Focus Groups for the Health Workforce Retention Study

1. Focus Groups for the Health Workforce Retention Study

2. By the end of this day’s session, you will be able to: • Describe what qualitative research is and when to use it • Understand the goals of the Health Workforce Retention Study focus groups • Identify roles and responsibilities of each team member participating in the focus groups • Understand how to facilitate a focus group for the Health Workforce Retention Project

3. Qualitative vs. Quantitative Research Why are we doing both qualitative and quantitative research as part of this study? • Complements the quantitative data • Provides us with more in-depth information • Allows us to discuss topics that we didn’t know were important • Provides a “human” element to the research through stories and examples

4. Focus Groups • Facilitated discussion which depends on group interaction to get more detailed information on a topic. • Gathers people with similar experience to discuss a topic of interest to the researcher. • Uses open-ended questions to hear to collect information about people’s feelings, values, and ideas. • The purpose is not to come to a consensus; participants can agree and disagree.

5. Health Workforce Retention Study Focus Groups Goals: • To gather in-depth information about the specific factors influencing job satisfaction for health workers. • To gather information on how policies might be changed to encourage health workers to stay in their positions.

6. Structure of Focus Groups • No more than 15 participants • Ideally no less than 6 participants • No managers • Organized by peer group • Need comfortable space - participants should face each other • Food and drink provided • Always set ground rules

7. Roles and Responsibilities

8. Facilitator • Discussion leader; control the session and keep the group on topic • Responsible for the directing the discussion using the “discussion script.” • Judge whether unexpected responses will contribute to objectives of the study • Manage group dynamics • Act as a good listener and encourage discussion and participation

9. Note-Taker • Take notes Record comments Record non-verbal messages • Responsible for tape recorder • “Back-up” moderator

10. ObserverSkills • Note-taking • Summarize each person’s response • Include direct quotes of interesting comments. • Keep summary true to what participants intended. • Fill in missing details immediately after the session.

11. Observer Skills, cont. • Tape recording • Check to see that voices can be heard. • Tell participants the session will be tape recorded. • Place the microphone in the center of the group. • Replace tape when first one is full. • Observation skills • Tone of voice • Body language • Facial expressions • Posture

12. Stages of the Focus Group • Introductions (approximately 10 minutes) • Rapport Building Stage (approximately 10 minutes) • In-Depth Discussion (approximately 45 minutes) • Closure (approximately 5 minutes)

13. Be Prepared! • Mentally alert • Memorize questions • Check tape recorder • Check that voices can be heard on tape • Bring spare batteries and tapes • Make sure you have name tags, pens, paper, sign-in sheets • Get food and drink for the group

14. Setting Up • Arrive before participants. • Note-taker should set up outside the room at the doorway to sign people in and give consent forms. • Welcome participants as if hosting friends. • Talk about something other than the Health Workforce Retention Study. • Avoid controversial subjects. • Give participants name tags or name tents. • Observe participants.

15. Debriefing • Immediately write down your thoughts and what you remember from the discussion • Meet with the other team member who participated in the focus group to discuss all aspects of the session. • Logistics • Check responses, review themes • Team skills and performance • Was the required information obtained? • Put consent forms and notes from focus group in data box.

16. Let’s Practice We need 5 volunteers to participate in a practice focus group. Please refer to your focus group protocol on page 18 of the manual.

17. Encouraging and Controlling Discussion

18. Encouraging discussion Atmosphere • Maintain a friendly and warm attitude. • Do not judge what participants say. • Aim to be somewhat casual, but not too much.

19. Encouraging discussion Pauses and prompts • Pauses to allow participants to think or a new speaker to comment. • A pause can last up to 5 seconds. • Establishing eye contact can encourage someone to speak. • Nodding and other gestures can also encourage people.

20. Encouraging discussion Probes. If a participant makes a vague comment, ask him/her for more information: • “Could you explain that further?” • “Would you give me an example of what you mean?” • “I don’t understand.”

21. Encouraging discussion • If you are not getting an answer, first repeat the question. If you are still not getting an answer, rephrase the question. • Use Reminder questions. e.g. “Dr. Y said that salary is an important factor for making job decisions. Dr. Y, how important is salary in your job decisions?” • Call on people individually if necessary.

22. Dealing with Specific Individuals Dominant talkers • Should not be allowed to “take over” the focus group • Remind group that all participants have knowledge and you want to hear from everyone. • Seat next to moderator • Moderator turn slightly away from dominant talker and avoid eye contact. • Thank dominant talker for comments and ask for comments from others in the group.

23. Dealing with Specific Individuals Shy participants • Seat them across from moderator • Moderator makes eye contact to encourage participant to speak. • Gently address him/her by name to ask for a comment.

24. Dealing with Specific Individuals People who don’t stop talking. • Stop eye contact after 20 or 30 seconds. • When participant pauses, quickly repeat question or ask a new question of another participant.