3. Research Design
3.3. Research Strategies and Methodological Choices
I used a qualitative research strategy with ethnography and case study as my methodological choices. Research of this type uses an inductive approach, where researchers start with a real-world setting and gather empirical materials from case studies. After this come the interpretation and reflections with a hypothesis and theory. Qualitative research follows an inductive design, where meaningful and descriptive data are generated (Leavy, 2017). This is in-depth research, where the aim is to collect different forms of data from different sources and investigate them from many different perspectives (Muratovski, 2015). According to Leedy and Ormorod (2010), qualitative research fits best for describing, interpreting, and verifying topics. It is ideal for understanding settings, processes, relationships, or people, which rings true with this study. In a service design setting, co-designing with people is crucial. Even though the developed topics are related to services and processes, they tie people and their relationships together and help to clarify user experiences.
Service design methods and tools aim to understand user experiences and the stories behind them through open-ended, narrative, and visual ways, where participants can share their views and opinions freely.
Case Studies
Case study approaches were used as a research strategy in sub-studies I, III, and IV. The case study is a qualitative research framework with a set of tools for data collection regarding complex phenomena (Baxter & Jack,
2008), and it is linked to the constructivist paradigm (Stake, 1995). The case study approach enables multiple levels of analysis from a single study (Yin, 2009), which can be a program, activity, process, or individual(s) (Creswell, 2014). According to Yin (2014), case study as a research approach should be considered in situations when the research focus is on answering “how”
and “why,” as relevant behavior cannot be manipulated by those who are involved in the study, and the study under investigation is contemporary.
In an explorative way, case studies give an in-depth understanding of a real-life context, which fits well in the service design field.
In general, case studies are criticized for lacking rigor and not following systematic procedures, being difficult to generalize, and taking up too much time while producing large amounts of information (Yin, 2014).
It was obvious that during the case studies, the forms of data collection and procedures changed to better suit the situations and environment.
Consequently, in some cases, the amount of data increased but was not too overwhelming to take into account. It should also be noted that in these case studies, the phenomenon was healthcare-related processes in the hospital context, where different stakeholders co-design using different design methods.
Ethnographic Studies
Previously, I introduced a case study approach that has some similarities to ethnographic studies. Ethnographic studies aim to obtain a holistic picture of the topic under investigation and engage individuals and understand their everyday experiences by interviewing and observing them (Creswell, 2014). Ethnography, which Leavy (2017) described as “a written text about culture” (p. 259), studies social interactions, people’s behavior, what they believe, and other perceptions that appear within communities, organizations, and groups (Muratovski, 2015). Both service design and ethnographic studies aim to provide holistic insights into different cultures, which Muratovski (2015) defined as “people’s views and actions” (p. 56).
Also under investigation are the elements of the environment around them, including the sounds, sights, and locations, which can be linked as touchpoints, according to service design literature. Service touchpoints are tangible objects or spaces (Moritz, 2005) in the line of interaction between the customer and service provider, or they are intangible elements, such as sounds, smells, and temperature. The service touchpoints are around us in different service moments and have an overall impact on how we
experience these moments. The service touchpoints are important to recognize in ethnographic studies.
Ethnography in the context of design is embedded in iterative design processes, is short-term and quick in its duration (Müller, 2021), and can offer numerous options for dealing playfully with collected data, which requires not only explication and reflection but also discipline (Müller, 2020). In design ethnography, “it is permitted to burst open conventions, explore boundaries and expand cognitive horizons. (…) Design ethnography can mean observing social situations passively in order to change them afterwards through interventions, then observing the results again, and so on” (Müller, 2020, p. 227). As in my research, the research process of design could change unexpectedly. In it, the researcher’s role is to adapt during the process and be creative, even playful, to better understand elements of the environment, for example.
Nevertheless, ethnography emphasizes three key elements that researchers need to consider: type of communication, level of integration, and duration of the study (Muratovski, 2015). The first element, type of communication, is crucial in research done in the healthcare field, where my personal motivation for conducting the study alone was not enough.
From my experience, there needs to be a clear introduction to what is going to happen, how it is done, and what its value is for participants.
In the healthcare context, professionals from the hospital give their time for the project, and the hospital lacks resources while the professionals attend a workshop. If the communication is unclear, it is difficult to engage them. In addition, the type of communication is crucial during the study especially when experts from various healthcare professions in the hospital, patients of different ages with different backgrounds and diseases, and I as a designer meet. The second element, level of integration, refers to the researcher being either an “outsider” or “insider,” as Muratovski (2015) explained. An experienced researcher knows when to be a silent observer or interviewer and when their role should be more active and engaging.
Regarding the third element, duration of the study, especially in healthcare-related co-design workshops, there needs to be enough time for thinking through complex scenarios, experiences, and service processes. This has been a huge learning point for me as a researcher, where a period of silence is not always a moment for ignorance or even for unconsciousness. It is usually a moment for in-depth thinking and processing—and sometimes, it exerts positive pressure that pushes people toward dialoguing. In the past, it was common to engage in ethnography as a long-term commitment, but that has changed, and it is currently more
short-term and multisided and/or focuses on a specific element or aspect (Madden, 2017). This was also considered in all the sub-studies in this work, as the healthcare organizations could not contribute full-time to the research. Well-scheduled and planned ethnography is an effective research approach for understanding organizations in a bigger service ecosystem picture, where multiple stakeholders, teams, and people also act in very narrow and specific service moments.