DOI: 10.5811/westjem.2014.9.23290
Iyer MS, Mullan PB, Santen SA, Sikavitsas A, Christner JG.
Deliberate Apprenticeship in the Pediatric Emergency Department
Improves Experience for Third-year Students.
West J Emerg Med. 2014;15(4):424-9.

To the Editor:

Iyer et al. have presented an interesting study of the usefulness of a deliberate apprenticeship model in the pediatric emergency department for third year students.¹ The deliberate apprenticeship model appeared from both the quantitative and qualitative results to show benefits of deliberate apprenticeship. However a closer examination of the methodology reveals potential problems with the quantitative techniques used. Put simply the multiple quantitative comparisons made may have yielded false positive results. By contrast although grounded theory has had its critics, most agree that the constant comparative method is a sound method of qualitative analysis.²

However perhaps most concerning is what the learners actually say in the qualitative feedback – or at least what we can see that they say from the selected quotes. One learner talks about being “able to jump from patient to patient” – not behavior that we would perhaps wish to encourage in our learners. The same learner talks about being given more autonomy in “ordering tests, discharging patients” – activities that are likely to be beyond their competence. Another learner complains that they “didn’t get to see as many interesting things” as they would liked – here using language that appears to dehumanize patients. It is interesting to wonder what other learners said in their qualitative feedback. The authors have undoubtedly done a good job in using the constant comparative method to draw conclusions from this feedback but it would be fascinating to see all the raw data. At a time when many leaders in quantitative research are calling for access to all data, should qualitative researchers follow suit and similarly call for access to all qualitative data? It would be too much for journals to publish, but online papers could include a link to an open data repository which interested readers could then access.

Footnote

Address for Correspondence: Kieran Walsh, MD, BMJ Learning, BMJ Knowledge, BMA House, Tavistock Square, London WC1H 9JR, UK. Email: kmwalsh@bmjgroup.com.

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.

REFERENCES

1. Iyer MS, Mullan PB, Santen SA, et al. Deliberate apprenticeship in the pediatric emergency department improves experience for third-year students. West J Emerg Med. 2014;15(4):424-9. [PubMed]

2. Thomas G, James D. Reinventing grounded theory: some questions about theory, ground and discovery. BERJ. 2006:32(6):767-795.