ethnographic study, for example. COREQ has been criticized for this reason, as it has an orientation toward grounded theory which may make research from other approaches appear inadequate. 

As one example, COREQ has an emphasis on coding and theme development with less concern for contextualization (Buus & Agdal, 2013). Other challenges arise when considering the broader epistemological controversies in qualitative research. Though the merit of these arguments could be debated at length in a future article, there still exists a divergence between researchers regarding the importance of validity, reliability, and generalizability in qualitative research (Cohen & Crabtree, 2008; Mays & Pope, 2000).

Conclusion Though multiple sets of recommendations exist for qualitative researchers, there is an even greater number of principles and practices sur- rounding qualitative research. Requiring all researchers to adhere to one standard is restrictive for such an expansive field. In health design research, COREQ and SRQR both provide a valuable checklist for researchers to ensure their decisions were communicated effectively and for evaluators to identify poorly supported decisions. 

Using guidelines when preparing an initial proposal will also assist researchers in designing high-impact qualitative studies. As health design continues to attract more researchers, a discipline-specific set of guidelines may eventually prove valuable to ensure consistency across methods and improve the translational quality of research as a whole.

Implications for Practice Reporting guidelines and checklists are useful tools not only during publication but also during study design and analysis. 

  1. Successful completion of a reporting checklist does not guarantee powerful or unbiased research, but it does help communicate the decision-making process. 
  2. With so much variance in qualitative methodology, one checklist cannot cover all areas of concern. 
  3. Care must still be taken by both researchers and reviewers to identify areas of weakness or poor communication.



Peditto, K. (2018). Reporting qualitative research: Standards, challenges, and implications for health design. HERD: Health Environments Research & Design Journal, 11(2), 16-19.

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