Which paradigm does ethnographic research belong to

Subjects [can become]…either suspicious and wary, or they [can become]…aware of what the researchers want and try to please them. Additionally, subjects sometimes do not know their feelings, interactions, and behaviors, so they cannot articulate them to respond to a questionnaire. One cannot understand human behavior without understanding the framework within which subjects interpret their thoughts, feelings, and actions. Researchers need to understand the framework.

Field study research can explore the processes and meanings of events. Realities are multiple, constructed, and holistic. The relationship of knower to the known Knower and known are independent, a dualism.

Knower and known are interactive, inseparable. The possibility of generalization Time- and context-free generalizations nomothetic statements are possible. Only time- and context-bound working hypotheses idiographic statements are possible.

The possibility of causal linkages There are real causes, temporally precedent to or simultaneous with their effects. All entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects. The role of values Inquiry is value-free. Inquiry is value-bound. What do I know about a problem that will allow me to formulate and test a hypothesis?

What do my informants know about their culture that I can discover? What concepts can I use to test this hypothesis? What concepts do my informants use to classify their experiences? How can I operationally define these concepts? How do my informants define these concepts? What scientific theory can explain the data?

What folk theory do my informants use to explain their experience? How can I interpret the results and report them in the language of my colleagues? How can I translate the cultural knowledge of my informants into a cultural description my colleagues will understand? Purpose Generalizability Prediction Causal explanations. El Faro. Oakland: University of California Press. Holmes, Seth M. Glass, Ira, host. Guerrero, Diane. New York: MacMillan.

Below are suggestions for in-class discussion and activities. We offer plans for two activities. These activities are flexible: they can constitute two class periods, be condensed and combined into one class period, or be broken up across some digital method of communication and a synchronous online or in-person class meeting.

Given the realities of online teaching right now, we also offer more detailed suggestions for conducting this entire lesson online in a separate section below. Depending on the size and format of your class, the following activity could be done in breakout groups or as a class, with the graphic organizer projected and visible to all. Prompt students to generate a table, Venn diagram, or double bubble map that tracks the following characteristics of whichever set of readings you selected:.

You might include the following topics:. Reflect on the discussions inspired by Activities 1 and 2. Consider the similarities and points of divergence between journalism and ethnography, and the issues of representation raised by both genres. We originally designed and piloted this activity in a face-to-face classroom. Here, we offer some suggestions for how to adapt these activities for online teaching.

The readings and discussion prompts above could easily yield broader discussions about whose stories get told and how they get told. If you want to expand this topic into a broader unit, you might consider using other types of texts, such as songs, poems, literature, photographs, and other forms of art. Below are a few examples of other resources related to the above topics.

Dalton, Roque. The paper locates both FE governance and ethnography within the challenges of the performative and Panoptic environments facing English education. In doing so, the paper explores how the informants'…. Nurses are the main users of supplies and equipment applied in the Intensive Care Units ICUs which are high-priced and costly. Therefore, understanding ICU nurses' experiences about resource management contributes to the better control of the costs.

This study aimed to investigate the culture of nurses' working environment regarding the resource management in the ICUs in Iran. In this study , a focused ethnographic method was used. Twenty-eight informants among ICU nurses and other professional individuals were purposively selected and interviewed. As well, hours of ethnographic observations as a participant observer was used for data gathering. Data analysis was performed using the methods described by Miles and Huberman Two main themes describing the culture of ICU nurses regarding resource management included a consumption monitoring and auditing, and b prudent use.

The results revealed that the efforts for resource management are conducted in the conditions of scarcity and uncertainty in supply. ICU nurses had a sense of futurism in the supply and use of resources in the unit and do the planning through taking the rules and guidelines as well as the available resources and their values into account.

Improper storage of some supplies and equipment was a reaction to this uncertain condition among nurses. To manage the resources effectively, improvement of supply chain management in hospital seems essential.

It is also necessary to hold educational classes in order to enhance the nurses' awareness on effective supply chain and storage of the items in the unit stock.

To identify the impact of a full suite of health information technology HIT on the relationships that support safety and quality among intensive care unit ICU clinicians. A year-long comparative ethnographic study of three academic ICUs was carried out.

A total of hours of observational data was collected in the form of field notes. A subset of these observations hours-was devoted to job-shadowing individual clinicians and conducting a time study of their HIT usage. Significant variation in HIT implementation rates and usage was noted. On the "low-use" ICU, it was 10 percent. Clinicians on the high-use ICUs experienced "silo" effects with potential safety and quality implications.

HIT work was associated with spatial, data, and social silos that separated ICU clinicians from one another and their patients. Situational awareness, communication, and patient satisfaction were negatively affected by this siloing. HIT has the potential to accentuate social and professional divisions as clinical communications shift from being in-person to electronically mediated.

Socio-technically informed usability testing is recommended for those hospitals that have yet to implement HIT. For those hospitals already implementing HIT, we suggest rapid, locally driven qualitative assessments focused on developing solutions to identified gaps between HIT usage patterns and organizational quality goals.

Publishing the confidential: an ethnographic study of young Irish bloggers. From blogs to social network sites, young people have been early adopters of all forms of Web 2.

Diary-style blogs have been one of the tools they have used as outlets for creativity and communication, whilst simultaneously bringing into a public forum a genre which was inherently private. This thesis is the result of a three year ethnographic study of two groups of young Irish bloggers on the LiveJournal platform, which mixes blogging tools with social network facilities The article presents an ethnographic study conducted in a class in a government-run primary school in Delhi.

It was found that a chief concern in the school was that of disciplining children. In the observed class, this took the shape of controlling children's bodies and motor movements. It is argued that through disciplining, teachers were…. Matsuoka, J. K; Minerbi, L. This report makes available and archives the background scientific data and related information collected for an ethnographic study of selected areas on the islands of Hawaii and Maui. The task was undertaken during preparation of an environmental impact statement for Phases 3 and 4 of the Hawaii Geothermal Project HGP as defined by the state of Hawaii in its April proposal to Congress.

Information is included on the ethnohistory of Puna and southeast Maui; ethnographic fieldwork comparing Puna and southeast Maui; and Pele beliefs, customs, and practices. The pros and cons of researching events ethnographically. Events remarkable, disruptive happenings are important subjects of study for understanding processes of change.

In this essay, I reflect upon the issue of what the ethnographic method has to offer for the analysis of this social phenomenon. To do so, I review three recently published ethnographic studies of events.

My conclusion is that it is indeed a very useful method for understanding the feelings and ideas of people who are experiencing eventful situations, for instance around protests or natural disasters. Next, as transformative responses to events are not bound by the place or time of the happening, other methods interviews, discourse analysis, surveys that make it easier to follow them in varying locations and periods might be more suitable for getting a comprehensive picture of their meaning-making dynamics.

New social media have become indispensable to people all over the world as platforms for communication, with Facebook being the most popular. What types of field And what kinds of data do these relations present to the ethnographer?

These questions must be considered in order to understand the challenges Facebook and other social media pose to ethnographic methodology. This article focuses on how Facebook may Most importantly it allows the ethnographer to keep up-to-date with the field.

I argue that ethnography is already in possession of the methodological tools critically to assess Ethnographic analysis: a study of classroom environments. Occupational therapists assess and adapt an environment to enhance clients' abilities to function. Therapists working in schools may assess several classroom environments in a week.

Identifying relevant information in an efficient manner is essential yet presents a challenge for school therapists. In this study , ethnographic research methodology was used to analyze the plethora of data gained from observations in eight classrooms. Three major categories were identified to structure observations: activities, people, and communication.

These categories were used to compile a Classroom Observation Guide that gives therapists relevant questions to ask in each category. Using the Classroom Observation Guide, occupational therapists can recommend classroom activities that suit a particular teacher's style.

For example, working with a teacher who prefers structural activities with clear time and space boundaries for one specific purpose, a therapist might suggest organized sensorimotor games with a distinct purpose to be carried out for a given time period. This qualitative ethnographic narrative inquiry explored the role of identity and the retention of Mexican American students in higher education. Leadership identity, a dimension of identity, was explored using narratives provided by 13 Mexican American students, attending a university in the northwest United States.

Interview data was compiled,…. The verification of ethnographic data. Anthropologists are increasingly required to account for the data on which they base their interpretations and to make it available for public scrutiny and re-analysis.

While this may seem straightforward why not place our data in online repositories? Ethnographic 'data' may consist of everything from verbatim transcripts 'hard data' to memories and impressions 'soft data'. Hard data can be archived and re-analysed; soft data cannot.

The focus on hard 'objective' data contributes to the delegitimizing of the soft data that are essential for ethnographic understanding, and without which hard data cannot be properly interpreted.

However, the credibility of ethnographic interpretation requires the possibility of verification. This could be achieved by obligatory, standardised forms of personal storage with the option for audit if required, and by being more explicit in publications about the nature and status of the data and the process of interpretation.

Ethnographic methods for language and gender research. Ethnographic approaches to language and gender emphasize the complex yet richly textured relationship between linguistic practices observed in their naturalistic form and their social, cultural, and political context.

The relationship between language and gender became the object of ethnographically. Unsafe acts are believed to account for approximately 80 to 90 percent of accidents. The study described here, part of a wider PhD project, was undertaken using an ethnographic approach.

Participant observation enabled the researcher to be involved in the whole accident investigation process including witness statemen In this study , researchers sought to capture students' authentic experience of finding books in the main library using a GoPro camera and the think-aloud protocol. The GoPro provided a first-person perspective and was an effective ethnographic tool for observing a student's individual experience, while also demonstrating what tools they use to….

Tackling complexities in understanding the social determinants of health: the contribution of ethnographic research.

The complexities inherent in understanding the social determinants of health are often not well-served by quantitative approaches. My aim is to show that well-designed and well-conducted ethnographic studies have an important contribution to make in this regard. Ethnographic research designs are a difficult but rigorous approach to research questions that require us to understand the complexity of people's social and cultural lives.

I draw on an ethnographic study to describe the complexities of studying maternal health in a rural area in India. I then show how the lessons learnt in that setting and context can be applied to studies done in very different settings.

I show how ethnographic research depends for rigour on a theoretical framework for sample selection; why immersion in the community under study , and rapport building with research participants, is important to ensure rich and meaningful data; and how flexible approaches to data collection lead to the gradual emergence of an analysis based on intense cross-referencing with community views and thus a conclusion that explains the similarities and differences observed.

When using ethnographic research design it can be difficult to specify in advance the exact details of the study design.

Researchers can encounter issues in the field that require them to change what they planned on doing. In rigorous ethnographic studies , the researcher in the field is the research instrument and needs to be well trained in the method. Ethnographic research is challenging, but nevertheless provides a rewarding way of researching complex health problems that require an understanding of the social and cultural determinants of health.

Ethnographic auditing is the application of ethnographic or anthropological concepts and methods to the appraisal of administrative controls over resources. Ethnographic auditing highlights the role of culture, subculture, values, rituals and physical environment in management in higher education.

The ethnographic auditor measures the fiscal and…. This ethnographic study aimed at understanding the cultural meaning that nursing professionals working at a Burns Unit attribute to the nursing process as well as at identifying the factors affecting the implementation of this methodology. Data were collected through participant observation and semi-structured interviews.

The findings indicate that, to the nurses from the investigated unit, the nursing process seems to be identified as bureaucratic management. Some factors determining this perception are: the way in which the nursing process has been taught and interpreted, routine as a guideline for nursing activity, and knowledge and power in the life-world of the Burns Unit.

Technology has greatly impacted educational systems around the world, even in the most geographically isolated places. This study utilizes an ethnographic approach to examine the patterns of learning in a kindergarten in Mana, Fiji.

Data comprised of interviews, observations and examination of related artifacts. The results provide baseline data…. This ethnographic case study examines perceptions of literacy and identity for a Korean-American student in a third-grade classroom. The researchers examine how teachers can misinterpret Asian identity in the classroom due to perceptions related to the "Model Minority Myth" and other stereotypical representations of Asian culture.

Buddhism in the United States: an Ethnographic Study. Full Text Available This paper focuses on Buddhism in America, an neglected area of inquiry in anthropological study. There is a need for modern ethnographic studies to shed light on historical issues, paradigms for comparative inquiry, and thus, explore the impact of Buddhism on modern American society Glazier, The enormous growth of Buddhism in the last quarter century Smith, makes this an especially pertinent topic in American anthropology.

This is a preliminary study of the nature of Buddhism in America. We conducted participant observation with a Buddhist meditation group in a north eastern state in the US for four months in the spring of Based on our preliminary ethnographic data, we believe that a unique perspectives of Buddhism in America can be identified: non-religious and therapeutic involvement or use of Buddhism.

It is interesting to note that at the end of meditation sessions, participants not only bow to the Buddha statue, but also bow to each other. This is a unique ritual dynamic which appears to be consistent with the worldview of American people - being equal and individual.

Additionally, we observed that American meditation rooms provide additional cushions to sit on which are a further element, along with walking meditation, which help American beginners to meditate more easily. The most important reflection is that religious change is not an. HIV in Japan: Epidemiologic puzzles and ethnographic explanations.

Full Text Available Japan is widely perceived to have a low level of HIV occurrence; however, its HIV epidemics also have been the subject of considerable misunderstanding globally.

I used a ground truthing conceptual framework to meet two aims: first, to determine how accurately official surveillance data represented Japan's two largest epidemics urban Kansai and Tokyo as understood and experienced on the ground; and second, to identify explanations for why the HIV epidemics were unfolding as officially reported.

This revealed seven epidemiologic puzzles involving officially reported trends and conspicuously missing information.

Ethnographically grounded explanations are presented for each. These included factors driving the epidemics, which ranged from waning government and public attention to HIV, to gaps in sex education and disruptive leadership changes in public institutions approximately every two years. Factors constraining the epidemics also contributed to explanations. These ranged from subsidized medical treatment for most people living with HIV, to strong partnerships between government and a well-developed, non-governmental sector of HIV interventionists, and protective norms and built environments in the sex industry.

Local and regional HIV epidemics were experienced and understood as worse than government reports indicated, and ground-level data often contradicted official knowledge.

Results thus call into question epidemiologic trends, including recent stabilization of the national epidemic, and suggest the need for revisions to the surveillance system and strategies that address factors driving and constraining the epidemics.

An ethnographic study of communication challenges in maternity care for immigrant women in rural Alberta. The negative consequences of miscommunication in health care settings are well documented although there has been little research on communication barriers facing immigrant women seeking maternity care in Canada.

This study identified the nature of communication difficulties in maternity services from the perspectives of immigrant women, health care providers and social service providers in a small city in southern Alberta, Canada. All interviews were recorded and audio files were transcribed verbatim by a professional transcriptionist. The data was analysed drawing upon principles expounded by Roper and Shapira for the analysis of ethnographic data, because of 1 the relevance to ethnographic data, 2 the clarity and transparency of the approach, 3 the systematic approach to analysis, and 4 the compatibility of the approach with computer-assisted qualitative analysis software programs such as Atlas.

This process included 1 coding for descriptive labels, 2 sorting for patterns, 3 identification of outliers, 4 generation of themes, 5 generalising to generate constructs and theories, and 6 memoing including researcher reflections. Communication difficulties extended beyond matters of language competency to those encompassing non-verbal communication and its relation to shared meaning as well as the interplay of underlying pre. To analyze the perception of parents about secondhand smoking in their children's health.

Ethnographic qualitative and quantitative study. We sought the point of view and understanding of the parents that were active smokers in relation to environmental tobacco smoke ETS and secondhand smoking. A descriptive and qualitative analysis was carried out through the ethnography.

Some parents knew some of the effects of secondhand smoking in the health of their children. Children were exposed to Environmental Tobacco Pollution in their residence if one considers parental duration of smoking and average of cigarettes smoked per day.

There was a lack of knowledge of the parents about ETS, secondhand smoking and the evils that cigarettes could cause in the health of their children. Publicado por Elsevier Editora Ltda. Perception of parents about second hand smoke on the health of their children: an ethnographic study. Full Text Available Objective: To analyze the perception of parents about secondhand smoking in their children's health.

Methods: Ethnographic qualitative and quantitative study. We sought the point of view and understanding of the parents who were active smokers in relation to environmental tobacco smoke ETS and secondhand smoking. Results: 58 parents with an average time of smoking of Conclusions: Children were exposed to environmental tobacco pollution in their residence if one considers parental duration of smoking and average of cigarettes smoked per day.

Doing the month in a Taiwanese postpartum nursing center: an ethnographic study. Traditionally Chinese and Taiwanese postpartum women conducted postpartum ritual practices, called "doing the month," at home. Today, many Taiwanese women undertake this ritual in postpartum nursing centers.

However, little is known about how the traditional practices are being transformed in relation to contemporary health care in Taiwan. In this ethnographic study observations were carried out in a large post-partum center attached to a major hospital in Taipei for nine months, and 27 postpartum women were interviewed.

Data were analyzed using ethnographic approaches to extract codes and categories. Doing the month was reshaped by being relocated from the home to a healthcare setting. Midwives took on roles traditionally taken by family members, which had an impact on family roles and relationships. Some postpartum practices were maintained, based on traditional explanations. However, many were modified or challenged, based on explanations from contemporary scientific knowledge.

Midwives need to be aware that there could be differences between their culture of care and the cultural values of the women they care for. This study informs culturally appropriate postpartum care and support for women with traditional and contemporary cultural beliefs and attitudes to doing the month in a range of healthcare contexts. Ethnographic research in immigrant-specific drug abuse recovery houses. Access to study populations is a major concern for drug use and treatment researchers.

Ethnographic research methods are indispensable for gaining and maintaining access to hidden or "hard-to-reach" populations. Here, we discuss our long-term ethnographic research on drug abuse recovery houses created by and for Latino migrants and immigrants in Northern California. We conclude that continued funding support for ethnography is essential for promoting health disparities research focused on diverse populations in recovery from substance use disorders.

This study involves qualitative method comprehending ethnographic method by Spradley model. This study lasted from November to June The data was obtained from participatory observation, interview, documentary analysis, and audio-visual material.

This study proves that: 1. And the syllabus applies Functional Syllabus. Scenario of the learning material covers themes on conversation, vocabulary, the maqala concerning to the most recent development and attractive topic on argumentative debate relating to educational issues. The media of learning is equipped by powerpoint presentation, video native speaker, and printed materials.

Everyday practices at the medical ward: a month ethnographic field study. Abstract Background Modern hospital care should ostensibly be multi-professional and person-centred, yet it still seems to be driven primarily by a hegemonic, positivistic, biomedical agenda. This study aimed to describe the everyday practices of professionals and patients in a coronary care unit, and analyse how the routines, structures and physical design of the care environment influenced their actions and relationships.

Methods Ethnographic fieldwork was conducted over a month period Employing an ethnographic approach: key characteristics. Nurses are increasingly embracing ethnography as a useful research methodology. This paper presents an overview of some of the main characteristics we considered and the challenges encountered when using ethnography to explore the nature of communication between children and health professionals in a children's hospital. There is no consensual definition or single procedure to follow when using ethnography.

This is largely attributable to the re-contextualisation of ethnography over time through diversification in and across many disciplines. Thus, it is imperative to consider some of ethnography's trademark features. To identify core trademark features of ethnography, we collated data following a scoping review of pertinent ethnographic textbooks, journal articles, attendance at ethnographic workshops and discussions with principle ethnographers.

This is a methodological paper. Essentially, ethnography is a field-orientated activity that has cultural interpretations at its core, although the levels of those interpretations vary. We identified six trademark features to be considered when embracing an ethnographic approach: naturalism; context; multiple data sources; small case numbers; 'emic' and 'etic' perspectives, and ethical considerations. Ethnography has an assortment of meanings, so it is not often used in a wholly orthodox way and does not fall under the auspices of one epistemological belief.

Yet, there are core criteria and trademark features that researchers should take into account alongside their particular epistemological beliefs when embracing an ethnographic inquiry. We hope this paper promotes a clearer vision of the methodological processes to consider when embarking on ethnography and creates an avenue for others to disseminate their experiences of and challenges encountered when applying ethnography's trademark features in different healthcare contexts.

Exploring the situational motivation of medical specialists: a qualitative study. A qualitative ethnographic design was used, and a constructivist approach was adopted with the Self-Determination theory of motivation as a framework. Six medical specialists from VU University Medical Center in the Netherlands, recruited through convenience, snowball, and purposive sampling, were shadowed for one day each. Data were transcribed and open-coded. Themes were finalized through discussion and consensus.

Sixty hours of observation data identified motivating and demotivating factors categorized into four themes that are important for specialists' motivation. Informational technology issues are demotivating factors. Working with colleagues can be both a motivating and demotivating factor, e. Being in control of one's planning through feelings of autonomy was motivating. Furthermore, patient care and teaching, especially in combination, stimulated specialists' motivation.

Regarding the design of the study , we found that situational motivation is indeed observable. The basic psychological needs autonomy, competence, and relatedness are important for specialists' motivation. Investing in a more motivating, open, transparent, and basic-needs- supportive work environment for medical specialists is necessary. Keywords: Continuing professional development, motivation, medical specialists, self-determination theory, qualitative research.

Research in academic libraries has recently seen an increase in the use of ethnographic -based methods to collect data. Primarily used to learn about library users and their interaction with spaces and resources, the methods are proving particularly useful to academic libraries. The data ethnographic methods retrieve is rich, context specific, and…. The insight and challenge of reflexive practice in an ethnographic study of black traumatically injured patients in Philadelphia. The integrity of critical ethnography requires engagement in reflexive practice at all phases of the research process.

In this discussion paper, I explore the insights and challenges of reflexive practice in an ethnographic study of the recovery experiences of black trauma patients in a Philadelphia hospital. Observation and interviews were conducted with twelve patients who were admitted to trauma-designated units of the hospital over the course of a year. During fieldwork, I learned the ways that my background as a professional nurse structured my way of being in clinical space and facilitated a particular interpretation of clinical culture.

In analysis, reflection on subjectivities through which I designed this ethnographic research allowed me to see beyond my preconceived and theoretically informed perspective to permit unexpected features of the field to emerge.

Reflexive practice also guided my reconciliation of key practical and epistemological differences between clinical ethnographic research and the anthropologic tradition in which it is rooted. I conclude that with careful reflection to the subjectivities that influence the research process, interdisciplinary clinically relevant applied interpretations of critical ethnographic work can be used to generate detailed knowledge across contexts in clinical care, nursing practice, and patient experiences.

Ethnography is a type of qualitative research that gathers observations, interviews and documentary data to produce detailed and comprehensive accounts of different social phenomena. The use of ethnographic research in medical education has produced a number of insightful accounts into its role, functions and difficulties in the preparation of medical students for clinical practice.

This AMEE Guide offers an introduction to ethnography - its history, its differing forms, its role in medical education and its practical application. Specifically, the Guide initially outlines the main characteristics of ethnography: describing its origins, outlining its varying forms and discussing its use of theory. It also explores the role, contribution and limitations of ethnographic work undertaken in a medical education context. In addition, the Guide goes on to offer a range of ideas, methods, tools and techniques needed to undertake an ethnographic study.

In doing so it discusses its conceptual, methodological, ethical and practice challenges e. Finally, the Guide provides a series of final thoughts and ideas for future engagement with ethnography in medical education. This Guide is aimed for those interested in understanding ethnography to develop their evaluative skills when reading such work.

It is also aimed at those interested in considering the use of ethnographic methods in their own research work. The ethnographic method and its relationship with the domain analysis. Full Text Available This paper analyzes the theoretical and conceptual relationship of the ethnographic method with domain analysis. A documentary analysis was performed, exploring the categories of domain analysis and ethnographic method. It was obtained as a result: the analysis of the points of contact between domain analysis and the ethnographic method from an epistemological, methodological and procedural terms.

It is concluded that the ethnographic method is an important research tool to scan the turbulent socio-cultural scenarios that occur within discursive communities that constitute the domains of knowledge. Many methodological approaches have been used to understand cultural dimensions to maternal health issues.

Although a well-designed quantitative survey with a representative sample can provide essential information on trends in behavior, it does not necessarily establish a contextualized understanding of the complexity in which different behaviors occur.

This article addresses how contextualized data can be collected in a short time and under conditions in which participants in conflict-affected zones might not have established, or time to establish, trust with the researchers.

The solution, the Participatory Ethnographic Evaluation and Research PEER approach, is illustrated through a study whereby South Sudanese marginalized women were trained to design research instruments, and collect and analyze qualitative data.

PEER overcomes the problem that many ethnographic or participatory approaches face-the extensive time and resources required to develop trusting relationships with the community to understand the local context and the social networks they form. Why is patient safety so hard? A selective review of ethnographic studies. Ethnographic studies are valuable in studying patient safety.

This is a narrative review of four reports of ethnographic studies of patient safety in UK hospitals conducted as part of the Patient Safety Research Programme. The studies found that hospitals were rarely geared towards ensuring perfect performances. The coordination and mobilization of the large number of inter-dependent processes and resources needed to support the achievement of tasks was rarely optimal. This produced significant strain that staff learned to tolerate by developing various compensatory strategies.

Teamwork and inter-professional communication did not always function sufficiently well to ensure that basic procedural information was shared or that the required sequence of events was planned.

Staff did not always do the right things, for a wide range of different reasons, including contestations about what counted as the right thing. Structures of authority and accountability were not always clear or well-functioning.

Patient safety incidents were usually not reported, though there were many different reasons for this. It can be concluded that securing patient safety is hard. There are multiple interacting influences on safety, and solutions need to be based on a sound understanding of the nature of the problems and which approaches are likely to be best suited to resolving them.