Metaphor theory in qualitative
inquiry: A research journey
Charlotte E. Rees
Office of Postgraduate Medical
Education, Sydney Medical School
Presentation aims to:
• Demonstrate how a cognitive linguistics
theory of metaphor informed the
construction of post-hoc research questions
• How the theory informed the analysis of
focus group data
• Discuss the strengths and challenges of
employing theory-based analysis
The research journey
• Patient involvement in medical education study (06/04-11/05)
• A priori RQ: What are the views and experiences of multiple
stakeholders about patient involvement in medical education?
• Conducted 8 focus group discussions with medical students,
medical educators (incl. doctors) and patients
• Conducted framework analysis to consider what participants
said and how they said it (1)
• Important process-related theme identified was participants’
metaphoric talk… so what?
• Enter theory
Cognitive linguistics theory of metaphor (2)
• Metaphors are ubiquitous in everyday
talk (2)
• They structure our thinking and
behavior (2)
• Understanding people’s metaphoric
talk can reveal how they
conceptualize themselves, their
relationships with others and
educational processes
Conceptual metaphors
• Metaphor involves understanding
an abstract domain (target) in terms
of another, more concrete domain
(source) e.g. ARGUMENT AS WAR
(2)
• “Your claims are indefensible. He
attacked every weak point in my
argument… He shot down all my
arguments (2, p. 4)
How did the theory help?
• Theory helped us construct an original
research question: What conceptual
metaphors underpin stakeholders’ talk about
student/doctor-patient relationships?
• Theory helped us determine how we should
re-interogate our data: Systematic metaphor
analysis (3)
Systematic metaphor analysis (3)
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Determine target area for metaphor analysis
(student, doctor, patient, S-P relationship, D-P
relationship)
Unsystematic collection of background
metaphors (e.g. paternalism, consumerism
etc.)
Identify and code all MLEs pertaining to target
domain e.g. consumers, real gems
Identify metaphorical concepts associated with
each MLE e.g. PATIENT AS CONSUMER (n=70)
Group majority of conceptual metaphors into
six higher-order metaphors relating to
relationships
STUDENT/DOCTOR-PATIENT RELATIONSHIP AS:
• WAR “she is terrified she will be struck off his
list”
• HIERARCHY “As you were saying about
doctors being up there and we being down
here”
• DOCTOR-CENTREDNESS “We keep it as a
closed shop”
• MARKET “Well, we’re the customer, aren’t
we?”
• MACHINE “They become like robots”
• THEATRE “You can actually see the different
performances” (4)
A long and difficult journey
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•
•
•
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We were novices, trying to understand new theory
and we misinterpreted some of the theory and
analysis
Social Science & Medicine sent our paper to a number
of reviewers including Schmitt
Feedback was positive but Schmitt recommended that
we re-analyse our data
We eventually re-analysed our data, emailing Schmitt
regularly for his feedback
Our resubmission was eventually accepted (4)
We have subsequently liaised with Schmitt on another
project (5)
What we learnt: to contact scholars for
advice/feedback if using their theory or methods…
they can be the perfect travel guide and prevent you
from getting lost
Strengths
• Theory helped us construct an original research
question
• It lead to us employing a rigorous method of analysis,
novel to medical education research
• It helped us yield results that extended beyond the
context of the medical school where we collected
data
• Now we have learnt this theory-based analysis, we
have employed it for a subsequent study efficiently
(5)
Challenges
• By employing one theory you
invariably preclude another theory
• By making theory explicit, restrictions
can be placed on where you
disseminate your research
• How can we bridge the theory-practice
gap?
• How can we go beyond using theory;
instead creating theoretical and
methodological innovation?
Acknowledgements
• The study team included a mixture of
theoretical and practically-orientated
researchers e.g. Lynn Monrouxe, Clare
Wilkinson etc.
• This patient involvement study was funded
by the British Academy (LRG-37523)
References
1.
2.
3.
4.
5.
Ritchie J, Spencer L. Qualitative data analysis for applied policy
research. In: A Bryman, RG Burgess (Eds.) Analyzing Qualitative Data.
New York: Routledge; 1994.
Lakoff G, Johnson M. Metaphors We Live By. London: The University
of Chicago Press; 1980.
Schmitt R. Systematic metaphor analysis as a method of qualitative
research. The Qualitative Report 2005;10:358-94.
Rees CE, Knight LV & Wilkinson CE. “Doctors being up there and we
being down here”: a metaphorical analysis of talk about
student/doctor-patient relationships. Social Science & Medicine
2007;65:725-737.
Rees CE, Knight LV, Cleland JA. Medical educators’ metaphoric talk
about their assessment relationship with students: “You don’t want to
sort of be the one who sticks the knife in them”. Assessment &
Evaluation in Higher Education 2008, doi:
10.1080/02602930802071098.