Down to Earth
Educational Research Questions
and Study Design
Catherine Horn, Ph.D., Blanca Plazas Snyder, Ed.D.
John H. Coverdale, M.D., M.Ed., F.R.A.N.Z.C.P., Alan K. Louie, M.D.
Laura Weiss Roberts, M.D., M.A.
E
ducational research is the systematic inquiry into a
research question of interest. What generally differentiates such research from other types of rigorous inquiry
is, most typically, the problem on which the work is centered. Although the field is broad, leaving much room for
rigorous analysis of a wide variety of questions under one
umbrella, ultimately all such studies carry with them an
assumption of benefiting education. In the case of medical
education, educational research has the potential to ultimately benefit patients.
One of the first steps in educational research design is to
determine the adequacy of the design for answering the
research question. This column reviews several of the
main quantitative and qualitative educational research designs and their utility. It follows from an earlier editorial
(1) that emphasized the responsibility of authors to provide a relatively comprehensive description of the study
design to enable critical appraisal and assessment of the
validity of the findings. One of our goals is to educate the
reader and prospective researcher about the range of educational research designs, their applicability, and strengths
and weaknesses.
In understanding the value of each of the methodological approaches discussed in this column, the prospective
Received August 18, 2008; accepted August 21, 2008. Dr. Horn is
affiliated with the College of Education at the University of Houston; Dr.
Plazas is affiliated with the University of Houston; Dr. Coverdale is
affiliated with the Department of Psychiatry and Behavioral Sciences at
Baylor College of Medicine in Houston; Dr. Louie is affiliated with
Psychiatry Residency Training at San Mateo County Mental Health
Services and with the Department of Psychiatry at UCSF; Dr. Roberts is
affiliated with the Department of Psychiatry and Behavioral Medicine at
the Medical College of Wisconsin in Milwaukee. Address correspondence to Catherine Horn, College of Education, Department of Educational Psychology, University of Houston, 4800 Calhoun Rd., Farish Hall
437, Houston, TX 77204 –5038; clhorn2@uh.edu (e-mail).
Copyright © 2009 Academic Psychiatry
researcher must first recognize the importance of choosing
a design that best matches the question of interest. Although various approaches to design have cycled in and
out of vogue in the academic community, fundamentally
sound empirical pursuit matches the optimal methodology
with the research question, goals, or hypotheses. The design helps the investigator focus on the research question(s) and plan a disciplined approach to the collection,
analysis, and interpretation of the related data (2). Design
issues are fundamental to reducing the possibility of bias,
decided in advance, and not readily rectified once the
study is begun.
Study design and conduct are important considerations
in reviewers’ and editors’ deliberations concerning the
worthiness of publication of a manuscript. For example,
Bordage (3) found that timeliness of the problem studied,
excellence of writing, and soundness of study design were
important strengths noted in accepted manuscripts. Alternatively, some of the reasons for rejecting medical educational research included insufficient problem statements,
choice of the sample and sampling limitations, and inadequacy of research design (3).
This column begins, then, with a discussion of key steps
in designing a study and follows with a description of
several of the most prominent methodological approaches,
both quantitative and qualitative, to analyzing and reaching conclusions from collected data. However, it is not our
intention to provide a comprehensive discussion of all
possible research designs or to describe appropriate statistical methodologies for each design option. Instead, we
will address research questions and sampling methods, as
well as experimental, quasi-experimental, meta-analysis,
nonexperimental, and qualitative research methods in education. Some examples are provided from Academic Psychiatry of published studies and designs. When applicable,
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we will use Campbell and Stanley’s (4) model for depicting the different forms of educational research designs.
Before turning to this discussion, the reader should note
that although this column presents quantitative and qualitative methods separately, the two may be used together.
A mixed-methods approach allows for the intersection of
quantitative and qualitative paradigms such that one can
foster or extend the work of the other toward answering a
question. Indeed, each approach is useful in its own right
and is often most productive when complementary (5).
Research Questions
To construct a well-designed and executed study, the
researcher must first establish clear, well-focused research
questions, goals, or hypotheses (6). Such efforts are important for several reasons. Primarily, the research question guides the choice of methodological approach(es) and
serves to clearly delineate the parameters of the study (7).
Additionally, a well-crafted research question allows the
study to be embedded in the context of a broader field of
complementary research. In turn, this enables a discussion
of how the proposed design replicates or alternatively
intends to improve on earlier methodologies and designs.
Finally, such efforts help ensure that appropriate variables
of interest are both identified and operationalized in such
a way that data collection yields useful information for
analysis.
However, it should be appreciated that limitations in
funding opportunities for educational research (8) may
prohibit optimization of design. The goal then becomes
finding the right balance between what is optimal and what
is achievable given financial and practical limitations and
given the research question. No study is perfect, after all;
accordingly, reviewers and readers should protect against
a particular form of bias that unduly focuses on perceived
weaknesses as opposed to strengths (9).
Sampling
In defining the parameters of the study, the researcher
must clearly define the population of interest. Establishing
these boundaries allows the researcher (and consumers of
research) to delineate both what is included and excluded
from the study at hand. Once that population has been
defined, an appropriate sampling procedure is identified
and applied to select a determined number of participants.
Several important characteristics drive sampling in educational (in fact, in all) research. Sampling provides the
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advantages of saving time and money, particularly in the
context of large populations of interest.
Both quantitative and qualitative educational research
use sampling procedures. For most quantitative work, researchers seek a representative sample— one that does not
vary in any important way from the full population. The
most efficient way to achieve such a sample is through a
simple random sample. Simple random sampling capitalizes on known probability theory to establish a relatively
smaller group that accurately represents a larger population of interest. If the approach adheres to the principle of
equal opportunity for selection, this sampling technique
allows generalizations to be made within a small margin of
error. More complicated sampling strategies (e.g., cluster
sampling, stratified random sampling) have built on the
foundation of simple random sampling to provide representativeness when circumstances do not allow for easy
selection simply at random. When convenience samples
are used, participants are included simply because they are
easily accessible; attending to the match between the subjects and the target population facilitates understanding of
the generalizability of the results (10).
A power analysis allows a determination of the needed
size of a sample to generalize findings with statistical
confidence to the population of interest. This undertaking
uses known or estimated characteristics of the extent to
which the outcome of interest manifests in the population.
This is typically represented through an effect size. A
researcher may use effect size to determine the magnitude
or strength of a relationship between two groups. However, it is important to note that effect size is independent
of sample size (11). Additionally, considerations of a willingness to reject a true null hypothesis (referred to as a
type I error) and, alternatively, retain a false null (type II
error) are made. Ultimately, sample size becomes a balance between need for statistical sensitivity with more
practical considerations.
Where power analysis attends to statistical significance,
it is important to differentiate such efforts with an understanding of substantive significance. Two examples serve
to make this point. As indicated in the paragraph above,
statistical significance is influenced by the number of participants included in the study. In other words, if the
researcher increases the sample size, he or she will have a
greater probability of finding statistical significance. As a
result, increasing sample size alone may result in findings
achieving statistical significance. Conversely, the most
common reason for the lack of statistical significance is a
lack of power to identify differences. When interpreting
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HORN ET AL.
statistical significance, the researcher needs to consider the
substantive implications of the findings. Where very small
differences may be statistically significant with large samples, the relevance or importance of those findings to
educational settings can be tenuous. Having a clear understanding of the artificial contribution of a sample is therefore important in attributing meaning to findings.
For qualitative educational research, sampling is purposive (12) in that it aims to cover a range of potentially
relevant social phenomena and perspectives from an appropriate array of data sources. Although convenience
sampling is the simplest and is least subject to complexity
of interpretation, reasons for describing and justifying the
participant selection strategies should be provided (13).
Qualitative research is especially valuable when the intent
of the study is to delve deeply into a particular group to
garner perspective from either its unique or typical characteristics relative to a broader population. An important
limitation of such an approach, however, is the lack of
generalizability of findings.
Quantitative Methods
Experimental Design
Randomized Control Trials. Heralded as the gold
standard of experimental research, randomized controlled
trials function as the primary mechanisms for drawing
causal conclusions with key features including randomization and control. Randomization comes in the form of
random placement into a treatment or control group so that
each participant has an equal and independent chance to be
placed in either group. When randomization is conducted
to acceptable standards (13), the experiment maximizes
the opportunity to attribute changes to the treatment because, by chance, the two (or more groups) are likely
equivalent in every other respect. Direct manipulation of a
single treatment variable allows the researcher to evaluate
the effects of that treatment on the participants when compared with the control group.
The determination of validity of randomized controlled
trials is described in terms of a range of considerations.
These include whether the assignment of subjects to treatments was appropriately randomized, whether groups
were similar at the start of treatment, and whether all the
subjects who entered the trial were properly accounted for
at its conclusion. In addition, the assessment of validity
includes whether groups were treated equally (aside from
the intervention) and whether the outcomes were meaAcademic Psychiatry, 33:3, May-June 2009
FIGURE 1. Pretest-Posttest Randomized Control
Group Design
R
O
X
O
R
O
X
O
sured without bias. Outcomes should be clearly defined
and replicable; the measurement of outcomes should be
similar between groups, and follow-up should be sufficiently long.
Several types of experimental designs are used in educational research. The pretest-posttest randomized control
group and the Solomon four group research design are the
most rigorous. The classic pretest-posttest randomized
control group design formulates the experiment as represented in Figure 1.
In Figure 1, R denotes randomization, and O represents
observational measures for both the control and treatment
groups. In educational research, observational measures
often come in the form of assessments such as standardized tests. The X in the first series represents the treatment
(educational intervention); its absence in the second represents the absence of treatment and designates the control
group. One example of a pretest-posttest randomized control group design was an exploration of the effects of
attitudes to and knowledge of ECT when learning by live
observation compared with learning by an instructional
videotape (14).
The Solomon four group research design is a variation
on this original design and tries to moderate Hawthorne
effects—that is, when improvement occurs as an artifact of
participation rather than actual changes. As represented in
Figure 2, the Solomon design includes four groups, two of
which receive treatment and two of which do not. By
combining varying observations with the presence or absence of treatment, the Solomon design “deservedly has
higher prestige and represents the first explicit consideration of” (4) factors that may threaten validity.
Sometimes pretesting is not feasible. The posttest-only
control group design is exactly the same as the pretestposttest design except that the observations are completed
FIGURE 2. Solomon Four Group Research Design
R
O
R
R
O
R
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X
O
X
O
O
O
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RESEARCH QUESTIONS AND STUDY DESIGN
only after the educational intervention (4). Another potential advantage of a posttest-only design is that the absence
of pretesting enhances the generalizability of study results,
because with the pretest-posttest design, results may only
be generalizable when participants are primed by pretesting (15, 16).
Randomized controlled trials in educational research are
not easy to perform and have limitations. For one, there
are sometimes ethical concerns about selecting students
for a treatment when denying others that same opportunity. Second, blinding of participants and educators can be
challenging. For example, educational researchers have
historically struggled to evaluate problem-based learning
because a myriad of factors, including educational facilities and teacher and student characteristics, are not within
the control of the researcher (17). Third, educational settings that might be logically suited for experimental design, such as individual residency training programs, often
do not contain sufficient numbers to power a randomized
study. Although experimental designs have much to offer
in attributing causality to interventions of interest, they
have not historically been utilized as the most appropriate
or efficacious for educational research. In fact, because of
the natural threats created by educational settings, educational research has advanced other research methodologies
in an effort to limit those threats while not substantially
comprising rigor.
Quasi-experimental Design. Quasi-experimental design is different from experimental design in that participants are not randomized to treatments or conditions although they are assigned to an intervention and
comparison group (Figure 3). Quasi-experimental design
is a natural extension of the classic experimental design
approach that attends to limitations in educational settings.
The distinct disadvantage of quasi-experimental designs is
that randomization is not explicitly attended to, and thus
the potential for significant differences between groups
and for confounding (when factors other than the experimental intervention affect outcomes) is increased.
One example of a quasi-experimental design is the nonrandomized, pretest-posttest control group research design. Here, the independent variable is manipulated, although participants are not randomly selected and
FIGURE 3. Quasi-Experimental Design
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O
O
X
O
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FIGURE 4. Nonexperimental Design
Oa = Ob
assigned to the experimental and control groups. A pretest
is administered, the intervention is administered to the
experimental group, and no intervention or an alternative
intervention is administered to the control group, followed
by posttesting. Relevant baseline differences should be
recorded, therefore, to allow for a determination of the
degree to which confounding might occur. One example of
a nonrandomized control group design is the effect of
personality characteristics of medical students on clinical
judgment and whether brief cognitive behavior interventions can modify this process (18).
Nonexperimental Designs. Correlational studies,
also known by educational researchers as associational
studies, seek to identify the extent to which relationships
may exist between variables. This can occur by assessing
the relationship between variables at one point in time or
by assessing how scores on one variable predict another
(19, 20). As opposed to experimental and quasi-experimental studies, variables are not manipulated in correlational research, and random assignment is not possible.
This means that the variables must be observed as they
occur naturalistically (21). Ultimately, the goal is to determine whether a relationship among variables exists or
can be predicted and what the strength of that relationship
is. It is important to note that causal inferences cannot be
made from the findings. When interpreting correlational
data, a researcher will look to the scores to determine the
relationship.
As depicted in Figure 4, the relationship is multidirectional and can be positive or negative. One example concerned the assessment of attitudes toward psychiatry by
Kenyan medical students (22).
Other forms of nonexperimental designs that include a
comparison group are cohort and case-control studies. Cohort studies proceed in a logical fashion from exposure to
outcome, whereas case-control studies work backward
(23). Cohort studies start with an exposure of interest and
follow this group and another without the exposure to
determine which groups develop a higher risk of a particular outcome (23). Alternatively, case control studies start
with the outcome and look backward to discover particular
exposures that might be associated with the outcome (23).
Case-control studies are most useful when the outcome of
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interest is unusual or rare. As an example of a casecontrol, current methods of evaluating residency applicants were assessed as to whether they enabled later prediction of impairment. Impaired physicians who had been
previously evaluated as a resident were compared with a
matched nonimpaired control group when records of their
earlier residency applications were available (24).
Survey research provides another form of nonexperimental research (25). Information can be collected from a
group at one time, which is called a cross-sectional survey
(19). For example, one study examined associations of
personality and other characteristics with clinical evaluations of third-year medical students in a psychiatry clerkship (26). Another option is for a researcher to obtain data
over a period of time, which is called a longitudinal survey. Types of longitudinal studies include the trend and
panel study (20). During a trend study, a survey is given to
different samples of a particular population at different
times. Within that specific population group, membership
may change, such as when a researcher is interested in
studying patient satisfaction with physician bedside manner over a 2-year period. Despite the fact that the specific
patients will change throughout the course of the study, the
population being studied (i.e., patients) remains the same.
The goal of a panel study is to survey a sample of the same
individuals over different points in time (19).
Researchers must be aware that if nonexperimental designs are chosen, the findings are only applicable to the
specific group or groups from which the data were extracted. Nonexperimental designs can attempt to infer causality among variables or to predict outcomes, but are
limited in their ability to do so compared with experimental designs.
mined the degree to which medical humanities have been
integrated into various medical fields by analyzing articles
in selected psychiatry and internal medicine journals from
1950 to 2000 (28).
Action Research
Derived from multiple traditions (e.g., psychology, anthropology, sociology), action research has become a practical approach to encourage the use of research in creating
positive social changes (27). Requiring high levels of
rigor, action research is highly reflective and interpretive,
focuses on the experience, and empowers and emancipates
both the participants and the researcher to improve social
conditions. Action research is best applied to situations in
which a problem needs to be solved or gathering the data
will inform practice (19, 27). Ultimately, the use of action
research is intended to address an immediate issue, assumes that those involved in the particular situation are
able to identify and respond appropriately to problems that
arise, and requires that the information gathered only be
applied to that specific situation (19).
Historical Research
Historical studies are similar to biographies in that a
biography requires historical context. A key difference is
that when conducting a historiography, the researcher
looks to records, accounts, and archives to study an event
or series of events that have already occurred (27). Despite
the fact that historical research as a method has existed for
a long time, only over the last 10 years or so has it become
appreciated as a serious qualitative method (27). Researchers have realized that examining a historical event or set of
events is advantageous in that they can examine the meaning of symbols used in the past and understand past behaviors and thoughts (27). For example, one study deter-
Case Study
Here, instead of looking at subjects or participants, the
researcher is focused on a case. An individual, a residency
program, or a medical school can all be a considered a
case. Conducting a case study is most appropriate “when
‘how’ or ‘why’ questions are being posed, when the investigator has little control over events, and when the
focus is on a contemporary phenomenon within some reallife context” (29). When conducting a case study, having
control over behavioral events is not required or necessarily desired (29). There are three different types of case
studies: intrinsic, instrumental, and multiple/collective
(19). Often applied for explanatory research purposes, an
intrinsic case study examines one specific person or situation to understand every aspect of the case, both internally and externally (19), for instance, when studying one
medical student’s journey. The focus of an instrumental
case study is much broader than the intrinsic study in that
the goal is more global. A researcher is interested in examining a specific case only insofar as the data can be
applied to a larger goal. Finally, a multiple or collective
case study involves looking at more than one case at the
same time. One example of a case study concerned the
evaluation of a mentoring model for junior faculty (30).
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Qualitative Methods
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Participant Observation
Most appropriately applied in theoretical, descriptive,
and exploratory studies, participant observation is an excellent method “for studying processes, relationships
among people and events, the organization of people and
events, continuities over time, and patterns, as well as the
immediate sociocultural contexts in which human existence unfolds” (31). At the root of this method is the
insider’s or participant’s perspective on his or her everyday life or world and the reality in which he or she lives.
A researcher takes an unobtrusive role and attempts to
avoid disrupting or intruding on the individual’s world
(31). The role of a participant observer can range from
overt, where the individual or group is aware of the researcher’s presence, or covert, in which the group or individual is not aware that the “new” person is the researcher (31). A fundamental aspect of this method is
forming and maintaining the relationships between the
researcher and the insiders to build trust, especially when
participating overtly. Gaining trust is key to ensuring that
the insiders do not alter their actions because of the researcher’s presence. Given the time required to gain this
trust, participant observation can be extremely time consuming and exhausting (31). This method is similar to
ethnography, which allows a researcher to examine and
observe individuals in their natural environment to attempt
to uncover what “truly” goes on in a particular situation
(19).
Grounded Theory
One of the most commonly used methods in qualitative
research is that of grounded theory. The term theory is
misleading in that this method is not based on an already
existing theory (20). To the contrary, grounded theory is
an inductive approach that analyzes and considers data as
a way to form theory to explain the observed findings (20).
In other words, the researcher does not begin the study
with a theoretical perspective or framework in mind;
rather, he or she lets the theory grow out of/be grounded in
the data collected. When grounded theory is applied, researchers use a constant comparative method in which
there is continuous interaction among the data, the researcher, and the developing theory (19). As new data are
collected, the researcher compares them with older data to
analyze any possible similarities or differences between
the older and newer data (20). Using this inductive method
is very beneficial when a researcher is interested in letting
the data dictate the theory. One example is when research266
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ers interviewed psychiatric residents to uncover key
themes in daily experiences with educators (32).
Systematic Reviews (Meta-Analysis)
In cases where much work has been done to explore the
same or similar questions of interest, researchers may
employ a systematic approach to empirically synthesizing
that work. A systematic review provides advantage over a
single study for two important reasons. First, when combining studies, the resultant statistical power is greater
than any single study. Second, understanding an intervention or phenomenon across multiple studies allows for a
better opportunity to identify and understand the influence
of moderating variables (33–36). Although there are many
empirical approaches to systematic reviews, a meta-analysis typically utilizes effect size as a statistical standardization to understand the relationship between outcomes
and predictor variables of interest (34).
Conclusion
Current and prospective researchers must fundamentally grapple with the link between the research question
and design. To do this well, researchers will need a downto-earth appreciation of the fundamentals of key design
approaches and issues. On one hand, because research is
time consuming, it is paramount that researchers have also
carefully considered the design in advance so as to protect
against insurmountable errors. On the other hand, no study
can be perfect; the goal is to minimize defects but not to
eliminate them entirely. Educational research design is
critical to rigorous, meaningful scholarship and should be
assiduously attended to by all researchers.
At the time of submission, Drs. Horn and Plazas Snyder disclosed no competing interests. Disclosures of Academic Psychiatry editors are published in each January issue.
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