A medical education Q-sort: applications in medical education research

Q-Methodology: A Technique to Assess Perceptions in Simulation Research

SUMMARY STATEMENT

Learner perceptions of simulation can be challenging to assess and are usually limited to qualitative strategies. Q-methodology is an exploratory, systematic research technique that combines quantitative and qualitative procedures to measure differences in subjectivity. This article briefly reviews Q-methodology, provides an example of how it could be applied to assess the affective domain of simulation-based learning, and discusses implications for the use of Q-methodology in future simulation scholarship.

Assessment of patient and caregiver needs in fragile X-associated tremor/ataxia syndrome by utilizing Q-sort methodology

OBJECTIVES

Psychosocial stressors faced by patients with fragile X-associated tremor/ataxia syndrome (FXTAS) and their caregivers have not been systematically explored. FXTAS is a neurodegenerative disease occurring in approximately 45% of elderly male carriers and 8-16% of female carriers of the fragile X mental retardation one premutation. This study investigated the subjective needs of patients with FXTAS and their family caregivers, by utilizing Q-sort methodology.

METHOD

Patients with FXTAS and their caregivers seen during January 2005 to June 2007 participated. The Q-sort was composed of 17 (eight formal and nine informal) items, designed to explore emotional, informational, and instrumental needs of patients with FXTAS and their caregivers. Item scores were generated from 1 = least important to 7 = most important. Analysis included descriptive statistics for all the demographic and outcome variables. Generalized estimating equations were used to identify which of the need domains were perceived as most important by the participants.

RESULTS

A total of 24 patients (79% men, mean age 65.6 ± 6.4 years) with FXTAS and 18 caregivers (11% men, mean age 63.6 ± 6.2 years) completed the Q-sort. Both patients and caregivers rated informational needs as most important, followed by emotional and, finally, by instrumental needs. Participants lacked many important resources, in particular those addressing instrumental needs.

CONCLUSION

Providers should be educated and able to provide timely information and referrals to formal services, as well as to informal resources, including the National Fragile X Foundation online support network (www.fragilex.org).

Q-methodology: a systematic approach to assessing learners in palliative care education

Q-methodology is a qualitative research method that has increasingly been used to identify the complex attributes and behaviors that impact learning within medicine. Because learners bring a lifetime of experiences, values, and beliefs to a palliative care education, this method is ideal for identifying the typology of learner's present, thus making it possible to adapt the palliative care curriculum to meet the identified needs of each subgroup of learners. A step-by-step overview of the methodology using an example from pediatric graduate medical education illustrates the process. Potential uses of Q-methodology in palliative care are outlined including its application to the assessment of affective learning competencies, before and after a palliative care curriculum. The development of a universal palliative care education Q-sample, a collection of subjective opinion statements reflecting the spectrum of opinions on the topic, would advance the use of the Q-methodology in palliative medicine education.

Statistical methodology: VII. Q-methodology, a structural analytic approach to medical subjectivity

Q-methodology is a relatively unknown tool to medical researchers, that uses a mixed quantitative/qualitative statistical technique known as by-person factor analysis to study subjectivity. Q-methodology allows the grouping of individuals according to their subjective feelings about a topic, without requiring preconceived ideas regarding the structure of those subjective feelings. Q-methodology is demonstrated using a study in which attitudes of emergency medicine residents toward computer education are explored systematically and classified in terms of statistically distinct factor viewpoints. In this example, Q-methodology identifies 4 attitude groups, as related to computers and computer education: 1) interested, eager to learn; 2) frustrated and interested, but with reservations; 3) interested mainly in benefits, willing to expend minimal effort; and 4) knowledgeable, independent learner. Q-methodology can be used to determine the structure of attitudes on a subjective topic, often yielding new insights.