Charms, challenges and hidden gems, reflecting on the use of QCA for a health care PhD

The use of Configurational Comparative Methods (CCM) offers opportunities to health care research. This paper will focus on the use of fuzzy set qualitative comparative analysis (fsQCA) for a PhD thesis in a health discipline area. It will outline the ‘charms’ of the methodology, discuss some of the ‘challenges’ that were dealt with and reveal some ‘hidden gems’ as well. By applying a qualitative descriptor to data, fsQCA allows for a rich interpretation of cases. In obtaining data for this thesis, a survey was distributed to nurses employed in rural clinical settings. The survey collected information about each nurse’s attitude to safety climate and their views of reporting and disclosure of a hypothetical medication error, along with some demographic information pertinent to the analysis. Whilst statistical analysis was undertaken, it is through the analysis conducted using fsQCA that the complexity between attitude to safety climate and views of error reporting and disclosure becomes apparent. Such is the charm of fsQCA (and other forms of CCM). In undertaking the thesis challenges arose. One of the hidden gems of fsQCA is it may be used effectively to undertake research involving areas of ethical sensitivity, but its use in these situations may come at the expense of modifications in research design that do not strictly adhere to methodological conventions of QCA. However, without these modifications it is likely that the data obtained may have been limited. What has resulted is a contribution to research that has the potential to inform theory and assist in policy development in relation to how rural clinical worksites deal with error reporting and disclosure.