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METHODOLOGY

We go farther together: practical steps towards conducting a collaborative autoethnographic study

Ratnapalan, Savithiri MBBS, PhD1; Haldane, Victoria MPH2

Author Information
JBI Evidence Implementation: June 2022 - Volume 20 - Issue 2 - p 113-116
doi: 10.1097/XEB.0000000000000302
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Abstract

What is known about the topic?

  • Autoethnography is a method that uses the experience and perceptions of researchers to explore phenomena.
  • Collaborative autoethnography explores group experiences and can shed light on complex processes.
  • Autoethnography is underused in implementation science research.

What does this article add?

  • Collaborative autoethnography is well suited to offer insights on the experience of conducting implementation science research.
  • An outline of practical steps for researchers to design and conduct a collaborative autoethnography.
  • We highlight three key actions to ensure a robust collaborative autoethnography.

Introduction

Autoethnography is a qualitative method that enables individuals and groups to reflect on and analyse personal and group experiences. This is particularly important in implementation science where multidisciplinary groups working on intersectional challenges in complex settings is the norm. Given that an aim of implementation science is to understand why, how, for whom and in which contexts an intervention works, collaborative autoethnography (sometimes referred to as group autoethnography) offers an important tool for reflecting on how this understanding is achieved and broadening the lens of context.1

Autoethnography connects individual or personal narratives to cultural and social contexts to make sense of individual and collective experiences.2 The author or authors use their own experiences to extend understanding of the culture, social world or phenomenon under study.3 In doing so, implementation science researchers can begin to shed light on the challenges, solutions and processes of producing or co-producing knowledge, in particular the negotiations, relationships and shared experiences of researchers and implementers.4

There are few examples of autoethnography used in implementation science; one such study explored implementation science researcher experiences within participatory research.5 Yet, despite limited examples of its application, the work of implementation science lends itself to autoethnographic exploration. Conducting implementation science is inherently a complex phenomenon carried out by multidisciplinary teams composed of intersectional identities and experiences navigating a shared phenomenon of studying program implementation.6 The ongoing pandemic offers an important opportunity for teams to conduct autoethno-graphic work to reflect on the dynamic challenges to research and implementation.7 For example, a recent collaborative autoethnography by multidisciplinary researchers and clinicians from four countries explored development of infection prevention and control (IPC) guidelines for coronavirus disease 2019 (COVID-19) pandemic management.8 Autoethnography, in particular, collaborative autoethnography, can yield important insights into the research process and should be an important component of any implementation science researcher's tool kit. Here we offer an outline of practical steps for such researchers embarking on a collaborative autoethnography.

Planning the study

The primary author (that is, the team member who is leading the autoethnography) must decide on which phenomena to study and must be a member of the social world or culture where the phenomena take place. The primary author need not be the team leader of the phenomenon being studied. These phenomena can be anything where the experiences of the author and coauthors will add to the existing knowledge base. Thus, there are numerous entry points for researchers to analyze their experiences using autoethnography. This is particularly true in implementation science where research may be multiphased, and it may be useful to reflect on the research experience at different points in the research endeavor (Fig. 1). The method is particularly well-suited to areas of uncertainty, competing demands, complexity, tensions, negotiations or other experiential areas of the act of research.

F1
Figure 1:
Autoethnography across the implementation research process.

In conducting a collaborative autoethnography, the primary author first develops a protocol to guide the study process. In doing so they must solicit advice from potential co-authors who will actively contribute to the autoethnographic process. The co-authors should be chosen carefully to ensure that all voices involved with the phenomenon are heard. Co-authors should be invited using a letter that clearly identifies the purpose of the study, requirements of participation, and all ethical considerations as mentioned below.

Ethical issues and data collection

It is important to be both transparent and create a space for sharing and honest reflection on experiences from the first stages of conducting an autoethnography. It is advisable that the research protocol be submitted to a research ethics board for review and approval. The invitation letter for co-authors should clearly state that individuals can reserve their rights to not participate in this review, abstain from the authorship and to not be identified in any publication at any stage of the process. Confidentiality is an important factor to be considered in autoethnography.9 Individuals reserve their rights to not participate in this study, discontinue their participation at any time, abstain from authorship and to not be identified in any publication as well. Individual testimonials should neither be shared with the group nor should they constitute in any way a performance evaluation of administrative activities. The narratives should be held in confidence and should only be read and analyzed by the primary author or co-authors. The raw data should never be shared with anyone who has a position of authority over participants’ career advancement or employment.

Narrative accounts of key team members are solicited by the primary author. Co-authors are asked to write or speak about their personal perception of what happened during the phenomenon, their part and contribution to the experience, and their sense of the challenges and enablers. Participants can either write their narrative or have face to face or phone conversation (interview) with a co-author. These interviews should be recorded, transcribed and sent back to the participant for editing and approval. In soliciting co-author narratives, exemplary stories and examples of what happened and the impact should be encouraged. It is important that authors pay attention to the so-called ‘mundane details’ and ‘hidden tasks’ that constitute the co-authors’ day-today experiences of the phenomenon.10 Although neglected from most research reporting, these details provide rich data on the process and action of how research and implementation science gets done. The narrative could take any form; of importance is that it reflects the co-authors’ own narrative of the phenomena. As such, participants are usually asked to refrain from describing or reporting numeric or other data and instead focus on their stories, attitudes, perceptions and feelings.

Data analysis and writing considerations

The primary author will synthesize written narratives and transcribe verbal narratives into a master narrative. The primary author must also be prepared to use reflexivity to analyze stories of self and others and in doing so must be actively present in the text and perform rigorous theoretical analysis.9 Reflexivity can be practiced through journaling or discussion and involves reflecting and scrutinizing the process of conducting research and how one's values, views and experiences shape one's research.11 The synthesis of the written narratives will be closely and iteratively reviewed with one or two coauthors who self-nominate to be more deeply involved with the analysis. The main approaches to the analysis often include meaning condensation, categorization, interpretation and narrative structuring to have a coherent narrative describing the shared experience of the phenomenon under study.12 Most of the information will be organized thematically and contextualized with examples and quotes as needed. Extracts from testimonials should not be quoted by name or other identifiers in the manuscript. Although a subset of authors may be more closely involved in constructing the narrative, drafts must be read and approved by all authors as a representative account of their experience. Sometimes the primary author has to negotiate between co-authors to create a coherent narrative without silencing certain voices or passing judgement. The authors should reflect and explain if there are obvious silences on any key aspects of the phenomenon under study in the master narrative. As authors of the manuscript, all participants will have the opportunity to clarify the interpretation of their experiences and edit or add to their testimonial as they see fit. This process usually includes several preliminary drafts that are edited and refined to ensure all voices are being heard in the master narrative.

For implementation scientists undertaking a collaborative autoethnography, the final narrative may benefit from being written in an analytical-interpretive style, where the master narrative is analyzed considering a broader context.3 However, other writing styles are available to those conducting autoethnographies including descriptive-realistic; confessional-emotive and imaginative-creative.9 What style to adopt will depend on the phenomenon under study, the emergent narrative and insights from analysis as well as the end user of the knowledge produced from the autoethnographic process. Regardless of style, it is important that the narrative is analyzed with attention to the social, cultural and contextual shaping of the collective experience being reported. Authors may also consider reporting what are the key takeaways, lessons learned or pearls of wisdom from their experience. Often research dissemination overlooks the learning and growth of the researcher as they undertake a study or experience a phenomenon. Collaborative autoethnography welcomes these reflections and is an important tool for sharing this knowledge with others experiencing similar phenomena.

Conducting a robust collaborative autoethnography

In summary, to conduct a robust collaborative autoeth-nography, implementation science researchers should be guided by three key actions:

  • (1) Focus on the group narrative and work with coauthors to ensure no single voice is prioritized above others.
  • (2) Emphasize the experiences, perceptions and perspectives of co-authors rather than a retelling of the official narrative or reporting of numeric data.
  • (3) Analyze the master narrative with social, cultural and contextual interpretation.

In applying these guiding actions while conducting a collaborative autoethnography, implementation science researchers can ask themselves the guiding and reflective questions outlined in Table 1.

Table 1 - Reflective questions towards conducting a collaborative autoethnography
Planning the study
 Have you selected co-authors to ensure that all perspectives involved in the phenomenon are represented?
 Have you created a protocol and invitation letter in a way that creates a safe space for sharing and honest reflection?
Data collection and ethical issues
 In soliciting personal narratives and exemplary stories, have you paid adequate attention to the mundane details and hidden tasks involved in the phenomenon?
 In what ways are you protecting your co-authors’ confidentiality?
Data analysis and write up
 Have you focused on one narrative or are all co-authors’ narratives equally represented?
 In what ways have you considered the social, cultural and contextual shaping of the collective experience you report?

Collaborative autoethnography provides a method to explore a tapestry of experiences. As individual narratives coalesce to create a master narrative, we can identify collective experiences, insights, and outlooks that influence the practice of implementation science. Collaborative autoethnography is a key tool to answer the growing calls for a greater and more reflexive understanding of how knowledge is produced and by whom. Robust collaborative autoeth-nographies are crucial to sharing and archiving experiences to curate individual and institutional memories in a scientific manner and advance our knowledge of implementation science.

Acknowledgements

Authors’ contributions: S.R. and V.H. conceived, wrote and reviewed the manuscript.

Consent for publication: The authors consent to publication.

Conflicts of interest

The authors report no conflicts of interest.

References

1. Ridde V. Need for more and better implementation science in global health. BMJ Glob Health 2016; 1:e000115.
2. Holt N. Representation, legitimation, and autoethnography: an autoethnographic writing story. Int J Qual Methods 2003; 2:18–28.
3. Chang H. Holman Jones S, Adams T, Ellis C. Individual and collaborative autoethnography as method: a social scientist's perspective. Handbook of autoethnography. Abingdon: Routledge; 2013; pp. 107-22.
4. Oliver K, Kothari A, Mays N. The dark side of coproduction: do the costs outweigh the benefits for health research? Health Res Policy Syst 2019; 17:33.
5. Steketee AM, Archibald TG, Harden SM. Adjust your own oxygen mask before helping those around you: an autoeth-nography of participatory research. Implement Sci 2020; 15:70.
6. Peters DH, Adam T, Alonge O, et al. Implementation research: what it is and how to do it. BMJ 2013; 347:f6753.
7. Roy R, Uekusa S. Collaborative autoethnography:’ self-reflection’ as a timely alternative research approach during the global pandemic. Qual Res J 2020; 20:383–392.
8. Haldane V, Ratnapalan S, Perera N, et al. Co-development of COVID-19 infection prevention and control guidelines in lower-middle-income countries: the ‘SPRINT’ principles. BMJ Global Health 2021; 6:e006406.
9. Chang H. Autoethnography as method. Abingdon: Routledge; 2016.
10. Conte KP, Shahid A, Gron S, et al. Capturing implementation knowledge: applying focused ethnography to study how implementers generate and manage knowledge in the scale-up of obesity prevention programs. Implement Sci 2019; 14:91.
11. Jootun D, McGhee G, Marland GR. Reflexivity: promoting rigour in qualitative research. Nurs Stand 2009; 23:42–46.
12. Kvale S. Methods of analysis. Interviews: an introduction to qualitative research interviewing. 1996; Thousand Oaks: Sage, pp. 187-209.
Keywords:

autoethnography; qualitative research; ethics; narratives; data analysis

© 2022 JBI. Unauthorized reproduction of this article is prohibited.

A video commentary on implementation project titled: How do health professionals prioritise clinical areas for implementation of evidence into practice? The commentary is provided by Andrea Rochon RN, MNSc, Research Assistant, Queen's University, Ontario, Canada