Table 3 Performance of rapid QUAL-qual Method against Guba and Lincoln’s trustworthiness criteria

Credibility

Extent to which findings accurately portray respondents’ constructions. Involves the following:

Prolonged engagement in targeted site to build rapport and trust between evaluators and setting members and provide evaluators with a deeper understanding of the relevant culture.

Prolonged engagement: One day site visits precluded prolonged engagement.

Persistent observation of site to provide sufficient understanding.

Persistent observation: Although it is recognized that persistent observation was not carried out for this study, the researchers attempted to respond to this criterion through repeated observation periods.

Peer debriefing: Extensive discussions of data and preliminary findings with one or more peers to refine thinking.

Peer debriefing: RAs provided field notes and reflections for each site visit and were able to debrief with Research Manager (SH) as often as necessary. Furthermore, the questions in the qualitative interview schedule were clarified and streamlined in response to feedback from a research assistant.

Negative case analysis: The constant reworking of hypotheses in light of disconfirming evidence.

Negative case analysis: In most practices, leadership was vested in the general practitioner, and nurses were relative newcomers to the practice. Specific analytical attention looking for difference was paid to one practice where the nurse was the senior clinician who had worked longest in the practice as a negative case.

Progressive subjectivity: Researchers identify and articulate any biases they hold, examine how their understandings shift during the project, and attend to how these biases might affect interpretations.

Progressive subjectivity: Assumptions were regularly challenged during fortnightly analysis meetings (see Case Study 1).

Member checks involve sharing and checking findings and interpretations with the people from whom the data were collected.

Member checks: Summaries of our research were returned to each practice for verification. We also presented our data at general practice and nursing conferences, and posted evolving data on a website developed for the project, inviting feedback from readers on the blog who were practice nurses on the summary de-identified findings and our interpretations. The Reference Group, formed at the commencement of the study, met over the course of the project and gave their feedback on topics specifically raised with them.

Transferability

Researchers describe features of targeted context in detail and suggest additional contexts to which findings might be generalized.

Extensive background and case information included in final report.

Dependability

Concerned with stability over time in researchers and methods. Assessed by means of a dependability audit, which involves reviewing project records to determine the extent to which project procedures and changes are documented.

This team included clinicians, academics and individuals engaged in organization policy and advocacy, who assisted in recruitment and in ensuring that the understanding of the project by the field sites was consistent. Regular meetings were held with all team members to monitor adherence to project procedures and to document changes in protocols.

The three chief investigators met regularly in person and via telephone, and a summary of the decisions made were routinely produced.

Confirmability

Extent to which findings are grounded in the data. Assessed by means of confirmability audits, which involve reviewing research records to determine if findings can be traced to data and data to original sources.

Kept all case-summary, substantive theme and pattern analysis documents.

Data and themes in all non-public documents were linked to subject IDs.

At regular team meetings to discuss the ongoing analysis, members were encouraged to look for the “black swans”, that is, evidence that might contradict the finding under discussion.