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Chapter 5: Qualitative descriptive research

Darshini Ayton

Learning outcomes

Upon completion of this chapter, you should be able to:

• Identify the key terms and concepts used in qualitative descriptive research.
• Discuss the advantages and disadvantages of qualitative descriptive research.

What is a qualitative descriptive study?

The key concept of the qualitative descriptive study is description.

Qualitative descriptive studies (also known as ‘exploratory studies’ and ‘qualitative description approaches’) are relatively new in the qualitative research landscape. They emerged predominantly in the field of nursing and midwifery over the past two decades. 1 The design of qualitative descriptive studies evolved as a means to define aspects of qualitative research that did not resemble qualitative research designs to date, despite including elements of those other study designs. 2

Qualitative descriptive studies  describe  phenomena rather than explain them. Phenomenological studies, ethnographic studies and those using grounded theory seek to explain a phenomenon. Qualitative descriptive studies aim to provide a comprehensive summary of events. The approach to this study design is journalistic, with the aim being to answer the questions who, what, where and how. 3

A qualitative descriptive study is an important and appropriate design for research questions that are focused on gaining insights about a poorly understood research area, rather than on a specific phenomenon. Since qualitative descriptive study design seeks to describe rather than explain, explanatory frameworks and theories are not required to explain or ‘ground’ a study and its results. 4 The researcher may decide that a framework or theory adds value to their interpretations, and in that case, it is perfectly acceptable to use them. However, the hallmark of genuine curiosity (naturalistic enquiry) is that the researcher does not know in advance what they will be observing or describing. 4 Because a phenomenon is being described, the qualitative descriptive analysis is more categorical and less conceptual than other methods. Qualitative content analysis is usually the main approach to data analysis in qualitative descriptive studies. 4 This has led to criticism of descriptive research being less sophisticated because less interpretation is required than with other qualitative study designs in which interpretation and explanation are key characteristics (e.g. phenomenology, grounded theory, case studies).

Diverse approaches to data collection can be utilised in qualitative description studies. However, most qualitative descriptive studies use semi-structured interviews (see Chapter 13) because they provide a reliable way to collect data. 3 The technique applied to data analysis is generally categorical and less conceptual when compared to other qualitative research designs (see Section 4). 2,3 Hence, this study design is well suited to research by practitioners, student researchers and policymakers. Its straightforward approach enables these studies to be conducted in shorter timeframes than other study designs. 3 Descriptive studies are common as the qualitative component in mixed-methods research ( see Chapter 11 ) and evaluations ( see Chapter 12 ), 1 because qualitative descriptive studies can provide information to help develop and refine questionnaires or interventions.

For example, in our research to develop a patient-reported outcome measure for people who had undergone a percutaneous coronary intervention (PCI), which is a common cardiac procedure to treat heart disease, we started by conducting a qualitative descriptive study. 5 This project was a large, mixed-methods study funded by a private health insurer. The entire research process needed to be straightforward and achievable within a year, as we had engaged an undergraduate student to undertake the research tasks. The aim of the qualitative component of the mixed-methods study was to identify and explore patients’ perceptions following PCI. We used inductive approaches to collect and analyse the data. The study was guided by the following domains for the development of patient-reported outcomes, according to US Food and Drug Administration (FDA) guidelines, which included:

• Feeling: How the patient feels physically and psychologically after medical intervention
• Function: The patient’s mobility and ability to maintain their regular routine
• Evaluation: The patient’s overall perception of the success or failure of their procedure and their perception of what contributed to it. 5(p458)

We conducted focus groups and interviews, and asked participants three questions related to the FDA outcome domains:

• From your perspective, what would be considered a successful outcome of the procedure?

Probing questions: Did the procedure meet your expectations? How do you define whether the procedure was successful?

• How did you feel after the procedure?

Probing question: How did you feel one week after and how does that compare with how you feel now?

• After your procedure, tell me about your ability to do your daily activities?

Prompt for activities including gardening, housework, personal care, work-related and family-related tasks.

Probing questions: Did you attend cardiac rehabilitation? Can you tell us about your experience of cardiac rehabilitation? What impact has medication had on your recovery?

• What, if any, lifestyle changes have you made since your procedure? 5(p459)

Data collection was conducted with 32 participants. The themes were mapped to the FDA patient-reported outcome domains, with the results confirming previous research and also highlighting new areas for exploration in the development of a new patient-reported outcome measure. For example, participants reported a lack of confidence following PCI and the importance of patient and doctor communication. Women, in particular, reported that they wanted doctors to recognise how their experiences of cardiac symptoms were different to those of men.

The study described phenomena and resulted in the development of a patient-reported outcome measure that was tested and refined using a discrete-choice experiment survey, 6 a pilot of the measure in the Victorian Cardiac Outcomes Registry and a Rasch analysis to validate the measurement’s properties. 7

Advantages and disadvantages of qualitative descriptive studies

A qualitative descriptive study is an effective design for research by practitioners, policymakers and students, due to their relatively short timeframes and low costs. The researchers can remain close to the data and the events described, and this can enable the process of analysis to be relatively simple. Qualitative descriptive studies are also useful in mixed-methods research studies. Some of the advantages of qualitative descriptive studies have led to criticism of the design approach, due to a lack of engagement with theory and the lack of interpretation and explanation of the data. 2

Table 5.1. Examples of qualitative descriptive studies

Qualitative descriptive studies are gaining popularity in health and social care due to their utility, from a resource and time perspective, for research by practitioners, policymakers and researchers. Descriptive studies can be conducted as stand-alone studies or as part of larger, mixed-methods studies.

• Bradshaw C, Atkinson S, Doody O. Employing a qualitative description approach in health care research. Glob Qual Nurs Res. 2017;4. doi:10.1177/2333393617742282
• Lambert VA, Lambert CE. Qualitative descriptive research: an acceptable design. Pac Rim Int J Nurs Res Thail. 2012;16(4):255-256. Accessed June 6, 2023. https://he02.tci-thaijo.org/index.php/PRIJNR/article/download/5805/5064
• Doyle L et al. An overview of the qualitative descriptive design within nursing research. J Res Nurs. 2020;25(5):443-455. doi:10.1177/174498711988023
• Kim H, Sefcik JS, Bradway C. Characteristics of qualitative descriptive studies: a systematic review. Res Nurs Health. 2017;40(1):23-42. doi:10.1002/nur.21768
• Ayton DR et al. Exploring patient-reported outcomes following percutaneous coronary intervention: a qualitative study. Health Expect. 2018;21(2):457-465. doi:10.1111/hex.1263
• Barker AL et al. Symptoms and feelings valued by patients after a percutaneous coronary intervention: a discrete-choice experiment to inform development of a new patient-reported outcome. BMJ Open. 2018;8:e023141. doi:10.1136/bmjopen-2018-023141
• Soh SE et al. What matters most to patients following percutaneous coronary interventions? a new patient-reported outcome measure developed using Rasch analysis. PLoS One. 2019;14(9):e0222185. doi:10.1371/journal.pone.0222185
• Hiller RM et al. Coping and support-seeking in out-of-home care: a qualitative study of the views of young people in care in England. BMJ Open. 2021;11:e038461. doi:10.1136/bmjopen-2020-038461
• Backman C, Cho-Young D. Engaging patients and informal caregivers to improve safety and facilitate person- and family-centered care during transitions from hospital to home – a qualitative descriptive study. Patient Prefer Adherence. 2019;13:617-626. doi:10.2147/PPA.S201054

Qualitative Research – a practical guide for health and social care researchers and practitioners Copyright © 2023 by Darshini Ayton is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License , except where otherwise noted.

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Overview of Descriptive Design

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A descriptive design is a flexible, exploratory approach to qualitative research. Descriptive design is referred to in the literature by other labels including generic, general, basic, traditional, interpretive, and pragmatic. Descriptive design as an acceptable research design for dissertation and other robust scholarly research has received varying degrees of acceptance within the academic community. However, descriptive design has been gaining momentum since the early 2000’s as a suitable design for studies that do not fall into the more mainstream genres of qualitative research (ie. Case study, phenomenology, ethnography, narrative inquiry and grounded theory). In contrast to other qualitative designs, descriptive design is not aligned to specific methods (for example, bracketing in phenomenology, bounded systems in case study, or constant comparative analysis in grounded theory). Rather, descriptive design “borrows” methods appropriate to the proposed study from other designs. 

Arguments supporting the flexible nature of descriptive designs describe it as being preferable to forcing a research approach into a design that is not quite appropriate for the nature of the intended study. However, descriptive design has also been criticized for this mixing of methods as well as for the limited literature describing it. The descriptive design can be the foundation for a rigorous study within the ADE program. Because of the flexibility of the methods used, a descriptive design provides the researcher with the opportunity to choose methods best suited to a practice-based research purpose.   

• Example Descriptive Design in an Applied Doctorate

Sources of Data in Descriptive Design

Because of the exploratory nature of descriptive design, the triangulation of multiple sources of data are often used for additional insight into the phenomenon. Sources of data that can be used in descriptive studies are similar to those that may be used in other qualitative designs and include interviews, focus groups, documents, artifacts, and observations.

The following video provides additional considerations for triangulation in qualitative designs including descriptive design: Triangulation: Pairing Thematic and Content Analysis

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Descriptive Research and Qualitative Research

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• Eunsook T. Koh 2 &
• Willis L. Owen 2  

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Descriptive research is a study of status and is widely used in education, nutrition, epidemiology, and the behavioral sciences. Its value is based on the premise that problems can be solved and practices improved through observation, analysis, and description. The most common descriptive research method is the survey, which includes questionnaires, personal interviews, phone surveys, and normative surveys. Developmental research is also descriptive. Through cross-sectional and longitudinal studies, researchers investigate the interaction of diet (e.g., fat and its sources, fiber and its sources, etc.) and life styles (e.g., smoking, alcohol drinking, etc.) and of disease (e.g., cancer, coronary heart disease) development. Observational research and correlational studies constitute other forms of descriptive research. Correlational studies determine and analyze relationships between variables as well as generate predictions. Descriptive research generates data, both qualitative and quantitative, that define the state of nature at a point in time. This chapter discusses some characteristics and basic procedures of the various types of descriptive research.

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Koh, E.T., Owen, W.L. (2000). Descriptive Research and Qualitative Research. In: Introduction to Nutrition and Health Research. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1401-5_12

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• Descriptive Research Design | Definition, Methods & Examples

Descriptive Research Design | Definition, Methods & Examples

Published on 5 May 2022 by Shona McCombes . Revised on 10 October 2022.

Descriptive research aims to accurately and systematically describe a population, situation or phenomenon. It can answer what , where , when , and how   questions , but not why questions.

A descriptive research design can use a wide variety of research methods  to investigate one or more variables . Unlike in experimental research , the researcher does not control or manipulate any of the variables, but only observes and measures them.

Table of contents

When to use a descriptive research design, descriptive research methods.

Descriptive research is an appropriate choice when the research aim is to identify characteristics, frequencies, trends, and categories.

It is useful when not much is known yet about the topic or problem. Before you can research why something happens, you need to understand how, when, and where it happens.

• How has the London housing market changed over the past 20 years?
• Do customers of company X prefer product Y or product Z?
• What are the main genetic, behavioural, and morphological differences between European wildcats and domestic cats?
• What are the most popular online news sources among under-18s?
• How prevalent is disease A in population B?

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Descriptive research is usually defined as a type of quantitative research , though qualitative research can also be used for descriptive purposes. The research design should be carefully developed to ensure that the results are valid and reliable .

Survey research allows you to gather large volumes of data that can be analysed for frequencies, averages, and patterns. Common uses of surveys include:

• Describing the demographics of a country or region
• Gauging public opinion on political and social topics
• Evaluating satisfaction with a company’s products or an organisation’s services

Observations

Observations allow you to gather data on behaviours and phenomena without having to rely on the honesty and accuracy of respondents. This method is often used by psychological, social, and market researchers to understand how people act in real-life situations.

Observation of physical entities and phenomena is also an important part of research in the natural sciences. Before you can develop testable hypotheses , models, or theories, it’s necessary to observe and systematically describe the subject under investigation.

Case studies

A case study can be used to describe the characteristics of a specific subject (such as a person, group, event, or organisation). Instead of gathering a large volume of data to identify patterns across time or location, case studies gather detailed data to identify the characteristics of a narrowly defined subject.

Rather than aiming to describe generalisable facts, case studies often focus on unusual or interesting cases that challenge assumptions, add complexity, or reveal something new about a research problem .

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Descriptive Research Design – Types, Methods and Examples

Table of Contents

Descriptive Research Design

Definition:

Descriptive research design is a type of research methodology that aims to describe or document the characteristics, behaviors, attitudes, opinions, or perceptions of a group or population being studied.

Descriptive research design does not attempt to establish cause-and-effect relationships between variables or make predictions about future outcomes. Instead, it focuses on providing a detailed and accurate representation of the data collected, which can be useful for generating hypotheses, exploring trends, and identifying patterns in the data.

Types of Descriptive Research Design

Types of Descriptive Research Design are as follows:

Cross-sectional Study

This involves collecting data at a single point in time from a sample or population to describe their characteristics or behaviors. For example, a researcher may conduct a cross-sectional study to investigate the prevalence of certain health conditions among a population, or to describe the attitudes and beliefs of a particular group.

Longitudinal Study

This involves collecting data over an extended period of time, often through repeated observations or surveys of the same group or population. Longitudinal studies can be used to track changes in attitudes, behaviors, or outcomes over time, or to investigate the effects of interventions or treatments.

This involves an in-depth examination of a single individual, group, or situation to gain a detailed understanding of its characteristics or dynamics. Case studies are often used in psychology, sociology, and business to explore complex phenomena or to generate hypotheses for further research.

Survey Research

This involves collecting data from a sample or population through standardized questionnaires or interviews. Surveys can be used to describe attitudes, opinions, behaviors, or demographic characteristics of a group, and can be conducted in person, by phone, or online.

Observational Research

This involves observing and documenting the behavior or interactions of individuals or groups in a natural or controlled setting. Observational studies can be used to describe social, cultural, or environmental phenomena, or to investigate the effects of interventions or treatments.

Correlational Research

This involves examining the relationships between two or more variables to describe their patterns or associations. Correlational studies can be used to identify potential causal relationships or to explore the strength and direction of relationships between variables.

Data Analysis Methods

Descriptive research design data analysis methods depend on the type of data collected and the research question being addressed. Here are some common methods of data analysis for descriptive research:

Descriptive Statistics

This method involves analyzing data to summarize and describe the key features of a sample or population. Descriptive statistics can include measures of central tendency (e.g., mean, median, mode) and measures of variability (e.g., range, standard deviation).

Cross-tabulation

This method involves analyzing data by creating a table that shows the frequency of two or more variables together. Cross-tabulation can help identify patterns or relationships between variables.

Content Analysis

This method involves analyzing qualitative data (e.g., text, images, audio) to identify themes, patterns, or trends. Content analysis can be used to describe the characteristics of a sample or population, or to identify factors that influence attitudes or behaviors.

Qualitative Coding

This method involves analyzing qualitative data by assigning codes to segments of data based on their meaning or content. Qualitative coding can be used to identify common themes, patterns, or categories within the data.

Visualization

This method involves creating graphs or charts to represent data visually. Visualization can help identify patterns or relationships between variables and make it easier to communicate findings to others.

Comparative Analysis

This method involves comparing data across different groups or time periods to identify similarities and differences. Comparative analysis can help describe changes in attitudes or behaviors over time or differences between subgroups within a population.

Applications of Descriptive Research Design

Descriptive research design has numerous applications in various fields. Some of the common applications of descriptive research design are:

• Market research: Descriptive research design is widely used in market research to understand consumer preferences, behavior, and attitudes. This helps companies to develop new products and services, improve marketing strategies, and increase customer satisfaction.
• Health research: Descriptive research design is used in health research to describe the prevalence and distribution of a disease or health condition in a population. This helps healthcare providers to develop prevention and treatment strategies.
• Educational research: Descriptive research design is used in educational research to describe the performance of students, schools, or educational programs. This helps educators to improve teaching methods and develop effective educational programs.
• Social science research: Descriptive research design is used in social science research to describe social phenomena such as cultural norms, values, and beliefs. This helps researchers to understand social behavior and develop effective policies.
• Public opinion research: Descriptive research design is used in public opinion research to understand the opinions and attitudes of the general public on various issues. This helps policymakers to develop effective policies that are aligned with public opinion.
• Environmental research: Descriptive research design is used in environmental research to describe the environmental conditions of a particular region or ecosystem. This helps policymakers and environmentalists to develop effective conservation and preservation strategies.

Descriptive Research Design Examples

Here are some real-time examples of descriptive research designs:

• A restaurant chain wants to understand the demographics and attitudes of its customers. They conduct a survey asking customers about their age, gender, income, frequency of visits, favorite menu items, and overall satisfaction. The survey data is analyzed using descriptive statistics and cross-tabulation to describe the characteristics of their customer base.
• A medical researcher wants to describe the prevalence and risk factors of a particular disease in a population. They conduct a cross-sectional study in which they collect data from a sample of individuals using a standardized questionnaire. The data is analyzed using descriptive statistics and cross-tabulation to identify patterns in the prevalence and risk factors of the disease.
• An education researcher wants to describe the learning outcomes of students in a particular school district. They collect test scores from a representative sample of students in the district and use descriptive statistics to calculate the mean, median, and standard deviation of the scores. They also create visualizations such as histograms and box plots to show the distribution of scores.
• A marketing team wants to understand the attitudes and behaviors of consumers towards a new product. They conduct a series of focus groups and use qualitative coding to identify common themes and patterns in the data. They also create visualizations such as word clouds to show the most frequently mentioned topics.
• An environmental scientist wants to describe the biodiversity of a particular ecosystem. They conduct an observational study in which they collect data on the species and abundance of plants and animals in the ecosystem. The data is analyzed using descriptive statistics to describe the diversity and richness of the ecosystem.

How to Conduct Descriptive Research Design

To conduct a descriptive research design, you can follow these general steps:

• Define your research question: Clearly define the research question or problem that you want to address. Your research question should be specific and focused to guide your data collection and analysis.
• Choose your research method: Select the most appropriate research method for your research question. As discussed earlier, common research methods for descriptive research include surveys, case studies, observational studies, cross-sectional studies, and longitudinal studies.
• Design your study: Plan the details of your study, including the sampling strategy, data collection methods, and data analysis plan. Determine the sample size and sampling method, decide on the data collection tools (such as questionnaires, interviews, or observations), and outline your data analysis plan.
• Collect data: Collect data from your sample or population using the data collection tools you have chosen. Ensure that you follow ethical guidelines for research and obtain informed consent from participants.
• Analyze data: Use appropriate statistical or qualitative analysis methods to analyze your data. As discussed earlier, common data analysis methods for descriptive research include descriptive statistics, cross-tabulation, content analysis, qualitative coding, visualization, and comparative analysis.
• I nterpret results: Interpret your findings in light of your research question and objectives. Identify patterns, trends, and relationships in the data, and describe the characteristics of your sample or population.
• Draw conclusions and report results: Draw conclusions based on your analysis and interpretation of the data. Report your results in a clear and concise manner, using appropriate tables, graphs, or figures to present your findings. Ensure that your report follows accepted research standards and guidelines.

When to Use Descriptive Research Design

Descriptive research design is used in situations where the researcher wants to describe a population or phenomenon in detail. It is used to gather information about the current status or condition of a group or phenomenon without making any causal inferences. Descriptive research design is useful in the following situations:

• Exploratory research: Descriptive research design is often used in exploratory research to gain an initial understanding of a phenomenon or population.
• Identifying trends: Descriptive research design can be used to identify trends or patterns in a population, such as changes in consumer behavior or attitudes over time.
• Market research: Descriptive research design is commonly used in market research to understand consumer preferences, behavior, and attitudes.
• Health research: Descriptive research design is useful in health research to describe the prevalence and distribution of a disease or health condition in a population.
• Social science research: Descriptive research design is used in social science research to describe social phenomena such as cultural norms, values, and beliefs.
• Educational research: Descriptive research design is used in educational research to describe the performance of students, schools, or educational programs.

Purpose of Descriptive Research Design

The main purpose of descriptive research design is to describe and measure the characteristics of a population or phenomenon in a systematic and objective manner. It involves collecting data that describe the current status or condition of the population or phenomenon of interest, without manipulating or altering any variables.

The purpose of descriptive research design can be summarized as follows:

• To provide an accurate description of a population or phenomenon: Descriptive research design aims to provide a comprehensive and accurate description of a population or phenomenon of interest. This can help researchers to develop a better understanding of the characteristics of the population or phenomenon.
• To identify trends and patterns: Descriptive research design can help researchers to identify trends and patterns in the data, such as changes in behavior or attitudes over time. This can be useful for making predictions and developing strategies.
• To generate hypotheses: Descriptive research design can be used to generate hypotheses or research questions that can be tested in future studies. For example, if a descriptive study finds a correlation between two variables, this could lead to the development of a hypothesis about the causal relationship between the variables.
• To establish a baseline: Descriptive research design can establish a baseline or starting point for future research. This can be useful for comparing data from different time periods or populations.

Characteristics of Descriptive Research Design

Descriptive research design has several key characteristics that distinguish it from other research designs. Some of the main characteristics of descriptive research design are:

• Objective : Descriptive research design is objective in nature, which means that it focuses on collecting factual and accurate data without any personal bias. The researcher aims to report the data objectively without any personal interpretation.
• Non-experimental: Descriptive research design is non-experimental, which means that the researcher does not manipulate any variables. The researcher simply observes and records the behavior or characteristics of the population or phenomenon of interest.
• Quantitative : Descriptive research design is quantitative in nature, which means that it involves collecting numerical data that can be analyzed using statistical techniques. This helps to provide a more precise and accurate description of the population or phenomenon.
• Cross-sectional: Descriptive research design is often cross-sectional, which means that the data is collected at a single point in time. This can be useful for understanding the current state of the population or phenomenon, but it may not provide information about changes over time.
• Large sample size: Descriptive research design typically involves a large sample size, which helps to ensure that the data is representative of the population of interest. A large sample size also helps to increase the reliability and validity of the data.
• Systematic and structured: Descriptive research design involves a systematic and structured approach to data collection, which helps to ensure that the data is accurate and reliable. This involves using standardized procedures for data collection, such as surveys, questionnaires, or observation checklists.

Advantages of Descriptive Research Design

Descriptive research design has several advantages that make it a popular choice for researchers. Some of the main advantages of descriptive research design are:

• Provides an accurate description: Descriptive research design is focused on accurately describing the characteristics of a population or phenomenon. This can help researchers to develop a better understanding of the subject of interest.
• Easy to conduct: Descriptive research design is relatively easy to conduct and requires minimal resources compared to other research designs. It can be conducted quickly and efficiently, and data can be collected through surveys, questionnaires, or observations.
• Useful for generating hypotheses: Descriptive research design can be used to generate hypotheses or research questions that can be tested in future studies. For example, if a descriptive study finds a correlation between two variables, this could lead to the development of a hypothesis about the causal relationship between the variables.
• Large sample size : Descriptive research design typically involves a large sample size, which helps to ensure that the data is representative of the population of interest. A large sample size also helps to increase the reliability and validity of the data.
• Can be used to monitor changes : Descriptive research design can be used to monitor changes over time in a population or phenomenon. This can be useful for identifying trends and patterns, and for making predictions about future behavior or attitudes.
• Can be used in a variety of fields : Descriptive research design can be used in a variety of fields, including social sciences, healthcare, business, and education.

Limitation of Descriptive Research Design

Descriptive research design also has some limitations that researchers should consider before using this design. Some of the main limitations of descriptive research design are:

• Cannot establish cause and effect: Descriptive research design cannot establish cause and effect relationships between variables. It only provides a description of the characteristics of the population or phenomenon of interest.
• Limited generalizability: The results of a descriptive study may not be generalizable to other populations or situations. This is because descriptive research design often involves a specific sample or situation, which may not be representative of the broader population.
• Potential for bias: Descriptive research design can be subject to bias, particularly if the researcher is not objective in their data collection or interpretation. This can lead to inaccurate or incomplete descriptions of the population or phenomenon of interest.
• Limited depth: Descriptive research design may provide a superficial description of the population or phenomenon of interest. It does not delve into the underlying causes or mechanisms behind the observed behavior or characteristics.
• Limited utility for theory development: Descriptive research design may not be useful for developing theories about the relationship between variables. It only provides a description of the variables themselves.
• Relies on self-report data: Descriptive research design often relies on self-report data, such as surveys or questionnaires. This type of data may be subject to biases, such as social desirability bias or recall bias.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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Descriptive research: what it is and how to use it.

8 min read Understanding the who, what and where of a situation or target group is an essential part of effective research and making informed business decisions.

For example you might want to understand what percentage of CEOs have a bachelor’s degree or higher. Or you might want to understand what percentage of low income families receive government support – or what kind of support they receive.

Descriptive research is what will be used in these types of studies.

In this guide we’ll look through the main issues relating to descriptive research to give you a better understanding of what it is, and how and why you can use it.

Free eBook: 2024 global market research trends report

What is descriptive research?

Descriptive research is a research method used to try and determine the characteristics of a population or particular phenomenon.

Using descriptive research you can identify patterns in the characteristics of a group to essentially establish everything you need to understand apart from why something has happened.

Market researchers use descriptive research for a range of commercial purposes to guide key decisions.

For example you could use descriptive research to understand fashion trends in a given city when planning your clothing collection for the year. Using descriptive research you can conduct in depth analysis on the demographic makeup of your target area and use the data analysis to establish buying patterns.

Conducting descriptive research wouldn’t, however, tell you why shoppers are buying a particular type of fashion item.

Descriptive research design

Descriptive research design uses a range of both qualitative research and quantitative data (although quantitative research is the primary research method) to gather information to make accurate predictions about a particular problem or hypothesis.

As a survey method, descriptive research designs will help researchers identify characteristics in their target market or particular population.

These characteristics in the population sample can be identified, observed and measured to guide decisions.

Descriptive research characteristics

While there are a number of descriptive research methods you can deploy for data collection, descriptive research does have a number of predictable characteristics.

Here are a few of the things to consider:

Measure data trends with statistical outcomes

Descriptive research is often popular for survey research because it generates answers in a statistical form, which makes it easy for researchers to carry out a simple statistical analysis to interpret what the data is saying.

Descriptive research design is ideal for further research

Because the data collection for descriptive research produces statistical outcomes, it can also be used as secondary data for another research study.

Plus, the data collected from descriptive research can be subjected to other types of data analysis .

Uncontrolled variables

A key component of the descriptive research method is that it uses random variables that are not controlled by the researchers. This is because descriptive research aims to understand the natural behavior of the research subject.

It’s carried out in a natural environment

Descriptive research is often carried out in a natural environment. This is because researchers aim to gather data in a natural setting to avoid swaying respondents.

Data can be gathered using survey questions or online surveys.

For example, if you want to understand the fashion trends we mentioned earlier, you would set up a study in which a researcher observes people in the respondent’s natural environment to understand their habits and preferences.

Descriptive research allows for cross sectional study

Because of the nature of descriptive research design and the randomness of the sample group being observed, descriptive research is ideal for cross sectional studies – essentially the demographics of the group can vary widely and your aim is to gain insights from within the group.

This can be highly beneficial when you’re looking to understand the behaviors or preferences of a wider population.

Descriptive research advantages

There are many advantages to using descriptive research, some of them include:

Cost effectiveness

Because the elements needed for descriptive research design are not specific or highly targeted (and occur within the respondent’s natural environment) this type of study is relatively cheap to carry out.

Multiple types of data can be collected

A big advantage of this research type, is that you can use it to collect both quantitative and qualitative data. This means you can use the stats gathered to easily identify underlying patterns in your respondents’ behavior.

Descriptive research disadvantages

Potential reliability issues.

When conducting descriptive research it’s important that the initial survey questions are properly formulated.

If not, it could make the answers unreliable and risk the credibility of your study.

Potential limitations

As we’ve mentioned, descriptive research design is ideal for understanding the what, who or where of a situation or phenomenon.

However, it can’t help you understand the cause or effect of the behavior. This means you’ll need to conduct further research to get a more complete picture of a situation.

Descriptive research methods

Because descriptive research methods include a range of quantitative and qualitative research, there are several research methods you can use.

Use case studies

Case studies in descriptive research involve conducting in-depth and detailed studies in which researchers get a specific person or case to answer questions.

Case studies shouldn’t be used to generate results, rather it should be used to build or establish hypothesis that you can expand into further market research .

For example you could gather detailed data about a specific business phenomenon, and then use this deeper understanding of that specific case.

Use observational methods

This type of study uses qualitative observations to understand human behavior within a particular group.

By understanding how the different demographics respond within your sample you can identify patterns and trends.

As an observational method, descriptive research will not tell you the cause of any particular behaviors, but that could be established with further research.

Use survey research

Surveys are one of the most cost effective ways to gather descriptive data.

An online survey or questionnaire can be used in descriptive studies to gather quantitative information about a particular problem.

Survey research is ideal if you’re using descriptive research as your primary research.

Descriptive research examples

Descriptive research is used for a number of commercial purposes or when organizations need to understand the behaviors or opinions of a population.

One of the biggest examples of descriptive research that is used in every democratic country, is during elections.

Using descriptive research, researchers will use surveys to understand who voters are more likely to choose out of the parties or candidates available.

Using the data provided, researchers can analyze the data to understand what the election result will be.

In a commercial setting, retailers often use descriptive research to figure out trends in shopping and buying decisions.

By gathering information on the habits of shoppers, retailers can get a better understanding of the purchases being made.

Another example that is widely used around the world, is the national census that takes place to understand the population.

The research will provide a more accurate picture of a population’s demographic makeup and help to understand changes over time in areas like population age, health and education level.

Where Qualtrics helps with descriptive research

Whatever type of research you want to carry out, there’s a survey type that will work.

Qualtrics can help you determine the appropriate method and ensure you design a study that will deliver the insights you need.

Our experts can help you with your market research needs , ensuring you get the most out of Qualtrics market research software to design, launch and analyze your data to guide better, more accurate decisions for your organization.

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Qualitative Descriptive Methods in Health Science Research

Affiliations.

• 1 College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ, USA [email protected].
• 2 College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ, USA.
• PMID: 26791375
• PMCID: PMC7586301
• DOI: 10.1177/1937586715614171

Objective: The purpose of this methodology paper is to describe an approach to qualitative design known as qualitative descriptive that is well suited to junior health sciences researchers because it can be used with a variety of theoretical approaches, sampling techniques, and data collection strategies.

Background: It is often difficult for junior qualitative researchers to pull together the tools and resources they need to embark on a high-quality qualitative research study and to manage the volumes of data they collect during qualitative studies. This paper seeks to pull together much needed resources and provide an overview of methods.

Methods: A step-by-step guide to planning a qualitative descriptive study and analyzing the data is provided, utilizing exemplars from the authors' research.

Results: This paper presents steps to conducting a qualitative descriptive study under the following headings: describing the qualitative descriptive approach, designing a qualitative descriptive study, steps to data analysis, and ensuring rigor of findings.

Conclusions: The qualitative descriptive approach results in a summary in everyday, factual language that facilitates understanding of a selected phenomenon across disciplines of health science researchers.

Keywords: qualitative analysis; qualitative descriptive; qualitative design; qualitative methodology; rigor.

© The Author(s) 2016.

• Data Collection / methods*
• Qualitative Research*
• Research Design*
• Statistics as Topic / methods

Grants and funding

• R01 NR010541/NR/NINR NIH HHS/United States
• T32 NR012718/NR/NINR NIH HHS/United States

• Open access
• Published: 30 April 2024

Students’ and junior doctors’ perspectives on radiology education in medical school: a qualitative study in the Netherlands

• Frederike S. Harthoorn 1 , 2 ,
• Sascha W. J. Scharenborg 1 , 2 ,
• Monique Brink 2 ,
• Liesbeth Peters-Bax 2 &
• Dylan J. H. A. Henssen 2  

BMC Medical Education volume  24 , Article number:  479 ( 2024 ) Cite this article

77 Accesses

Metrics details

Modern medicine becomes more dependent on radiologic imaging techniques. Over the past decade, radiology has also gained more attention in the medical curricula. However, little is known with regard to students’ perspectives on this subject. Therefore, this study aims to gain insight into the thoughts and ideas of medical students and junior doctors on radiology education in medical curricula.

A qualitative, descriptive study was carried out at one medical university in the Netherlands. Participants were recruited on social media and were interviewed following a predefined topic list. The constant comparative method was applied in order to include new questions when unexpected topics arose during the interviews. All interviews were transcribed verbatim and coded. Codes were organized into categories and themes by discussion between researchers.

Fifteen participants (nine junior doctors and six students) agreed to join. From the coded interviews, four themes derived from fifteen categories arose: (1) The added value of radiology education in medical curricula, (2) Indispensable knowledge on radiology, (3) Organization of radiology education and (4) Promising educational innovations for the radiology curriculum.

This study suggests that medical students and junior doctors value radiology education. It provides insights in educational topics and forms for educational improvement for radiology educators.

• Ultrasound was suggested to integrate within radiology education in medical curricula.

• Integration of applied radiology in a longitudinal learning community could be explored.

• Regardless of their personal interests, participants valued radiology education in medical curricula.

Peer Review reports

Can you imagine practicing medicine without using radiologic imaging techniques, such as chest radiographs, CT-scans or ultrasound? It would be almost inconceivable in modern medicine [ 1 ]. Coherent to this increasing role of radiology in healthcare, education of radiology in medical curricula has been a topic of discussion with proponents among both clinicians and students for more radiology education [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ]. The results of a recent review on the role of radiology in medical student teaching reflect this, showing a significant increase in medical articles published over the past decade [ 10 ].

Regarding the learning objectives of radiology education, not only consensus between radiologists and clinicians is needed [ 11 , 12 , 13 , 14 ], but also between students and these groups [ 9 , 15 , 16 ]. The studies of Subramaniam et al. were the only ones that investigated the opinions of clinicians and medical students in a study of three papers to create an overview of the opinions of the different groups on this subject [ 15 , 17 , 18 ]. When focusing on students’ opinions regarding radiology education, various studies investigated these by use of surveys with closed-ended questions [ 9 ] and open-ended questions [ 15 , 16 ]. These studies reported that students recognized the importance of radiology as an educational topic, especially with regard to reading radiographs and the detection of gross abnormalities on medical images [ 15 , 16 ]. Additionally, students in these studies also stated to have little knowledge regarding the possible health effects of ionizing radiation and MRI safety [ 9 ]. Although interesting, these results need further clarification: what exactly do students expect by “reading radiographs”, what pathologies should we consider “gross abnormalities” and how should we teach these subjects to students? To gain deeper insights in quantitative data, a qualitative research method is needed [ 19 ]. Therefore, this study sets out to further elucidate students’ perspectives on radiology education in medical curricula by use of individual interviews.

A qualitative, descriptive study with semi-structured interviews was performed. Prior to conducting these interviews, a list of topics was assembled based on relevant scientific literature, discussion sessions between two researchers (F.H. and D.H) and the educational experiences of the research team. Interviews were performed following an inductive iterative process using the constant comparative method [ 20 ]. This study was approved by the ethics committee of the Netherlands Association of Medical Education (NVMO, case number 2023.2.9).

Participants

Master’s students from the Radboud University Nijmegen, The Netherlands, and junior doctors were recruited between August 2020 and October 2020 by placing public advertisements on social media including electronic student environments and Facebook and by contacting students personally, to reach as many students as possible. These ways of recruitment was since no other ways were facilitated. To be included in this study, students needed to be enrolled in the master’s Medicine program of the Radboud University Nijmegen, implying that they had at least some clinical experience. Furthermore, students who followed an elective internship in Radiology were encouraged to participate to gain insights in their experience of an internship.

Data collection

Interviewees participated in one-on-one semi-structured interviews which were conducted in person, via electronic telecommunication software (e.g. Skype version 8.65.0.78; Skype Technologies, Luxembourg City, Luxembourg Palo Alto, CA, United States ) or by telephone with one of the researchers (F.H.). Semistructured interviews were conducted to obtain nuanced descriptions and extensive, salient data regarding the perspectives on radiology education. The interview schedule was derived from literature-dependent topics and discussions between the researchers. This resulted in a predefined topic list.

During the interviews, participants were encouraged to speak openly about their thoughts and considerations on the subject using open-ended questions. Therefore, it was highlighted that the interviewer had no relations with the board of examiners, the university medical center educational board or any other educational management team.

To ensure reliable data, all interviews were audio- and/or video-recorded, facilitating the transcription of these interviews verbatim afterwards. Prior to the interview, informed consent was obtained from all participants. The transcription of the interviews immediately started after the first interview. When information saturation occurred, two additional interviews were held to control data saturation. When it was confirmed that saturation was achieved, no new subjects were included as this would not result in new insights.

Data analysis

The transcribed data was thereafter analyzed via direct content analysis [ 21 ]. The inductive iterative process was performed using the constant comparative method. Data analysis started after completion of the first interview. Codes derived from the previous interview were used as starting point for coding the next one and additional codes were added when needed. Two researchers (F.H. and D.H) analyzed four interviews independently in order to compare the coding process. Discrepancies in coding were solved by discussion and concession. Thereafter, one researcher (F.H.) coded the remaining interviews. The coding process was performed using Atlas.ti software, version 8.2.29.0 (ATLAS.ti Scientific Software Development GmbH, Berlin, Germany). As a result, the created coding list was used to make an overview of categories and themes as a final product.

Sixteen subjects responded to the recruitment, one student was excluded due to not yet being enrolled in the master’s program, resulting in a total of fifteen participants who were interviewed. Tables  1 and 2 give an overview of the characteristics of the participants. All answers were collected via interviews; nine via Skype, one via Facetime, three via telephone and two in person. The interviews lasted between 25 and 50 min.

Four themes derived from fifteen categories arose from the qualitative data: (1) the added value of radiology education in medical curricula, (2) indispensable knowledge on radiology, (3) organization of radiology education and (4) promising educational innovations for the radiology curriculum (Fig.  1 ).

Summary of students’ perspectives on radiology education in medical curricula organized in themes and categories

The added value of radiology education in medical curricula

Current radiology education in medical curricula.

Interviewees expressed a heterogeneous exposure to radiology education moments, due to their preferences (e.g. attending elective courses) and changes in the medical curriculum. However, all interviewees stated that they received education on interpretating chest radiographs. Despite that, the medical curriculum paid little attention to it and interviewees felt ill-prepared to perform this task adequately. Additionally, participants expressed that systematic reading of chest radiographs, once taught, was easily forgotten due to a lack of repetition.

Interviewees considered radiology education fragmented throughout the study program and lacking proper structure. Participants also believed that radiological images were rather used as a tool to support other educational moments and indicated that they were often not aware of the relevance of gaining knowledge in radiology.

Integration of radiology in other internships

Participants expressed greater exposure to radiological images during their internships compared to their theoretical courses. Nonetheless, most interviewees experienced little or no expectations from supervisors regarding radiologic knowledge. Therefore, almost all their radiologic knowledge was acquired via self-study and critical evaluation of radiologic knowledge by an expert was lacking. Participants expressed that they did master different skills, dependent on their clinical exposure during the internships. This includes balancing pros and cons when choosing a radiologic exam, how to write a decent question for the radiologist and systematically reviewing chest radiographs.

Radiology during the work of junior doctors

Although the exposure of radiology varied in the participants’ jobs, several aspects of knowledge in radiology were described as advantageous for their work. For example: understanding and interpretating a radiologic report or conclusion, knowledge in different imaging techniques and useful skills for requesting a radiologic exam. This knowledge was considered important for night shifts, when junior doctors have little supervision. Participants appointed that this knowledge was gained via clinical practice and experiences and not through received education.

The added value of radiology education

There were no opponents for radiology education among the interviewees. The majority believed that knowledge in radiology would be beneficial for all medical students as radiology is an omnipresent, important diagnostic tool in medical disciplines. Therefore, they considered it important to integrate into medical curricula.

One participant questioned if other disciplines deserve more time in the already crowded medical curricula instead of radiology. Several participants expressed that specific radiologic knowledge for certain specialisms should be gained during residency. However, they dismissed this consideration since the wide occurrence of radiology in various specialisms is also the reason that basic knowledge in radiology would be beneficial for (almost) all medical students. Consequently, participants experienced a need for more education in the basics of radiology.

“For me [as a medical advisor for insurance] it is not that relevant anymore to know all that. But yes, most of the students will obviously work in the clinical sector or will end up in the treatment sector” – Junior doctor .

Indispensable knowledge on Radiology

Knowledge of anatomy was considered of great importance in order to understand a radiologic image and to distinguish normal images from abnormal ones. CT-scans and radiographs were thought to be imaging techniques on which students should be able to recognize anatomy. Whether the same applies to MRI was a point of discussion, because of the complexity of the imaging technique itself.

“If you do not understand the anatomy, you will not understand the image and vice versa […] so you will not be able to assess an image without knowing the anatomy” – Student .

Skills in interpretation

The interpretation of chest radiographs was considered a potential learning topic, but discussion arose to what extent this topic should be taught. Beliefs varied from interpretating the whole radiologic image with an own conclusion, to only systematically reviewing, to questioning if this should be taught at all during medical school. Interpretation of other imaging modalities (i.e. MRI and CT) was seen as a specialistic skill that should not be a learning goal in medical curricula. However, opinions differed as to which depth a student should be able to recognize certain anatomical landmarks and/or abnormalities.

Overall, it was considered important that students can differentiate normal from abnormal whilst looking at a radiologic image. Furthermore, participants indicated the importance of recognizing the most prevalent anomalies on the most commonly used modalities (Fig.  2 ) and the abnormalities that need rapid medical intervention. Two frequently given examples were recognizing fractures and pneumonia on (chest)radiographs.

A list of mentioned structures or 1 abnormalities that junior doctors should recognize according to the respondents

“…I believe that you should be able to assess the acute pathologies of every modality. This enables you to get ahead in the clinical decision-making process, when no radiologist is present on short notice” – Junior Doctor .

Basic technological background

Participants expressed that basic technological background of radiological images should be less prominent in medical curricula. It was experienced that there is too much focus on these theoretical aspects, which are too specific for junior doctors. However, interviewees did indicate that a certain (basic) knowledge is required to understand an image.

“You need basic understanding of how the modality works…At the beginning of the curriculum, our education focuses mainly on the different techniques. I just miss the clinical application” – Student .

(Contra-)indications, strengths and limitations of the different modalities

Knowledge of (contra-)indications of the different techniques was considered important by the majority of the interviewees. They believed it to be an important part of the clinical reasoning process. Additionally, differentiation in indication between available techniques such as CT, MRI or ultrasound was believed to be important.

“…it is paramount to learn the most important indications for the different radiological examinations for the most frequently encountered pathologies during every internship” – Junior Doctor .

These thoughts were accompanied by the idea that a student must know the strengths and limitations of commonly used radiologic exams. Knowledge on radiation, patient characteristics, influence of timing on accuracy of an image, sensitivity and specificity and false-positivity and false-negativity were suggested. There was a discrepancy in whether this is essential to teach or just good to know between participants.

“Knowing not to order an ultrasound for a heavily obese patient” – Student .

Application and outcome

The application of radiologic studies was considered an important educational topic. This included the added value of implications and consequences of the outcome of a radiologic study, the costs of different modalities, knowing which tests are available in specific circumstances and knowing what to mention when requesting a radiologic study.

Radiological imaging is getting better, fancier and clearer, but consequently it also getting more expensive. …When I believe that it is important to know something, I need to consider whether it will change my course of action for a patient. Only then, I must order the radiological examination – Junior Doctor .

Knowledge in the use of outcome of a study was regarded to be important as well. This included items such as understanding the terminology, looking critically at the conclusion and the role as a clinician to create a link between the clinical case and the image.

Lastly the role of the radiologists was mentioned. Interviewees believed that the ability to consult a radiologist should always be present when in doubt, for both application and outcome. Additionally, it was found important to create more insight into the tasks of a radiologist, so it would become clearer what can be asked and expected, and what is important information to provide when requesting a radiologic examination.

“That would be very interesting indeed, to know what the radiologist considers important regarding an application. I do not know that at all actually. I write down what the symptoms are and what diseases I am suspicious of, but I am not sure whether this is actually knowledge the radiologist needs. I can imagine that there is a lot to gain in that area” – Junior Doctor .

Organization of Radiology Education

Timing and emphasizing responsibilities.

It was believed that radiology education would be more useful if taught in the master’s phase, since students would be able to understand the value of this knowledge in a clinical context. Furthermore, interviewees believed repetition to be the key for both creating a better learning environment and ensuring less time investment in the overcrowded medical curriculum. Some participants suggested an integrated radiology curriculum including only basic topics while others advised against a separate radiology course.

Accompanied by this view, it was believed that radiology education should be integrated within other internships. Interviewees suggested teaching specific modalities before the start of different internships. For example, formal education on how to read radiological examinations of the brain (i.e. MRI and/or CT) should be organized prior to neurology rotations and principles of ultrasound should be taught prior to the gynecology internship. Education on indications and application was suggested to be taught during the last year of the master’s phase. This is because in the Netherlands a medical student is only allowed to perform this task during this last phase of the master. Recapitulating some radiology teaching material prior to starting the elective internships was also suggested.

“Before starting my surgery internship, I wanted to have some education about reading radiographs of fractures. We did receive some education on this topic, but it was really short, and it was not really about radiology. That might be a good addition.” – Student .

Educational forms

Participants suggested an integrated, repetitive radiology curriculum within the courses and internships of other specialties. Within this curriculum, students would like to see applied radiology and applied anatomy integrated in clinical cases, as well as a combination between self-study and practice. Other suggested teaching forms were working groups, computer guided education, e-learnings, self-study assessments, education in the dissection room and radiology meetings.

“I believe that it would be best if radiology education is integrated in the education preparing a student for a specific internship: these are the investigations that you will see encounter during this internship.” – Junior Doctor .

Although digital education (e-learnings and computer-guided education) was considered a good tool to learn recognizing images and to teach the basics of radiology, interviewees also had a negative view towards these teaching forms. They highlighted the pitfalls of having no feedback or possibility to ask questions, resulting in a passive learning style.

“I consider e-learnings useful to learn about the basics, but I think lectures or small group assignments are more useful for clinical discussions as you can have interaction with a professional.” – Student .

The majority of the participants had a positive view towards interactive education forms. In Fig.  3 an overview of the proposed educational forms per educational topic is shown. Additionally, the importance of having good references present was highlighted.

“It is better to use radiologic images that are examples of the really obvious during medical education. Usually, you will encounter complicated pathologies and as a beginning intern you need to study more simple pathologies, for example pneumonia on chest radiographs.” – Student .

Suggested educational forms per educational topic

Potential areas of improvement for a better learning environment

Interviewees believed that teaching radiology before starting a new internship would be beneficial to their radiologic knowledge and could result in increased self-esteem. Linking radiology education to a specific specialty and aligning the education with clinical practice was considered important. It was believed essential that students understand why certain topics are discussed. Other suggestions to enhance the learning environment were: enough exposure and repetition, providing feedback on questions in e-learnings and aligning learning objectives with the changing tasks of students during the years of their internships.

“You will have to implement your knowledge right after learning a radiological principle. Thereby, you will use the acquired knowledge which will result in better recall” – Student .

Promising educational innovation for the radiology curriculum

Internship in radiology.

While some participants suggested a regular (mini-)internship in radiology, the majority of the interviewees believed an elective internship in radiology to be better for personal deepening, also including the student’s personal learning objectives. Integration of a couple (internship)days of radiology in regular internships was also proposed.

However, if an internship would be created, participants suggested a duration of two weeks with integrated educational moments. The educational objectives of the internship were difficult to come up with and ideas on timing in the medical curriculum differed from before the start of the regular internships to the last year. By providing the internship in the first master year, the gained knowledge would come in handy during the next internships. On the other hand, there would be a danger that students would not understand the importance of this knowledge and could potentially have too little foreknowledge to help them assess and interpret the images.

Longitudinal educational curriculum

The idea of a longitudinal learning community (LLC) was pitched among participants as a new type of radiology education in the medical curriculum. This was described as a community-based approach to learning that stimulates meaningful student interaction via repetitive small-group learning and peer-group evaluation during a time period of more than one year. All participants were advocates for the suggested LLC and believed it would be a great addition to the current medical curriculum. One student suggested facilitating the LLC and withdrawing the internship in radiology. The aforementioned topics were proposed to be incorporated in the LLC.

“I think that it is a really good idea to have a continuous process of learning activities which helps you to expand your knowledge. And indeed, radiological imaging is somewhat different for different internships as some techniques are more often used than others in different settings” – Junior Doctor .

It was believed that the LCC would increase the attention for radiology education during other internships. It was noted that the complexity of the study materials taught in the LLC could progress over time. Although, it was disclosed that fragmentation could also be a pitfall of an LLC in radiology.

“You could embed an afternoon or day of radiology into other internships. So that during the neurology internship, you will observe the work of the neuro-radiologist. Then you will have more exposure.” – Student .

Ultrasound education

Interviewees noted that ultrasound is an emerging modality and believed education in ultrasound to be attractive. Discussions arose on both the added value of the theoretical aspects (including interpretation) as well as the practical aspects of ultrasound education.

“Good ultrasound education is lacking in the medical curriculum. Whereas ultrasound, in my opinion, is the bedside diagnostic tool of the future, especially with the hand-held ultrasounds which fit in your pocket.” – Student .

For ultrasound education to become useful, participants believed repetition and basic educational topics to be essential components. It was believed that these topics should be the same as other radiologic modalities. Regions that were suggested to teach were the abdomen and heart. As for teaching forms it was suggested to either use a separate course consisting of a combination of computer-guided education and self-study or integrate the study material via clinical cases (applied radiology).

However, there was disagreement on teaching practical sonography skills. Opponents mainly stated that this would be too specialized, while an advocate highlighted that it would be beneficial to master this skill since ultrasound is a dynamic examination.

“Performing an ultrasound examination properly and interpreting those images adequately, that is not something you will learn in one group session. For that, you would really need more time in the medical curriculum, to teach it consequently”- Student .

This study suggests that medical students and junior doctors value radiology education in medical curricula as they see it as a relevant topic, regardless of personal interests. However, radiology education in its current form was criticized. Adaptions to facilitate a more integrated and applied form of radiology education were suggested, in order to establish the skills a junior doctor should master. An elective radiology internship was suggested for those more interested.

Our results are in line with outcomes reported by Subramaniam and colleagues [ 15 ]. They found that medical students considered (1) learning to systematically analyze radiographs, (2) distinguishing normal from abnormal and (3) identifying gross abnormalities important learning goals. However, several new topics arose from our study. For example, we found that students believe that less time should be invested in the theoretical background of the radiologic techniques. Nevertheless, in a previous study, students also reported the lowest mean score for “Basic knowledge of radiation protection, including timing of organogenesis and radiation effects”. This indicates that students regard this learning goal least interesting [ 15 ]. In our study, on the other hand, the students detail their comments and provide insights on how to implement this theoretical aspect of radiology in daily educational practice; For example by in-time learning and using clinical cases to teach radiology in a more applied way. In addition, our study suggested that students have nuanced views on the depth of their knowledge with regard to different topics. Also, students suggest in this paper that more time should be created for learning applied radiology, and that ultrasound education should be implemented more broadly. Nevertheless, this study was unable to investigate the nuanced views of students and junior doctors on each topic. Regarding the basic technological background, further research should aim to provide a detailed overview of the benefits and limitations as perceived by students and junior doctors regarding this subject. Such a detailed overview of the topics described in this study could help to further shape radiology education of the future.

Participants suggested integrating ultrasound as an imaging technique within the medical curriculum. Discussion arose if this should also include practical skills. This increased interest in ultrasound education has been shown in literature [ 22 , 23 ]. Although the theoretical aspect of this technology is getting more implemented in medical curricula in Europe, and ultrasonography is practically taught in some countries, not all universities have developed an ultrasound curriculum to teach the practical skills [ 24 ]. One explanation that could help understand why such an ultrasound curriculum is not ubiquitous within modern medical curricula, could be that a well-designed ultrasound curriculum is needed for optimal integration that meets students’ expectations and matches the existing clinical needs. Nonetheless, a recent study did provide recommendations for such an ultrasound curriculum in medical school [ 25 ], although further investigation of the learning outcomes would be paramount [ 26 , 27 , 28 , 29 ]. Positive outcomes on teaching anatomy have been reported, though the impact of ultrasound education on clinical examination skills of medical students is less clear and needs further investigation [ 29 , 30 ].

The possibility of developing an LLC to improve radiology curricula was positively reviewed by participants. Literature showed examples of national radiology curricula that were developed in the UK, Australia and Germany [ 23 , 31 ]. However, it was unclear whether these curricula are also integrated in medical curricula. To our knowledge no national LLC curriculum has yet been developed in the Netherlands. Since positive outcomes have been reported of an integrated imaging curriculum [ 23 , 32 ], we believe it would be beneficial to explore this educational form of radiology education. It has been reported that a vertically integrated “virtual” radiology internship is as effective as a freestanding internship [ 33 ]. The remark of the interviewees that a radiology internship should be elective when a LLC is applied is in line with these findings.

This study has several strengths and limitations. The qualitative research design provided a detailed insight into students’ perspectives on radiology education in medical curricula. By including junior doctors, more insight into the gaps of the current radiology education and the challenges of radiology in daily clinical work was obtained. The group of participants varied in personal interests and interest in future specialties, which was essential to get insight into whether every medical student would benefit from radiology education, and which topics should be taught. Lastly, some participants followed an elective internship in radiology and others did not. This information was used to obtain more information if an internship in radiology would be useful, either mandatory or elective.

The generalizability of these data is affected by the small group of included participants. This should be seen as a limitation of this study. Second, representativeness could have been affected by the method of recruiting students and junior doctors, creating selection bias. Third, only students from one University Centre in the east of the Netherlands were included, potentially creating responses that are not representative for students participating in other Dutch curricula. Finally, the fact that only junior doctors were included might have led to unbalanced answers when it comes to professional needs later in their medical career and to the costs of suggested improvements. Although we have no reason to assume that the interviewees cannot reflect the large group of medical students, more qualitative research on the importance of radiology education is warranted to confirm the presented findings.

This study suggests that medical students and junior doctors consider radiology education important within medical school curricula and provided insight into educational topics and ways to improve the current curriculum. Participants were positive about an integrated radiology curriculum that included applied radiology and incorporating more ultrasound education in the medical curriculum. The implementation of a LLC in radiology, incorporating ultrasound education, could be investigated. Overall, more research is needed to get information from more students on these specific subjects and get an agreement between clinicians and students on these topics.

Data availability

The dataset which was generated from the interviews and analyzed during the current study is not publicly available since individual privacy could potentially be compromised. Data are however available from the corresponding author on reasonable request.

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FH contributed to the design of the study, the acquisition, analysis and interpretation of data and drafted the work. SS and MB have substantively revised the work. LPB designed the study and substantively revised the work. DH supervised the whole project and consequently contributed to the design of the study and to revisions of the work. All authors approve the submitted version of this article and have agreed to both to be personally accountable for the author’s own contributions and to ensure that questions related to the accuracy or integrity of any part of the work are appropriately investigated, resolved and the resolution is documented in the literature.

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Harthoorn, F.S., Scharenborg, S.W., Brink, M. et al. Students’ and junior doctors’ perspectives on radiology education in medical school: a qualitative study in the Netherlands. BMC Med Educ 24 , 479 (2024). https://doi.org/10.1186/s12909-024-05460-9

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Health system lessons from the global fund-supported procurement and supply chain investments in Zimbabwe: a mixed methods study

• Abaleng Lesego 1 ,
• Lawrence P. O. Were 1 , 2 ,
• Tsion Tsegaye 1 ,
• Rafiu Idris 3 ,
• Linden Morrison 3 ,
• Tatjana Peterson 3 ,
• Sheza Elhussein 3 ,
• Esther Antonio 4 ,
• Godfrey Magwindiri 4 ,
• Ivan Dumba 5 ,
• Cleyland Mtambirwa 5 ,
• Newman Madzikwa 5 ,
• Raiva Simbi 5 ,
• Misheck Ndlovu 6 &
• Tom Achoki 1  

BMC Health Services Research volume  24 , Article number:  557 ( 2024 ) Cite this article

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Metrics details

The Global Fund partnered with the Zimbabwean government to provide end-to-end support to strengthen the procurement and supply chain within the health system. This was accomplished through a series of strategic investments that included infrastructure and fleet improvement, training of personnel, modern equipment acquisition and warehouse optimisation. This assessment sought to determine the effects of the project on the health system.

This study employed a mixed methods design combining quantitative and qualitative research methods. The quantitative part entailed a descriptive analysis of procurement and supply chain data from the Zimbabwe healthcare system covering 2018 – 2021. The qualitative part comprised key informant interviews using a structured interview guide. Informants included health system stakeholders privy to the Global Fund-supported initiatives in Zimbabwe. The data collected through the interviews were transcribed in full and subjected to thematic content analysis.

Approximately 90% of public health facilities were covered by the procurement and distribution system. Timeliness of order fulfillment (within 90 days) at the facility level improved from an average of 42% to over 90% within the 4-year implementation period. Stockout rates for HIV drugs and test kits declined by 14% and 49% respectively. Population coverage for HIV treatment for both adults and children remained consistently high despite the increasing prevalence of people living with HIV. The value of expired commodities was reduced by 93% over the 4-year period.

Majority of the system stakeholders interviewed agreed that support from Global Fund was instrumental in improving the country's procurement and supply chain capacity. Key areas include improved infrastructure and equipment, data and information systems, health workforce and financing. Many of the participants also cited the Global Fund-supported warehouse optimization as critical to improving inventory management practices.

It is imperative for governments and donors keen to strengthen health systems to pay close attention to the procurement and distribution of medicines and health commodities. There is need to collaborate through joint planning and implementation to optimize the available resources. Organizational autonomy and sharing of best practices in management while strengthening accountability systems are fundamentally important in the efforts to build institutional capacity.

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The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), together with its Zimbabwean national and international stakeholders have continued to invest in health system strengthening to improve public health in the country. These investments have been guided by systemwide strategic assessments to understand the fundamental challenges facing the Zimbabwean health system [ 1 , 2 , 3 , 4 ].

Given the strategic importance of access to essential medicines, vaccines, and other health technologies as a strategic pillar of any health system [ 4 , 5 ], the Global Fund supported the Ministry of Health and Child Care (MOHCC) through the United Nations Development Program (UNDP) to undertake a comprehensive assessment of the national procurement and supply chain management (PSCM) system in 2013 [ 6 ]. This assessment aimed to develop a strategic vision and costed action plan for improvement. This covered both upstream and downstream aspects of PSCM. The strategic purpose was to help the MOHCC launch a coordinated approach to invest in PSCM improvements and enhance coordination and cooperation in managing all health commodities across the health system [ 3 , 6 , 7 ].

Subsequently, the Global Fund supported several initiatives aimed at the realization of the improvements proposed by the comprehensive assessment undertaken by UNDP [ 6 ]. These initiatives primarily encompassed end-to-end supply chain assistance in critical areas, including demand quantification and forecasting, warehousing capacity development, fleet improvement, distribution systems, and waste management systems. Other support aspects focused on warehouse optimization, data and information management systems, and personnel training [ 7 , 8 ]. In general, warehouse optimization is the process of improving the efficiency and effectiveness of warehouse operations. It involved refining workflows, leveraging technology, enhancing spatial utilization, and ensuring precise inventory management [ 6 , 7 ].

More specifically, the Global Fund provided funds for the construction of warehouses for the National Pharmaceutical Company of Zimbabwe (NATPHARM) to facilitate the smooth handling of health commodities. Additionally, this support extended to water supplies (in terms of sinking boreholes) for various warehouses, water tanks, and booster pumps for the other branches. Global Fund also supported NATPHARM in constructing two incinerators in the two main cities, Harare, and Bulawayo to handle pharmaceutical waste effectively [ 9 , 10 ].

Through Global Fund support, NATPHARM also received modern warehouse equipment such as forklifts, pallet jacks and rolling ladders, and data and information management system support for better visibility and effective handling of health commodities. The support further extended to optimising the Harare branch warehouse with modern receiving and transit capabilities to serve other feeder locations and the procurement of modern delivery trucks to facilitate the distribution of commodities. Global Fund support also extended to personnel training and retention for the effective functioning of NATPHARM and the broader procurement and supply system [ 3 , 6 , 9 ].

Focusing on quality assurance and safety of medicines and other health commodities, Global Fund supported the Medicines Control Authority of Zimbabwe (MCAZ) to develop capacity in quality testing of all commodities procured through grants. MCAZ was also supported with the installation of solar panels that allowed for an uninterrupted power supply to facilitate smooth operations at the organization. The Global Fund support was also critical in the upgrading of the biology and chemistry laboratories to attain WHO prequalification standards [ 8 , 9 , 11 ]. Similarly, there was direct support from the Global Fund to facilitate pharmacovigilance activities, such as adverse drug reactions reporting using electronic systems. All these measures were meant to ensure that the medicines and health commodities consumed in the Zimbabwean health system were safe and quality-assured [ 4 , 5 , 9 , 11 ].

The overarching project by the Global Fund to support the Zimbabwean government was designed and implemented in response to the nationally identified gaps and opportunities that were established through various research and consultative efforts [ 3 , 4 , 6 , 8 ]. The project was kickstarted in the first quarter of 2019 and continued through 2021, with various project components being implemented in a phased approach to achieve the national targets [ 3 , 4 , 7 , 10 , 11 ]. To ensure effective coordination, accountability, and avoidance of duplicative efforts, the project was designed and implemented in close coordination with other partners represented in the National Health Development Partners Coordination Forum (HDPCF), Health Sector Technical Working Group (HSTWG), and the Global Fund Country Coordination Mechanism (CCM), among others [ 3 , 4 , 6 , 8 , 10 ]. There was regular reporting to the respective coordination mechanisms to track progress as well as troubleshoot any implementation issues as they arose [ 6 , 9 ].

Overall, the gaps identified through the various assessments commissioned by the Global Fund included a lack of effective coordination, poor inventory and order management, human resource constraints, and warehousing and storage inefficiencies [ 12 , 13 ]. Therefore, the focus of the Global Fund support was to retool the Zimbabwean PSCM system to be efficient, cost-effective and responsive to the population's health needs, particularly in the face of global epidemics and pandemics such as HIV/AIDS and COVID-19 [ 14 , 15 , 16 , 17 , 18 ].

In an attempt to resolve these issues, healthcare systems around the world are working on streamlining their supply chains through various health system strengthening measures [ 19 , 20 , 21 , 22 ]. Therefore, the objective of this analysis was to assess the overall effects of the Global Fund-supported investments in the Zimbabwean PSCM system and document the lessons learned to inform future programming efforts to strengthen healthcare systems.

The assessment covered a period of 2018 -2021 and employed both qualitative and quantitative research methods. Figure 1 . illustrates the convergent mixed methods study design that was applied. In this study design, both the qualitative and quantitative data collection and analyses are implemented simultaneously, and the insights merged to provide a fuller picture [ 23 ].

Convergent mixed methods design

The quantitative part of the study entailed collecting and analysing administrative data covering priority indicators that are routinely reported on the Zimbabwe PSCM. Meanwhile, the qualitative part comprised of key informant interviews (KII) focusing on stakeholders within the healthcare system to give perspective to the observed data trends. Insight from the two parts of the analysis were merged and subjected to comparative assessment and interpretation to ensure that a consistent picture emerged [ 23 , 24 ]. More details on the methods are provided in later sections.

Analytical framework

The overall analytical approach espoused in this assessment was anchored on the logical relationships of the building blocks of the health system as described by the World Health Organization (WHO) health system framework [ 5 ]. Figure 2 shows the analytical framework, which illustrates the results chain cascading from the Global Fund-supported initiatives to the expected improvements in intermediate and long-term outcomes related to PSCM, including the availability of medicines, reduced wastage, and overall improvements in population-level coverage [ 4 , 5 ].

Analytic framework

Overall, the framework graphically displays the results Global Fund intended to achieve through its support to the Zimbabwean PSCM. The "theory of change" that underlies the Global Fund’s strategy is revealed through the arrows in the diagram that identify “causal” linkages through which various intermediate results interact to make progress toward the overall goal of improving health system performance [ 3 , 5 ].

Quantitative research

The quantitative research entailed a detailed descriptive analysis of the operational data that was routinely reported across the Zimbabwe PSCM system. Table 1 . shows some of the key performance indicators (KPI) that were considered in our analysis.

Data collection, management and analysis

The data used in this analysis were obtained from the routinely reported operational data that included the NATPHARM-operated warehouses and healthcare facilities in the country. The data were extracted from the various data management systems operated by the different institutions, cleaned, and collated into a comprehensive dataset in the form of a spreadsheet covering the period of the assessment. The database was examined for completeness and accuracy by cross-referencing the corresponding progress reports for specific periods. Trends of priority indicators were compared over time, as they related to Global Fund support to the PSCM space.

Qualitative research

The qualitative assessment entailed KIIs with health system stakeholders who were knowledgeable and intimately involved in the Global Fund-supported initiatives and its intended beneficiaries. This included provincial and district management teams, hospital and clinic personnel, and other stakeholders in the Zimbabwe health system. Informed consent was obtained from each study participant involved in the study. The data collection protocol ensured that all study participants fully understood the objectives of the study and consented verbally to provide the required information.

As previously stated, the literature review helped map and identify critical organisations involved in the PSCM space, and more specifically, those involved in the procurement and health system strengthening activities supported by the Global Fund. A full list of those organisations is provided on Table  2 .

Sampling techniques

Convenience purposive sampling was used to select key informants and in-depth interviews [ 23 ]. Our sample was supplemented using snowball sampling methods (also called chain sampling). The initial respondents referred other potential respondents until no new information was forthcoming or achieved saturation. Efforts were made to be all-inclusive, involving various stakeholder groups and organisations intimately linked to the operations of the Zimbabwe PSCM landscape.

This comprised of KIIs using a structured interview guide that covered various thematic areas relevant to the assessment to obtain a comprehensive perspective of the impact of the Global Fund-supported initiatives in the country. In its development, testing and validation, the key informant guide was pretested and adapted to ensure suitability for the task. In view of the restrictions imposed to prevent the spread of COVID-19 infections at the time of the study, some KIIs were conducted online using multimedia channels such as Zoom, Skype, and telephonically.

Three research assistants supported the two project leaders in conducting the KIIs. After each interview, all notes taken by the research assistant were checked by the two project leaders to ensure completeness and readability to minimise recording errors. In addition, a tape recorder was used for interviews to assist with reference post data collection. All the recordings were stored in a pin-protected cloud storage which was only accessible by the two project evaluation leaders. Qualitative data obtained from the KIIs were transcribed in full and then manually analysed applying thematic content analysis. Where there was a divergence of opinion, an agreement was established through discussion with three members of the project evaluation team. In thematic analysis, data from interview transcripts were grouped into similar concepts. This approach was appropriate for semi-structured expert interviews as it is used to code text with a predefined coding system that can then be refined and completed with new themes emerging [ 23 , 24 ]. Our initial coding system was defined during the desk review stage and continuously updated in the successive phases of data collection employing a deductive approach of qualitative research. The emerging themes were not preconceived (desk review) but emerged from the data during the coding process, while the global themes were the highest-order themes that emerged from the data and were broad enough to capture the essence of the entire dataset [ 23 ]. The codes are presented in a tabular format in the results section below.

This section presents both the quantitative and qualitative research results from the study. The quantitative results comprise of trends of the priority operational PSCM indicators for the relevant period. The qualitative results present the perspectives of the key health stakeholders involved in the Zimbabwe healthcare system.

Quantitative results

Table 3 shows that the total warehouse capacity across the Zimbabwean health system increased by 37.8% between 2018 and 2021.

Of the 1500 public health facilities in Zimbabwe coverage by the PSCM system was consistently high between the years 2018 and 2021, averaging 94%, and increasing by 13.6% over the same period. However, order fulfillment rate within 90 days, for 1410 reporting health facilities was consistently below 50% from 2018 to 2020, despite the reported high coverage for the health facilities by the PSCM in the country. Notably, this indicator showed remarkable improvement to 91% in 2021, from an average of 42% from the previous three years. More specifically, the order fill rate for Tenofovir 300mg/ lamivudine 300mg/efavirenz 600mg (TLE 600mg) improved despite the significant drop observed in 2020. However, when comparing 2018 and 2021, the order fill rate for this specific HIV drug increased by around 36.5%, while the stockout rates for the same drug at the central stores declined by about 14.5% over the same period.

Table 3 further shows a 44% drop of order fill rates for the Determine HIV Test Kit between 2018 and 2020 for the 1410 reporting health facilities, only to recover in the year 2021, where order fill rates improved to 83%. At the same time, the stockout rates for the Determine HIV Test Kit at the central stores declined by 49% between 2018 and 2021.

Figure  3 shows the estimated average population coverage for HIV treatment for adults and children, from 2018 to 2020, at 92% and 71%, respectively. The figure shows that there was limited variation in the population level coverage over the years, despite the estimated increase in the number of people living with HIV over the same period. The national target for this indicator is 95%.

Adult and paediatric HIV treatment population coverage

Figure  4 shows the proportion of the value of the expired stock in the 7 warehouses, over three years, between 2019 and 2021, which demonstrates a declining trend over time. The highest expiry was in quarter 4 2019 at 1.9%, compared with the lowest in quarter 3 2021 at 0.1%. This represents a 93% reduction in value of expired stock.

Percentage value of expired stock

Figure  5 shows the combined stock-taking variance valued in United States Dollar terms across 7 warehouses over a three-year period. The stock variance shows a declining trend over the three-year period to negligible values at the end of 2021.

Stock-taking variance

Figure  6 shows the temporal trend of the number of days that it took NATPHARM to resolve the stock variances across the different warehouses in the country. Overall, there is a decline from the average of 8 days from the December 2018 stocktake (with Harare warehouse as an outliner at 25 days), to an average of 1 day in the December 2021 stocktake, where all warehouses converge.

Duration to resolve stock variance

Table 4 shows the funding levels in USD$ to support the diagnostic capacity for Covid-19, comprising of the polymerase chain reaction test (PCR) and rapid diagnostic tests (RDT). The table further shows the PSCM related costs, the total test done, and positive cases identified over the two-year period. The total funding between 2020 and 2021 increased by 290%, with testing levels increasing by 490% over the same period. The average Covid-19 positivity rate in 2020 was 6.4% while the positivity rate for 2021, was 3.1%, indicating a greater than 50% drop.

Qualitative results

Most of the participants interviewed acknowledged that the Global Fund support to NATPHARM and the broader Zimbabwean health system had been central in improving the overall performance of the health system through improved availability of essential medicines and other health commodities. This was largely achieved by ramping up the various components of the PSCM value chain and related operations, leading to efficiency, effectiveness and reliability.

Table 5 shows the codes, emerging and global themes from the thematic content analysis. The emerging themes revolved around the lack of infrastructure and equipment curtailing warehouse operations before the Global Fund support. Data gaps and poor product visibility were also emerging themes, as were the effects of the old fleet on the overall supply and distribution system. Similarly, issues of infrastructure, capacity, and personnel training gaps emerged as crucial themes hindering quality assurance within the PSCM. Global themes also largely focused on infrastructural inadequacy leading to underperformance. Improvements leading to better handling of commodities; data and information systems, enhancing visibility and supporting accuracy in forecasts; improvements in the distribution systems enabled by newer fleets also featured as global themes. Similarly, better trained and motivated personnel, able to perform critical functions; capacity to ensure the quality and safety of medicines and other health commodities; and the need for effective multistakeholder partnerships to improve effectiveness and sustainability of health systems, were key themes.

NATPHARM operations

According to the NATPHARM management, warehouse improvement and optimisation exercise resulted in better visibility and improved efficiency in the operations related to the commodity handling across the entire value chain. More specifically, the processes related to stock taking improved markedly over time according to the reports presented by various organizations that had been commissioned to undertake the stock audits.

“ …. warehouse optimisation supported implementing an inventory management system which conformed with bin location and variant codes, according to different donors. The result was improved, faster and more accurate stock takes, a sharp reduction of variances and more streamlined order processing ” Participant, NATPHARM.

Further, it was reported by various participants that order processing and deliveries had improved to be timely and on schedule as a result of the improved visibility and efficiency harnessed across the PSCM. Similarly, there was consensus that receiving processes and documentation had significantly improved through the support offered by Global Fund particularly towards warehouse optimization. The improvements in the data management systems and related trainings were also cited as contributory to the overall trend that was observed.

“ Reporting quality has greatly improved and is now timely, accurate and complete. This helps in accurate forecasting of demand, which in turn avoids unnecessary wastage and expiries” Participant MOHCC.

There was consensus from the majority of participants interviewed that the fleet improvements had improved the availability of essential commodities vital for the effective management of high burden diseases; HIV/AIDS, Malaria and Tuberculosis in Zimbabwe. According to participants from a local health facility, this was evidenced by low stockout rates for the key commodities needed to manage these three conditions effectively. The new fleet was reported to facilitate deliveries from various warehouses to the recipient health facilities on a regular basis. This level of distributional access coupled with better demand forecasting as a result of improved data use, was noted as critical in the improved availability of medicines and health commodities at the health facility levels.

Further, respondents in the leadership of NATPHARM revealed that the Global Fund support had benefited the overall financial position of the organisation by tapping into efficiencies harnessed through the various measures that have been implemented. Some of the support measures that resulted in efficiency improvements include, the warehouse optimization, pharmaceutical waste management and fleet improvements, which ultimately reduced operational costs.

For example, it was noted that running a newer fleet of vehicles led to lower maintenance and fuelling costs than previously was the case, when deliveries were done using older vehicles. Similarly, it was noted that pharmaceutical waste resulting from expired medicines and other health commodities was expensive to store and dispose, particularly when engaging third party organizations. However, this additional cost was reportedly in the decline, as a result of the investment in the incinerators for waste management.

“ The provision of incinerators for waste management has resulted in huge savings in terms of the cost of waste destruction. It has also resulted in significant compliance with environmental health regulations.”, Participant, NATPHARM.

MCAZ operations

Majority of the participants agreed that the Global Fund support to MCAZ strengthened its overall capacity to handle the requisite safety and quality assurance needs to effectively support the procurement functions for medicines and other health commodities within the country and regionally. The installation of solar panels to provide uninterrupted electricity power supply for the operations of the organization was cited as a huge advantage allowing for improved performance, in a country where power supply is unreliable. Similarly, other participants cited, the support for MCAZ laboratories to obtain the WHO prequalification status, as a major step towards effectiveness and sustainability for the organization; citing the fact that MCAZ is offering quality assurance services regionally at a fee.

“ We [MCAZ] now have the capacity to conduct the safety and quality assurance tests needed to support the procurement of commodities in the country and the region. We [MCAZ] even recently won the tender to support the regional procurement activities ”, Participant, MCAZ.

Based on the results framework provided in Fig.  3 , there is clear evidence that the Global Fund-supported initiatives resulted in positive improvements in the overall performance of the Zimbabwean PSCM system. However, it is important to recognise some of the assessment’s limitations in interpreting these findings. First, the results reported are for a limited observation period and a limited set of indicators, which are largely confined to the national level analysis, missing out on granular subnational and commodity-specific analysis that could be more informative. Secondly, this study was not conceptualised before the onset of the intervention reported here (i.e., Global Fund-supported initiatives), and therefore, no specific steps were taken to develop an appropriate prospective research design and data collection strategy to support a more rigorous assessment. Therefore, the study relied on secondary PSCM data that were sparse and covered a limited period. Third, the study could be subject to confounding relationships with other concurrent interventions being implemented by other health system stakeholders that have direct or indirect effects on the PSCM system, complicating impact attribution to specific interventions. Forth, the analysis focused only on a narrow subset of medicines and commodities related to HIV/AIDS and COVID-19. However, despite these limitations, every effort has been made to use the most up-to-date and complete information available, including validation using official reports and collaborative reported data with key informant interviews.

The estimated population coverage for HIV treatment for both adults and children remained consistently high despite the increasing prevalence in the country. It was estimated that adults living with HIV increased by 10% from a baseline of 2018, to reach 1.3M in 2020, while children living with HIV increased by 24%, from a baseline of 2018, to reach 75 000 in 2020 [ 3 , 4 , 9 ]. As a key last mile population outcome, it can be rightly assumed that high HIV treatment coverage in the Zimbabwean system emanated from strengthened inventory management functionality and improved delivery of orders supported by a modern fleet of vehicles, which allowed for meeting the supply target of four quarterly rounds [ 3 , 8 ]. Population coverage is an important performance measure for a health system. It unites two important concepts; need and utilisation of an intervention to improve health [ 25 ]. In our case, the intervention is HIV treatment and the population in need is those living with HIV needing treatment; and the proportion with access and able to use the treatment they need, represents population coverage. This is a fundamentally important consideration as various health systems, including low- and middle-income countries, are making universal health coverage (UHC) efforts. There is no question, that improved access to essential medicines and other health technologies is a fundamental cornerstone towards UHC [ 1 , 5 , 26 ].

Other intermediate indicators that are critical for progress towards improved availability of medicines and other health commodities and hence UHC, also showed significant improvements that could be attributed to Global Fund-supported initiatives. For example, reduced wastage and decreasing value of expired health commodities reported, point towards improving efficiency across the value chain. As noted earlier, efficiency is one of the fundamental expectations of an effective health system outlined in the WHO health system framework [ 3 , 5 ]. The diminishing value of expiries could be ascribed to various factors, including the improved workflow processes and data accuracy at NATPHARM. This improvement which is associated with better visibility of commodities across the value chain could be attributed to investments made by Global Fund such as the enterprise resource planning platform, coupled with concomitant training and supervision.

Through Global Fund’s assistance to NATPHARM, automation of tasks such as stock management, ordering, and other operational activities was central and contributory to driving the observed improvements in the handling of commodities; reduction of wastage and expiries and improving availability. Similarly, better inventory management and warehouse optimization activities such as decongestion resulted in quicker, timely, more accurate, and well-documented stock takes, improving overall commodity management.

Variances between stock on hand and physical counts were used to determine whether facilities are conducting period checks on their stocks and therefore calculating monthly consumption of commodities accurately. As such the variance across commodities should be zero. Low variance indicates that the stocks at hand are generally similar and do not vary widely from the physical stock counts, while high variance indicates that the respective values have greater variability and are more widely dispersed from one another. There is clear evidence pointing towards the reduction in stock variances when comparing stock on hand and physical counts across the different warehouses in the country over time. This trend can be attributed to better visibility of commodities at the warehouses and training of personnel which was supported by the Global Fund [ 2 , 9 ]. Similarly, the number of days it took the NATPHARM personnel to resolve stock variances showed a dramatic reduction, from an average of 8 days to 1 day in a span of 3 years. This observed trend could also further support the claim that overall, the Global Fund supported initiatives produced the desired results.

With the advent of Covid-19, the effects of the Global Fund support on the PSCM became evident considering the robust response the country was able to mount particularly in terms of diagnostics [ 9 ]. The country was able to rapidly roll out COVID-19 testing, reaching many people between 2020 and 2021. Similarly, the Covid-19 positivity rates declined from 6.4% to about 3.1% over the same period. High positivity rates may indicate that the health system is only testing the sickest patients who seek medical attention and is not casting a wide enough net to know how much of the virus is spreading within its communities. A low rate of positivity on the other hand, can be seen as a sign that a health system has sufficient testing capacity for the size of the Covid-19 outbreak and is testing enough of its population to make informed decisions about reopening the economy. The WHO guidance is that countries which have conducted extensive testing for COVID-19, should remain at 5% or lower positivity rate for at least 14 days.

Safe pharmaceutical waste management and disposal is a primary consideration of any effective health system in completing the PSCM loop [ 27 ]. The Global Fund supported the investment in MOHCC operated incinerators. These investments could largely be associated with reduction in the cost of storage, handling and disposal of the expired stock, particularly when considering that certain space was rented from third parties which often charged a premium. Safe pharmaceutical waste disposal also became more priority with the increased supplies that resulted from the efforts to tackle the Covid-19 pandemic.

Despite signs of progress, there was temporary faltering of indicators- namely, order fill and stockout rates; associated with key commodities for effective management of HIV in the year 2020, warranting an explanation. The drop in Tenofovir/Lamivudine/Efavirenz (TLE 600mg) in 2020 could be linked to several factors. In the year 2019, the Zimbabwe MOHCC adopted new treatment regimens containing Dolutegravir. This means, newly HIV positive clients were started on Dolutegravir regimen as standard of care rather than the previous first line treatment which then surged Tenofovir/Lamivudine/Dolutegravir 50mg order fill rate, while having the opposite effect on the old regimen. Lastly, the effects of COVID-19 pandemic cannot be underestimated as the global supply chain systems were logged with delays which caused disruptions and inefficiencies in health systems in many countries [ 28 ]. In the same period, Determine HIV Test Kit rebounded from stocking out in central stores because of strengthened warehouse optimization activities, including better inventory management, purposeful stock taking, and approval processes contributed to the lowering of stockout rates.

The Global Fund-supported initiatives were also instrumental in building capacity by training key personnel for the effective implementation of activities related to the procurement and supply chain management function [ 8 , 29 , 30 ]. Better quantification and forecasting capabilities (due to data availability through e-LMIS and personnel training), improved warehousing capacity to hold a wide portfolio of products, and direct delivery to facilities through a modern fleet could have contributed to the high population coverage reported [ 26 , 30 , 31 ]. According to the WHO health system framework, effective leadership is required to coordinate all the functions of the health system in order to achieve the desired outcomes [ 5 ]. Therefore, it is sensible to conclude that, the reported health system improvements could not have happened without effective leadership and well-trained staff tasked with coordination and management across the PSCM value chain. It can be further inferred that the training and capacity development measures offered to the NATPHARM personnel were consequential in supporting the broader health system to meet its overall objectives, including improving PSCM performance [ 2 , 7 , 29 ].

Similarly, adequate infrastructure, equipment, data, and information management systems are crucial ingredients for a well-functioning health system, according to the WHO health system framework [ 4 , 5 , 9 ]. The Global Fund-supported initiatives were central in supporting these aspects of the health system through improved warehousing capacity, of modern equipment, installation of solar panels, fleet improvement and deployment of an electronic-logistic management information system (e-LMIS). The cumulative benefits of these investments include optimised procurement and distribution of commodities leading to a reduction in stockout rates and timely order refills to meet the population health needs [ 9 ].

Based on these findings, it would be reasonable to conclude that the Global Fund-supported initiatives in Zimbabwe contributed positively to strengthening the health system, particularly through the improved performance of the various indicators linked to the PSCM system at national and regional warehouses, as well as health facilities. Considering the prevailing health needs in the country, the implementation of this project and the manner of investments provide a basis and playbook for further support to make progress. This is particularly true considering the various competing priorities in the Zimbabwean healthcare system amidst resource constraints [ 3 , 6 , 8 ]. This was largely underpinned on the overarching focus on UHC and the critical role that an effective PSCM plays towards that very objective [ 3 , 12 , 13 , 14 ].

The Global Fund-supported project in Zimbabwe worked through the existing national coordination mechanisms where various key stakeholders, including MOHCC and NATPHARM, were involved in all key strategic planning and implementation decisions, ensuring country leadership and ownership. It was clear from the outset that this approach required sound partnership, transparency, and accountability among all the involved stakeholders, to deliberate and find common ground, guided by the overarching objective to make progress towards UHC.

The question of securing the gains and ensuring sustainability is fundamental for donor supported health programs in low- and middle- income countries. To make progress, it is imperative for health system stakeholders, including governments and donor organizations that are keen to sustainably strengthen health systems to pay close attention to critical areas like the procurement and distribution of health commodities. It is critical to collaborate with key stakeholders through joint planning and implementation to optimize the available resources. Organizational autonomy coupled with strong data driven accountability systems and the sharing of best management practices are fundamentally important in this discourse.

Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request and once written permission is obtained from NATPHARM.

Abbreviations

Country Coordination Mechanism

Health Development Partners Coordination Forum

Health Sector Technical Working Group

Key Informant Interview

Medicines Control Authority of Zimbabwe

Ministry of Health and Child Care

National Pharmaceutical Company of Zimbabwe

Polymerase Chain Reaction

Procurement and Supply Chain Management

Rapid Diagnostic Tests

Tenofovir Lamivudine Efavirenz

Universal Health Coverage

United Nations Development Program

World Health Organization

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Acknowledgements

The authors would like to thank the participants from the different organizations in Zimbabwe that provided feedback during the study. They are also grateful to the management of the various organizations that allowed their staff to participate and provided premises and other resources that were used during the interviews. Gratitude to Sarah Gurrib who proofread the manuscript and offered useful comments.

The study was funded by the Global Fund to Fight AIDs, Tuberculosis and Malaria. The funder had no role in the study design, data collection, data analysis, data interpretation, or writing of the article. All authors had full access to study data and had final responsibility for the decision to submit for publication.

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Contributions

Tom Achoki (TA), Rafiu Idris (RI), Lawrence Were (LW) and Abaleng Lesego (AL) conceptualized and designed the study. AL, TA, and Godfrey Magwindiri (GM) collected and analyzed data. TA and AL drafted the manuscript. Tsion Tsegaye (TT), Linden Morrison (LM), Tatjana Peterson (TP), Sheza Elhussein (SE), Esther Antonio(EA), Ivan Dumba (ID), Cleyland Mtambirwa (CM), Newman Madzikwa(NM), Raiva Simbi (RS), Misheck Ndlovu (MN) and LW did the critical revisions of the manuscript. All authors read and approved the final manuscript.

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Ethical approval including the consent procedure for participants was obtained from the Ethics Committee of the MOHCC Department of Research and NATPHARM, Harare Zimbabwe. The conduct and methods of this study adhered to the tenets outlined in the Declaration of Helsinki. Informed consent was obtained from each study participant involved in the study. The data collection protocol ensured that all study participants fully understood the objectives of the study and consented in writing to provide the required information. Before the interview commenced, the participants also consented verbally and confirmed that they had understood the objectives of the study and that they could opt out of the interview at any time without prejudice. No sensitive or personally identifying information was collected regarding the study participants.

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RI, LM, TP and SE declare that they are fulltime employees at the Global Fund to Fight AIDs, Tuberculosis and Malaria. EA and GM declare that they are fulltime employees at PricewaterhouseCoopers. ID, CM, NM and RS are fulltime employees at National Pharmaceutical Company of Zimbabwe. The rest of the authors declare that they have no competing interests.

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Lesego, A., Were, L.P.O., Tsegaye, T. et al. Health system lessons from the global fund-supported procurement and supply chain investments in Zimbabwe: a mixed methods study. BMC Health Serv Res 24 , 557 (2024). https://doi.org/10.1186/s12913-024-11028-6

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DOI : https://doi.org/10.1186/s12913-024-11028-6

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The 6-Step Guide to Market Research Processes

Looking for a step-by-step guide to market research processes? Learn more about the marketing research process and methods to gather data—and make the most of it.

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Researchers are curious people. That’s why every research project starts with a question.

What is the part of your business you want to know more about? Identifying the problem is the most important step in market research processes. It’s going to determine every step you take in the future—of market research, anyway.

Not sure where to start? Here are a few tips:

Look for marketing challenges or opportunities. Maybe your brand awareness could use a boost. You've noticed declining customer loyalty, or you’re considering opportunities in emerging markets.

Frame it as a question. Why is customer loyalty decreasing? How can we enter the market for luxury hotels? What does our customer’s typical path to purchase look like?

Determine what type of problem you have. In market research, a problem can be ambiguous, clearly defined, or somewhere in the middle. Do you know the variables and factors influencing what you want to measure? This is important as it'll influence your overall research design, which is up next.

2. Design the research

There are three types of research designs. The design you choose will be informed by how well-defined your problem is.

If you don’t know much about the problem, you need:

Exploratory research: If you don’t know the major variables or factors at play, your research is ambiguous. Exploratory research can help you develop a hypothesis or ask a more precise question. If you have a vague idea about what’s important to solve the problem, you need:

Descriptive research: Descriptive research does what it says on the box— it describes a certain phenomenon or the characteristics of a population. It can build on exploratory research but doesn’t give insight into the how, when, or why. Descriptive research is useful for parsing out market segments and measuring performance. Consequently, you need a pretty good idea of what you’re measuring and how it'll be measured. If you want to know how cause and effect are linked, you need:

Causal research: Market researchers conduct causal research when they want to understand the relationships between two or more variables. Simply put, causal research helps you understand cause and effect.

3. Choose your sample and market research methods

Data is the essence of market research. At the end of these market research processes, data is analyzed, interpreted, and turned into information and actionable insights.

Data can be qualitative or quantitative . Qualitative data can take many forms, from descriptions to audio and video. Quantitative data is typically presented in values and figures.

When choosing your sample, you must select the population you want to study. A population is a group with some shared characteristics that you’re interested in gathering data from. It can be broad (Canadians) or narrow (independent gym owners in Chicago).

No matter how small or large your population, you’ll unlikely be able to work with everyone.

The key to choosing a good sample is that it is representative. That means the people you select to participate (the sample) should reflect the larger group you’re studying.

4. Get the data

There are two forms of data you can collect: primary and secondary data.

Primary data is gathered specifically for your project. Secondary data has already been collected, either internally or externally through government agencies, consulting or market research firms, websites, social networks, and so on.

Depending on your research design, you may want to check internally for secondary data. For example, let’s say you’re trying to understand the annual purchase cycle for your business. You'd gather sales and reports and company records—that's secondary data.

But of course, secondary data still needs to be prepared for analysis

There are two ways to collect primary data: directly or indirectly. Direct data collection is just that—you are speaking to your participants directly. That can be through surveys, interviews, focus groups, and so on. Indirect data collection typically means observation. Think in-store observation, shelf experiments, or website heatmaps.

5. Analyze the data

Data analysis is a process of looking for patterns in data and trying to understand why those patterns exist. Data can be analyzed quantitatively or qualitatively.

Quantitative data analysis is a process more complicated than can be described here. Unless you’re a math whiz, you’ll probably just use a data analysis software like SPSS or StatCrunch.

Qualitative data analysis typically involves coding—but not the computer programming kind, don’t you worry. This type of coding can be done by hand or using software such as NVivo. It involves looking for themes, concepts, and words that are repeated throughout the data.

6. Interpret and present the insights

Interpretation involves answering the question: What does the data tell me about what I wanted to know?

That’s where themes and patterns come in. You can describe trends and present them using figures or descriptions drawn from your participants.

Part of interpretation is using what you know about customers, businesses, or markets to provide recommendations for how to move forward. These data-driven suggestions should offer a solution to the initial problem. The results of the research can also bring to light a problem you weren’t even aware you had.

Overview of market research methods

Market researchers are able to draw on a large toolbox of market research methods. Typically, they fall into the qualitative or quantitative category because of the type of data they produce.

Focus groups

Best for: Exploratory research

Type of method: Qualitative

A market research technique that involves a group discussion about certain topics led by a moderator to uncover the thoughts and opinions of participants.

In-depth interviews

Best for: Descriptive research

An interview that's conducted with an individual aimed at getting deeper insights about attitudes, motivations, or experiences.

Ethnography

Best for: Descriptive research 

Also known as participant observation, it involves spending time with participants in their natural environment (as opposed to a lab setting). 

Observational

Carefully watch people to understand what they’re doing. It allows you to learn about consumer or employee behavior but not the motivation behind it.

Discourse analysis

Best for: Exploratory or descriptive research

This is a fancy way of saying “analyzing what people say.” Social listening is a form of discourse analysis. Examining customer reviews, help transcripts, social media comments, and more are all forms of discourse analysis.

Type of method: Quantitative

Surveys are the crux of market research. They involve collecting facts, figures, and opinions using a questionnaire. Surveys can also yield qualitative data if participants write out answers. Surveys may seem simple, but there are a lot of factors that can turn good intentions into bad data—be sure to read our tips on the right question types to ask . 

Structured observation

Observation research can also be quantitative if you are observing participants without direct involvement and assigning values to certain behaviors.

A/B testing

Also called split testing, this is a way to compare responses to a variation of a single variable to see which performs better. For example, presenting users with two versions of an ad to see which gets more clicks.

Best for: Causal research

Marketing experimentation typically involves manipulating a variable to see how it influences behavior. It can be conducted in a lab or in the field. 

Examples of market research

Time to put this into practice. Let’s look at market research examples of various types of research designs. 

Exploratory market research

Mobile phone company HTC wanted to understand how they could improve the user experience of their phones. This problem required exploratory research because there wasn’t a specific feature they wanted to test. They simply wanted to learn more from their customers.

With market research, they observed how participants interacted with their phones. They looked for challenges people had with everyday usage. After analyzing these pain points, they added new functions to their next model that made the phones easier to use.

Descriptive market research

Company ABC wants to understand how large the market for vegan cheese is in Canada. They have a somewhat defined research problem: What is the potential market share for vegan cheese?

In order to provide an answer, market researchers will have to describe various characteristics: who the customers are, why they buy vegan cheese, competitor market penetration, and potential opportunities.

This requires mixed-method research. The researchers might collect secondary data on the number of vegans in Canada or how much vegan cheese is sold in the country and through which companies. They may also conduct focus groups to understand what motivates people to buy vegan cheese.

Once complete, they'll be able to present statistics on vegans in Canada and estimate Company ABC’s potential market share.

Causal market research

Causal research requires keeping variables and conditions the same, save for the one you are testing. German marketing and sensory research company iSi is a company that runs both field and lab experiments.

They worked with a chocolate bar company to design an experiment that tested 12 different chocolate bar recipes.

The consumers sequentially tested the recipes and provided ratings (quantitative data) and descriptions (qualitative data) of each one. The result was that consumers were most satiated by “a firm, tough texture and a higher amount of caramel and peanuts.”

Discovering market research processes

One thing to remember is that market research is an iterative process. You can keep using what you learn to conduct better studies and evaluate the changing market conditions and the whims of consumers. 

Ready to tackle the market research process? Build a market research survey with Typeform—choose from one of our customizable templates to gather beautifully designed data.

About the author

We're Typeform - a team on a mission to transform data collection by bringing you refreshingly different forms.

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