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• What Is Ethnography? | Definition, Guide & Examples

What Is Ethnography? | Definition, Guide & Examples

Published on March 13, 2020 by Jack Caulfield . Revised on June 22, 2023.

Ethnography is a type of qualitative research that involves immersing yourself in a particular community or organization to observe their behavior and interactions up close. The word “ethnography” also refers to the written report of the research that the ethnographer produces afterwards.

Ethnography is a flexible research method that allows you to gain a deep understanding of a group’s shared culture, conventions, and social dynamics. However, it also involves some practical and ethical challenges.

Table of contents

What is ethnography used for, different approaches to ethnographic research, gaining access to a community, working with informants, observing the group and taking field notes, writing up an ethnography, other interesting articles.

Ethnographic research originated in the field of anthropology, and it often involved an anthropologist living with an isolated tribal community for an extended period of time in order to understand their culture.

This type of research could sometimes last for years. For example, Colin M. Turnbull lived with the Mbuti people for three years in order to write the classic ethnography The Forest People .

Today, ethnography is a common approach in various social science fields, not just anthropology. It is used not only to study distant or unfamiliar cultures, but also to study specific communities within the researcher’s own society.

For example, ethnographic research (sometimes called participant observation ) has been used to investigate  football fans , call center workers , and police officers .

Advantages of ethnography

The main advantage of ethnography is that it gives the researcher direct access to the culture and practices of a group. It is a useful approach for learning first-hand about the behavior and interactions of people within a particular context.

By becoming immersed in a social environment, you may have access to more authentic information and spontaneously observe dynamics that you could not have found out about simply by asking.

Ethnography is also an open and flexible method. Rather than aiming to verify a general theory or test a hypothesis , it aims to offer a rich narrative account of a specific culture, allowing you to explore many different aspects of the group and setting.

Disadvantages of ethnography

Ethnography is a time-consuming method. In order to embed yourself in the setting and gather enough observations to build up a representative picture, you can expect to spend at least a few weeks, but more likely several months. This long-term immersion can be challenging, and requires careful planning.

Ethnographic research can run the risk of observer bias . Writing an ethnography involves subjective interpretation, and it can be difficult to maintain the necessary distance to analyze a group that you are embedded in.

There are often also ethical considerations to take into account: for example, about how your role is disclosed to members of the group, or about observing and reporting sensitive information.

Should you use ethnography in your research?

If you’re a student who wants to use ethnographic research in your thesis or dissertation , it’s worth asking yourself whether it’s the right approach:

• Could the information you need be collected in another way (e.g. a survey , interviews)?
• How difficult will it be to gain access to the community you want to study?
• How exactly will you conduct your research, and over what timespan?
• What ethical issues might arise?

If you do decide to do ethnography, it’s generally best to choose a relatively small and easily accessible group, to ensure that the research is feasible within a limited timeframe.

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There are a few key distinctions in ethnography which help to inform the researcher’s approach: open vs. closed settings, overt vs. covert ethnography, and active vs. passive observation. Each approach has its own advantages and disadvantages.

Open vs. closed settings

The setting of your ethnography—the environment in which you will observe your chosen community in action—may be open or closed.

An open or public setting is one with no formal barriers to entry. For example, you might consider a community of people living in a certain neighborhood, or the fans of a particular baseball team.

• Gaining initial access to open groups is not too difficult…
• …but it may be harder to become immersed in a less clearly defined group.

A closed or private setting is harder to access. This may be for example a business, a school, or a cult.

• A closed group’s boundaries are clearly defined and the ethnographer can become fully immersed in the setting…
• …but gaining access is tougher; the ethnographer may have to negotiate their way in or acquire some role in the organization.

Overt vs. covert ethnography

Most ethnography is overt . In an overt approach, the ethnographer openly states their intentions and acknowledges their role as a researcher to the members of the group being studied.

• Overt ethnography is typically preferred for ethical reasons, as participants can provide informed consent…
• …but people may behave differently with the awareness that they are being studied.

Sometimes ethnography can be covert . This means that the researcher does not tell participants about their research, and comes up with some other pretense for being there.

• Covert ethnography allows access to environments where the group would not welcome a researcher…
• …but hiding the researcher’s role can be considered deceptive and thus unethical.

Active vs. passive observation

Different levels of immersion in the community may be appropriate in different contexts. The ethnographer may be a more active or passive participant depending on the demands of their research and the nature of the setting.

An active role involves trying to fully integrate, carrying out tasks and participating in activities like any other member of the community.

• Active participation may encourage the group to feel more comfortable with the ethnographer’s presence…
• …but runs the risk of disrupting the regular functioning of the community.

A passive role is one in which the ethnographer stands back from the activities of others, behaving as a more distant observer and not involving themselves in the community’s activities.

• Passive observation allows more space for careful observation and note-taking…
• …but group members may behave unnaturally due to feeling they are being observed by an outsider.

While ethnographers usually have a preference, they also have to be flexible about their level of participation. For example, access to the community might depend upon engaging in certain activities, or there might be certain practices in which outsiders cannot participate.

An important consideration for ethnographers is the question of access. The difficulty of gaining access to the setting of a particular ethnography varies greatly:

• To gain access to the fans of a particular sports team, you might start by simply attending the team’s games and speaking with the fans.
• To access the employees of a particular business, you might contact the management and ask for permission to perform a study there.
• Alternatively, you might perform a covert ethnography of a community or organization you are already personally involved in or employed by.

Flexibility is important here too: where it’s impossible to access the desired setting, the ethnographer must consider alternatives that could provide comparable information.

For example, if you had the idea of observing the staff within a particular finance company but could not get permission, you might look into other companies of the same kind as alternatives. Ethnography is a sensitive research method, and it may take multiple attempts to find a feasible approach.

All ethnographies involve the use of informants . These are people involved in the group in question who function as the researcher’s primary points of contact, facilitating access and assisting their understanding of the group.

This might be someone in a high position at an organization allowing you access to their employees, or a member of a community sponsoring your entry into that community and giving advice on how to fit in.

However,  i f you come to rely too much on a single informant, you may be influenced by their perspective on the community, which might be unrepresentative of the group as a whole.

In addition, an informant may not provide the kind of spontaneous information which is most useful to ethnographers, instead trying to show what they believe you want to see. For this reason, it’s good to have a variety of contacts within the group.

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The core of ethnography is observation of the group from the inside. Field notes are taken to record these observations while immersed in the setting; they form the basis of the final written ethnography. They are usually written by hand, but other solutions such as voice recordings can be useful alternatives.

Field notes record any and all important data: phenomena observed, conversations had, preliminary analysis. For example, if you’re researching how service staff interact with customers, you should write down anything you notice about these interactions—body language, phrases used repeatedly, differences and similarities between staff, customer reactions.

Don’t be afraid to also note down things you notice that fall outside the pre-formulated scope of your research; anything may prove relevant, and it’s better to have extra notes you might discard later than to end up with missing data.

Field notes should be as detailed and clear as possible. It’s important to take time to go over your notes, expand on them with further detail, and keep them organized (including information such as dates and locations).

After observations are concluded, there’s still the task of writing them up into an ethnography. This entails going through the field notes and formulating a convincing account of the behaviors and dynamics observed.

The structure of an ethnography

An ethnography can take many different forms: It may be an article, a thesis, or an entire book, for example.

Ethnographies often do not follow the standard structure of a scientific paper, though like most academic texts, they should have an introduction and conclusion. For example, this paper begins by describing the historical background of the research, then focuses on various themes in turn before concluding.

An ethnography may still use a more traditional structure, however, especially when used in combination with other research methods. For example, this paper follows the standard structure for empirical research: introduction, methods, results, discussion, and conclusion.

The content of an ethnography

The goal of a written ethnography is to provide a rich, authoritative account of the social setting in which you were embedded—to convince the reader that your observations and interpretations are representative of reality.

Ethnography tends to take a less impersonal approach than other research methods. Due to the embedded nature of the work, an ethnography often necessarily involves discussion of your personal experiences and feelings during the research.

Ethnography is not limited to making observations; it also attempts to explain the phenomena observed in a structured, narrative way. For this, you may draw on theory, but also on your direct experience and intuitions, which may well contradict the assumptions that you brought into the research.

If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.

• Normal distribution
• Degrees of freedom
• Null hypothesis
• Discourse analysis
• Control groups
• Mixed methods research
• Non-probability sampling
• Quantitative research
• Ecological validity

Research bias

• Rosenthal effect
• Implicit bias
• Cognitive bias
• Selection bias
• Negativity bias
• Status quo bias

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Qualitative research methodologies: ethnography

• Related content
• Peer review
• Scott Reeves , associate professor 1 ,
• Ayelet Kuper , assistant professor 2 ,
• Brian David Hodges , associate professor and vice chair (education) 3
• 1 Department of Psychiatry, Li Ka Shing Knowledge Institute, Centre for Faculty Development, and Wilson Centre for Research in Education, University of Toronto, 200 Elizabeth Street, Eaton South 1-565, Toronto, ON, Canada M5G 2C4
• 2 Department of Medicine, Sunnybrook Health Sciences Centre, and Wilson Centre for Research in Education, University of Toronto, Toronto, ON, Canada M4N 3M5
• 3 Department of Psychiatry, Wilson Centre for Research in Education, University of Toronto, Toronto, ON, Canada M5G 2C4
• Correspondence to: S Reeves scott.reeves{at}utoronto.ca

The previous articles (there were 2 before this 1) in this series discussed several methodological approaches commonly used by qualitative researchers in the health professions. This article focuses on another important qualitative methodology: ethnography. It provides background for those who will encounter this methodology in their reading rather than instructions for carrying out such research.

What is ethnography?

Ethnography is the study of social interactions, behaviours, and perceptions that occur within groups, teams, organisations, and communities. Its roots can be traced back to anthropological studies of small, rural (and often remote) societies that were undertaken in the early 1900s, when researchers such as Bronislaw Malinowski and Alfred Radcliffe-Brown participated in these societies over long periods and documented their social arrangements and belief systems. This approach was later adopted by members of the Chicago School of Sociology (for example, Everett Hughes, Robert Park, Louis Wirth) and applied to a variety of urban settings in their studies of social life.

The central aim of ethnography is to provide rich, holistic insights into people’s views and actions, as well as the nature (that is, sights, sounds) of the location they inhabit, through the collection of detailed observations and interviews. As Hammersley states, “The task [of ethnographers] is to document the culture, the perspectives and practices, of the people in these settings. The aim is to ‘get inside’ the way each group of people sees the world.” 1 Box 1 outlines the key features of ethnographic research.

Box 1 Key features of ethnographic research 2

A strong emphasis on exploring the nature of a particular social phenomenon, rather than setting out to test hypotheses about it

A tendency to work primarily with “unstructured data” —that is, data that have not been coded at the point of data collection as a closed set of analytical categories

Investigation of a small number of cases (perhaps even just one case) in detail

Analysis of data that involves explicit interpretation of the meanings and functions of human actions; the product of this analysis primarily takes the form of verbal descriptions and explanations

Examples of ethnographic research within the health services literature include Strauss’s study of achieving and maintaining order between managers, clinicians, and patients within psychiatric hospital settings; Taxis and Barber’s exploration of intravenous medication errors in acute care hospitals; Costello’s examination of death and dying in elderly care wards; and Østerlund’s work on doctors’ and nurses’ use of traditional and digital information systems in their clinical communications. 3 4 5 6 Becker and colleagues’ Boys in White , an ethnographic study of medical education in the late 1950s, remains a classic in this field. 7

Newer developments in ethnographic inquiry include auto-ethnography, in which researchers’ own thoughts and perspectives from their social interactions form the central element of a study 8 ; meta-ethnography, in which qualitative research texts are analysed and synthesised to empirically create new insights and knowledge 9 ; and online (or virtual) ethnography, which extends traditional notions of ethnographic study from situated observation and face to face researcher-participant interaction to technologically mediated interactions in online networks and communities. 10

What should I be looking for in an ethnographic study?

Ethnographers typically gather participant observations, necessitating direct engagement and involvement with the world they are studying. Owing to the complex nature of social life, ethnographers need to record a variety of elements in their field notes (box 2).

Box 2 Nine observational dimensions and their descriptions 11

Space—Physical layout of the place(s)

Actor—Range of people involved

Activity—A set of related activities that occur

Object—The physical things that are present

Act—Single actions people undertake

Event—Activities that people carry out

Time—The sequencing of events that occur

Goal—Things that people are trying to accomplish

Feeling—Emotions felt and expressed

During their observations, ethnographers routinely use informal or conversational interviews, which allow them to discuss, probe emerging issues, or ask questions about unusual events in a naturalistic manner. Because of the “casual” nature of this type of interview technique it can be useful in eliciting highly candid accounts from individuals. Ethnographers also gather formal in-depth interviews and documentary data such as minutes of meetings, diaries, and photographs.

Participants or situations are sampled on an opportunistic or purposive basis. It is also usual for ethnographers to focus upon specific features (for example, medical ward rounds) that occur within a research setting.

Analysis of ethnographic data tends to be undertaken in an inductive thematic manner: data are examined to identify and to categorise themes and key issues that “emerge” from the data. Through a careful analysis of their data, using this inductive process, ethnographers generate tentative theoretical explanations from their empirical work.

Reflexivity (that is, the relationship a researcher shares with the world he or she is investigating) is a central element of ethnographic work, owing to the relationship the ethnographer shares with participants and the ethical issues that flow from this close relationship. Within research reports, reflexivity is presented in the form of a description of the ethnographer’s ideas and experiences, which can be used by readers to judge the possible impact of these influences on a study.

To enhance the quality of their work, ethnographers will often provide a detailed or “thick description” of the research setting and its participants, which will typically be based on many hours of direct observation and interviews with several key informants. 12

In addition, ethnographic work commonly uses methodological triangulation—a technique designed to compare and contrast different types of methods to help provide more comprehensive insights into the phenomenon under study. This type of triangulation can be very useful, as sometimes what people say about their actions can contrast with their actual behaviour. 13 Box 3 provides further information about triangulation and the different types that can be employed within ethnographic research.

Box 3 Triangulation in ethnography

Triangulation is a term linked to navigation or surveying: people discover their position on a map by taking bearings on landmarks, and where the lines intersect is where they are positioned. As well as methodological triangulation, Denzin 14 outlines three other types:

Data triangulation, which uses different sources of data to examine a phenomenon in several different settings and different points in time or space

Investigator triangulation, which uses multiple researchers to generate a complex range of perspectives on the data

Theory triangulation, in which researchers approach data with different concepts and theories to see how each helps to understand the data

Ethnographers often draw upon social sciences theory (for example, interactionism, feminism, and postmodernism) to strengthen their research focus and analyses. (The use of theory within qualitative research is examined in more depth in another paper in this series). See box 3 for an example of an ethnographic study.

Box 4 An ethnographic study of professional relationships

This ethnographic study took place in a large general hospital in the United Kingdom. 15 It aimed to understand, in depth, the nature of hospital based nurse-doctor relationships in the wake of changes to health policy and to the delivery of professional education.

The author, a nurse, undertook participant observations for 10 months, during which she worked as a nurse (on an unpaid basis) with doctors, nurses, managers, and auxiliary staff on both a surgical and a medical ward. To gain a candid insight into these professionals’ views, she undertook informal interviews with staff while they worked together. She also collected 57 tape recorded interviews, each lasting 60 to 90 minutes, with nurses, doctors, auxiliaries, and managers. These explored in more depth participants’ views of their interprofessional relationships. Documentary data were also generated through analysis of organisational documents and through attendance at professional and managerial meetings.

The author undertook an inductive approach to data analysis, in which meanings emerged from the data through exploration of all data sets. In addition, she used data from different sources (observations, interviews, documentary data) to generate a more comprehensive understanding in the emerging analysis. The author drew upon negotiated order perspective—a sociological theory developed by Strauss to frame and illuminate the findings from her analysis. She also discussed her reflexive role in the study, and as a nurse, how that helped her secure access into this clinical setting, and how it helped her attain richer insights into the nature of nurse-doctor relationships in relation to how they negotiate professional boundaries in their clinical work.

Why choose ethnography?

Ethnographic research offers several advantages. For example, the use of participant observation enables ethnographers to “immerse” themselves in a setting, thereby generating a rich understanding of social action and its subtleties in different contexts.

Participant observation also gives ethnographers opportunities to gather empirical insights into social practices that are normally “hidden” from the public gaze. Additionally, since it aims to generate holistic social accounts, ethnographic research can identify, explore, and link social phenomena which, on the surface, have little connection with each other.

Ethnographic research can be problematic. Owing to the relatively long periods of time ethnographers spend talking to participants and observing actions, it can be difficult to secure repeated access, especially if institutional gatekeepers are concerned that the research may cast their organisation in a poor light. Obtaining formal approval from research ethics committees can be complicated. The direct interaction that occurs between ethnographers and patients or clinicians during fieldwork can be regarded with suspicion, as traditional notions of health services research rest on researchers’ detachment rather than involvement. Comprehensively recording the multifaceted nature of social action that occurs within a clinic or ward is a difficult task, as a range of temporal, spatial, and behavioural elements need to be documented (see box 1). In addition, the unpredictability of social (and clinical) life often means that ethnographers have to be flexible, patient, and persistent in their work, as data collection activities can be disrupted or access withdrawn as local circumstances and politics change.

Ethnography is a highly useful methodology for addressing a range of research questions within the health professions. In particular, it can generate rich and detailed accounts of clinicians’ professional and interprofessional relationships, their interactions with patients, and their approaches to delivering care, as well as in-depth accounts of patients’ care experiences. Understanding the foundations of ethnography and its key elements will help readers when they come across reports that use this methodology. A later article in this series will provide readers with a more formal framework to use when critically appraising qualitative research papers, including ethnographies. Readers interested in undertaking such research should refer to the works listed in box 4.

Box 4 Further reading

Atkinson P, Coffey A, Delamont S, Lofland J, Lofland L, eds. Handbook of ethnography . London: Sage, 2001.

Fetterman D. Ethnography: step by step . 2nd ed. London: Sage, 1988.

Fielding N. Ethnography. In: Researching social life . London: Sage, 1993:155-71.

Hammersley M, Atkinson P. Ethnography: principles in practice . 2nd ed. London: Routledge, 1995.

Spradley J. The ethnographic interview . New York: Holt, 1979.

Journal articles

Atkinson P, Pugsley L. Making sense of ethnographic research in medical education. Med Educ 2005;39:228-34.

Charmaz K, Oleson V. Ethnographic research in medical sociology: its foci and distinctive contributions. Sociol Methods Res 1997;25:452-94.

Fine G. Ten lies of ethnography. J Contemp Ethnogr 1993;22:267-94.

Jeffrey B, Troman G. Time for ethnography. Br Educ Res J 30:535-48

Savage J. Ethnography and health care. BMJ 2000;321:1400-2.

Summary points

Ethnography is the study of social interactions, behaviours, and perceptions that occur within teams, organisations, and communities.

Ethnographic studies typically gather participant observations and interviews; through using these methods ethnographers can immerse themselves in settings and can generate rich understanding of the social action that occurs

Owing to the relationship the ethnographer shares with research participants, reflexivity (whereby ethnographers describe the relationship they shares with the people and world they are studying) occupies a central element of this type of research

Ethnographers commonly triangulate (that is, compare and contrast) interview and observation methods to enhance the quality of their work; this technique is important as what people say about their behaviour can contrast with their actual actions

Cite this as: BMJ 2008;337:a1020

• Related to doi: , 10.1136/bmj.a288
• doi: , 10.1136/bmj.39602.690162.47
• doi: , 10.1136/bmj.a879
• doi: , 10.1136/bmj.a949
• doi: 10.1136/bmj.a1035

This is the third in a series of six articles that aim to help readers to critically appraise the increasing number of qualitative research articles in clinical journals. The series editors are Ayelet Kuper and Scott Reeves.

For a definition of general terms relating to qualitative research, see the first article in this series

Funding: None.

Competing interests: None declared.

Provenance and peer review: Commissioned; externally peer reviewed.

• ↵ Hammersley M. What’s wrong with ethnography? Methodological explorations. London: Routledge, 1992 .
• ↵ Hammersley M, Atkinson P. Ethnography: principles in practice. 2nd ed. London: Routledge, 1995
• ↵ Strauss A, Schatzman D, Ehrlich R, Bucher M, Sabshin C. The hospital and its negotiated order. In: Freidson E, ed. The hospital in modern society . New York: Free Press, 1963 :147-69.
• ↵ Taxis K, Barber N. Causes of intravenous medication errors: an ethnographic study. Qual Saf Health Care 2003 ; 12 : 343 -7. OpenUrl Abstract / FREE Full Text
• ↵ Costello J. Nursing older dying patients: findings from an ethnographic study of death and dying in elderly care wards. J Adv Nurs 2001 ; 35 : 59 -68. OpenUrl CrossRef PubMed Web of Science
• ↵ Østerlund C. Genre combinations: a window into dynamic communication practices. J Manage Inf Syst 2007 ; 23 : 81 -108. OpenUrl
• ↵ Becker H, Geer B, Hughes E, Strauss A. Boys in white: student culture in medical school . Chicago: University of Chicago Press, 1961 .
• ↵ Reed-Danahay D. Auto-ethnography: rewriting the self and the social . London: Berg, 1997 .
• ↵ Britten N, Campbell R, Pope C, Donovan J, Morgan M, Pill R. Using meta-ethnography to synthesise qualitative research: a worked example. J Health Serv Res Policy 2002 ; 7 : 209 -15. OpenUrl Abstract / FREE Full Text
• ↵ Hine C. Virtual ethnography . London: Sage, 2000 .
• ↵ Spradley J. Participant observation. New York: Holt, 1980
• ↵ Geertz C. The interpretation of cultures: selected essays . New York: Basic Books, 1973 .
• ↵ Strong P. The ceremonial order of the clinic . London: Routledge, 1977 .
• ↵ Denzin N. The research act in sociology . London:Butterworth, 1970 .
• ↵ Allen D. The nursing-medical boundary: a negotiated order? Sociol Health Illn 1997 ; 19 : 498 -520. OpenUrl CrossRef Web of Science

The Ultimate Guide to Qualitative Research - Part 1: The Basics

• Introduction and overview
• What is qualitative research?
• What is qualitative data?
• Examples of qualitative data
• Qualitative vs. quantitative research
• Mixed methods
• Qualitative research preparation
• Theoretical perspective
• Theoretical framework
• Literature reviews
• Research question
• Conceptual framework
• Conceptual vs. theoretical framework
• Data collection
• Qualitative research methods
• Focus groups
• Observational research
• Case studies
• Introduction

Defining ethnographic research

What are the methods in ethnographic research, how do i conduct an ethnography.

• Ethical considerations
• Confidentiality and privacy
• Power dynamics
• Reflexivity

What is ethnographic research?

An ethnographic study is one of the most ambitious endeavors a researcher can pursue in qualitative research . It involves using several ethnographic methods to observe and describe social life, social relations, or human society as a whole. Time-consuming and arduous as the data collection and data analysis might be, conducting an ethnography can be one of the most rewarding challenges in cultural anthropology, social anthropology, and similar qualitative research areas.

Let's look at the fundamentals of ethnographic research, examples of ethnographic studies, and the fundamentals of ethnography as a qualitative research method.

"Culture" is an ambiguous term that resists an easy definition. What defines a culture? What takes place inside a culture? What cultures does a particular individual belong to? Who decides who belongs to any specific culture?

Even within a particular context, there are several layers of cultures. Take the United States, for example. Given how diverse and as big as it is, how can one define American culture in as brief an explanation as possible? What are the different social groups within this one country, and how do those groups interact with each other?

Quantitative research is often incapable of capturing such detail, especially because it is extremely difficult to adequately capture a culture in quantitative terms. As a result, researchers often conduct traditional ethnographic research when they want to understand a culture. A credible, written account of a social group is challenging to produce. It requires looking at participant experiences, interviews , focus groups , and document collection, which are different ways to collect data for ethnographic research.

Ethnography belongs squarely in the realm of observational research . In other words, writing culture and cultural critique cannot be based on experiments performed in controlled settings. Ethnography aims to provide an immersive experience in a culture for audiences who are unfamiliar with it. In that case, the researcher must observe the intricate dimensions of social interaction in its natural environment. In ethnographic research, this observation is active and involves being part of the culture to understand the dimensions of cultural norms from the inside.

That said, even observation alone cannot capture concepts such as social relationships or cultural practices. Researchers conducting ethnographic studies acknowledge that simply observing and describing actions are insufficient to grasp social interaction fully. The concept of thick description, or the description of perspectives and beliefs informing those actions in addition to the actions themselves, guides the use of various methods to capture social phenomena from multiple angles.

What is the purpose of ethnographic research?

Ethnographic studies are heavily used in social and cultural anthropology disciplines to generate and expand theory. Outside of anthropology, the insights uncovered by ethnography help to propose or develop theories that can be verified by further qualitative or quantitative research within the social and human sciences.

In simple terms, ethnographic studies relate what a culture is to audiences who are otherwise unfamiliar outsiders. Armed with this understanding, researchers can illustrate and persuade audiences about patterns that emerge from a community or group of people. These patterns are essential to generating theory and pioneering work.

What are examples of ethnographic research?

Ethnographic research aims to reach a deep understanding of various socially-constructed topics, including:

• Rituals and other cultural practices in everyday life
• Social interaction among people of different cultures
• People's interactions with their natural environment
• Creation of and tensions in social relationships

Ethnography as a qualitative method is common in social and cultural anthropology and any scholarly discipline concerned with social interaction. The traditional role of ethnography is to inform scholars interested in cultures they wouldn't otherwise have contact or experience with. Various topics that have been explored by such research with ethnography include:

• health care workers interacting with patients
• teachers and students constructing classroom dialogue
• workplace relations between employees and managers
• experiences of refugees in conflict zones

Other disciplines, especially in the social sciences, employ ethnographic research methods for varied reasons, including understanding:

• effective teaching practices
• socialization processes
• intercultural cohesiveness
• company-customer relations

The range of inquiries that ethnography can answer is vast, highlighting the importance of ethnographic methods in studies where the researcher seeks a deep understanding of a particular topic.

Even within anthropology, there is a lack of consensus on the particular processes for conducting research through ethnography. Interaction among people is unpredictable to the extent that the researcher might encounter unexpected issues with research participants not foreseen at the outset of a study. Because no observational research can be conducted in a fully controlled setting, it is a challenge to define an exact process for an ethnography beyond the general principles guiding an ethnographic approach.

In broad terms, ethnographic data collection methods are varied. Still, all such methods carry the assumption that a single research method cannot fully capture a thorough understanding of a cultural phenomenon. A systematic study that employs ethnographic research methods collects data from observations, participant observations, and interviews . The researchers' reflections also contribute to the body of data since personal experiences are essential to understanding the unfolding ethnography.

Participant observation

At the core of field research is a method called participant observation . Scholars in contemporary ethnography have long acknowledged the importance of active participation in understanding cultural life. This method allows the researcher to experience activities and interactions alongside participants to establish an understanding they wouldn't otherwise achieve by observing from afar. In active participant observation, the ethnographic researcher takes field notes of what they see and experience. They are essential during fieldwork as they create a record that the researcher can look at later on to structure their analysis and recall crucial developments useful to data analysis .

During participant observation, the researcher may also collect other forms of data, including photographs and audio and video recordings . Sensory data is beneficial to ethnography because it helps the researcher recall essential experiences with vivid detail and provides potentially abundant supporting evidence for the arguments in their findings.

Interviews and focus groups

Participant observation provides data for seeing what people say and do in their natural environment. However, observation has its limits for capturing what people think and believe. As a result, an ethnographic researcher conducts interviews to follow up on what they saw in fieldwork with research participants.

A common type of interview in an ethnography is the stimulated recall interview. In a stimulated recall interview, research participants are asked questions about the events the researcher observed. These questions help research participants remember past experiences while providing the researcher with their way of thinking about those experiences.

A focus group involves interactions between the researcher and multiple research participants. Suppose the researcher is interested in the interpersonal dynamics between research participants. In that case, they might consider conducting focus groups to elicit interactions that are markedly different from one-on-one exchanges between a single research participant and the researcher. Interviews and focus groups also help uncover insights otherwise unfamiliar to the researcher, who can then use those insights to guide their theoretical understanding and further data collection .

Document collection

Documents often make up an essential aspect of cultural practices. Think about these examples:

• student homework
• medical records
• newspaper articles
• informational posters

The visual elements uncovered during an ethnography are potentially valuable to theoretical insights, and a researcher might find it important to incorporate documents in their project data.

Reflections

In any ethnography, the researcher is the main instrument of data collection. Their thoughts and beliefs are consequential to the data analysis in that any theoretical insights are filtered by their interpretations . As a result, a researcher should take field notes during participant observation and reflection notes about any connections between what they saw and what it might mean for generating theory during data analysis.

As with taking field notes, a researcher might not remember all the different things that transpire during an ethnography without being able to refer to some sort of record later on. More importantly, reflecting on theory during participant observation may be challenging. A useful practice involves sitting down after observations or interviews and writing down potential theoretical insights that come to mind.

Reflections guide participant observations during an ethnography and theoretical analysis afterward. They point the researcher toward phenomena that are most relevant to theory and guide discussion of that theory when the time comes to write a description of their ethnographic study.

Organizing data

With a research approach as complex as ethnography, you will likely collect abundant data that require organization to make the analytical process more efficient. Researchers can use ATLAS.ti to store all their data in a single project. Document groups allow you to categorize data into different types (e.g., text, audio, video), different contexts (e.g., hospital room, doctor's office), or even different dates (e.g., February 17th observation, March 21st observation).

Moreover, researchers can integrate text with multimedia in ATLAS.ti, which is ideal for analyzing interviews, because you can look at transcripts and their video or audio recordings simultaneously. This is a valuable feature in ethnographic studies examining how people speak and what they say. Photos and other visual documents can also easily be incorporated and analyzed, adding further valuable dimensions to your research.

Choose ATLAS.ti for analysis of all forms of data.

Download a free trial of ATLAS.ti to put your project data to work.

Now that we have established a foundational understanding of the various methods associated with ethnography, let's look at what an ethnographic approach to research might look like.

Defining your research questions

As with any research study, ethnographic studies begin when researchers want to know more about something unfamiliar. Do you want to understand how a particular group of people interact with their natural environment? What about how group members decide on a social structure? How is daily life affected by changing economic conditions over a long period of time?

Ethnographic research may also be appropriate for conducting a comparative study of multiple cultures. For example, consider the different groups of soccer fans in several parts of the world: fans in South America might act differently from fans in Europe or Asia. Teaching and learning in high school are bound to look different than teaching and learning in university settings. Emergency room medicine and hospice care have distinct purposes that affect the nature of interactions between doctors and patients.

Whatever the inquiry, the researcher benefits from defining a focus for their ethnography. A clear research question can help the researcher narrow their field of perception during participant observation . Suppose the research question has to do with doctor-patient interactions. In that case, the ethnographer can lend more focus to those conversations and less emphasis on ancillary developments within their research context. With a more specific view, they can examine how doctors speak to their patients while being less concerned about the hospital executives in earshot or the orderlies passing by unless and until they are relevant to the research inquiry.

Choosing theoretical perspectives

To further narrow the focus of the ethnography, a theoretical lens can direct the ethnographer toward aspects relevant to theory. Continuing with the example regarding doctor-patient interactions, let's imagine that the ethnographic study explores the role of reassuring language in situations regarding dire medical conditions. Are there relevant theories about what people can say to give peace of mind to others?

Typically, theories in qualitative research consist of a framework with discrete indicators you can use to organize knowledge. For example, let's suppose that there exists a concept of reassurance that can be broken down like this:

empathy - understanding and affirming other people's emotions evidence - providing examples of favorable results in similar situations responsiveness - actively listening to and validating others' concerns

With this sort of theory in mind, an ethnography can focus on listening for instances of these particular indicators during participant observation and recording these examples in field notes . Naturally, a theory is more credible if it's grounded in previous research.

Entering ethnographic fieldwork

The next step is to choose an appropriate and accessible context for your ethnography. Ethics are an important part of contemporary research in the social sciences, requiring permission from potential participants to observe and interact with them for research purposes.

Before any meaningful data collection, make sure to obtain informed consent from the research participants you are studying. Essentially, this involves receiving permission from your participants to document what they say and do after explaining the purpose of your study and the rights they have while participating in your ethnography.

Ethnographic collection of data

With a context and theory in mind, it's now time to conduct your ethnography. In general terms, this means entering the field and capturing as much rich data relevant to your research question as possible.

Good ethnographic practice relies on pursuing multiple research methods to capture data. Participant observation can help you document what people say and do, but good ethnographies also capture what people believe about their everyday actions.

However, the research method most associated with ethnographic research is note-taking. Field notes capture the researcher's personal experience with the culture they observe, which is necessary to fully understand the captured data. With the ethnographer as the main instrument of data collection, readers of ethnographic studies can attain a sense of the possible ways they can view cultures through the researcher's eyes.

Moreover, ethnography relies on rapport with research participants. Ethnographers who want to conduct interviews later will benefit from establishing good relationships with their research participants. As a result, more involved interactions during fieldwork can generate deeper and richer data for your study.

Considerations during fieldwork

It's important to remember that the ethnographer's presence can affect how people behave. Especially in participant observation, your interactions with research participants will directly influence what they do in their daily lives. Even our natural environment is affected by what we do in it. When writing your reflections, qualifying your interactions in the field with a sufficient accounting of how your presence might change what others say and do is important.

There are also ethical questions about what to document and how to use the resulting data afterward. Within anthropology, there are issues of representing cultural groups with respect and ensuring you have their permission to use what you observe and collect from the field. Top scholarly journals and academic conferences also want to know how you observed research ethics during fieldwork, so it is necessary to use your reflection memos to document your ethics practices in addition to the data you collect.

Further development in ethnographic fieldwork

Unexpected issues in field research, especially long-term fieldwork, can help you refine your theoretical framework . Returning to the example of the concept of reassurance, you might observe a doctor's explanation of a medical procedure and find that it's similar to providing evidence. Still, it does not fully align with the established theory. In other words, studying real-world episodes of medical explanations may contribute novel insights about reassurance, helping you further develop your focus in subsequent observations.

As you continue your ethnography, refining the scope of your theoretical perspective helps you more easily gather observational data relevant to your research inquiry and thus provide a fully developed framework for your data.

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Chapter 9: Ethnography

Darshini Ayton

Learning outcomes

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

• Identify the key terms and concepts used in ethnography.
• Discuss the advantages and disadvantages of ethnography.

What is ethnography?

The key concept in ethnography is culture .

Ethnography studies emerged from the discipline of anthropology. They aim to understand the meanings and behaviours associated with the membership of groups, teams, organisations and communities. 1 The focus of ethnographic research is on the lived culture of groups of people; ethnographers have studied systems of belief, religious frameworks, worldviews and structures that form the social world. There are many definitions of culture. In ethnography, culture is defined as the group norms and expectations that allow members of the group to communicate and work together. This includes attributes, beliefs, customs, behaviours, knowledge, capabilities and habits. Examples of cultural groups include people from a particular region or race, religious groups, organisational groups, workplaces and social groups (for example, friendship groups, and mothers groups). Note that culture is dynamic and socially constructed and it is normal for there to be sub-cultures within cultural groups. 2

Multiple methods can be used in ethnographic research, but participant observation is a hallmark method. 1,3 To explore culture requires a ‘triangulation’; that is,  the use of multiple methods, such as observations and interviews, to develop a comprehensive understanding of culture through observing people and listening to what they have to say about (or within) the culture.

Several approaches to data analysis lend themselves to ethnography, including the identification, study and analysis of patterns. The process of analysis follows a typically unstructured and iterative path consisting of description (describing data), analysis (examining relationships and linkages) and interpretation (explanations beyond analysis). 4

There are other key concepts in ethnographic research, which are outlined below.

Additional key concepts in ethnographic research

• Fieldwork and field notes – the time spent engaging in primary data collection, which is predominantly participant observation, and the mode of data collection. Fieldwork is the time spent immersed in the culture under study, while field notes are the written reflections, observations and ideas documented during or soon after fieldwork. 5
• Participant observation – the main method of data collection in ethnography involves the researcher participating as a member of the community or culture, to gain first-hand experience of daily life in the research setting. 5
• An emic perspective – ethnography seeks to understand the worldview of the participant; it thus follows that the researcher can have an emic perspective (insider) or an etic perspective (outsider). This is not a binary category. Rather, researchers might be considered on a continuum, from emic to etic 6 (see Chapter 28 for an overview of insider and outsider research), and therefore reflexivity (Chapter 30) and researcher positionality (Chapter 28) are important elements of the research process . Implementing ‘insider’ ethnography: lessons from the Public Conversations about HIV/AIDS  project in rural South Africa describes an ethnography project involving insider community members and outsider investigators reflecting on the advantages and challenges of this approach. 7
• Thick description – the researcher creates detailed observational field notes with references to the social actions and behaviours of participants. The field notes include anecdotes, observations about the language used and quotes to illustrate the activities of the cultural group being observed. The researcher then integrates theoretical frameworks to help create meaning for the observations. 8
• Holism – ethnography focuses on studying all aspects of a culture, including religious practices, politics, institutions, family structures and cultural traditions. Using the analogy of the structure of the human body, Bronislaw Malinowski, one of the founders of the functionalist school of anthropology, described survey research as the skeleton and ethnography as the flesh and blood. 4

How long researchers spend conducting observations in the field depends on the research question and context. For example, in research to observe and characterise the behaviours and processes of antimicrobial decision-making in two surgical units of an acute hospital setting, researchers spent 58 hours in participant observation at three points of care: pre-admission clinic, surgery and on the ward following surgery. These three points of care were chosen as key moments in the patient’s experience of surgery. The observations were conducted in an acute hospital where medical practice is process-driven and protocol-driven. Hence, it did not take extensive time to observe the typical process and protocol in this setting. Researchers used an observation audit sheet (see Chapter 15) and informed participants that the study was focused on clinical decision-making, rather than specifically antimicrobial prescribing. This was done to minimise the ‘Hawthorne effect’, whereby people are said to change their behaviour because they know they are being observed. Following participant observations, six semi-structured interviews were conducted with two surgeons and four anaesthetists to clarify and discuss the findings of the observations. Interview data were analysed thematically, using inductive and deductive coding. 9

In contrast, an ethnographic study of homecare workers supporting people living with dementia involved 100 hours of participant observations of 16 homecare workers who were supporting 17 people living with dementia. Interviews were conducted with 82 people, including people living with dementia, family carers, homecare managers and support staff, homecare workers, and health and social care professionals. 10

Advantages and challenges of ethnography

The immersive approach to ethnography enables a nuanced understanding of the cultural group under study. Unlike other research designs, the prolonged engagement with the research setting provides an opportunity to refine and iterate research questions leading to a deeper understanding of the phenomenon. Participant observation provides a first hand of the behaviours and interactions of people within a cultural group which can be triangulated with interviews and documents to increase the rigour of the research. 9

There are many challenges in conducting ethnographic research. The time required to undertake ethnographic fieldwork can range from short sessions of observations over months or years, to the researcher living in the community for a period of time. The resources and time required may be substantial. When a researcher is embedded within a community, their departure can cause anxiety and distress for both the researcher and the community members. This experience was described by Paolo Franco, who spent 18 months conducting fieldwork in a retirement village, as a volunteer technology supporter for the residents. Franco described how the participants became dependent on his technology service as well as socially and emotionally connected to him as the researcher. To mitigate problems occurring with a researcher withdraws from a research setting, the researcher should let participants know as early as possible about their estimated time in the community, and should have a plan for their exit. 11

Another key challenge in ethnography is gaining access to ‘the field’ and enlisting the support of gatekeepers. Careful planning and engagement are required to ensure communication channels are open and positive relationships are established. Managing ethical conduct is another important consideration in ethnography. Researchers need to consider how much they will disclose to participants about the purpose of the research, and whether they will be covert (undercover) or overt (open and transparent) in their approach to fieldwork. For the most part, researchers are overt about their research, hoping that participants will ‘forget’ that they are being studied and will revert to natural behaviours. 5

Table 9.1 provides two examples of ethnography from health and social care.

Table 9.1. Ethnographic examples

Ethnography focuses on understanding culture and the behaviours, experiences and meanings at the group level. The main method of data collection is participant observation, which can be combined with interviews, focus groups and field notes to inform interpretations of the research topic.

• Reeves S, Kuper A, Hodges BD. Qualitative research methodologies: ethnography. BMJ . 2008;337:a1020. doi:10.1136/bmj.a1020
• Hudelson PM. Culture and quality: an anthropological perspective. Int J Qual Health Care . 2004;16(5):345-346. doi:10.1093/intqhc/mzh076
• Strudwick RM. Ethnographic research in healthcare – patients and service users as participants. Disabil Rehabil . 2020;43(22): 3271-327. doi:10.1080/09638288.2020.1741695
• Reeves S, Peller J, Goldman J, Kitto S. Ethnography in qualitative educational research: AMEE Guide No. 80. Med Teach . 2013;35(8):e1365-e1379. doi:10.3109/0142159X.2013.804977
• O’Reilly K, Bone JH. Key Concepts in Ethnography . The SAGE Key Concepts Series. SAGE; 2009.
• Eriksson P, Kovalainen A. Qualitative Methods in Business Research . SAGE; 2008.
• Angotti N, Sennott C. Implementing ‘insider’ ethnography: lessons from the Public Conversations about HIV/AIDS project in rural South Africa. Qual Res . 2015;15(4):437-453. doi:10.1177/1468794114543402
• Clark L, Chevrette R. Thick Description. In: Matthes J, Davis CS, Potter RE, eds. The International Encyclopedia of Communication Research Methods : John Wiley & Sons; 2017.
• Jackson J. Ethnography. In: Hua Z, ed. Research Methods in Intercultural Communication . John Wiley & Sons;  2015.
• Leverton M, Burton A, Beresford-Dent J, et al. Supporting independence at home for people living with dementia: a qualitative ethnographic study of homecare. Soc Psychiatry Psychiatr Epidemiol . 2021;56(12):2323-2336. doi:10.1007/s00127-021-02084-y
• Franco P, Yang YN. Existing fieldwork ‘with grace’: reflections on the unintended consequences of participant observation and researcher-participant relationships. Qualitative Market Research . 2021;24(3):358-374. doi:10.1108/QMR-07-2020-0094
• Johnson EK. The costs of care: an ethnography of care work in residential homes for older people. Sociol Health Illn . 2023;45(1):54-69. doi:10.1111/1467-9566.13546
• Kitson C, Haines M, O’Byrne P. Understanding the perspectives of women who use intravenous drugs and are experiencing homelessness in an urban centre in Canada: an analysis of ethnographic data. Glob Qual Nurs Res . Published online March 20, 2022. doi:10.1177/23333936221080935

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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Qualitative Research: Ethnography

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Journals on Ethnography

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• The Journal for Undergraduate Ethnography
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• Journal of Organizational Ethnography

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• What Is Ethnography? | Meaning, Guide & Examples

What Is Ethnography? | Meaning, Guide & Examples

Published on 6 May 2022 by Jack Caulfield . Revised on 6 April 2023.

Ethnography is a type of qualitative research that involves immersing yourself in a particular community or organisation to observe their behaviour and interactions up close. The word ‘ethnography’ also refers to the written report of the research that the ethnographer produces afterwards.

Ethnography is a flexible research method that allows you to gain a deep understanding of a group’s shared culture, conventions, and social dynamics. However, it also involves some practical and ethical challenges.

Table of contents

What is ethnography used for, different approaches to ethnographic research, gaining access to a community, working with informants, observing the group and taking field notes, writing up an ethnography.

Ethnographic research originated in the field of anthropology, and it often involved an anthropologist living with an isolated tribal community for an extended period of time in order to understand their culture.

This type of research could sometimes last for years. For example, Colin M. Turnbull lived with the Mbuti people for three years in order to write the classic ethnography The Forest People .

Today, ethnography is a common approach in various social science fields, not just anthropology. It is used not only to study distant or unfamiliar cultures, but also to study specific communities within the researcher’s own society.

For example, ethnographic research (sometimes called participant observation ) has been used to investigate football fans , call centre workers , and police officers .

Advantages of ethnography

The main advantage of ethnography is that it gives the researcher direct access to the culture and practices of a group. It is a useful approach for learning first-hand about the behavior and interactions of people within a particular context.

By becoming immersed in a social environment, you may have access to more authentic information and spontaneously observe dynamics that you could not have found out about simply by asking.

Ethnography is also an open and flexible method. Rather than aiming to verify a general theory or test a hypothesis , it aims to offer a rich narrative account of a specific culture, allowing you to explore many different aspects of the group and setting.

Disadvantages of ethnography

Ethnography is a time-consuming method. In order to embed yourself in the setting and gather enough observations to build up a representative picture, you can expect to spend at least a few weeks, but more likely several months. This long-term immersion can be challenging, and requires careful planning.

Ethnographic research can run the risk of observer bias . Writing an ethnography involves subjective interpretation, and it can be difficult to maintain the necessary distance to analyse a group that you are embedded in.

There are often also ethical considerations to take into account: for example, about how your role is disclosed to members of the group, or about observing and reporting sensitive information.

Should you use ethnography in your research?

If you’re a student who wants to use ethnographic research in your thesis or dissertation , it’s worth asking yourself whether it’s the right approach:

• Could the information you need be collected in another way (e.g., a survey , interviews)?
• How difficult will it be to gain access to the community you want to study?
• How exactly will you conduct your research, and over what timespan?
• What ethical issues might arise?

If you do decide to do ethnography, it’s generally best to choose a relatively small and easily accessible group, to ensure that the research is feasible within a limited time frame.

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There are a few key distinctions in ethnography which help to inform the researcher’s approach: open vs closed settings, overt vs covert ethnography, and active vs passive observation. Each approach has its own advantages and disadvantages.

Open vs closed settings

The setting of your ethnography – the environment in which you will observe your chosen community in action – may be open or closed.

An open or public setting is one with no formal barriers to entry. For example, you might consider a community of people living in a certain neighbourhood, or the fans of a particular football team.

• Gaining initial access to open groups is not too difficult …
• … but it may be harder to become immersed in a less clearly defined group.

A closed or private setting is harder to access. This may be for example a business, a school, or a cult.

• A closed group’s boundaries are clearly defined and the ethnographer can become fully immersed in the setting …
• … but gaining access is tougher; the ethnographer may have to negotiate their way in or acquire some role in the organisation.

Overt vs covert ethnography

Most ethnography is overt . In an overt approach, the ethnographer openly states their intentions and acknowledges their role as a researcher to the members of the group being studied.

• Overt ethnography is typically preferred for ethical reasons, as participants can provide informed consent …
• … but people may behave differently with the awareness that they are being studied.

Sometimes ethnography can be covert . This means that the researcher does not tell participants about their research, and comes up with some other pretence for being there.

• Covert ethnography allows access to environments where the group would not welcome a researcher …
• … but hiding the researcher’s role can be considered deceptive and thus unethical.

Active vs passive observation

Different levels of immersion in the community may be appropriate in different contexts. The ethnographer may be a more active or passive participant depending on the demands of their research and the nature of the setting.

An active role involves trying to fully integrate, carrying out tasks and participating in activities like any other member of the community.

• Active participation may encourage the group to feel more comfortable with the ethnographer’s presence …
• … but runs the risk of disrupting the regular functioning of the community.

A passive role is one in which the ethnographer stands back from the activities of others, behaving as a more distant observer and not involving themselves in the community’s activities.

• Passive observation allows more space for careful observation and note-taking …
• … but group members may behave unnaturally due to feeling they are being observed by an outsider.

While ethnographers usually have a preference, they also have to be flexible about their level of participation. For example, access to the community might depend upon engaging in certain activities, or there might be certain practices in which outsiders cannot participate.

An important consideration for ethnographers is the question of access. The difficulty of gaining access to the setting of a particular ethnography varies greatly:

• To gain access to the fans of a particular sports team, you might start by simply attending the team’s games and speaking with the fans.
• To access the employees of a particular business, you might contact the management and ask for permission to perform a study there.
• Alternatively, you might perform a covert ethnography of a community or organisation you are already personally involved in or employed by.

Flexibility is important here too: where it’s impossible to access the desired setting, the ethnographer must consider alternatives that could provide comparable information.

For example, if you had the idea of observing the staff within a particular finance company but could not get permission, you might look into other companies of the same kind as alternatives. Ethnography is a sensitive research method, and it may take multiple attempts to find a feasible approach.

All ethnographies involve the use of informants . These are people involved in the group in question who function as the researcher’s primary points of contact, facilitating access and assisting their understanding of the group.

This might be someone in a high position at an organisation allowing you access to their employees, or a member of a community sponsoring your entry into that community and giving advice on how to fit in.

However,  i f you come to rely too much on a single informant, you may be influenced by their perspective on the community, which might be unrepresentative of the group as a whole.

In addition, an informant may not provide the kind of spontaneous information which is most useful to ethnographers, instead trying to show what they believe you want to see. For this reason, it’s good to have a variety of contacts within the group.

The core of ethnography is observation of the group from the inside. Field notes are taken to record these observations while immersed in the setting; they form the basis of the final written ethnography. They are usually written by hand, but other solutions such as voice recordings can be useful alternatives.

Field notes record any and all important data: phenomena observed, conversations had, preliminary analysis. For example, if you’re researching how service staff interact with customers, you should write down anything you notice about these interactions – body language, phrases used repeatedly, differences and similarities between staff, customer reactions.

Don’t be afraid to also note down things you notice that fall outside the pre-formulated scope of your research; anything may prove relevant, and it’s better to have extra notes you might discard later than to end up with missing data.

Field notes should be as detailed and clear as possible. It’s important to take time to go over your notes, expand on them with further detail, and keep them organised (including information such as dates and locations).

After observations are concluded, there’s still the task of writing them up into an ethnography. This entails going through the field notes and formulating a convincing account of the behaviours and dynamics observed.

The structure of an ethnography

An ethnography can take many different forms: It may be an article, a thesis, or an entire book, for example.

Ethnographies often do not follow the standard structure of a scientific paper, though like most academic texts, they should have an introduction and conclusion. For example, this paper begins by describing the historical background of the research, then focuses on various themes in turn before concluding.

An ethnography may still use a more traditional structure, however, especially when used in combination with other research methods. For example, this paper follows the standard structure for empirical research: introduction, methods, results, discussion, and conclusion.

The content of an ethnography

The goal of a written ethnography is to provide a rich, authoritative account of the social setting in which you were embedded – to convince the reader that your observations and interpretations are representative of reality.

Ethnography tends to take a less impersonal approach than other research methods. Due to the embedded nature of the work, an ethnography often necessarily involves discussion of your personal experiences and feelings during the research.

Ethnography is not limited to making observations; it also attempts to explain the phenomena observed in a structured, narrative way. For this, you may draw on theory, but also on your direct experience and intuitions, which may well contradict the assumptions that you brought into the research.

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Ethnographic research as an evolving method for supporting healthcare improvement skills: a scoping review

Georgia b. black.

Department of Applied Health Research, UCL, London, UK

Sandra van Os

Samantha machen, naomi j. fulop, associated data.

All papers included in the review are listed in Additional file 4 and are publicly available from their publishers’ websites.

The relationship between ethnography and healthcare improvement has been the subject of methodological concern. We conducted a scoping review of ethnographic literature on healthcare improvement topics, with two aims: (1) to describe current ethnographic methods and practices in healthcare improvement research and (2) to consider how these may affect habit and skill formation in the service of healthcare improvement.

We used a scoping review methodology drawing on Arksey and O’Malley’s methods and more recent guidance. We systematically searched electronic databases including Medline, PsychINFO, EMBASE and CINAHL for papers published between April 2013 – April 2018, with an update in September 2019. Information about study aims, methodology and recommendations for improvement were extracted. We used a theoretical framework outlining the habits and skills required for healthcare improvement to consider how ethnographic research may foster improvement skills.

We included 274 studies covering a wide range of healthcare topics and methods. Ethnography was commonly used for healthcare improvement research about vulnerable populations, e.g. elderly, psychiatry. Focussed ethnography was a prominent method, using a rapid feedback loop into improvement through focus and insider status. Ethnographic approaches such as the use of theory and focus on every day practices can foster improvement skills and habits such as creativity, learning and systems thinking.

Conclusions

We have identified that a variety of ethnographic approaches can be relevant to improvement. The skills and habits we identified may help ethnographers reflect on their approaches in planning healthcare improvement studies and guide peer-review in this field. An important area of future research will be to understand how ethnographic findings are received by decision-makers.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12874-021-01466-9.

Research can help to support the practice of healthcare improvement, and identify ways to “improve improvement” [ 1 ]. Ethnography has been identified particularly as a research method that can show what happens routinely in healthcare, and reveal the ‘ what and how of improving patient care [ 2 ]. Ethnography is not one method, but a paradigm of mainly qualitative research involving direct observations of people and places, producing a written account of natural or everyday behaviours and ideas [ 3 ]. Ethnographic research can identify contextual barriers to healthcare improvement. For example, Waring and colleagues suggested that hospital discharge could be improved by allowing staff to have more opportunities for informal communication [ 4 ].

There have been advances in ethnographic methods that support its role in supporting healthcare improvement. Multi-site, collaborative modalities of ethnography have evolved that suit the networked nature of modern healthcare [ 5 ]. Similarly, rapid ethnographic approaches (e.g. Bentley et al. [ 6 ];) meet the needs of improvement activities to produce findings within short timeframes [ 7 ]. However, the production of sustained ethnographic fieldwork has waned in response to demands for rapid evidence [ 6 , 8 , 9 ]. Critics of rapid ethnographic methods worry that they are diluting ethnography within applied contexts more widely [ 5 , 10 ].

The relationship between ethnography and healthcare improvement has been the subject of methodological concern [ 8 ]. The first concern is that some research identified as ethnography does not fit within the ethnographic paradigm, merely collecting observational data without a theoretical analysis, interpretation or researcher reflexivity [ 11 ]. A second concern is whether the topics of ethnographic inquiry produce findings that are seen as useful for improvement [ 12 ], particularly if they do not make explicit recommendations or produce checklists [ 8 , 13 – 15 ]. Authors fear that ethnographic findings that capture complexity [ 16 ] and expose taken-for-granted behaviours and phenomena [ 14 , 17 ] may be too abstract to be relevant to healthcare improvement [ 8 ]. However, these critiques position ethnographic research as a product which may be taken up by healthcare improvers, rather than seeing ethnographic work itself as an improvement activity. We take the view that healthcare improvement aims to change human behaviour to improve patient care, and is therefore reliant on the development of particular skills and habits (such as good communication) [ 18 ]. We would consider that engaging in ethnographic research may support skill development and habit formation that serves healthcare improvement.

In the literature of ethnography in healthcare improvement, there is not much discussion of the close relationship between methodological features of ethnographic research, and their impact on improvement skills. The aim of this paper is twofold: (1) to describe current ethnographic methods and practices in healthcare improvement research and (2) to consider how these may affect habit and skill formation in the service of healthcare improvement [ 19 ].

This is a scoping review following the methods outlined by Arksey & O’Malley and later refined by Levac et al., [ 20 , 21 ] including a systematically conducted literature review and reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR; see Additional file 1 for PRISMA checklist). No protocol was published for this review. Our literature search and analyses were conducted iteratively, searching reference lists and undertaking discussions with colleagues about key lines of argument. We also held a workshop at Health Services Research UK conference in 2018 on this topic to gain a wide range of stakeholder views.

Systematic retrieval of empirical papers and purposive sampling

Our search strategy was designed to capture a wide range of approaches to ethnography from different journals, healthcare settings and types of research environment. It was not our aim to capture every study using this methodology, but to map the current field. Thus we did not search grey literature, books or monographs. The search strategy was developed and piloted in consultation with a health librarian. Medline (on OVID platform), PsychINFO, CINAHL and EMBASE databases were searched, and six journals were hand-searched, including: BMJ Quality & Safety, Social Science and Medicine, Medical Anthropology, Cochrane library, Sociology of Health and Illness and Implementation Science. These databases were searched between dates April 2013 – April 2018 and an update was performed in September 2019 using the search terms outlined in Additional file 2 . We limited the search to these dates in order to capture the most recent methodological characteristics of ethnographic studies in this field.

We screened titles and then abstracts according to the inclusion and exclusion criteria detailed in Table ​ Table1. 1 . We included studies which self-identified as using ethnography or ethnographic methods rather than using our own criteria. This is because ethnography can be hard to define, and use of criteria may risk excluding papers which exemplify the sorts of tensions and workarounds we are trying to capture.

Inclusion and exclusion criteria

The retrieved papers were screened by GB, SVO and SM based on inclusion and exclusion criteria (Table ​ (Table1). 1 ). The total number of papers after screening titles, abstracts and full texts was 274 (Fig. ​ (Fig.1 1 ).

PRISMA statement of all references retrieved, screened and included in the scoping review

Numerical charting

Characteristics of each paper, such as title, authors, journal, year, country and healthcare subject area were extracted (see Table ​ Table2 2 ).

Characteristics of studies in review

a some studies have been allocated to more than one region

Thematic analysis and development

We coded all 274 papers using NVivo software for stated aims and recommendations. This included close reading, and retrieval of key ideas and quotations from the papers that exemplified key ideas in relation to healthcare improvement, methodology and the authors’ reflections on these. The coded extracts of aims and recommendation in conjunction with the closer reading of the sub-sample were used to inductively develop conceptual ideas, such as how the corpus of papers explicitly aimed to contribute to healthcare improvement, and if not, how this affected the types of conclusions drawn. Some papers were read in greater depth to understand how the authors’ methods related to their findings and conclusions. In order to consider how ethnography supports habits and skills associated with healthcare improvement, we drew on a framework which identifies five habits of ‘improvers’: creativity, learning, systems thinking, resilience and influencing [ 19 ]. Applying this model to our selected papers, we mapped traits or approaches to the ethnographic studies that exemplified these habits either in the authors, or as part of developing these habits in others (e.g. healthcare decision-makers and professionals). Thematic interpretations and lines of argument were generated and discussed by all the authors.

Overview of study characteristics

The included studies covered a wide range of ethnographic methodologies and healthcare subjects, published internationally (Table ​ (Table2) 2 ) in predominantly social science and clinical journals (see Additional file 3 ). The full list of the 274 included studies is available in Additional file 4 .

Most studies described themselves as an ‘ethnography’ or ‘ethnographic’, although some described their methodology as ‘mixed methods’ including ethnographic components. For example, Collet et al. conducted a mixed methods participatory action research study using observations to produce an “ethnographic description” [ 22 ].

Almost all studies relied on observation and interviews as the main data sources. It was not always specified whether researchers took a participant or non-participant approach to observation. There were some examples of other data sources e.g. video data, surveys, documents, field notes, diaries, and artefacts. A few examples contained a paucity of data, such as only video data [ 23 ], limited fieldwork [ 24 ], a small number of interviewees [ 25 ], or reliance on focus group data alone [ 26 ]. Methods associated with qualitative methodology (but not necessarily ethnographic) were also used, such as data ‘saturation’ to denote that additional data did not provide new insights into the topic [ 27 ].

There were a number of minority or unusual ethnographic variations:

• Quantitative ethnography [ 23 ]: temporal coding of physicians' workflow and interaction with the electronic health record system, and their patient.
• Cognitive ethnography [ 28 ]: “identifying and elaborating distributed cognitive processes that occur when an individual enacts purposeful improvements in a clinical context”.
• Street-level organizational ethnography [ 29 ]: intensive case study methods to explore the implications of healthcare policy at a street level.
• Phenomenological ethnographies [ 30 ]: focussing on the lived experience and meanings associated with a phenomenon.
• Geo-mapping [ 31 ]: geomapping of selected service data to define Latino immigrant community before conducting interviews and observations.

Use of different types of ethnography to support healthcare improvement

We found that many studies used methods that could identify issues relating to power and vulnerability, with potential relevance to how healthcare improvement problems are defined and solved, and by whom [ 1 ]. For example we noted a significant minority of studies using institutional and critical ethnography, mostly in vulnerable populations (see Table ​ Table3). 3 ). These studies were explicitly attentive to systems and power relations, rather than on individual practices. We suggest that the use of geographically-oriented methods such as geo-mapping and street-level organisational ethnography are also attentive to the power structures inherent in place and space, and could be relevant to other geographical healthcare improvement topics such as networked healthcare systems, care at home and patient travel for treatment.

Ethnographic methodology and its relevance to healthcare improvement

The high prevalence of ethnographic studies with vulnerable populations (e.g. psychiatry, end of life care) suggests that ethnography is also being conceptualised as an emancipatory method, reversing healthcare power structures in its focus. This has been a traditional focus of ethnography since social changes in power and representation in the 1970s, incorporated into the development of healthcare research methodology [ 40 , 41 ]. Some methods used were calculated to maximise the potential for supporting vulnerable groups, for example, Nightingale et al. [ 42 ] used focused ethnography (prolonged fieldwork in a small number of settings) to look at patient-professional interactions in paediatric chronic illness settings. The authors suggested that focussed ethnography is particularly suited to settings where fostering trust is essential. We would also suggest that ethnography may be particularly suited to settings in which participants are less able to verbalise their experiences.

The reviewed studies suggested that video ethnography can support healthcare improvement at a team level. For example, Stevens et al. [ 43 ] promoted video ethnography as a way to capture in-depth data on intimate interactions, in their study of elective caesareans. The video data allowed them to make use of timing data (e.g. of certain actions), physical positioning of different actors and equipment, and verbatim dialogue recording. The video data also suited the technical nature of the procedure, which was relatively time-limited. This form of data collection may not suit environments where healthcare activities are more spread out.

The impact of healthcare practitioner involvement in ethnographic fieldwork and findings

We noted that the use of ethnography for healthcare improvement has led to healthcare practitioners’ widespread involvement in data collection or analysis. We suggest that this is a form of negotiation across the healthcare-academia boundary, translating from ‘real world’ to data and back again. This has potential to create rich and relevant ethnographic studies that are geared towards improvement. However, some studies were undermined by a lack of reflexivity about the dual practitioner-ethnographer role.

A significant number of papers involved healthcare practitioners in fieldwork (e.g. Abdulrehman, 2017, Hoare et al. 2013; [ 37 , 44 ]). For example in Hoare et al. the lead researcher was a nurse, and wrote that they hoped “to bring both an emic and etic perspective to the data collection by bracketing my emic sense of self as a nurse practitioner in order to become a participant observer within my own general practice ” [ 37 ]. In this study, the findings fed directly into local service improvement as the lead researcher felt compelled to “share new ‘best practice’ information and join in the conversation.” There was little discussion about how this affected the generalisability of the findings, and whether their recommendations were adopted.

Similarly, Bergenholz et al. [ 45 ] conducted a study where a nursing researcher completed the main fieldwork and “assisted the nurses with practical care .” They acknowledged that “This may have caused limitations with regards to ‘blind spots’ in the nursing practice, but that it also gave access to a field that might be difficult for ‘outside-outsiders’ to gain .” However, there was no commentary on where the blind spots or extra access occurred, and how this may have affected the relevance and dissemination of their findings.

How might ethnography support healthcare improvement habits?

In this section, we evaluate the studies included in the review in terms of how their methods relate to improvement. We draw on the idea that successful improvement is based on a set of habits and their related skills acquired through experience and practice [ 19 ]. This section is structured around Lucas’s five habits of ‘improvers’: creativity, learning, systems thinking, resilience and influencing [ 19 ]. Under those headings, we describe the mechanisms by which ethnographic studies can support healthcare improvement habits, using illustrative examples.

Resilience is defined as being adaptable, particularly tolerating calculated risks and uncertainty, and proceeding with optimism. Being able to recover from adverse events is core to improvement, reframing them as opportunities. Adaptation and the ability to bounce back from adverse events and variation are core to improvement.

Tolerating the uncertainty of ethnographic data collection

While we did not relate these traits to any particular ethnographic approach in our studies, we would consider that undertaking any ethnographic project requires resilience, as data collection is inherently exploratory and uncertain. For example, Belanger et al. wanted to know how health care providers and their patients approach patient participation in palliative care decisions. The authors explicitly eschewed the pull to create guidelines or other formalised knowledge, but aimed to explore the “unforeseen and somewhat unavoidable ways in which discursive practices prompt or impede patient participation during these interactions.” [ 46 ]

Creativity is defined as working together to encourage fresh thinking by generating ideas and thinking critically.

Using a theoretical lens

Researchers may consider healthcare through a particular theory or framework (e.g. private ordering [ 47 ], masculine discourse [ 48 ], compassion [ 49 ]). The restriction of the theoretical lens enables critical thinking, and keeps the ethnographer creatively engaged. For example, Mylopoulos & Farhat [ 28 ] used the concept of adaptive expertise in a cognitive ethnography to explore “the phenomenon of purposeful improvement” in a teaching hospital. This theoretical lens revealed that clinicians were engaging in “invisible” improvement in their daily work, in “specific activities such as scheduling, establishing patient relationships, designing physical space and building supporting resources”. The authors suggested that these practices were devalued in comparison to more formal improvement activities, justifying the utility of the ‘adaptive expertise’ theory in bringing the daily improvement practices to light.

Challenging current problems and perspectives

We identified studies that challenged or reframed existing improvement problems e.g. Mishra [ 50 ]. This role removes the ‘blinkers’ of improvement research [ 51 ], and can ‘dissolve’ previously intractable implementation problems. For example, Boonan et al. [ 52 ] studied the practice of bar-coded medication from the perspective of nurses using the intervention. In their discussion, the authors challenge the assumption that if you introduce technology, then you will mitigate human factor risks. They highlighted that external pressures on hospitals perpetuate this perspective, and that “nurses and patients are consequently drawn into this discourse and institutional ruling, to which they are not oblivious”. Their recommendation was to understand the skills of nurses in tailoring technology to meet individual patients’ needs rather than trusting in systems blindly.

Learning is defined as harnessing curiosity and using reflective processes to extract meaning from experience.

Inviting reflection

We noted that some studies did not make explicit recommendations for improvement, but wrote their findings in a manner that would invite reflection on its subject matter. For example, Thomas & Latimer [ 53 ] wrote that they view their role as provocateurs of new ideas, stating that their intention “is not to propose specific policies or discourses designed to change or improve practice. More modestly, we hope that by analysing the everyday and by theorising the mundane, this article will ignite reflexive, ethical and pluralistic dialogues – and so better communication between practitioners, parents and the wider lay public – around reproductive technologies and medical conditions” (authors’ underline; p.951-2) [ 53 ]. Others such as Mackintosh et al [ 54 ] used their discussion section to examine their results in the context of other theories and provide illumination: “Our focus on trajectories illuminates the physiological process of birth and the unfolding pathology of illness (and death). This frame provides a means for us to link the agency of those involved in organising the care of acutely ill patients with the wider socio-political factors beyond the clinic, such as governmentality and risk (Heyman 2010, Waring 2007), death brokering (Timmermans 2005) and the medicalisation of birth and death (De Vries 1981).” (p.264). These two examples show that ethnographic work can be offered as an opportunity for learning and reflection, without a translation to specific recommendations.

Supporting a more ethical, expansive, inclusive, and participatory mode of healthcare

Problem-finding is highlighted as an important part of learning in improvement [ 19 ]. Several studies paid attention to multivocality and power, using this to find problematic, unethical and exclusive practices in healthcare. For example, some studies reported previously unheard viewpoints [ 55 – 57 ], or identified restrictive organisational barriers and normative assumptions [ 58 , 59 ]. Others promoted ethnography as a way of exploring ethics and morality [ 47 , 60 , 61 ], such as criticising research that prioritizes the needs of individuals over the good of society [ 62 ]. Ross et al. [ 63 ] suggested that it is also more ethical to use critical ethnography than other evaluative methods in researching vulnerable populations (e.g. neurological illness), by being able to “explore perceived political and emancipatory implications, [clarify] existing power differentials and [maintain] an explicit focus on action” .

Some studies directly researched power within the healthcare setting. For example, Batch and Windsor’s study of nursing workforce suggested that senior nurse leaders should use their positions to advocate for better working conditions [ 35 ], “ Manageable nurse/patient ratios, flexible patient-centred work models, equal opportunity for advancement, skill development for all and unit teamwork promotion”. Challenging traditional cultural assumptions that have produced and reproduced stereotypes is problematic because they most often are, by their very nature, invisible. In a more critical approach, Gesbeck’s thesis [ 62 ] on diabetes care work challenges the very mechanism of achieving healthcare improvement through research, stating that “we need to change the social and political context in which health care policy is made. This requires social change that prioritizes the good of the society over the good of the individual—a position directly opposed to the current system oriented toward profit and steeped in the ideology of personal responsibility.”

Systems thinking

Systems thinking is defined as seeing whole systems as well as their parts and recognising complex relationships, connections and interdependencies.

Suggesting reorientation to new ‘problem’ areas

We found that many ethnographic studies emphasised skills of synthesis and connection-making, reorienting improvement to different areas, for example in overarching policy recommendations (e.g. Hughes [ 36 ]; Liu et al. [ 64 ], Matinga et al. [ 65 ]), or resetting priorities. For example, Manias’ [ 66 ] ethnography of communication relating to family members' involvement in medication management in hospital suggests that “greater attention should be played on health professionals initiating communication in proactive ways ” [p.865]. In another example, Cable-Williams & Wilson’s (2017) focussed ethnography captures cultural factors within long-term care facilities. Their discussion suggests that acknowledgement of death is under-represented in front-line practice and government policy, reorienting discussions towards an integration of living and dying care.

Exposing hidden practices within the everyday

We found that several studies drew attention to ‘hidden’ practices in healthcare work, allowing them to evaluated and improved. For example, we found reference to practices such as coordinating [ 67 ], repair [ 68 ], caretaking [ 69 ], scaffolding [ 68 ], tinkering [ 52 ] and bricolage [ 58 ]. We also found that some studies had new interpretations of ‘the everyday’ or ‘taken-for-granted’ (e.g. nursing culture [ 34 , 35 , 45 , 70 ], interprofessional practice [ 67 , 71 – 75 ]). Authors’ outputs included frameworks [ 76 ] or models [ 69 , 71 , 77 , 78 ] that map these types of practices in a way that is helpful for intervention development or quality improvement. For example, Mackintosh et al. [ 54 ] looked at rescue practices in medical wards and maternity care settings using Strauss’s concept of the patient trajectory. Their findings highlighted the risks inherent in the wider social practices of hospital care, and suggested that improvement was needed at a level “beyond individual and team processes and technical safety solutions.”

Influencing

Influencing is defined as engaging others and gaining buy-in using a range of facilitative processes.

Direct translation of findings to targets for improvement

Lucas suggests that to be influential, ethnographic studies need to have some empathy with clinical reality, whilst being facilitative and comfortable with conflict [ 19 ]. This was shown in ethnographic studies that made pragmatic recommendations, such as in Jensen’s study of clinical simulation. They advised that simulation might be useful in staging “adverse event scenarios with a view to creating more controlled and safer environments.” ( 80). In MacKichan et al. [ 79 ] observations and interviews were used to understand how primary care access influenced decisions to seek help at the emergency department. The authors made empathic, actionable recommendations such as “ simplifying appointments systems and communicating mechanisms to patients.” (p.10).

Evaluating the context of healthcare improvement

By capturing contextual and social aspects of healthcare improvement, ethnographic evaluations can support leaders and managers who are trying to implement improvement activities. This is a particularly helpful trait in ethnographic studies that pay attention to politics, governance and social theory in their evaluation of new interventions, “zooming out” [ 80 ] beyond the patient-clinician interaction to broader social networks. For example, Tietbohl et al. [ 81 ] investigated the difficulties of implementing a patient decision support intervention (DESI) in primary care through the theoretical lens of relational coordination between “physician and clinical staff groups (healthcare professionals)”. The authors’ recommended attention to the “underlying barriers such as the relational dynamics in a medical clinic or healthcare organization” when creating policies and programs that support shared decision-making using support interventions. This sort of insight can make it more likely that new policies or interventions will succeed. This skill was particularly fertile in the tradition of techno-anthropology, exploring technology-induced errors and the real-world interaction between people and technology, e.g. decision-support tools [ 81 – 86 ], the introduction of robot caregivers [ 87 ] and clinical simulations [ 88 ]. Other approaches included an investigation of one intervention or change but with a theoretical lens of inquiry.

Summary of findings

This scoping review has identified the methodological characteristics of 5 years of published papers that self-identify as ethnography or ethnographic in the field of healthcare improvement. Ethnography is currently a popular research method in a wide range of healthcare topics, particularly in psychiatry, e.g. mental health, dementia and experiential concerns such as quality of life. Focused ethnography is a significant sub-group in healthcare, suggesting that messages about the importance of research timeliness have taken hold [ 89 ].

We have identified ethnographic methods reported in these papers, and considered their utility in developing skills and habits that support healthcare improvement. Specific practices associated with the ethnographic paradigm can encourage good habits (resilience, creativity, learning, systems thinking and influencing) in healthcare, which can support improvement. For example, using relevant theories to look at every day work in healthcare can foster creativity. The use of critical and institutional ethnography could increase skills in ‘systems thinking’ by critically evaluating how healthcare improvement problems are defined and solved, and by whom.

Comparison with previous literature

This scoping review is the first to consider how current ethnographic methods and practices may relate to healthcare improvement. Within the paradigm of applied healthcare research, there is normative value in being ‘useful’ or ‘impactful’ in our research, which affects our prospects for funding and career success [ 12 ]. However, our review has uncovered a multitude of ways that an ethnographic study can be useful in relation to healthcare improvement, without creating actionable findings. We found a spectrum of interactions with healthcare improvement: some authors explicitly eschewed recommendations or clinical implications; others made imperative statements about required changes to policy or practice. However, this diversity was not necessarily a reflection on how ‘traditional’ the ethnographic methodology was. This challenges the paper by Leslie et al. which puts ethnographic studies in two output categories with respect to healthcare improvement: critique versus feedback [ 8 ]. Instead, we uncovered a variety of ways that ethnography can support healthcare improvement habits, such as encouraging reflection, problem-finding and exposing hidden practices in healthcare.

We did find that supporting healthcare improvement through ethnographic research can require strategic effort, however. For example, we noted that several authors wrote multiple articles based on the same project, often for different types of journal to reach different audiences such as diverse readerships in health services and academic settings. For example, Collier and colleagues published two papers based on a video ethnography of end-of-life care (both in 2016), one in a healthcare quality journal [ 32 ] and one in a qualitative research journal [ 76 ]. The former is shorter, with explicit recommendations for patient safety, whereas the latter is longer, has more detailed results and long sections on reflexivity. Similarly, Grant published an article in a sociology journal [ 90 ] and a healthcare improvement paper [ 91 ] on the same work about medication safety. The sociological paper covered “spatio-temporal elements of articulation work” whereas the other put forward “key stages” and risks, suggesting that it was more closely oriented to improvement.

There have been some considerable debates about changes in ethnographic methods and tools, with concerns about lost researcher identity, dilution of the method, and challenges to “upholding ethnographic integrity” [ 92 ] . We contest this, suggesting that new variants such as focussed and cognitive ethnography are evolving in response to the complexity of hospitals and healthcare [ 93 ], while also being highly regulated, standardised and ordered by biomedicine. Such complex environments cannot be studied and improved under one paradigm alone. Ethnographic identity and method have also been affected by the cross-pollination of ethnography with other social science paradigms and applied environments (e.g. clinical trials, technology development). Debates about theoretical and methodological choices are not only made merely with respect to healthcare improvement, but also in response to professional pressures (e.g. university requirements for impact) [ 12 ], and the mores of taste situated within the overlapping communities of practice that evaluate ethnographic healthcare research [ 94 ]. That said, we echo previous authors’ calls for attention to reflexivity, particularly in embedded or clinician-as-researcher roles [ 95 ].

Our scoping review challenges a previously expressed concern that ethnographic studies may not produce findings that are useful for improvement [ 10 , 12 , 16 ]. By considering different ethnographic designs in relation to skills and habits needed for improvement, we have shown that studies need not necessarily produce ‘actionable findings’ in order to make a valuable contribution. Instead, we would characterise ethnography’s role in the canon of healthcare research methodologies as a way of enhancing improvement habits such as comfort with conflict, problem-finding and connection-making.

Strengths and limitations

This review has a number of limitations. The search may not have found all relevant studies, however the retrieved papers are intended as an exemplar rather than an exhaustive or aggregative review. The review is also limited to journal articles as evidence of researchers’ approach to improvement. This ignores many other ‘offline’ and ‘online’ activities such as meetings, presentations, blogs, books, and websites, which are conducted to disseminate findings and ideas. Our reliance on self-report for the identification of ethnographic studies will have excluded some studies within an ethnographic paradigm who chose different terms for their methodology (e.g. critical inquiry, case study). The strengths of this paper are its comprehensive coverage, incorporating all representative studies in healthcare research published within a five year period, and a wide range of ethnographic sub-types and healthcare subjects, drawn from an international pool of research communities.

We did not prescribe the right way for ethnographers to engage in healthcare improvement, indeed, we have identified that a variety of approaches can be relevant to improvement. The habits we identified may help ethnographers reflect on their approaches in planning healthcare improvement studies and guide peer-review in this field. Issues of taste, traditionalism and researcher identity need to be scrutinised in favour of value and audience. An important area of future research will be to understand how ethnographic findings are received by decision-makers, and further focused reviews on the relationship(s) between ethnographic methods, quality improvement skills and improvement outcomes.

Acknowledgements

The authors wish to thank Lorelei Jones, Natalie Armstrong, Justin Waring and Bill Lucas for their insightful comments and direction in the undertaking of this work.

Authors’ contributions

NJF and GB led the development and conceptualization of this scoping review and provided guidance on methods and design of the scoping review. GB, SVO and SM made contributions to study search, study screening, and all data extraction work. All authors analysed the data. All authors contributed to the writing and editing of the paper, and all authors have read and approved the manuscript.

This paper is independent research funded by the National Institute for Health Research CLAHRC North Thames. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.

NJF is an NIHR Senior Investigator. GB is supported by the Health Foundation’s grant to the University of Cambridge for The Healthcare Improvement Studies Institute.

Availability of data and materials

Declarations.

The authors have no competing interests to declare.

The original online version of this article was revised: due to incorrect figure 1 and the number of included papers need to be changed from "283" to "274".

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Change history

A Correction to this paper has been published: 10.1186/s12874-022-01587-9

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Ethnography

Associate Professor of Sociology

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Ethnography (Understanding Qualitative Research) provides a comprehensive guide to understanding, conceptualizing, and critically assessing ethnographic research and its resultant texts. Through a series of discussions and illustrations, utilizing both classic and contemporary examples, the book highlights distinct features of ethnography as both a research methodology and a writing tradition. It emphasizes the importance of training—including familiarity with culture as an anthropologically derived concept and critical awareness of the history of ethnography. To this end, it introduces the notion of ethnographic comportment , which serves as a standard for engaging and gauging ethnography. Indeed, ethnographic comportment issues from a familiarity with ethnography’s problematic past and inspires a disposition of accountability for one’s role in advancing ethnographic practices. Following an introductory chapter outlining the emergence and character of ethnography as a professionalized field, subsequent chapters conceptualize ethnographic research design, consider the practices of representing research methodologies, discuss the crafting of accurate and evocative ethnographic texts, and explain the different ways in which research and writing gets evaluated. While foregrounding interpretive and literary qualities that have gained prominence since the late twentieth century, the book properly situates ethnography at the nexus of the social sciences and the humanities. Ethnography (Understanding Qualitative Research) presents novice ethnographers with clear examples and illustrations of how to go about conducting, analyzing, and representing their research; its primary purpose, however, is to introduce readers to effective practices for understanding and evaluating the quality of ethnography.

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Home » Ethnographic Research -Types, Methods and Guide

Ethnographic Research -Types, Methods and Guide

Table of Contents

Ethnographic Research

Definition:

Ethnographic research is a qualitative research method used to study and document the culture, behaviors, beliefs, and social interactions of a particular group of people. It involves direct observation and participation in the daily life and activities of the group being studied, often for an extended period of time.

Ethnographic Study

An ethnographic study is a research method that involves the detailed and systematic study of a particular group, culture, or community. Ethnographic studies seek to understand the beliefs, values, behaviors, and social dynamics of a group through direct observation and participation in their daily life.

Ethnographic Research vs Ethnographic Study

here’s a table comparing ethnographic study and ethnographic research:

While there are some differences between the two, they are similar in that they both use qualitative research methods to study a particular group, culture, or community. The main difference is that an ethnographic study involves the researcher spending an extended period of time within the community being studied in order to develop a deep understanding, while ethnographic research is focused on documenting and analyzing the culture, beliefs, behaviors, and social interactions of the group being studied.

Ethnographic Research Types

Ethnographic research can be divided into several types based on the focus of the study and the research objectives. Here are some common types of ethnographic research:

Classic Ethnography

This type of ethnographic research involves an extended period of observation and interaction with a particular community or group. The researcher aims to understand the community’s culture, beliefs, practices, and social structure by immersing themselves in the community’s daily life.

Autoethnography

Autoethnography involves the researcher using their own personal experiences to gain insights into a particular community or culture. The researcher may use personal narratives, diaries, or other forms of self-reflection to explore the ways in which their own experiences relate to the culture being studied.

Participatory Action Research

Participatory action research involves the researcher working collaboratively with members of a particular community or group to identify and address social issues affecting the community. The researcher aims to empower community members to take an active role in the research process and to use the findings to effect positive change.

Virtual Ethnography

Virtual ethnography involves the use of online or digital media to study a particular community or culture. The researcher may use social media, online forums, or other digital platforms to observe and interact with the group being studied.

Critical Ethnography

Critical ethnography aims to expose power imbalances and social inequalities within a particular community or culture. The researcher may use their observations to critique dominant cultural narratives or to identify opportunities for social change.

Ethnographic Research Methods

Some common ethnographic research methods include:

Participant Observation

This involves the researcher directly observing and participating in the daily life and activities of the group being studied. This technique helps the researcher gain an in-depth understanding of the group’s behavior, culture, and social dynamics.

Ethnographic researchers use interviews to gather information about the group’s beliefs, values, and practices. Interviews may be formal or informal and can be conducted one-on-one or in group settings.

Surveys can be used to collect data on specific topics, such as attitudes towards a particular issue or behavior patterns. Ethnographic researchers may use surveys as a way to gather quantitative data in addition to qualitative data.

Document Analysis

This involves analyzing written or visual documents produced by the group being studied, such as newspapers, photographs, or social media posts. Document analysis can provide insight into the group’s values, beliefs, and practices.

Field Notes

Ethnographic researchers keep detailed field notes of their observations and interactions with the group being studied. These notes help the researcher organize their thoughts and observations and can be used to analyze the data collected.

Focus Groups

Focus groups are group interviews that allow the researcher to gather information from multiple people at once. This technique can be useful for exploring shared beliefs or experiences within the group being studied.

Ethnographic Research Data Analysis Methods

Ethnographic research data analysis methods involve analyzing qualitative data collected from observations, interviews, and other sources in order to identify patterns, themes, and insights related to the research question.

Here are some common data analysis methods used in ethnographic research:

Content Analysis

This involves systematically coding and categorizing the data collected from field notes, interviews, and other sources. The researcher identifies recurring themes, patterns, and categories in the data and assigns codes or labels to each one.

Narrative Analysis

This involves analyzing the stories and narratives collected from participants in order to understand how they construct and make sense of their experiences. The researcher looks for common themes, plot structures, and rhetorical strategies used by participants.

Discourse Analysis

This involves analyzing the language and communication practices of the group being studied in order to understand how they construct and reproduce social norms and cultural meanings. The researcher looks for patterns in the use of language, including metaphors, idioms, and other linguistic devices.

Comparative Analysis

This involves comparing data collected from different groups or communities in order to identify similarities and differences in their cultures, behaviors, and social structures. The researcher may use this analysis to generate hypotheses about why these differences exist and what factors may be contributing to them.

Grounded Theory

This involves developing a theoretical framework based on the data collected during the research process. The researcher identifies patterns and themes in the data and uses these to develop a theory that explains the social phenomena being studied.

How to Conduct Ethnographic Research

To conduct ethnographic research, follow these general steps:

• Choose a Research Question: Identify a research question that you want to explore. It should be focused and specific, but also open-ended to allow for flexibility and exploration.
• Select a research site: Choose a site or group that is relevant to your research question. This could be a workplace, a community, a social movement, or any other social setting where you can observe and interact with people.
• Obtain ethical clearance: Obtain ethical clearance from your institution or organization before beginning your research. This involves ensuring that your research is conducted in an ethical and responsible manner, and that the privacy and confidentiality of participants are protected.
• Conduct observations: Observe the people in your research site and take detailed notes. This involves being present and engaged in the social setting, participating in activities, and taking note of the behaviors, interactions, and social norms that you observe.
• Conduct interviews : Conduct interviews with people in the research site to gain deeper insights into their experiences, perspectives, and beliefs. This could involve structured or semi-structured interviews, focus groups, or other forms of data collection.
• Analyze data: Analyze the data that you have collected, looking for themes and patterns that emerge. This involves immersing yourself in the data and interpreting it within the social and cultural context of the research site.
• Write up findings: Write up your findings in a clear and concise manner, using quotes and examples to illustrate your key points. This may involve creating narratives, tables, or other visual representations of your findings.
• Reflect on your process: Reflect on your process and methods, thinking about what worked well and what could be improved for future research.

When to Use Ethnographic Research

Here are some situations where ethnographic research may be particularly appropriate:

• When exploring a new topic: Ethnographic research can be useful when exploring a topic that has not been well-studied before. By engaging with members of a particular group or community, researchers can gain insights into their experiences and perspectives that may not be visible from other research methods.
• When studying cultural practices: Ethnographic research is particularly useful when studying cultural practices and beliefs. By immersing themselves in the cultural context being studied, researchers can gain a deeper understanding of the ways in which cultural practices are enacted, maintained, and transmitted.
• When studying complex social phenomena: Ethnographic research can be useful when studying complex social phenomena that cannot be easily understood through quantitative methods. By observing social interactions and behaviors, researchers can gain insights into the ways in which social norms and structures are created and maintained.
• When studying marginalized communities: Ethnographic research can be particularly useful when studying marginalized communities, as it allows researchers to give voice to members of these communities and understand their experiences and perspectives.

Overall, ethnographic research can be a useful research approach when the goal is to gain a deep understanding of a particular group or community and their cultural practices, beliefs, and experiences. It is a flexible and adaptable research method that can be used in a variety of research contexts.

Applications of Ethnographic Research

Ethnographic research has many applications across a wide range of fields and disciplines. Some of the key applications of ethnographic research include:

• Informing policy and practice: Ethnographic research can provide valuable insights into the experiences and perspectives of marginalized or underrepresented groups, which can inform policy and practice in fields such as health care, education, and social services.
• Developing theories and concepts: Ethnographic research can contribute to the development of theories and concepts in social and cultural anthropology, sociology, and other disciplines, by providing detailed and nuanced accounts of social and cultural phenomena.
• Improving product design and marketing: Ethnographic research can be used to understand consumer behavior and preferences, which can inform the design and marketing of products and services.
• Studying workplace culture: Ethnographic research can provide insights into the norms, values, and practices of organizations, which can inform efforts to improve workplace culture and employee satisfaction.
• Examining social movements: Ethnographic research can be used to study the practices, beliefs, and experiences of social movements, which can inform efforts to understand and address social and political issues.
• Studying healthcare practices: Ethnographic research can provide insights into healthcare practices and patient experiences, which can inform efforts to improve healthcare delivery and patient outcomes.

Examples of Ethnographic Research

Here are some real-time examples of ethnographic research:

• Anthropological study of a remote indigenous tribe: Anthropologists often use ethnographic research to study remote indigenous tribes and gain insights into their culture, beliefs, and practices. For example, an anthropologist may live with a tribe for an extended period of time, observing and participating in their daily activities, and conducting interviews with members of the community.
• Study of workplace culture: Ethnographic research can be useful in studying workplace culture and understanding the dynamics of the organization. For example, an ethnographer may observe and interview employees in a particular department or team to gain insights into their work practices, communication styles, and social dynamics.
• Study of consumer behavior: Ethnographic research can be useful in studying consumer behavior and understanding how people interact with products and services. For example, an ethnographer may observe and interview consumers as they use a particular product, such as a new smartphone or fitness tracker, to gain insights into their behaviors and preferences.
• Study of health care practices: Ethnographic research can be useful in studying health care practices and understanding how patients and providers interact within the health care system. For example, an ethnographer may observe and interview patients and providers in a hospital or clinic to gain insights into their experiences and perspectives.
• Study of social movements: Ethnographic research can be useful in studying social movements and understanding how they emerge and evolve over time. For example, an ethnographer may observe and interview participants in a protest movement to gain insights into their motivations and strategies.

Purpose of Ethnographic Research

The purpose of ethnographic research is to provide an in-depth understanding of a particular group or community, including their cultural practices, beliefs, and experiences. This research approach is particularly useful when the research question is exploratory and the goal is to generate new insights and understandings. Ethnographic research seeks to understand the experiences, perspectives, and behaviors of the participants in their natural setting, without imposing the researcher’s own biases or preconceptions.

Ethnographic research can be used to study a wide range of topics, including social movements, workplace culture, consumer behavior, and health care practices, among others. The researcher aims to understand the social and cultural context of the group or community being studied, and to generate new insights and understandings that can inform future research, policy, and practice.

Overall, the purpose of ethnographic research is to gain a deep understanding of a particular group or community, with the goal of generating new insights and understandings that can inform future research, policy, and practice. Ethnographic research can be a valuable research approach in many different contexts, particularly when the goal is to gain a rich, contextualized understanding of social and cultural phenomena.

Advantages of Ethnographic Research

Ethnographic research has several advantages that make it a valuable research approach in many different fields. Here are some of the advantages of ethnographic research:

• Provides in-depth and detailed information: Ethnographic research involves direct observation of the group or community being studied, which allows researchers to gain a detailed and in-depth understanding of their beliefs, practices, and experiences. This type of information cannot be obtained through other research methods.
• Offers a unique perspective: Ethnographic research allows researchers to see the world from the perspective of the group or community being studied. This can provide unique insights into the ways in which different cultural practices and beliefs are constructed and maintained.
• Promotes cultural understanding: Ethnographic research can help to promote cultural understanding and reduce stereotypes by providing a more nuanced and accurate picture of different cultures and communities.
• Allows for flexibility: Ethnographic research is a flexible research approach that can be adapted to fit different research contexts and questions. Researchers can adjust their methods based on the needs of the group being studied and the research goals.
• Generates rich and diverse data: Ethnographic research generates rich and diverse data through a combination of observation, interviews, and other methods. This allows researchers to analyze different aspects of the group or community being studied and identify patterns and themes in the data.
• Supports theory development: Ethnographic research can support theory development by providing empirical data that can be used to test and refine theoretical frameworks.

Limitations of Ethnographic Research

Ethnographic research has several limitations that researchers should consider when selecting this research approach. Here are some of the limitations of ethnographic research:

• Limited generalizability: Ethnographic research typically involves studying a small and specific group or community, which limits the generalizability of the findings to other contexts or populations.
• Time-consuming: Ethnographic research is a time-consuming process that requires a significant investment of time and resources. Researchers must spend time observing and interacting with the group being studied, which may not be feasible in all research contexts.
• Subjectivity: Ethnographic research relies on the researcher’s interpretation and analysis of the data collected, which may introduce subjective bias into the research findings.
• Limited control: Ethnographic research involves studying a group or community in their natural setting, which limits the researcher’s control over the research context and the behavior of the participants.
• Ethical concerns: Ethnographic research can raise ethical concerns, particularly when studying marginalized or vulnerable populations. Researchers must be careful to ensure that they do not harm or exploit the participants in the research process.
• Limited quantitative data: Ethnographic research typically generates qualitative data, which may limit the types of analysis that can be conducted and the types of conclusions that can be drawn.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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