METHODSUsing Reflexive Thinking to Establish Rigor in Qualitative ResearchRettke, Horst; Pretto, Manuela; Spichiger, Elisabeth; Frei, Irena Anna; Spirig, RebeccaAuthor Information Horst Rettke, PhD, RN, is Clinical Nurse Scientist, Centre for Clinical Nursing Science, University Hospital Zurich, Switzerland. Manuela Pretto, MNSc, RN, is Surgical Clinical Nurse Specialist, Surgery Department, University Hospital Basel, Switzerland. Elisabeth Spichiger, PD, PhD, RN, is Scientific Collaborator and Lecturer, Directorate of Nursing, Medical-Technical and Medical-Therapeutic Areas, Inselspital Bern University Hospital, and Institute of Nursing Science, Medical Faculty, University Basel, Switzerland. Irena Anna Frei, PhD, RN, is Head, Practice Development Unit, Department of Nursing and Allied Health Professions, University Hospital Basel, Switzerland. Rebecca Spirig, PhD, RN, is Director of Nursing and Allied Health Care Professions and Lecturer, Department of Nursing and Allied Health Professions, University Hospital Zurich, and Institute of Nursing Science, Medical Faculty, University Basel, Switzerland. Accepted for publication March 30, 2018. The authors acknowledge this discussion paper refers to a larger mixed-methods research program, “Assessing the impact of diagnosis related groups (DRGs) on patient care and professional practice: An interdisciplinary approach,” which was funded by The Swiss National Science Foundation (SNF; CRSII3_132786/1). Ethical approval from Cantonal Ethics Committee Zurich, Switzerland (KEK-ZH-2011-0091/0). The authors declare no conflicts of interest to report. Corresponding author: Horst Rettke, PhD, RN, Centre for Clinical Nursing Science, University Hospital Zurich, Raemistrasse 100 (SHM26 B 6), CH-8091 Zurich, Switzerland (e-mail: email@example.com). Nursing Research: 11/12 2018 - Volume 67 - Issue 6 - p 490-497 doi: 10.1097/NNR.0000000000000307 Buy Metrics Abstract Background Reflexivity can be helpful in developing the methodological rigor necessary to attaining trustworthy qualitative study results. Objectives The aim of this study was to evaluate strategies of critical reflexive thinking during a qualitative enquiry rooted in a mixed-methods study. Methods Guided by the questions of Rolfe and colleagues from 2001 (“what,” “so what,” and “now what”), we applied reflexive thinking to all aspects of the investigation. Results Critical reflexive thinking strongly supported our efforts to establish methodological rigor and helped reveal shortcomings. Discussion Effective strategical use of reflexive thinking takes concerted effort. Both time and space are essential to applying reflexive thinking throughout the qualitative research process. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.