Mixed-methods research in medical education: Lessons from a meta-study of methodological practice.

introductionMixed-methods research (MMR) intentionally combines (variously) theories, study designs, data collection, analyses and/or syntheses associated with more than one approach to research. Despite a rich literature on the theory and practice of MMR, the authors were concerned that much MMR in medical education fell short of the state of the art. To substantiate the problem, the authors conducted a meta-study to explore the strengths and weaknesses of MMR in medical education and to propose a framework to improve the conduct and reporting of this research design.

methodsStructured searches were conducted, and returns were filtered based on inclusion and exclusion criteria, establishing a corpus of 1070 articles. A series of purposive samples was taken from this corpus and put through full data extraction. The findings from these extractions were synthesized using descriptive statistics and a dialogical identification of core issues of concern.

resultsDescriptive statistics were produced for the full corpus, after which a series of samples led to 547 (51%) articles undergoing full data extraction. There was a significant increase in the number of articles reporting the use of MMR in the last 20 years. Several recurring issues were identified including a lack of theoretical and conceptual grounding in MMR, a lack of diversity in what constitutes MMR, questionable component rigour, a lack of integration (mixing), a tension between MMR as more than one thing and MMR as a methodology in its own right, and very little adaptation and innovation in MMR approaches. These issues had not improved over time. DISCUSSION: Major gaps in how MMR was justified and used were found. Integration, central to MMR, was notably lacking. Thus, the authors propose a checklist to help researchers and reviewers ensure that future use of MMR in medical education is more rigorous, transparent, complete and accurate.