Qualitative Research on Emergency Medicine Physicians: A Literature Review

Aim: This study aims to review the qualitative research studying Emergency Medicine (EM) physicians in Emergency Departments (ED). Background: Qualitative research aims to study complex social phenomena by other means than quantification often through verbal or observational investigation. EM is a highly complex medical and social environment that has been investigated through qualitative methodologies. A literature review is needed to show what qualitative studies illuminate about EM and why this work is important to develop EM as a complex organizational and communicative practice. Methods: Electronic databases of English peer-reviewed articles were searched from 1971 to 2012 using Medline through PubMed and PsychINFO. This search was supplemented with hand-searches of Academic Emergency Medicine and Emergency Medicine Journal from 1999 to 2012 and cross references were reviewed. The key words used were emergency medicine, qualitative, ethnography, observation, interview, video, anthropology, simulation, and simulation-based. Results: 820 papers were identified and 46 studies were included in this review. This literature review found that the reviewed qualitative studies on EM physicians were designed using the following strategies of inquiry: Ethnography, mixed methods, action research, grounded theory, phenomenology, content analysis, discourse analysis, and critical incident analysis. The reviewed studies were categorized into four main themes: Education and training, communication, professional roles, and organizational factors, and into 12 sub-themes. Conclusion: The strength of qualitative research is its ability to grasp and operationalize complex relations within EM. Although qualitative research methodologies have gained in rigor in recent years and few researchers would question their value in studying complex medical and social phenomena, rigorous design in qualitative studies is needed. Qualitative research studies that stick with one strategy of inquiry that they follow closely are likely to yield more valid studies.