Interviews help researchers understand people’s views or experiences. A good interview is like a good conversation: it is important that the conversation flows, that participants feel comfortable and free to speak their minds, and that the participants understand one another. But unlike everyday conversations the researcher is seeking information to answer a research question and often de-identified quotations from interviews appear in research publications and outputs.
Questions in qualitative research are often ‘open-ended’, that is, they cannot be easily be answered with a simple ‘yes’ or ‘no’. They often start with ‘why’ (Why did the practice introduce this particular access system?), ‘how’ (How has the way you get an appointment changed over the years?) or they ask for examples (Can you tell me about your experience of using the appointment system at your surgery for the last appointment you had?).
We drew up a draft list of questions for our ‘interview guide’ – a document that ensures that all researchers ask roughly the same questions, so that we can compare the answers during the analysis. The questions are flexible so that each researcher can adjust the order and phrasing so that the interview ‘flows’.
Researchers often ‘test’ or ‘pilot’ their interview questions. For GP-SUS we did six pilot interviews with one GP practice receptionist, one nurse and one GP, and three volunteers from our public advisory panel. After each pilot interview we asked for feedback: was any of the interview repetitive or puzzling? Was any question redundant or was something important missed? Afterwards four members of the research team met to discuss the useful feedback we received. For example, one patient suggested the term ‘access system’ was opaque. So we have adjusted questions to ask about appointment systems (e.g. Have there been times when booking appointments has worked well for you?). Another had pointed out that they had recently changed GP so were unsure which practice to discuss; we found that talking about the differences between the two practices helpful so we added a ‘prompt’ to remind the interviewers to look out for opportunities to ask about experience of other general practices. Lastly, we received useful feedback from our patient pilot interviewees who said they would value being asked how access to appointments could be improved. This is now embedded in the interview guide.
The staff pilot interviews also helped us add to and refine our interview guide. They alerted us to questions exploring their role in the practice and in relation to the implementation of the new access system, or indeed different systems. Talking this through helped us to clarify the wording around booking system(s). We were also able to explore the best way to ask if they had noticed any differences in the types of patients accessing appointments associated with changes to the practice’s access system.
The pilot interviews helped improve the interview guide by making its language more accessible and its questions more specific and clear. We would like to thank our six interviewees – Amie Hardwick (practice receptionist), Brian Nicholson (GP and researcher), Chris Skerrett (PPI panel member), Clara Martins de Barros (PPI panel member), Vikki Seeney (advanced clinical practitioner) and one member of the PPI panel who preferred to remain anonymous – for helping us with this part of the study.
The programme presents independent research funded by the NIHR under its Health Services and Delivery Research funding scheme (NIHR133620). The views expressed in this blog are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.