Clinical Colleague and Clinical Academic: A Physician’s Autoethnographical Reflexive Account of Opportunities and Challenges as an ‘Insider’ Researcher

Abstract

‘Insider’ positionality, where the researcher shares a context with those researched, has been considered in many settings but infrequently by physicians. In this reflexive autoethnographic account, a physician undertaking qualitative methods research exploring shared decision-making in the acute hospital setting describes and critically appraises her experience of studying physician colleagues. She considers each step of the research in turn with reference to her insider positionality which she came to realise was neither absolute nor fixed. Professional experience informed a clinically relevant line of inquiry while the sometimes uncomfortable transition between physician and researcher prompted reflection which added depth to the research question. Being an insider was beneficial in accessing potential participants, but the extent to which the ‘ethnographic toolkit’ of the physician-colleague social position defined recruitment success is discussed. Data collection during semi-structured interviews benefitted from a shared clinical language although this needed to be balanced with avoiding assumptions of shared meaning. There was heightened researcher consciousness of peer scrutiny on questioning the status quo and of workplace hierarchy when interviewing senior colleague ‘elites’. A sense of responsibility to colleagues and tendency to draw on personal clinical experience to make sense of an elusive thematic analysis became apparent during the analysis. The research experience ultimately led to increased confidence with inhabiting a role neither truly insider nor outsider. This critical account contributes to methodological understanding of reflexivity by physician qualitative researchers and seeks to benefit others embarking on a similar journey.