JAN Forum: your views and letters
Response to: Watson's Guest Editorial ‘Scientific methods are the only credible way forward for nursing research’, Journal of Advanced Nursing 43, 219–220.
Does Professor Watson really believe that ‘all forms of research involving subjectivity – such as phenomenology, grounded theory and ethnography – are not scientific’ (p. 217) and by implication that they have little to offer to nursing research? If so, we suggest he has a very limited and partial view of the purpose and potential of nursing research. His provocative editorial will no doubt stimulate debate concerning the definition of ‘scientific’ nursing research and as colleagues (and friends) of Prof. Watson, we know he will relish the ripples created! We initiate this process by exposing what we believe to be a number of fundamental flaws in Watson's argument, namely the definition of science, the subjective/objective binary and the old chestnut – the quantitative/qualitative debate.
Definition of science
Watson begins by asking what is the place of scientific methods in nursing research, and he makes the suggestion that ‘It is very hard to imagine that anyone could argue against them’ or (and this is the silly bit) ‘could argue exclusively for another approach to investigation in any field’. It took us about 2 minutes to construct a list of disciplines in which numerical forms of analysis have very little to contribute: poetry, history, theology, philosophy, ethics, literature and art.
The point is that there are many ways of knowing about the world. Quantification may be one way among others, but there is no reason in principle why it should always be valued above others. Science, as Watson says, may have got us to the moon, but that is only impressive if you think that spending billions of dollars to put two men on the moon is a smart thing to do. Other major ways of knowing about the world harness the power of language and words, and words are not interchangeable with the ‘better’ language of mathematics. It is interesting to note that Watson's editorial is written in the English language and not in mathematical code, despite his avowed preference for number. The reason Watson writes in English is simply that it is the best and most appropriate medium in which to construct and express certain kinds of complex argument.
Watson's argument for quantification is not even a very good explanation of what happens in science. Darwin's theory of evolution by natural selection is not the product of statistical analysis, but of years of observation and thinking accompanied by an intuitive process that took him beyond all current understanding and which cannot simply be reproduced.
Our final point on the nature of science concerns the role of replication. Watson implies that any analytical process that cannot be replicated must be arbitrary and is therefore of no value. We would argue, on the contrary, that the intellectual respectability of all scholarly inquiry rests on the ability of researchers to display the evidence upon which their conclusions rest, and this is as true of qualitative research as it is of quantitative approaches. The grounded theorist, for instance, should be able to explain how the data were gathered, what analytical processes were adopted and what, specifically, is the link between the data and the conclusions.
Watson regards research methods which acknowledge the role of ‘subjectivity’ (or as he puts it which ‘Glorify themselves in, subjectivity’ p. 217) as ‘unscientific’. He says that ‘subjectivity is what scientific methods expressly aim to avoid’ (p. 217). We argue however, that qualitative research, in openly acknowledging the place of subjectivity, is a rather more authentic position than the absolute denial of any element of subjectivity in quantitative research methods. Despite positivistic arguments to the contrary, we suggest that investigation of the world can never be devoid of the influence of the investigator (Koch & Harrington 1998).
There is of course a place for scientific quantitative methods in nursing research when, for instance, a research question is attempting to explain or predict relationships between variables. However, it is dangerous to assume that just because these methods are more able to reduce bias that they are utterly objective. Positivism assumes that there is a ‘pure vision’ (Mitchell 1986 in Jenks 1995, p. 4), one that sees ‘reality’ as empirical data (Petchesky 1987) removed or bracketed from its original context in order to render it objective and scientific. Positivistic attempts at ‘pure vision’, by ignoring historical, political and psychological contexts, ironically result in a ‘partial sight’ (Jenks 1995). However, it is impossible to bracket reality (or multiple realities) in this way as ‘there is no transcendent and naturally given reality’ (Jenks 1995). This is the deception of positivism –‘that flawed epistemology’ as Petchesky (1987) puts it – that it does not recognize the impaired vision it really is because it is itself legitimated (or blinded) by the ideology of ‘pure perception’ (Jenks 1995). So the pursuit of ‘pure vision’ turns out, paradoxically, to be a form of blindness (Mitchell 1986 in Jenks 1995).
If this is Watson's view, then he himself is blinded by the ‘partial sight’ of positivism.
Quantitative and qualitative research methods
So then, where does this leave the fundamental question about the status, purpose and potential of nursing research in general? We are of the view that to reopen the quantitative vs. qualitative debate is unhelpful (Closs & Cheater 1999). Rather, we advocate a valuing of the breadth of all different research methodologies – so that researchers are able to choose freely the right tools for the job, rather than be wedded to one type of research design. Different approaches to research can generate different but equally valuable forms of evidence and ‘different forms of evidence are required to answer different questions’ (King's Fund 2000, p. 192).
To illustrate this, we return to Watson's metaphor of the football match. He suggests ‘why not just measure the number of goals scored by each side and add them up? Give or take a few visually challenged referees and linesmen, it is a fairly reliable test of who won, and it is utterly valid once the referee has blown the final whistle. Making such a measurement tells us the result in an instant; it cuts through the spurious and subjective opinion (p. 218). However, whilst the score line gives us the ‘result’, does it give us a ‘view’ or an ‘account’ of the match? No. Does it tell us whether it was a ‘good’ game? No. Does it tells us about the quality of the decisions made by the referee and linesmen? No. Does it capture the feeling of the fans? No. Does it provide us with information about near misses? No. It is patently not true that the ‘truth’ of a football match can be reduced to its score. If that were the case then no-one would watch the match, as they would just be interested in knowing how many goals had been scored and they could read that in the newspapers. The ‘point’ of football might equally be membership of a crowd, the noise, getting into a fight, eating pies, watching your children play, buying the new strip, pride in your city, or wanting a haircut like Beckham's. The score line only ever can present a partial picture of the point of a football match, just like Watson's view of science can only ever present a partial view of the discipline of nursing.
So let's blow the final whistle on this debate! Rigorously conducted qualitative research is also ‘scientific’ and it has a valuable role to play, arguably an invaluable one, in contemporary nursing research.