Using Q-Methodology for Research and Evaluation in Nursing Education

Sunday, 22 July 2018: 4:05 PM

Desiree Hensel, PhD, RN, PCNS-BC, CNE
School of Nursing, Curry College, Milton, MA, USA

Purpose: Q methodology provides a theoretical framework and set of procedures to objectively find groups of individuals with shared viewpoints within a given population. This flexible, mixed-method research design can be used to understand students’ perspectives of their educational experience and systematically evaluate affective domain learning in a way that does not rely on interviews or objective tests. The purpose of this presentation is to describe the theoretical basis for Q methodology and to illustrate how it can be used for student-centered nursing education research and holistic program evaluation.

Methods: After identifying a research question, the next and most time consuming step of a Q study is to gather stimuli that represent a group’s range of opinions, attitudes, or beliefs known as the concourse. The concourse most often contains statements that might be heard in conversation or appear in various media; however, using pictures, objects, and sounds is also possible. A subset of the concourse is presented to participants for sorting. Participants make their preferences known by sorting items in order from high to low levels of significance. Data gathered through the sorting process are subjected to by-person factor analysis. Factors then represent naturalist groupings of participants with shared viewpoints. The computerized analysis reveals an idealized composite Q sort with charactering statements for the factor. Normalized Z scores help determine what statements represent consensus among the groups or distinguishing them from one another. Researchers construct a narrative using the Q sort analysis, demographic or contextual data, any follow-interviews to help further interpret the factor.

Results: Examples of how Q methodology has been used in nursing education include exploring how students integrated the Quality and Safety Education for Nurses competencies into their professional identities, understanding what attitudes nursing students held about clients living in poverty, and evaluating how a curricular change impacted student preferences for working in diverse health care environments. Most recently Q methodology has been used to evaluate changes in attitudes about research among students enrolled in nursing honors programs.

Conclusion: Q methodology provides a rich and robust way to assess nursing students’ baseline subjective perspectives and evaluate affective learning domain outcomes from educational activities. Such information can be used to inform evidence-based teaching and learning.