Ethnography: traditional and criticalist conceptions of a qualitative research method.

Teaching family medicine residents how to conduct research is increasingly being seen as a crucial component of their training, in part as a means of strengthening the discipline and in part to improve their practices. Whereas quantitative methods once dominated approaches to medical research, the application of qualitative methods is seen as an effective way to study issues in primary care.1-3 Ethnography is one such qualitative approach that offers residents a useful tool for conducting research. This article presents an overview of ethnography as a research method that is used to gain a deeper understanding of human behaviour, motivation, and social interaction within specific and complex cultural contexts. Ethnographic research has long played an important role in medicine.4-6 Becker and colleagues’ landmark ethnographic study, Boys in White: Student Culture in Medical School,7 used qualitative interviews and participant observation to learn how medical students are acculturated into the medical profession; how they learn to negotiate the social complexities within the hospital; and their anxieties, doubts, and idealism as they go through medical training. The study also provides useful insight into students’ evolving and shifting conceptions of the medical profession. Ethnographies such as this one provide an in-depth perspective on a range of health-related issues, such as the professional8 and corporate culture,9 social determinants,10 the illness experiences of patients,11 moral problems in health care,12 the family’s role in patient care,13 patient attitudes toward delivery of care,14 and other factors that influence health care and health outcomes.15-17 In essence, ethnographies provide a deeper insight into a culture. In this sense culture is defined as the collective assumptions and beliefs that influence the practices of a particular group of people who share a social space. The term ethnography is thought to have first been introduced in 1922 by Bronsilaw Malinowski (18841942).18 It has its roots in the descriptive science19 of social anthropology, central to which is the study of culture and cultural behaviour.20 Ethnographies, however, are not limited to studies of ethnic rituals and practices. They include studies that describe and explain a range of social phenomena within various culture-sharing groups. These ethnographies provide an in-depth description and analysis, and paint a portrait of the ways in which culture-sharing groups interpret their experiences and create meaning from their interactions. Surgeons, for example, have a particular professional culture influenced by attitudes and behaviour that are characteristic of that group and transmitted across generations through learning.21