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      Brokered dialogue: A new research method for controversial health and social issues

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      BMC Medical Research Methodology
      BioMed Central

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          Abstract

          Abstract
          Background

          Dialogue is a foundational feature of social life and an important way in which we come to understand one another. In situations of controversy dialogue is often absent because of a range of social barriers. We have developed a new film-based qualitative research method for studying controversial issues in healthcare and social policy. We call this method Brokered Dialogue. Theoretically informed by the traditions in narrative inquiry and visual anthropology, the method is premised on the idea that dialogue possesses features making it unique as a generator of new knowledge and opportunities for social intervention. Film is not only an extraordinarily rich data source, but an excellent medium for knowledge transfer and dissemination.

          Discussion

          The paper introduces the Brokered Dialogue method. We outline its critical steps, including the procedures for sampling, data collection and data analysis of both textual and visual data. Participants in a Brokered Dialogue engage in filmed interviews that capture their perspectives on a given topic; they then share their perspectives with, and pose questions of, one another through the medium of film. Using a participatory editing process, only footage that participants feel comfortable showing to others is incorporated. This technique offers participants a ‘safe’ space for respectful interaction. The editing process itself is analytic, and the final assembly of footage approximates a dialogue on the topic at hand. A link to a film produced from a project piloting the method is provided to demonstrate its real world application.

          Summary

          Brokered Dialogue is a method for promoting respectful interactions among those with seemingly divergent views on a controversial topic and for discovering critical points of divergence that may represent pathways for improvement. While the end product is a ‘film’, the goal is to have these films used as catalysts for ongoing respectful dialogue and problem-solving concerning the topic at hand informing relevant practice and policy change. In this paper, we consider Brokered Dialogue’s potential future uses and impacts, and how these might be evaluated.

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          Most cited references9

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          Judging the quality of qualitative inquiry: Criteriology and relativism in action

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            Reframing the evaluation of qualitative health research: reflections on a review of appraisal guidelines in the health sciences.

            In this article, we explore the form of evaluation put forward by guidelines used in the health sciences for appraising qualitative research and we begin to articulate an alternative posture. Most guidelines are derivative of the modes of assessment developed by clinical epidemiologists as part of the promotion of evidence-based medicine (EBM). They are predominantly proceduralist in orientation, equating quality with the proper execution of research techniques. We argue that this form of judgment assumes a fixed relationship between research practice and knowledge generated, and tends to over-simplify and standardize the complex and non-formulaic nature of qualitative inquiry. A concern with methods as objects of judgment in and of themselves restricts the reader's field of vision to the research process and diverts attention away from the analytic content of the research. We propose an alternative 'substantive' perspective that focuses on the analysis put forward, and regards methods as resources for engaging with and understanding the substantive findings and topic of inquiry. An important challenge is to find a way to embody such a form of judgment in practical assessment tools.
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              Misunderstandings in prescribing decisions in general practice: qualitative study.

              To identify and describe misunderstandings between patients and doctors associated with prescribing decisions in general practice. Qualitative study. 20 general practices in the West Midlands and south east England. 20 general practitioners and 35 consulting patients. Misunderstandings between patients and doctors that have potential or actual adverse consequences for taking medicine. 14 categories of misunderstanding were identified relating to patient information unknown to the doctor, doctor information unknown to the patient, conflicting information, disagreement about attribution of side effects, failure of communication about doctor's decision, and relationship factors. All the misunderstandings were associated with lack of patients' participation in the consultation in terms of the voicing of expectations and preferences or the voicing of responses to doctors' decisions and actions. They were all associated with potential or actual adverse outcomes such as non-adherence to treatment. Many were based on inaccurate guesses and assumptions. In particular doctors seemed unaware of the relevance of patients' ideas about medicines for successful prescribing. Patients' participation in the consultation and the adverse consequences of lack of participation are important. The authors are developing an educational intervention that builds on these findings.
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                Author and article information

                Journal
                BMC Med Res Methodol
                BMC Med Res Methodol
                BMC Medical Research Methodology
                BioMed Central
                1471-2288
                2012
                2 July 2012
                : 12
                : 92
                Affiliations
                [1 ]Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
                [2 ]Centre for Research on Inner City Health and Centre for Global Health Research, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
                [3 ]Department of Physical Therapy, University of Toronto, Toronto, Canada
                [4 ]Dalla Lana School of Public Health and Joint Centre for Bioethics, University of Toronto, Toronto, Canada
                Article
                1471-2288-12-92
                10.1186/1471-2288-12-92
                3426478
                22747922
                bd6247fc-39de-43be-a4f6-0d90321bcd44
                Copyright ©2012 Parsons and Lavery; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 September 2011
                : 2 July 2012
                Categories
                Correspondence

                Medicine
                Medicine

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