Methodology in Medical Anthropology

 Questions and Methods in the Study of Sickness and Healing

Fieldwork in medical anthropology is a dynamic process that is NOT well suited to the structured, HYPOTHESIS TESTING RESEARCH PARADIGM of the laboratory sciences.

• Because of the nature of working in different cultures, the direction of your research, and your research technique may shift in response as you become more sophisticated in the knowledge of the culture, or in response to ongoing debates in the profession at home.

The Research Experience:

• How do we balance the demands of scientific research methods 
• testable hypotheses
• replicable experiments
• representative samples
• experimental controls

         with the constraints and opportunities of research carried out in "natural settings" outside of the laboratory?

• SOLUTION: Participant Observation
• learn the local language
• live in the community and participate in public life as is appropriate
• develop rapport with local patients and healers that would allow you to participate in local healing session (Peru) or learn about other healing practices.
• once rapport develops you may be able to move to more structured interviews and surveys
• PROBLEMS: 
• How to minimize your effect on these local practices due to your presence and observation, while you document it
• those you work with have the right to set LIMITS to your research (human subjects). Ethically your first duty is to protect the rights and lives of the people that you study.

Learning How To Look: "Deep Observation" and "Thick Description":

• Beginner's Mind (assume you know nothing and look at everything with fresh eyes)
• Take your time (hang out at your block at all different times of the day, weather, etc.)
• Look for the unusual in the usual
• Describe everything in as much detail as possible, you never know what will be important later.
• look everywhere: up, down, sideways.

Click here for a great article on looking by a photographer and writer.

What to Jot about:

                                                                 Notes

• observations
• impressions
• personal feelings
• tentative explanations
• behaviors
• body language
• sketches of places
• words (vocabulary)
• scents, sounds

Students need to make a distinction between what they OBSERVE and how they INTERPRET what they observe (keep them separate---the whats and the whys)

                                                                       Updated Notes

How to do it:

• be flexible, what you planned on taking notes on may be less interesting than what is in front of you
• be sensitive to people 
• include informants in jottings/interact
• frame what you are doing in a positive and non intrusive way 
• be selective about when to take notes
• Ethics
• ensure confidentiality (pseudonym or coding) and omit sensitive information
• be upfront about what you are doing

What to write

• terse, evocative phrases
• short quotes or phrases hat seem important (note time on recording)
• maps and sketches
• gestures, flavors, shouts, whispers, and all first impressions
• distinguish between WHAT you saw and tasted and heard (objective) and HOW you interpreted these things (subjective).
• do not impute MOTIVE (describe what you see and hear instead)
• do not make guesses or judgments
• describe observed behavior in as much detail as possible (don't use vague descriptions of mental states or attitudes).

                                                          More Notes

Writing Up Your Fieldnotes

• write up your notes ASAP so you do not forget things
• headnotes (fill in the jottings)
• keep a separate journal of your emotional responses (optional)

Interviews

• Session 1: get comfortable with each other and establish rapport
• get comfortable
• no right answers
• answer questions and explain project
• demonstrate a non-judgmental attitude and establish trust
• Sessions which follow: subsequent sessions give informant a chance to reflect
• do not read off a list of questions
• avoid directed questions, let informant speak until they are finished
• remember it is your interviewee's story (not the projects)
• ethics:
•  ensure anonymity that is important to informant
• be prepared to leave out information which is damaging
• Neutral Topic
• start interviews with neutral (easy) topics
• avoid ASSUMPTIONS and EXPECTATIONS
• Cultural differences and miscommunication
• Do not take the meaning of words, phrases or gestures for granted-even if you know them!
• Process
• develop rapport
• apprehension (emphasize the importance of THEIR story)
• explanation (restate what the informant says for confirmation)
• cooperation (equal partners)
• participation (interviewee as teacher)
• Breaks in Interview
• avoid leading questions