Overly ambitious critics and the Medici Effect: a reply to Kampen and Tamás

Using Q methodology in health sciences education to study subjectivity

Q methodology is a unique, yet underutilized methodology designed specifically to scientifically study subjectivity. Q, as it is most often referred to, is an appropriate methodology whenever a researcher is interested in uncovering and describing the multiple divergent viewpoints on any topic. Such discovery of viewpoints provides insight into the subjectivities related to policies, values, priorities, judgements, opinions, and decisions. The disciplines where Q has been used for research are many, and include health sciences, education, and other social science / behavioral science fields. Because of its rather idiosyncratic place in research, however, many Q methodologists are self-taught or seek education through a few select universities that offer graduate level Q courses. The key to successfully approaching a Q study is to embrace its unique approach to studying subjectivity such that it is a powerful tool in health science education and other fields. It is common to find inconsistencies related to Q terminology, analyses, and decision making across studies. There is often an over reliance on concepts that come from purely quantitative methodologies such as R factor analysis rather than embracing the qualitative-quantitative hybridity of Q. This article is written as a primer with a focus on understanding Q at a deeper level rather than a step-by-step guide.

Children's perspectives on being absorbed when reading fiction: A Q methodology study

Research in the intersections of literature, media, and psychology increasingly examines the absorbing story experiences of adult readers, typically relying on quantitative self-report questionnaires. Meanwhile, little work has been done to explore how being "lost in a book" is experienced by children, despite the phenomenon's importance for literacy education. Such work requires tools that are more inductive and child-centered than questionnaires. We have conducted a Q methodology study with participants aged 9-12 (n = 28), exploring how it feels for them when the mind and body are attuned to a story and how different facets of absorption (e.g., mental imagery, emotional engagement) inform the experience. Participants numerically sorted 24 cards expressing inner states and expectations relating to book-length fiction reading and were subsequently interviewed regarding their sorting choices. The cards were generated inductively based on preliminary research (focus groups, individual interviews, observations). By-person factor analysis of the sortings combined with reflective thematic analysis of the post-sorting interviews revealed four distinct reader subjectivities, or perspectives: Growth, Confirmation, Attachment and Mental Shift. Crucially, the children in these groups differed as to prominent dimensions of absorption but also as to the overall place of reading in their inner and everyday lives. Based on the four perspectives, we demonstrate that children have varied ways of being absorbed when reading fiction, and reflect on the affordances of Q methodology as a suitable child-centered approach to studying the subjective experiences of reading.

Identifying Player Types to Tailor Game-Based Learning Design to Learners: Cross-sectional Survey using Q Methodology

BACKGROUND

Game-based learning appears to be a promising instructional method because of its engaging properties and positive effects on motivation and learning. There are numerous options to design game-based learning; however, there is little data-informed knowledge to guide the choice of the most effective game-based learning design for a given educational context. The effectiveness of game-based learning appears to be dependent on the degree to which players like the game. Hence, individual differences in game preferences should be taken into account when selecting a specific game-based learning design.

OBJECTIVE

We aimed to identify patterns in students' perceptions of play and games-player types and their most important characteristics.

METHODS

We used Q methodology to identify patterns in opinions on game preferences. We recruited undergraduate medical and dental students to participate in our study and asked participants to sort and rank 49 statements on game preferences. These statements were derived from a prior focus group study and literature on game preferences. We used by-person factor analysis and varimax rotation to identify common viewpoints. Both factors and participants' comments were used to interpret and describe patterns in game preferences.

RESULTS

From participants' (n=102) responses, we identified 5 distinct patterns in game preferences: the social achiever, the explorer, the socializer, the competitor, and the troll. These patterns revolved around 2 salient themes: sociability and achievement. The 5 patterns differed regarding cheating, playing alone, story-telling, and the complexity of winning.

CONCLUSIONS

The patterns were clearly interpretable, distinct, and showed that medical and dental students ranged widely in how they perceive play. Such patterns may suggest that it is important to take students' game preferences into account when designing game-based learning and demonstrate that not every game-based learning-strategy fits all students. To the best of our knowledge, this study is the first to use a scientifically sound approach to identify player types. This can help future researchers and educators select effective game-based learning game elements purposefully and in a student-centered way.

Universities and the COVID-19 Pandemic: Comparing Views about How to Address the Financial Impact

Universities were forced to move instruction online and send residential students home due to the pandemic, resulting in financial shortfalls. Governing boards, administrators, and governments made decisions including eliminating faculty and staff, and programs yet these decisions were rarely inclusive of university stakeholders or innovative. This study's purpose is to examine and compare viewpoints of stakeholders in relation to addressing the financial impact of the pandemic in hopes of capturing innovative and effective pathways for universities. Because the purpose involved describing and comparing these viewpoints, the researcher selected a unique mixed method, Q methodology [Q] for this study. In Q, participants sort statements related to the topic into a grid such that their Q-sort provides a snapshot of their subjectivity. Participants' sorts are grouped empirically into factors, each representing unique viewpoints. Three distinct viewpoints emerged: 1) Focus on teaching mission and students, 2) University as a business, and 3) University as community. Views 1 and 3 were dominated by university faculty while View 2 was dominated by non-faculty including administrators and staff. Q's determination of distinguishing statements within each view provides the ability to compare these views' uniqueness. The three views and consensus among the views represent rejection of decisions to lay off faculty or close programs, among others, in order to balance university finances. The importance of tenured faculty in relationship to shared governance and academic freedom is especially stressed by two of the viewpoints. Implications for higher education policy, innovation, democratic problem-solving, and governance are discussed.

Young People’s Citizen Identities: A Q-Methodological Analysis of English Youth Perceptions of Citizenship in Britain

Since the late 1980s, successive United Kingdom (UK) governments have sought to develop initiatives designed to promote forms of “active citizenship” among young people. But despite the substantial amount of work done by social scientists on the topic of citizenship in recent decades, relatively little research work has been done in social psychology to analyse citizens’ actual understandings of citizenship, viewed in terms of membership of a political community. This article presents the findings of a Q-methodological study of how teenagers (n = 75) from different parts of England (M = 17.25 years; SD = 1.41) regard citizenship and construct their own identities as citizens. It sets out the three factors and four distinct stances on what it means to be a citizen that emerged in the research: The active citizen, the rooted citizen, the cosmopolitan citizen, and the secure citizen. Understanding the multiple ways in which young people construct citizenship is essential for effectively engaging with them. In this way, young citizens can be enabled to make an impact on, rather than simply being at the receiving end of, the development of citizenship policy in Britain.

Mapping discourses using Q methodology in Matang Mangrove Forest, Malaysia

The sustainable management of natural resources requires the consideration of multiple stakeholders' perspectives and knowledge claims, in order to inform complex and possibly contentious decision-making dilemmas. Hence, a better understanding of why people in particular contexts do manage natural resources in a particular way is needed. Focusing on mangroves, highly productive tropical intertidal forests, this study's first aim is to map the diversity of subjective viewpoints among a range of stakeholders on the management of Matang Mangrove Forest in peninsular Malaysia. Secondly, this study aims to feed the reflection on the possible consequences of the diversity of perspectives for the future management of mangroves in Malaysia and beyond. The use of the semi-quantitative Q methodology allowed us to identify three main discourses on mangrove management: i. the optimization discourse, stressing the need to improve the current overall satisfactory management regime; ii. the 'change for the better' discourse, which focuses on increasingly participatory management and on ecotourism; and iii. the conservative 'business as usual' discourse. The existence of common points of connection between the discourses and their respective supporters provides opportunities for modifications of mangrove management regimes. Acknowledging this diversity of viewpoints, reflecting how different stakeholders see and talk about mangrove management, highlights the need to develop pro-active and resilient natural resource management approaches.

Exploring student preferences with a Q-sort: the development of an individualized renal physiology curriculum

Medical education reform is underway, but the optimal course for change has yet to be seen. While planning for the redesign of a renal physiology course at the Duke School of Medicine, the authors used a Q-sort survey to assess students' attitudes and learning preferences to inform curricular change. The authors invited first-year medical students at the Duke School of Medicine to take a Q-sort survey on the first day of renal physiology. Students prioritized statements related to their understanding of renal physiology, learning preferences, preferred course characteristics, perceived clinical relevance of renal physiology, and interest in nephrology as a career. By-person factor analysis was performed using the centroid method. Three dominant factors were strongly defined by learning preferences: "readers" prefer using notes, a textbook, and avoid lectures; "social-auditory learners" prefer attending lectures, interactivity, and working with peers; and "visual learners" prefer studying images, diagrams, and viewing materials online. A smaller, fourth factor represented a small group of students with a strong predisposition against renal physiology and nephrology. In conclusion, the Q-sort survey identified and then described in detail the dominant viewpoints of our students. Learning style preferences better classified first-year students rather than any of the other domains. A more individualized curriculum would simultaneously cater to the different types of learners in the classroom.

Found in transition: applying milestones to three unique discharge curricula

Introduction. A safe and effective transition from hospital to post-acute care is a complex and important physician competency. Milestones and Entrustable Professional Activities (EPA) form the new educational rubric in Graduate Medical Education Training. “A safe and effective discharge from the hospital” is an EPA ripe for educational innovation.

Methods. The authors collaborated in a qualitative process called mapping to define 22 of 142 Internal Medicine (IM) curricular milestones related to the transition of care. Fifty-five participant units at an Association for Program Directors in Internal Medicine (APDIM) workshop prioritized the milestones, using a validated ranking process called Q-sort. We analyzed the Q-sort results, which rank the milestones in order of priority. We then applied this ranking to three innovative models of training IM residents in the transitions of care: Simulation (S), Discharge Clinic Feedback (DCF) and TRACER (T).

Results. We collected 55 Q-sort rankings from particpants at the APDIM workshop. We then identified which milestones are a focus of the three innovative models of training in the transition of care: Simulation = 5 of 22 milestones, Discharge Clinic Feedback = 9 of 22 milestones, and TRACER = 7 of 22 milestones. Milestones identified in each innovation related to one of the top 8 prioritized milestones 75% of the time; thus, more frequently than the milestones with lower priority. Two milestones are shared by all three curricula: Utilize patient-centered education and Ensure succinct written communication. Two other milestones are shared by two curricula: Manage and coordinate care transitions across multiple delivery systems and Customize care in the context of the patient’s preferences. If you combine the three innovations, all of the top 8 milestones are included.

Discussion. The milestones give us a context to share individual innovations and to compare and contrast using a standardized frame. We demonstrate that the three unique discharge curricula in aggregate capture all of the highest prioritized milestones for this discharge EPA.