a research question appropriate for a grounded theory approach is

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Grounded theory research: A design framework for novice researchers

Ylona chun tie.

1 Nursing and Midwifery, College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia

Melanie Birks

Karen francis.

2 College of Health and Medicine, University of Tasmania, Australia, Hobart, TAS, Australia

Background:

Grounded theory is a well-known methodology employed in many research studies. Qualitative and quantitative data generation techniques can be used in a grounded theory study. Grounded theory sets out to discover or construct theory from data, systematically obtained and analysed using comparative analysis. While grounded theory is inherently flexible, it is a complex methodology. Thus, novice researchers strive to understand the discourse and the practical application of grounded theory concepts and processes.

The aim of this article is to provide a contemporary research framework suitable to inform a grounded theory study.

This article provides an overview of grounded theory illustrated through a graphic representation of the processes and methods employed in conducting research using this methodology. The framework is presented as a diagrammatic representation of a research design and acts as a visual guide for the novice grounded theory researcher.

Discussion:

As grounded theory is not a linear process, the framework illustrates the interplay between the essential grounded theory methods and iterative and comparative actions involved. Each of the essential methods and processes that underpin grounded theory are defined in this article.

Conclusion:

Rather than an engagement in philosophical discussion or a debate of the different genres that can be used in grounded theory, this article illustrates how a framework for a research study design can be used to guide and inform the novice nurse researcher undertaking a study using grounded theory. Research findings and recommendations can contribute to policy or knowledge development, service provision and can reform thinking to initiate change in the substantive area of inquiry.

Introduction

The aim of all research is to advance, refine and expand a body of knowledge, establish facts and/or reach new conclusions using systematic inquiry and disciplined methods. 1 The research design is the plan or strategy researchers use to answer the research question, which is underpinned by philosophy, methodology and methods. 2 Birks 3 defines philosophy as ‘a view of the world encompassing the questions and mechanisms for finding answers that inform that view’ (p. 18). Researchers reflect their philosophical beliefs and interpretations of the world prior to commencing research. Methodology is the research design that shapes the selection of, and use of, particular data generation and analysis methods to answer the research question. 4 While a distinction between positivist research and interpretivist research occurs at the paradigm level, each methodology has explicit criteria for the collection, analysis and interpretation of data. 2 Grounded theory (GT) is a structured, yet flexible methodology. This methodology is appropriate when little is known about a phenomenon; the aim being to produce or construct an explanatory theory that uncovers a process inherent to the substantive area of inquiry. 5 – 7 One of the defining characteristics of GT is that it aims to generate theory that is grounded in the data. The following section provides an overview of GT – the history, main genres and essential methods and processes employed in the conduct of a GT study. This summary provides a foundation for a framework to demonstrate the interplay between the methods and processes inherent in a GT study as presented in the sections that follow.

Glaser and Strauss are recognised as the founders of grounded theory. Strauss was conversant in symbolic interactionism and Glaser in descriptive statistics. 8 – 10 Glaser and Strauss originally worked together in a study examining the experience of terminally ill patients who had differing knowledge of their health status. Some of these suspected they were dying and tried to confirm or disconfirm their suspicions. Others tried to understand by interpreting treatment by care providers and family members. Glaser and Strauss examined how the patients dealt with the knowledge they were dying and the reactions of healthcare staff caring for these patients. Throughout this collaboration, Glaser and Strauss questioned the appropriateness of using a scientific method of verification for this study. During this investigation, they developed the constant comparative method, a key element of grounded theory, while generating a theory of dying first described in Awareness of Dying (1965). The constant comparative method is deemed an original way of organising and analysing qualitative data.

Glaser and Strauss subsequently went on to write The Discovery of Grounded Theory: Strategies for Qualitative Research (1967). This seminal work explained how theory could be generated from data inductively. This process challenged the traditional method of testing or refining theory through deductive testing. Grounded theory provided an outlook that questioned the view of the time that quantitative methodology is the only valid, unbiased way to determine truths about the world. 11 Glaser and Strauss 5 challenged the belief that qualitative research lacked rigour and detailed the method of comparative analysis that enables the generation of theory. After publishing The Discovery of Grounded Theory , Strauss and Glaser went on to write independently, expressing divergent viewpoints in the application of grounded theory methods.

Glaser produced his book Theoretical Sensitivity (1978) and Strauss went on to publish Qualitative Analysis for Social Scientists (1987). Strauss and Corbin’s 12 publication Basics of Qualitative Research: Grounded Theory Procedures and Techniques resulted in a rebuttal by Glaser 13 over their application of grounded theory methods. However, philosophical perspectives have changed since Glaser’s positivist version and Strauss and Corbin’s post-positivism stance. 14 Grounded theory has since seen the emergence of additional philosophical perspectives that have influenced a change in methodological development over time. 15

Subsequent generations of grounded theorists have positioned themselves along a philosophical continuum, from Strauss and Corbin’s 12 theoretical perspective of symbolic interactionism, through to Charmaz’s 16 constructivist perspective. However, understanding how to position oneself philosophically can challenge novice researchers. Birks and Mills 6 provide a contemporary understanding of GT in their book Grounded theory: A Practical Guide. These Australian researchers have written in a way that appeals to the novice researcher. It is the contemporary writing, the way Birks and Mills present a non-partisan approach to GT that support the novice researcher to understand the philosophical and methodological concepts integral in conducting research. The development of GT is important to understand prior to selecting an approach that aligns with the researcher’s philosophical position and the purpose of the research study. As the research progresses, seminal texts are referred back to time and again as understanding of concepts increases, much like the iterative processes inherent in the conduct of a GT study.

Genres: traditional, evolved and constructivist grounded theory

Grounded theory has several distinct methodological genres: traditional GT associated with Glaser; evolved GT associated with Strauss, Corbin and Clarke; and constructivist GT associated with Charmaz. 6 , 17 Each variant is an extension and development of the original GT by Glaser and Strauss. The first of these genres is known as traditional or classic GT. Glaser 18 acknowledged that the goal of traditional GT is to generate a conceptual theory that accounts for a pattern of behaviour that is relevant and problematic for those involved. The second genre, evolved GT, is founded on symbolic interactionism and stems from work associated with Strauss, Corbin and Clarke. Symbolic interactionism is a sociological perspective that relies on the symbolic meaning people ascribe to the processes of social interaction. Symbolic interactionism addresses the subjective meaning people place on objects, behaviours or events based on what they believe is true. 19 , 20 Constructivist GT, the third genre developed and explicated by Charmaz, a symbolic interactionist, has its roots in constructivism. 8 , 16 Constructivist GT’s methodological underpinnings focus on how participants’ construct meaning in relation to the area of inquiry. 16 A constructivist co-constructs experience and meanings with participants. 21 While there are commonalities across all genres of GT, there are factors that distinguish differences between the approaches including the philosophical position of the researcher; the use of literature; and the approach to coding, analysis and theory development. Following on from Glaser and Strauss, several versions of GT have ensued.

Grounded theory represents both a method of inquiry and a resultant product of that inquiry. 7 , 22 Glaser and Holton 23 define GT as ‘a set of integrated conceptual hypotheses systematically generated to produce an inductive theory about a substantive area’ (p. 43). Strauss and Corbin 24 define GT as ‘theory that was derived from data, systematically gathered and analysed through the research process’ (p. 12). The researcher ‘begins with an area of study and allows the theory to emerge from the data’ (p. 12). Charmaz 16 defines GT as ‘a method of conducting qualitative research that focuses on creating conceptual frameworks or theories through building inductive analysis from the data’ (p. 187). However, Birks and Mills 6 refer to GT as a process by which theory is generated from the analysis of data. Theory is not discovered; rather, theory is constructed by the researcher who views the world through their own particular lens.

Research process

Before commencing any research study, the researcher must have a solid understanding of the research process. A well-developed outline of the study and an understanding of the important considerations in designing and undertaking a GT study are essential if the goals of the research are to be achieved. While it is important to have an understanding of how a methodology has developed, in order to move forward with research, a novice can align with a grounded theorist and follow an approach to GT. Using a framework to inform a research design can be a useful modus operandi.

The following section provides insight into the process of undertaking a GT research study. Figure 1 is a framework that summarises the interplay and movement between methods and processes that underpin the generation of a GT. As can be seen from this framework, and as detailed in the discussion that follows, the process of doing a GT research study is not linear, rather it is iterative and recursive.

Research design framework: summary of the interplay between the essential grounded theory methods and processes.

Grounded theory research involves the meticulous application of specific methods and processes. Methods are ‘systematic modes, procedures or tools used for collection and analysis of data’. 25 While GT studies can commence with a variety of sampling techniques, many commence with purposive sampling, followed by concurrent data generation and/or collection and data analysis, through various stages of coding, undertaken in conjunction with constant comparative analysis, theoretical sampling and memoing. Theoretical sampling is employed until theoretical saturation is reached. These methods and processes create an unfolding, iterative system of actions and interactions inherent in GT. 6 , 16 The methods interconnect and inform the recurrent elements in the research process as shown by the directional flow of the arrows and the encompassing brackets in Figure 1 . The framework denotes the process is both iterative and dynamic and is not one directional. Grounded theory methods are discussed in the following section.

Purposive sampling

As presented in Figure 1 , initial purposive sampling directs the collection and/or generation of data. Researchers purposively select participants and/or data sources that can answer the research question. 5 , 7 , 16 , 21 Concurrent data generation and/or data collection and analysis is fundamental to GT research design. 6 The researcher collects, codes and analyses this initial data before further data collection/generation is undertaken. Purposeful sampling provides the initial data that the researcher analyses. As will be discussed, theoretical sampling then commences from the codes and categories developed from the first data set. Theoretical sampling is used to identify and follow clues from the analysis, fill gaps, clarify uncertainties, check hunches and test interpretations as the study progresses.

Constant comparative analysis

Constant comparative analysis is an analytical process used in GT for coding and category development. This process commences with the first data generated or collected and pervades the research process as presented in Figure 1 . Incidents are identified in the data and coded. 6 The initial stage of analysis compares incident to incident in each code. Initial codes are then compared to other codes. Codes are then collapsed into categories. This process means the researcher will compare incidents in a category with previous incidents, in both the same and different categories. 5 Future codes are compared and categories are compared with other categories. New data is then compared with data obtained earlier during the analysis phases. This iterative process involves inductive and deductive thinking. 16 Inductive, deductive and abductive reasoning can also be used in data analysis. 26

Constant comparative analysis generates increasingly more abstract concepts and theories through inductive processes. 16 In addition, abduction, defined as ‘a form of reasoning that begins with an examination of the data and the formation of a number of hypotheses that are then proved or disproved during the process of analysis … aids inductive conceptualization’. 6 Theoretical sampling coupled with constant comparative analysis raises the conceptual levels of data analysis and directs ongoing data collection or generation. 6

The constant comparative technique is used to find consistencies and differences, with the aim of continually refining concepts and theoretically relevant categories. This continual comparative iterative process that encompasses GT research sets it apart from a purely descriptive analysis. 8

Memo writing is an analytic process considered essential ‘in ensuring quality in grounded theory’. 6 Stern 27 offers the analogy that if data are the building blocks of the developing theory, then memos are the ‘mortar’ (p. 119). Memos are the storehouse of ideas generated and documented through interacting with data. 28 Thus, memos are reflective interpretive pieces that build a historic audit trail to document ideas, events and the thought processes inherent in the research process and developing thinking of the analyst. 6 Memos provide detailed records of the researchers’ thoughts, feelings and intuitive contemplations. 6

Lempert 29 considers memo writing crucial as memos prompt researchers to analyse and code data and develop codes into categories early in the coding process. Memos detail why and how decisions made related to sampling, coding, collapsing of codes, making of new codes, separating codes, producing a category and identifying relationships abstracted to a higher level of analysis. 6 Thus, memos are informal analytic notes about the data and the theoretical connections between categories. 23 Memoing is an ongoing activity that builds intellectual assets, fosters analytic momentum and informs the GT findings. 6 , 10

Generating/collecting data

A hallmark of GT is concurrent data generation/collection and analysis. In GT, researchers may utilise both qualitative and quantitative data as espoused by Glaser’s dictum; ‘all is data’. 30 While interviews are a common method of generating data, data sources can include focus groups, questionnaires, surveys, transcripts, letters, government reports, documents, grey literature, music, artefacts, videos, blogs and memos. 9 Elicited data are produced by participants in response to, or directed by, the researcher whereas extant data includes data that is already available such as documents and published literature. 6 , 31 While this is one interpretation of how elicited data are generated, other approaches to grounded theory recognise the agency of participants in the co-construction of data with the researcher. The relationship the researcher has with the data, how it is generated and collected, will determine the value it contributes to the development of the final GT. 6 The significance of this relationship extends into data analysis conducted by the researcher through the various stages of coding.

Coding is an analytical process used to identify concepts, similarities and conceptual reoccurrences in data. Coding is the pivotal link between collecting or generating data and developing a theory that explains the data. Charmaz 10 posits,

codes rely on interaction between researchers and their data. Codes consist of short labels that we construct as we interact with the data. Something kinaesthetic occurs when we are coding; we are mentally and physically active in the process. (p. 5)

In GT, coding can be categorised into iterative phases. Traditional, evolved and constructivist GT genres use different terminology to explain each coding phase ( Table 1 ).

Comparison of coding terminology in traditional, evolved and constructivist grounded theory.

Adapted from Birks and Mills. 6

Coding terminology in evolved GT refers to open (a procedure for developing categories of information), axial (an advanced procedure for interconnecting the categories) and selective coding (procedure for building a storyline from core codes that connects the categories), producing a discursive set of theoretical propositions. 6 , 12 , 32 Constructivist grounded theorists refer to initial, focused and theoretical coding. 9 Birks and Mills 6 use the terms initial, intermediate and advanced coding that link to low, medium and high-level conceptual analysis and development. The coding terms devised by Birks and Mills 6 were used for Figure 1 ; however, these can be altered to reflect the coding terminology used in the respective GT genres selected by the researcher.

Initial coding

Initial coding of data is the preliminary step in GT data analysis. 6 , 9 The purpose of initial coding is to start the process of fracturing the data to compare incident to incident and to look for similarities and differences in beginning patterns in the data. In initial coding, the researcher inductively generates as many codes as possible from early data. 16 Important words or groups of words are identified and labelled. In GT, codes identify social and psychological processes and actions as opposed to themes. Charmaz 16 emphasises keeping codes as similar to the data as possible and advocates embedding actions in the codes in an iterative coding process. Saldaña 33 agrees that codes that denote action, which he calls process codes, can be used interchangeably with gerunds (verbs ending in ing ). In vivo codes are often verbatim quotes from the participants’ words and are often used as the labels to capture the participant’s words as representative of a broader concept or process in the data. 6 Table 1 reflects variation in the terminology of codes used by grounded theorists.

Initial coding categorises and assigns meaning to the data, comparing incident-to-incident, labelling beginning patterns and beginning to look for comparisons between the codes. During initial coding, it is important to ask ‘what is this data a study of’. 18 What does the data assume, ‘suggest’ or ‘pronounce’ and ‘from whose point of view’ does this data come, whom does it represent or whose thoughts are they?. 16 What collectively might it represent? The process of documenting reactions, emotions and related actions enables researchers to explore, challenge and intensify their sensitivity to the data. 34 Early coding assists the researcher to identify the direction for further data gathering. After initial analysis, theoretical sampling is employed to direct collection of additional data that will inform the ‘developing theory’. 9 Initial coding advances into intermediate coding once categories begin to develop.

Theoretical sampling

The purpose of theoretical sampling is to allow the researcher to follow leads in the data by sampling new participants or material that provides relevant information. As depicted in Figure 1 , theoretical sampling is central to GT design, aids the evolving theory 5 , 7 , 16 and ensures the final developed theory is grounded in the data. 9 Theoretical sampling in GT is for the development of a theoretical category, as opposed to sampling for population representation. 10 Novice researchers need to acknowledge this difference if they are to achieve congruence within the methodology. Birks and Mills 6 define theoretical sampling as ‘the process of identifying and pursuing clues that arise during analysis in a grounded theory study’ (p. 68). During this process, additional information is sought to saturate categories under development. The analysis identifies relationships, highlights gaps in the existing data set and may reveal insight into what is not yet known. The exemplars in Box 1 highlight how theoretical sampling led to the inclusion of further data.

Examples of theoretical sampling.

Thus, theoretical sampling is used to focus and generate data to feed the iterative process of continual comparative analysis of the data. 6

Intermediate coding

Intermediate coding, identifying a core category, theoretical data saturation, constant comparative analysis, theoretical sensitivity and memoing occur in the next phase of the GT process. 6 Intermediate coding builds on the initial coding phase. Where initial coding fractures the data, intermediate coding begins to transform basic data into more abstract concepts allowing the theory to emerge from the data. During this analytic stage, a process of reviewing categories and identifying which ones, if any, can be subsumed beneath other categories occurs and the properties or dimension of the developed categories are refined. Properties refer to the characteristics that are common to all the concepts in the category and dimensions are the variations of a property. 37

At this stage, a core category starts to become evident as developed categories form around a core concept; relationships are identified between categories and the analysis is refined. Birks and Mills 6 affirm that diagramming can aid analysis in the intermediate coding phase. Grounded theorists interact closely with the data during this phase, continually reassessing meaning to ascertain ‘what is really going on’ in the data. 30 Theoretical saturation ensues when new data analysis does not provide additional material to existing theoretical categories, and the categories are sufficiently explained. 6

Advanced coding

Birks and Mills 6 described advanced coding as the ‘techniques used to facilitate integration of the final grounded theory’ (p. 177). These authors promote storyline technique (described in the following section) and theoretical coding as strategies for advancing analysis and theoretical integration. Advanced coding is essential to produce a theory that is grounded in the data and has explanatory power. 6 During the advanced coding phase, concepts that reach the stage of categories will be abstract, representing stories of many, reduced into highly conceptual terms. The findings are presented as a set of interrelated concepts as opposed to presenting themes. 28 Explanatory statements detail the relationships between categories and the central core category. 28

Storyline is a tool that can be used for theoretical integration. Birks and Mills 6 define storyline as ‘a strategy for facilitating integration, construction, formulation, and presentation of research findings through the production of a coherent grounded theory’ (p. 180). Storyline technique is first proposed with limited attention in Basics of Qualitative Research by Strauss and Corbin 12 and further developed by Birks et al. 38 as a tool for theoretical integration. The storyline is the conceptualisation of the core category. 6 This procedure builds a story that connects the categories and produces a discursive set of theoretical propositions. 24 Birks and Mills 6 contend that storyline can be ‘used to produce a comprehensive rendering of your grounded theory’ (p. 118). Birks et al. 38 had earlier concluded, ‘storyline enhances the development, presentation and comprehension of the outcomes of grounded theory research’ (p. 405). Once the storyline is developed, the GT is finalised using theoretical codes that ‘provide a framework for enhancing the explanatory power of the storyline and its potential as theory’. 6 Thus, storyline is the explication of the theory.

Theoretical coding occurs as the final culminating stage towards achieving a GT. 39 , 40 The purpose of theoretical coding is to integrate the substantive theory. 41 Saldaña 40 states, ‘theoretical coding integrates and synthesises the categories derived from coding and analysis to now create a theory’ (p. 224). Initial coding fractures the data while theoretical codes ‘weave the fractured story back together again into an organized whole theory’. 18 Advanced coding that integrates extant theory adds further explanatory power to the findings. 6 The examples in Box 2 describe the use of storyline as a technique.

Writing the storyline.

Theoretical sensitivity

As presented in Figure 1 , theoretical sensitivity encompasses the entire research process. Glaser and Strauss 5 initially described the term theoretical sensitivity in The Discovery of Grounded Theory. Theoretical sensitivity is the ability to know when you identify a data segment that is important to your theory. While Strauss and Corbin 12 describe theoretical sensitivity as the insight into what is meaningful and of significance in the data for theory development, Birks and Mills 6 define theoretical sensitivity as ‘the ability to recognise and extract from the data elements that have relevance for the emerging theory’ (p. 181). Conducting GT research requires a balance between keeping an open mind and the ability to identify elements of theoretical significance during data generation and/or collection and data analysis. 6

Several analytic tools and techniques can be used to enhance theoretical sensitivity and increase the grounded theorist’s sensitivity to theoretical constructs in the data. 28 Birks and Mills 6 state, ‘as a grounded theorist becomes immersed in the data, their level of theoretical sensitivity to analytic possibilities will increase’ (p. 12). Developing sensitivity as a grounded theorist and the application of theoretical sensitivity throughout the research process allows the analytical focus to be directed towards theory development and ultimately result in an integrated and abstract GT. 6 The example in Box 3 highlights how analytic tools are employed to increase theoretical sensitivity.

Theoretical sensitivity.

The grounded theory

The meticulous application of essential GT methods refines the analysis resulting in the generation of an integrated, comprehensive GT that explains a process relating to a particular phenomenon. 6 The results of a GT study are communicated as a set of concepts, related to each other in an interrelated whole, and expressed in the production of a substantive theory. 5 , 7 , 16 A substantive theory is a theoretical interpretation or explanation of a studied phenomenon 6 , 17 Thus, the hallmark of grounded theory is the generation of theory ‘abstracted from, or grounded in, data generated and collected by the researcher’. 6 However, to ensure quality in research requires the application of rigour throughout the research process.

Quality and rigour

The quality of a grounded theory can be related to three distinct areas underpinned by (1) the researcher’s expertise, knowledge and research skills; (2) methodological congruence with the research question; and (3) procedural precision in the use of methods. 6 Methodological congruence is substantiated when the philosophical position of the researcher is congruent with the research question and the methodological approach selected. 6 Data collection or generation and analytical conceptualisation need to be rigorous throughout the research process to secure excellence in the final grounded theory. 44

Procedural precision requires careful attention to maintaining a detailed audit trail, data management strategies and demonstrable procedural logic recorded using memos. 6 Organisation and management of research data, memos and literature can be assisted using software programs such as NVivo. An audit trail of decision-making, changes in the direction of the research and the rationale for decisions made are essential to ensure rigour in the final grounded theory. 6

This article offers a framework to assist novice researchers visualise the iterative processes that underpin a GT study. The fundamental process and methods used to generate an integrated grounded theory have been described. Novice researchers can adapt the framework presented to inform and guide the design of a GT study. This framework provides a useful guide to visualise the interplay between the methods and processes inherent in conducting GT. Research conducted ethically and with meticulous attention to process will ensure quality research outcomes that have relevance at the practice level.

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article.

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Home » Grounded Theory – Methods, Examples and Guide

Grounded Theory – Methods, Examples and Guide

Table of Contents

Grounded Theory

Definition:

Grounded Theory is a qualitative research methodology that aims to generate theories based on data that are grounded in the empirical reality of the research context. The method involves a systematic process of data collection, coding, categorization, and analysis to identify patterns and relationships in the data.

The ultimate goal is to develop a theory that explains the phenomenon being studied, which is based on the data collected and analyzed rather than on preconceived notions or hypotheses. The resulting theory should be able to explain the phenomenon in a way that is consistent with the data and also accounts for variations and discrepancies in the data. Grounded Theory is widely used in sociology, psychology, management, and other social sciences to study a wide range of phenomena, such as organizational behavior, social interaction, and health care.

History of Grounded Theory

Grounded Theory was first introduced by sociologists Barney Glaser and Anselm Strauss in the 1960s as a response to the limitations of traditional positivist approaches to social research. The approach was initially developed to study dying patients and their families in hospitals, but it was soon applied to other areas of sociology and beyond.

Glaser and Strauss published their seminal book “The Discovery of Grounded Theory” in 1967, in which they presented their approach to developing theory from empirical data. They argued that existing social theories often did not account for the complexity and diversity of social phenomena, and that the development of theory should be grounded in empirical data.

Since then, Grounded Theory has become a widely used methodology in the social sciences, and has been applied to a wide range of topics, including healthcare, education, business, and psychology. The approach has also evolved over time, with variations such as constructivist grounded theory and feminist grounded theory being developed to address specific criticisms and limitations of the original approach.

Types of Grounded Theory

There are two main types of Grounded Theory: Classic Grounded Theory and Constructivist Grounded Theory.

Classic Grounded Theory

This approach is based on the work of Glaser and Strauss, and emphasizes the discovery of a theory that is grounded in data. The focus is on generating a theory that explains the phenomenon being studied, without being influenced by preconceived notions or existing theories. The process involves a continuous cycle of data collection, coding, and analysis, with the aim of developing categories and subcategories that are grounded in the data. The categories and subcategories are then compared and synthesized to generate a theory that explains the phenomenon.

Constructivist Grounded Theory

This approach is based on the work of Charmaz, and emphasizes the role of the researcher in the process of theory development. The focus is on understanding how individuals construct meaning and interpret their experiences, rather than on discovering an objective truth. The process involves a reflexive and iterative approach to data collection, coding, and analysis, with the aim of developing categories that are grounded in the data and the researcher’s interpretations of the data. The categories are then compared and synthesized to generate a theory that accounts for the multiple perspectives and interpretations of the phenomenon being studied.

Grounded Theory Conducting Guide

Here are some general guidelines for conducting a Grounded Theory study:

• Choose a research question: Start by selecting a research question that is open-ended and focuses on a specific social phenomenon or problem.
• Select participants and collect data: Identify a diverse group of participants who have experienced the phenomenon being studied. Use a variety of data collection methods such as interviews, observations, and document analysis to collect rich and diverse data.
• Analyze the data: Begin the process of analyzing the data using constant comparison. This involves comparing the data to each other and to existing categories and codes, in order to identify patterns and relationships. Use open coding to identify concepts and categories, and then use axial coding to organize them into a theoretical framework.
• Generate categories and codes: Generate categories and codes that describe the phenomenon being studied. Make sure that they are grounded in the data and that they accurately reflect the experiences of the participants.
• Refine and develop the theory: Use theoretical sampling to identify new data sources that are relevant to the developing theory. Use memoing to reflect on insights and ideas that emerge during the analysis process. Continue to refine and develop the theory until it provides a comprehensive explanation of the phenomenon.
• Validate the theory: Finally, seek to validate the theory by testing it against new data and seeking feedback from peers and other researchers. This process helps to refine and improve the theory, and to ensure that it is grounded in the data.
• Write up and disseminate the findings: Once the theory is fully developed and validated, write up the findings and disseminate them through academic publications and presentations. Make sure to acknowledge the contributions of the participants and to provide a detailed account of the research methods used.

Data Collection Methods

Grounded Theory Data Collection Methods are as follows:

• Interviews : One of the most common data collection methods in Grounded Theory is the use of in-depth interviews. Interviews allow researchers to gather rich and detailed data about the experiences, perspectives, and attitudes of participants. Interviews can be conducted one-on-one or in a group setting.
• Observation : Observation is another data collection method used in Grounded Theory. Researchers may observe participants in their natural settings, such as in a workplace or community setting. This method can provide insights into the social interactions and behaviors of participants.
• Document analysis: Grounded Theory researchers also use document analysis as a data collection method. This involves analyzing existing documents such as reports, policies, or historical records that are relevant to the phenomenon being studied.
• Focus groups : Focus groups involve bringing together a group of participants to discuss a specific topic or issue. This method can provide insights into group dynamics and social interactions.
• Fieldwork : Fieldwork involves immersing oneself in the research setting and participating in the activities of the participants. This method can provide an in-depth understanding of the culture and social dynamics of the research setting.
• Multimedia data: Grounded Theory researchers may also use multimedia data such as photographs, videos, or audio recordings to capture the experiences and perspectives of participants.

Data Analysis Methods

Grounded Theory Data Analysis Methods are as follows:

• Open coding: Open coding is the process of identifying concepts and categories in the data. Researchers use open coding to assign codes to different pieces of data, and to identify similarities and differences between them.
• Axial coding: Axial coding is the process of organizing the codes into broader categories and subcategories. Researchers use axial coding to develop a theoretical framework that explains the phenomenon being studied.
• Constant comparison: Grounded Theory involves a process of constant comparison, in which data is compared to each other and to existing categories and codes in order to identify patterns and relationships.
• Theoretical sampling: Theoretical sampling involves selecting new data sources based on the emerging theory. Researchers use theoretical sampling to collect data that will help refine and validate the theory.
• Memoing : Memoing involves writing down reflections, insights, and ideas as the analysis progresses. This helps researchers to organize their thoughts and develop a deeper understanding of the data.
• Peer debriefing: Peer debriefing involves seeking feedback from peers and other researchers on the developing theory. This process helps to validate the theory and ensure that it is grounded in the data.
• Member checking: Member checking involves sharing the emerging theory with the participants in the study and seeking their feedback. This process helps to ensure that the theory accurately reflects the experiences and perspectives of the participants.
• Triangulation: Triangulation involves using multiple sources of data to validate the emerging theory. Researchers may use different data collection methods, different data sources, or different analysts to ensure that the theory is grounded in the data.

Applications of Grounded Theory

Here are some of the key applications of Grounded Theory:

• Social sciences : Grounded Theory is widely used in social science research, particularly in fields such as sociology, psychology, and anthropology. It can be used to explore a wide range of social phenomena, such as social interactions, power dynamics, and cultural practices.
• Healthcare : Grounded Theory can be used in healthcare research to explore patient experiences, healthcare practices, and healthcare systems. It can provide insights into the factors that influence healthcare outcomes, and can inform the development of interventions and policies.
• Education : Grounded Theory can be used in education research to explore teaching and learning processes, student experiences, and educational policies. It can provide insights into the factors that influence educational outcomes, and can inform the development of educational interventions and policies.
• Business : Grounded Theory can be used in business research to explore organizational processes, management practices, and consumer behavior. It can provide insights into the factors that influence business outcomes, and can inform the development of business strategies and policies.
• Technology : Grounded Theory can be used in technology research to explore user experiences, technology adoption, and technology design. It can provide insights into the factors that influence technology outcomes, and can inform the development of technology interventions and policies.

Examples of Grounded Theory

Examples of Grounded Theory in different case studies are as follows:

• Glaser and Strauss (1965): This study, which is considered one of the foundational works of Grounded Theory, explored the experiences of dying patients in a hospital. The researchers used Grounded Theory to develop a theoretical framework that explained the social processes of dying, and that was grounded in the data.
• Charmaz (1983): This study explored the experiences of chronic illness among young adults. The researcher used Grounded Theory to develop a theoretical framework that explained how individuals with chronic illness managed their illness, and how their illness impacted their sense of self.
• Strauss and Corbin (1990): This study explored the experiences of individuals with chronic pain. The researchers used Grounded Theory to develop a theoretical framework that explained the different strategies that individuals used to manage their pain, and that was grounded in the data.
• Glaser and Strauss (1967): This study explored the experiences of individuals who were undergoing a process of becoming disabled. The researchers used Grounded Theory to develop a theoretical framework that explained the social processes of becoming disabled, and that was grounded in the data.
• Clarke (2005): This study explored the experiences of patients with cancer who were receiving chemotherapy. The researcher used Grounded Theory to develop a theoretical framework that explained the factors that influenced patient adherence to chemotherapy, and that was grounded in the data.

Grounded Theory Research Example

A Grounded Theory Research Example Would be:

Research question : What is the experience of first-generation college students in navigating the college admission process?

Data collection : The researcher conducted interviews with first-generation college students who had recently gone through the college admission process. The interviews were audio-recorded and transcribed verbatim.

Data analysis: The researcher used a constant comparative method to analyze the data. This involved coding the data, comparing codes, and constantly revising the codes to identify common themes and patterns. The researcher also used memoing, which involved writing notes and reflections on the data and analysis.

Findings : Through the analysis of the data, the researcher identified several themes related to the experience of first-generation college students in navigating the college admission process, such as feeling overwhelmed by the complexity of the process, lacking knowledge about the process, and facing financial barriers.

Theory development: Based on the findings, the researcher developed a theory about the experience of first-generation college students in navigating the college admission process. The theory suggested that first-generation college students faced unique challenges in the college admission process due to their lack of knowledge and resources, and that these challenges could be addressed through targeted support programs and resources.

In summary, grounded theory research involves collecting data, analyzing it through constant comparison and memoing, and developing a theory grounded in the data. The resulting theory can help to explain the phenomenon being studied and guide future research and interventions.

Purpose of Grounded Theory

The purpose of Grounded Theory is to develop a theoretical framework that explains a social phenomenon, process, or interaction. This theoretical framework is developed through a rigorous process of data collection, coding, and analysis, and is grounded in the data.

Grounded Theory aims to uncover the social processes and patterns that underlie social phenomena, and to develop a theoretical framework that explains these processes and patterns. It is a flexible method that can be used to explore a wide range of research questions and settings, and is particularly well-suited to exploring complex social phenomena that have not been well-studied.

The ultimate goal of Grounded Theory is to generate a theoretical framework that is grounded in the data, and that can be used to explain and predict social phenomena. This theoretical framework can then be used to inform policy and practice, and to guide future research in the field.

When to use Grounded Theory

Following are some situations in which Grounded Theory may be particularly useful:

• Exploring new areas of research: Grounded Theory is particularly useful when exploring new areas of research that have not been well-studied. By collecting and analyzing data, researchers can develop a theoretical framework that explains the social processes and patterns underlying the phenomenon of interest.
• Studying complex social phenomena: Grounded Theory is well-suited to exploring complex social phenomena that involve multiple social processes and interactions. By using an iterative process of data collection and analysis, researchers can develop a theoretical framework that explains the complexity of the social phenomenon.
• Generating hypotheses: Grounded Theory can be used to generate hypotheses about social processes and interactions that can be tested in future research. By developing a theoretical framework that explains a social phenomenon, researchers can identify areas for further research and hypothesis testing.
• Informing policy and practice : Grounded Theory can provide insights into the factors that influence social phenomena, and can inform policy and practice in a variety of fields. By developing a theoretical framework that explains a social phenomenon, researchers can identify areas for intervention and policy development.

Characteristics of Grounded Theory

Grounded Theory is a qualitative research method that is characterized by several key features, including:

• Emergence : Grounded Theory emphasizes the emergence of theoretical categories and concepts from the data, rather than preconceived theoretical ideas. This means that the researcher does not start with a preconceived theory or hypothesis, but instead allows the theory to emerge from the data.
• Iteration : Grounded Theory is an iterative process that involves constant comparison of data and analysis, with each round of data collection and analysis refining the theoretical framework.
• Inductive : Grounded Theory is an inductive method of analysis, which means that it derives meaning from the data. The researcher starts with the raw data and systematically codes and categorizes it to identify patterns and themes, and to develop a theoretical framework that explains these patterns.
• Reflexive : Grounded Theory requires the researcher to be reflexive and self-aware throughout the research process. The researcher’s personal biases and assumptions must be acknowledged and addressed in the analysis process.
• Holistic : Grounded Theory takes a holistic approach to data analysis, looking at the entire data set rather than focusing on individual data points. This allows the researcher to identify patterns and themes that may not be apparent when looking at individual data points.
• Contextual : Grounded Theory emphasizes the importance of understanding the context in which social phenomena occur. This means that the researcher must consider the social, cultural, and historical factors that may influence the phenomenon of interest.

Advantages of Grounded Theory

Advantages of Grounded Theory are as follows:

• Flexibility : Grounded Theory is a flexible method that can be used to explore a wide range of research questions and settings. It is particularly well-suited to exploring complex social phenomena that have not been well-studied.
• Validity : Grounded Theory aims to develop a theoretical framework that is grounded in the data, which enhances the validity and reliability of the research findings. The iterative process of data collection and analysis also helps to ensure that the research findings are reliable and robust.
• Originality : Grounded Theory can generate new and original insights into social phenomena, as it is not constrained by preconceived theoretical ideas or hypotheses. This allows researchers to explore new areas of research and generate new theoretical frameworks.
• Real-world relevance: Grounded Theory can inform policy and practice, as it provides insights into the factors that influence social phenomena. The theoretical frameworks developed through Grounded Theory can be used to inform policy development and intervention strategies.
• Ethical : Grounded Theory is an ethical research method, as it allows participants to have a voice in the research process. Participants’ perspectives are central to the data collection and analysis process, which ensures that their views are taken into account.
• Replication : Grounded Theory is a replicable method of research, as the theoretical frameworks developed through Grounded Theory can be tested and validated in future research.

Limitations of Grounded Theory

Limitations of Grounded Theory are as follows:

• Time-consuming: Grounded Theory can be a time-consuming method, as the iterative process of data collection and analysis requires significant time and effort. This can make it difficult to conduct research in a timely and cost-effective manner.
• Subjectivity : Grounded Theory is a subjective method, as the researcher’s personal biases and assumptions can influence the data analysis process. This can lead to potential issues with reliability and validity of the research findings.
• Generalizability : Grounded Theory is a context-specific method, which means that the theoretical frameworks developed through Grounded Theory may not be generalizable to other contexts or populations. This can limit the applicability of the research findings.
• Lack of structure : Grounded Theory is an exploratory method, which means that it lacks the structure of other research methods, such as surveys or experiments. This can make it difficult to compare findings across different studies.
• Data overload: Grounded Theory can generate a large amount of data, which can be overwhelming for researchers. This can make it difficult to manage and analyze the data effectively.
• Difficulty in publication: Grounded Theory can be challenging to publish in some academic journals, as some reviewers and editors may view it as less rigorous than other research methods.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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Your complete guide to grounded theory research.

11 min read If you have an area of interest, but no hypothesis yet, try grounded theory research. You conduct data collection and analysis, forming a theory based on facts. Read our ultimate guide for everything you need to know.

What is grounded theory in research?

Grounded theory is a systematic qualitative research method that collects empirical data first, and then creates a theory ‘grounded’ in the results.

The constant comparative method was developed by Glaser and Strauss, described in their book, Awareness of Dying (1965). They are seen as the founders of classic grounded theory.

Research teams use grounded theory to analyze social processes and relationships.

Because of the important role of data, there are key stages like data collection and data analysis that need to happen in order for the resulting data to be useful.

The grounded research results are compared to strengthen the validity of the findings to arrive at stronger defined theories. Once the data analysis cannot continue to refine the new theories down, a final theory is confirmed.

Grounded research is different from experimental research or scientific inquiry as it does not need a hypothesis theory at the start to verify. Instead, the evolving theory is based on facts and evidence discovered during each stage.Also, grounded research also doesn’t have a preconceived understanding of events or happenings before the qualitative research commences.

Free eBook: Qualitative research design handbook

When should you use grounded theory research?

Grounded theory research is useful for businesses when a researcher wants to look into a topic that has existing theory or no current research available. This means that the qualitative research results will be unique and can open the doors to the social phenomena being investigated.

In addition, businesses can use this qualitative research as the primary evidence needed to understand whether it’s worth placing investment into a new line of product or services, if the research identifies key themes and concepts that point to a solvable commercial problem.

Grounded theory methodology

There are several stages in the grounded theory process:

1. Data planning

The researcher decides what area they’re interested in.

They may create a guide to what they will be collecting during the grounded theory methodology. They will refer to this guide when they want to check the suitability of the qualitative data, as they collect it, to avoid preconceived ideas of what they know impacting the research.

A researcher can set up a grounded theory coding framework to identify the correct data. Coding is associating words, or labels, that are useful to the social phenomena that is being investigated. So, when the researcher sees these words, they assign the data to that category or theme.

In this stage, you’ll also want to create your open-ended initial research questions. Here are the main differences between open and closed-ended questions:

These will need to be adapted as the research goes on and more tangents and areas to explore are discovered. To help you create your questions, ask yourself:

• What are you trying to explain?
• What experiences do you need to ask about?
• Who will you ask and why?

2. Data collection and analysis

Data analysis happens at the same time as data collection. In grounded theory analysis, this is also known as constant comparative analysis, or theoretical sampling.

The researcher collects qualitative data by asking open-ended questions in interviews and surveys, studying historical or archival data, or observing participants and interpreting what is seen. This collected data is transferred into transcripts.

The categories or themes are compared and further refined by data, until there are only a few strong categories or themes remaining. Here is where coding occurs, and there are different levels of coding as the categories or themes are refined down:

• Data collection (Initial coding stage): Read through the data line by line
• Open coding stage: Read through the transcript data several times, breaking down the qualitative research data into excerpts, and make summaries of the concept or theme.
• Axial coding stage: Read through and compare further data collection to summarize concepts or themes to look for similarities and differences. Make defined summaries that help shape an emerging theory.
• Selective coding stage: Use the defined summaries to identify a strong core concept or theme.

During analysis, the researcher will apply theoretical sensitivity to the collected data they uncover, so that the meaning of nuances in what they see can be fully understood.

This coding process repeats until the researcher has reached theoretical saturation. In grounded theory analysis, this is where all data has been researched and there are no more possible categories or themes to explore.

3. Data analysis is turned into a final theory

The researcher takes the core categories and themes that they have gathered and integrates them into one central idea (a new theory) using selective code. This final grounded theory concludes the research.

The new theory should be a few simple sentences that describe the research, indicating what was and was not covered in it.

An example of using grounded theory in business

One example of how grounded theory may be used in business is to support HR teams by analyzing data to explore reasons why people leave a company.

For example, a company with a high attrition rate that has not done any research on this area before may choose grounded theory to understand key reasons why people choose to leave.

Researchers may start looking at the quantitative data around departures over the year and look for patterns. Coupled with this, they may conduct qualitative data research through employee engagement surveys , interview panels for current employees, and exit interviews with leaving employees.

From this information, they may start coding transcripts to find similarities and differences (coding) picking up on general themes and concepts. For example, a group of excepts like:

• “The hours I worked were far too long and I hated traveling home in the dark”
• “My manager didn’t appreciate the work I was doing, especially when I worked late”
• There are no good night bus routes home that I could take safely”

Using open coding, a researcher could compare excerpts and suggest the themes of managerial issues, a culture of long hours and lack of traveling routes at night.

With more samples and information, through axial coding, stronger themes of lack of recognition and having too much work (which led people to working late), could be drawn out from the summaries of the concepts and themes.

This could lead to a selective coding conclusion that people left because they were ‘overworked and under-appreciated’.

With this information, a grounded theory can help HR teams look at what teams do day to day, exploring ways to spread workloads or reduce them. Also, there could be training supplied to management and employees to engage professional development conversations better.

 Advantages of grounded theory

• No need for hypothesis – Researchers don’t need to know the details about the topic they want to investigate in advance, as the grounded theory methodology will bring up the information.
• Lots of flexibility – Researchers can take the topic in whichever direction they think is best, based on what the data is telling them. This means that exploration avenues that may be off-limits in traditional experimental research can be included.
• Multiple stages improve conclusion – Having a series of coding stages that refine the data into clear and strong concepts or themes means that the grounded theory will be more useful, relevant and defined.
• Data-first – Grounded theory relies on data analysis in the first instance, so the conclusion is based on information that has strong data behind it. This could be seen as having more validity.

Disadvantages of grounded theory

• Theoretical sensitivity dulled – If a researcher does not know enough about the topic being investigated, then their theoretical sensitivity about what data means may be lower and information may be missed if it is not coded properly.
• Large topics take time – There is a significant time resource required by the researcher to properly conduct research, evaluate the results and compare and analyze each excerpt. If the research process finds more avenues for investigation, for example, when excerpts contradict each other, then the researcher is required to spend more time doing qualitative inquiry.
• Bias in interpreting qualitative data – As the researcher is responsible for interpreting the qualitative data results, and putting their own observations into text, there can be researcher bias that would skew the data and possibly impact the final grounded theory.
• Qualitative research is harder to analyze than quantitative data – unlike numerical factual data from quantitative sources, qualitative data is harder to analyze as researchers will need to look at the words used, the sentiment and what is being said.
• Not repeatable – while the grounded theory can present a fact-based hypothesis, the actual data analysis from the research process cannot be repeated easily as opinions, beliefs and people may change over time. This may impact the validity of the grounded theory result.

What tools will help with grounded theory?

Evaluating qualitative research can be tough when there are several analytics platforms to manage and lots of subjective data sources to compare. Some tools are already part of the office toolset, like video conferencing tools and excel spreadsheets.

However, most tools are not purpose-built for research, so researchers will be manually collecting and managing these files – in the worst case scenario, by pen and paper!

Use a best-in-breed management technology solution to collect all qualitative research and manage it in an organized way without large time resources or additional training required.

Qualtrics provides a number of qualitative research analysis tools, like Text iQ , powered by Qualtrics iQ, provides powerful machine learning and native language processing to help you discover patterns and trends in text.

This also provides you with research process tools:

• Sentiment analysis — a technique to help identify the underlying sentiment (say positive, neutral, and/or negative) in qualitative research text responses
• Topic detection/categorisation — The solution makes it easy to add new qualitative research codes and group by theme. Easily group or bucket of similar themes that can be relevant for the business and the industry (eg. ‘Food quality’, ‘Staff efficiency’ or ‘Product availability’)

Related resources

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An Introduction to Grounded Theory with a Special Focus on Axial Coding and the Coding Paradigm

• Open Access
• First Online: 27 April 2019

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• Maike Vollstedt 4 &
• Sebastian Rezat 5  

Part of the book series: ICME-13 Monographs ((ICME13Mo))

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In this chapter we introduce grounded theory methodology and methods. In particular we clarify which research questions are appropriate for a grounded theory study and give an overview of the main techniques and procedures, such as the coding procedures, theoretical sensitivity, theoretical sampling, and theoretical saturation. We further discuss the role of theory within grounded theory and provide examples of studies in which the coding paradigm of grounded theory has been altered in order to be better suitable for applications in mathematics education. In our exposition we mainly refer to grounded theory techniques and procedures according to Strauss and Corbin (Basics of qualitative research: Grounded theory procedures and techniques, Sage Publications, Thousand Oaks, 1990 ), but also include other approaches in the discussion in order to point out the particularities of the approach by Strauss and Corbin.

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Grounded Theory

Grounded Theory Methods

Grounded Theory Methodology: Principles and Practices

• Grounded theory
• Coding procedures
• Coding paradigm
• Coding families
• Theoretical sensitivity

1 Introduction

In 1967, sociologists Barney Glaser and Anselm Strauss published their seminal book “The discovery of grounded theory: Strategies for qualitative research” (Glaser and Strauss 1967 ), which lays the foundation for one of the most prominent and influential qualitative research methodologies in the social sciences and beyond. With their focus on theory development, they dissociate themselves from mere theory verification and the concomitant separation of the context of theory discovery and the context of theory justification, which was the prominent scientific method at that time. With their approach to qualitative research, they also go beyond the mere description of phenomena. Originally, the book was written as a book for young researchers. One of its main intentions was to legitimate qualitative research (Mey and Mruck 2011 ).

Quite soon after their joint publication in 1967, Glaser and Strauss developed grounded theory in different directions and started to argue their own understanding of grounded theory methodology and methods apart from each other in different ways, Glaser primarily on his own, Strauss also together with Juliet Corbin (Glaser 1978 ; Strauss 1987 ; Strauss and Corbin 1990 ). Later, students of Glaser and Strauss further developed the different interpretations of grounded theory methodology so that today there is a second generation of grounded theory researchers, namely Juliet Corbin, Adele E. Clarke, and Kathy Charmaz (Morse et al. 2009 ). As those further developments of grounded theory resulted in different research methodologies, it has been suggested to talk about grounded theory methodologies in plural or at least to acknowledge that there are numerous modi operandi involving grounded theory methods in different fields of research as well as different national traditions (Mey and Mruck 2011 ). In Germany, for instance, it is still most common to work with the grounded theory methodology version that was published by Strauss and Corbin in 1990 (German translation from 1996 ). The second generation’s developments are still hardly noticed.

As this chapter is an introduction to grounded theory methodology and methods, our aim is to outline the common core of the different approaches to grounded theory. Therefore, we give a short introduction to grounded theory as a methodology (Sect. 4.2 ) and its techniques and procedures (Sect. 4.3 ). We further discuss an issue that lies at the heart of grounded theory, namely the role of theory within the methodology (Sect.  4.4 ). There, we also describe some examples of studies that used grounded theory as the main methodology, but took a specific stance to theory development in using the methodology.

2 A Short Positioning of Grounded Theory

This section provides a short overview of grounded theory as a methodology. We aim to answer two questions: 1. What is a grounded theory? 2. What kind of research questions are appropriate for a grounded theory study?

2.1 What Is Grounded Theory?

There is no simple answer to this question as the term grounded theory adheres to different research elements. In the first place, grounded theory is a methodology, which is characterized by the iterative process and the interrelatedness of planning, data collection, data analysis, and theory development. Grounded theory further provides a particular set of systematic methods, which support abstraction from the data in order to develop a theory that is grounded in the empirical data. These methods include different coding procedures, which are based on the method of constant comparison. New data are gathered continuously and new cases are included in the analysis based on their potential contribution to the further development and refinement of the evolving theory. This sampling method is called theoretical sampling . The iterative process of data collection according to theoretical sampling, data analysis, and theory development is continued until new data do not contribute any longer to a substantial development of the theory, i.e. until theoretical saturation is achieved. The theory that is the product of this process is also referred to as grounded theory . The quality of a grounded theory is not evaluated according to the standard criteria of test theory, i.e. objectivity, reliability and validity, but according to criteria such as credibility, plausibility, and trustworthiness.

2.2 What Kind of Research Questions Are Appropriate for a Grounded Theory Study?

According to the usual scientific procedure, the research question is at the outset of any scientific endeavour. It is the essence of what the researcher wants to know. The overall purpose of the study is to find an answer to the research question. Methodology and related methods are but a vehicle to find the (possibly best) answer to the research question. Ideally, it should be the research question that determines the methodology and not vice versa. Thus, it is important to ask what kind of research questions are appropriate for a grounded theory study. The character of the research question will influence the methodology and the choice of methods. We will try to characterize the kind of questions to which grounded theory could probably provide a good answer.

The overarching goal of grounded theory is to develop theory. Therefore, grounded theory studies may be carried out related to research phenomena or objects, which lack a (sufficient) theoretical foundation. It may be, that no theory exists for the phenomena under study or that the existing theories are insufficient in that

they lack important concepts;

the relationships among the concepts are not elaborated enough;

the relevance of the concepts and their relationships has not been corroborated for the population or the context under study.

Due to the origins of grounded theory in the social sciences, the main epistemological interest lies in predicting and explaining behavior in social interaction. Thus, Strauss and Corbin ( 1990 ) stress the orientation towards action and processes of grounded theory research questions.

3 A Short Introduction to the Methods and Techniques of Grounded Theory

The methods and techniques of grounded theory make use of different elements: some relate to the collection, some to the evaluation of data, and some refer to the research process. The following section gives a short introduction to the most important methods and techniques to make the start of working with grounded theory easier for a newcomer to this vast field. A more detailed description of the procedures and techniques can be found in the original literature describing grounded theory (e.g., Glaser 1978 ; Strauss 1987 ; Strauss and Corbin 1990 ). Note that technical terms and procedures may differ (slightly) when adhering to literature from different traditions of grounded theory. Even within one tradition of grounded theory, the methodology may also change over time (see Sect.  4.3.3.2 for an example with relation to the coding paradigm proposed by Strauss and Corbin 1990 and Corbin and Strauss 2015 respectively). To gain a more practical idea about the application of grounded theory, we suggest looking at Vollstedt ( 2015 ) for an example of the application of grounded theory methods in an international comparative study in mathematics education carried out in Germany and Hong Kong.

3.1 Theoretical Sensitivity and Sensitizing Concepts

When starting to work with grounded theory, there is no fixed theory at hand with which to evaluate the data. On the contrary, the researcher moves into an open field of study with many unclear aspects. As described above, important concepts are missing, and/or their relationship is not elaborated enough. The longer the researcher will have worked in this field, the clearer those unclear aspects will (hopefully) become. In order to make sense of the data, an important ability of the researcher is theoretical sensitivity. The notion of theoretical sensitivity is closely linked to grounded theory and Glaser ( 1978 ) even devoted a whole book to this issue. Corbin and Strauss ( 2015 ) describe sensitivity as “having insights as well as being tuned into and being able to pick up on relevant issues, events, and happenings during collection and analysis of the data” (p. 78). According to Glaser with the assistance of Holton ( 2004 ) the essence of theoretical sensitivity is the “ability to generate concepts from data and to relate them according to normal models of theory in general” (para. 43). They further sum up a number of single abilities that characterize the theoretical sensitivity of a researcher. These are “the personal and temperamental bent to maintain analytic distance, tolerate confusion and regression while remaining open, trusting to preconscious processing and to conceptual emergence […] the ability to develop theoretical insight into the area of research combined with the ability to make something of these insights […] the ability to conceptualize and organize, make abstract connections, visualize and think multivariately” (para. 43).

The opinions about how a researcher might develop theoretical sensitivity differ between the two founders of grounded theory and are in fact one of the main differences between their approaches. While Glaser (with the assistance of Holton 2004 ) suggests that the “first step in gaining theoretical sensitivity is to enter the research setting with as few predetermined ideas as possible” (para. 43), Strauss and Corbin ( 1990 ) name different sources of theoretical sensitivity: these are respective literature, the professional and personal experience of the researcher as well as the analytical process itself. However, the researcher is not supposed to follow the beaten track of the literature or his/her personal experience, but to question these and go beyond in order to get novel theoretical insight. In “Basics of qualitative research” Strauss and Corbin ( 1990 ) describe techniques to foster theoretical sensitivity. These are questioning, analyzing single words, phrases or sentences, and comparing, thus techniques, which pervade grounded theory in general.

3.2 Interdependence of Data Collection, Analysis, and Development of Theory

One characteristic of grounded theory is that data collection, data analysis, and theory development are not successive steps in the research procedure but are intertwined and interdependent. Thus, action in terms of data collection and reflexion in terms of data analysis and theory development always alternate. Data collection and analysis initialize the process of theory development. Further cycles of data collection and analysis are guided by theoretical sampling and serve to specify the research focus on the one hand, and to develop hypotheses and theory on the other. Theoretical sampling denotes a cumulative sampling method, in which the selection of new cases that are to be included in the analysis is guided by the unfolding theory. In this context “cases” does not necessarily mean “people”. Corbin and Strauss ( 2015 ) point out that “it is concepts and not people, per se, that are sampled” (p. 135). The authors point out that the goal of theoretical sampling might vary throughout the process of theory development. In the beginning of the process, cases are selected, because they are likely to enable the discovery of new relevant concepts. Later on, cases are selected because they are likely to contribute to the differentiation, elaboration, consolidation, and validation of categories in terms of their properties, their dimensions, or their interrelations (see the next section for the development of concepts and categories).

Theoretical sampling and the development of theory are continued until theoretical saturation is achieved, i.e., new data do not seem to contribute any longer to the elaboration of categories. The relations between the categories are well developed and validated (Strauss and Corbin 1990 ).

3.3 Data Analysis

The overarching goal of data analysis in the grounded theory methodology is theory development. In order to achieve this goal, the collected data are evaluated by applying different ways of coding as the core process. Coding in grounded theory methodology is a process of conceptual abstraction by assigning general concepts (codes) to singular incidences in the data.

After having collected some (not necessarily all) data, the evaluation process may begin. Depending on which line of grounded theory methodology one follows, the different kinds of coding that are applied may vary in nomenclature as well as procedures (Glaser 1978 ; Mey and Mruck 2011 ; Strauss and Corbin 1990 ; Teppo 2015 ). Glaser ( 1978 ) discriminates between substantive coding, which consists of open and selective coding, and theoretical coding. In contrast, Strauss and Corbin ( 1990 ) differentiate between three kinds of coding procedures that are needed to develop a grounded theory from the data: open, axial, and selective coding. These procedures are not to be misunderstood as being precise procedures that are easily distinguishable. On the contrary, the procedures are neither clear-cut, nor do they easily define phases that chronologically come one after the other. They embody rather different ways of working with the data that can be combined with each other and between which the researcher can move back and forth if needed (Mey and Mruck 2011 ).

The following sections give a brief overview of open, axial, and selective coding following Strauss and Corbin ( 1990 ). Section  4.4 then focusses on the role of theory in grounded theory with a special focus on axial coding and the coding paradigm.

3.3.1 Open Coding

Although the different procedures of coding do not occur in a strict sequence, open coding is usually the first approach to the data. Core elements of open coding are posing sensitizing questions and constantly comparing data and codes.

Open coding is the part of data analysis that focuses on the conceptualisation and categorisation of phenomena through an intensive analysis of the data. In this first step of open coding, the data are broken up into smaller parts that are deeply analysed. The aim of this analysis is to grasp the core idea of each part and to develop a code to describe it. Open codes can be either developed in vivo, i.e. directly from the data using descriptions that also are derived from or close to the data, or with reference to technical literature referring, e.g., to theories from mathematics education, educational psychology, or other relevant areas of study.

In a second step then, these smaller analytical parts are compared with respect to similarities and differences. Similar parts can be labelled with the same code. Strauss and Corbin ( 1990 ) use the terms concept and category to denote a phenomenon that is categorized and conceptualized by assigning it to one code ( concept ) or concepts of higher order ( category ). This means that the concepts developed are then related to other concepts so that categories of a higher order emerge so that different dimensions of the category can be described. During the process of developing the dimensions of categories, theoretically relevant characteristics of every category are determined and explicated in the code descriptions (Mey and Mruck 2011 ).

The overall goal of open coding is to develop a wealth of codes with which to describe the data. To reach this goal, sensitizing questions are posed regarding the data when they are being analysed. This finally leads to new discoveries (Strauss and Corbin 1990 ). The following list shows some of the questions that offer rich answers for the interpretation of the data (Böhm 2004 ; Mey and Mruck 2011 ; Strauss and Corbin 1990 ):

What?—Which phenomenon is described?

Who?—Which people are involved? Which roles do they embody, or which ones are assigned to them?

How?—Which aspects of the phenomenon are dealt with? Which are left out?

When? How long? Where?—In what way is the spaciotemporal dimension biographically relevant or important for single actions?

Why?—Which justifications are given or deducible?

Whereby?—Which strategies are used?

What for?—Which consequences are anticipated?

To pose those sensitizing questions, the researcher uses his/her personal and professional experience as well as knowledge that was gained from the relevant literature. All those resources are used in a creative manner of free association (Strauss and Corbin 1990 ) to interpret the data and to develop codes to describe the interpretation found. Thus, the researcher’s own and other people’s presuppositions in relation to the phenomenon are questioned and investigated.

3.3.2 Axial Coding

To develop a grounded theory, the emerging relationships between the elaborated concepts need to be integrated into an overarching framework with one core category. Glaser ( 1978 ) calls this process theoretical coding ; Strauss and Corbin ( 1990 ) differentiate between axial coding and selective coding , but themselves emphasize that there is not much of a difference, except at the level of abstraction.

According to Strauss and Corbin ( 1990 ), axial coding is needed to investigate the relationships between concepts and categories that have been developed in the open coding process. As people act and interact with other people, they possess different strategies to handle their interpretations of the situations in which they are involved. Their acting as well as the pursuit of their strategies have consequences. Explanations contain conditions that have an impact on one’s actions and interaction as well as the consequences that result from these (Strauss and Corbin 1990 ). To work out the relations between the categories, Strauss and Corbin ( 1990 ) suggest examining the data and the codes based on a coding paradigm that focuses on and relates causal conditions, context, intervening conditions, action/interaction strategies, and consequences. These perspectives on the data help to detect relations between concepts and categories in order to relate them on a meta level. Strauss and Corbin ( 1990 ) perceive the coding paradigm as an obligatory element of a grounded theory: if the coding paradigm was not used in theory development, the theory would miss density and precision.

One of the most difficult questions for a researcher new to the field of grounded theory is as follows: How does the coding paradigm work? After having broken up the data in the process of open coding, they are joined together in a new way in the process of axial coding as links are worked out between a category and its subcategories. The focus of axial coding is on a category (the phenomenon) in relation to the following aspects. First, causal conditions specify the phenomenon with respect to incidents or occurrences that result in appearance or development of a phenomenon. Second, the context is the specific set of characteristics in which the phenomenon is embedded. Simultaneously, the context also characterizes the special set of conditions in which action/interaction strategies take place to overcome, handle or react to a certain phenomenon. Third, intervening strategies are the broad and general conditions that influence action/interaction strategies. These comprise, for instance, time, space, culture, socioeconomic status, technological status, career, history, and individual biography. Fourth, action or interaction strategies are directed towards the phenomenon. No matter whether the research is about individuals, groups or collectives, there is always action or interaction that is directed towards the phenomenon, to handle or to overcome it, to perform it, or to react to it. The phenomenon always appears in a certain context or under specific circumstances. The interactional component is related to the self of the acting person as well as to other interactions. And finally, action and interaction that are performed or—on the contrary—are not performed as an answer to or to overcome a phenomenon, lead to results and consequences. These are neither always predictable nor intended, and also the default of an action/interaction leads to results and consequences. Consequences can be real or hypothetical in the present or in the future. In addition, consequences can change their frame of reference as in one point of time they can be consequences of an action/interaction, whereas at a later point of time, they can be part of causal conditions for another phenomenon. Note that in the fourth edition of the “Basics of qualitative research”, Corbin and Strauss ( 2015 ) reduced the coding paradigm to the three main features “conditions”, “actions-interactions”, and “consequences or outcomes”.

As Glaser, Strauss, and his colleagues were social scientists, the aspects chosen for their coding paradigm do not necessarily meet the necessities for educational research. Thus, there have been researchers who have changed the procedure of axial coding such that they in general followed the idea to look for relations between the phenomena described in the categories that were developed in the process of open coding but changed the aspects in the coding paradigm to look for those relations. We take a deeper look at the coding paradigm and its possibilities of amendment in Sect.  4.4 .

3.3.3 Selective Coding

The goal of selective coding is to integrate the different categories that have been developed, elaborated, and mutually related during axial coding into one cohesive theory. To reach this goal, the results from axial coding are further elaborated, integrated, and validated. Thus, selective coding is quite similar to axial coding, but it is carried out on a more abstract level. The categories are theoretically integrated into a consistent overarching theory as they are subsumed under a core category that is linked to all other categories that were established in axial coding. As Teppo ( 2015 , with reference to Corbin and Strauss 2008 , p. 14) points out, the questions that have to be answered are “what is the research all about?” and “what seems to be going on here?”. Thus, selective coding is the process of choosing the core category and relating it with the other categories from axial coding. In addition, these relations need to be validated and some categories might need to be refined and further elaborated. The core category described “the central phenomenon around which all the other categories are integrated” (Strauss and Corbin 1990 , p. 116). If the core category is found, the story line of the research is set or, as Vollstedt ( 2015 ) writes, the path is detected that leads the way through all the trees so that the wood can finally be seen. Having detected the core category, the researcher knows the central phenomenon of his/her research and can finally answer the research question. The product of this research process finally appears: the grounded theory that arose from the data.

3.3.4 Memos and Diagrams

A further central rule of grounded theory methodology is to interrupt the coding process again and again to write down memos: “Stop coding and record a memo on your ideas”, as Glaser and Strauss ( 1967 , p. 113) put it. In general, memos are very special types of written notes as they keep track of the analytical process and the directions for the analyst. Thus, they not only describe the phenomena they are about, but move on a meta level by being analytical and conceptual and help the researcher to step back from the material to see it from an analytical distance (Strauss and Corbin 1990 ). Glaser (with the assistance of Holton 2004 , para. 61) writes: “Memos are theoretical notes about the data and the conceptual connections between categories. The writing of theoretical memos is the core stage in the process of generating theory. If the analyst skips this stage by going directly to sorting or writing up, after coding, he/she is not doing GT” [i.e., grounded theory].

There are different kinds of memos like memos on methodical decisions, planning steps, case selection, or interpretative team sessions. The most important variant for the development of a grounded theory is writing memos that contain code notes and theoretical notes. In the process of data analysis, codes can be elaborated so that code notes can be further developed into theoretical notes (see Strauss and Corbin 1990 for a detailed description). Although it is tempting not to write memos in the analytical process, “writing memos and doing diagrams are important elements of analysis and never should be considered superfluous, regardless of how pressed for time the analyst might be” (Strauss and Corbin 1998 , p. 218). Thus, writing memos should accompany the whole analytical process from the development of the first code to the final grounded theory. Memos are written only for the analyst in order to keep track of the analytical “process, thoughts, feelings, and directions of the research and researcher—in fact, the entire gestalt of the research process” (Strauss and Corbin 1998 , p. 218). Hence, they are hardly seen by people other than the researchers involved, but are nevertheless of high importance, also from the perspective of quality criteria. As mentioned above, the quality of a grounded theory can be judged—among other criteria—with reference to credibility, plausibility, and trustworthiness. Memos are needed to argue and prove the development of the grounded theory from the data and are thus a crucial aspect to draw back to when writing down the theory. In addition, Strauss and Corbin also warn “if memos and diagrams are sparsely done, then the final product theory might lack conceptual density and integration. At the end, it is impossible for the analyst to reconstruct the details of the research without memos” (Strauss and Corbin 1998 , p. 218).

Supplementary to written memos, diagrams also help the researcher to find relations between concepts and develop the grounded theory from the data. Strauss and Corbin ( 1998 ) define diagrams as “visual devices that depict the relationships among concepts” (p. 217). Thus, diagrams are needed to link concepts graphically, which is especially helpful for instance to illustrate the relations between the different elements of the coding paradigm (cf. Vollstedt 2015 for a concrete example).

4 The Role of Theory Within Grounded Theory and the Coding Paradigm

From its origins, there has been a conflict inherent in the grounded theory methodology, which relates to the role of theory. The main idea of grounded theory and one of its hallmarks is that categories, concepts, and finally theory ‘emerge’ from the data. In “The discovery of grounded theory” the researcher is therefore advised to “ignore the literature of theory and fact on the area under study, in order to assure that the emergence of categories will not be contaminated” (Glaser and Strauss 1967 , p. 37). However, Glaser and Strauss also admit that “of course, the researcher does not approach reality as a tabula rasa . He must have a perspective that will help him see relevant data and abstract significant categories from his scrutiny of the data” (Glaser and Strauss 1967 , p. 3). Thus, they acknowledge that in modern epistemology it is taken for granted that the world is always perceived through theoretical lenses and related conceptual networks, and empirical observation therefore is always influenced by the theoretical and conceptual knowledge of the observer. Thus, the inherent conflict in terms of the role of theory in grounded theory is, if it is possible that theory only “emerges” from the data or if theory is actually “forced” on the data. This has in fact been a major issue of debate between the two founders of grounded theory—Glaser and Strauss—which finally led to their separation and constitutes the fundamental difference between the two approaches to grounded theory today (Kelle 2005 ).

In order to resolve this conflict between an unbiased emerging of theory and the inevitably theory-laden perspective of the researcher, Glaser and Strauss introduce the notion of theoretical sensitivity . In later works, the coding families (Glaser 1978 ) and the coding paradigm (Strauss and Corbin 1990 ) can also be seen as answers to the same problem.

The coding families (Glaser 1978 ) are sets of general sociological concepts organized into loosely connected frameworks, which are supposed to foster the theoretical sensitivity of the researcher in order to support the development of theory from the data. Some illustrative examples of coding families are provided in Table  4.1 . Glaser’s ( 1978 ) original list is much more detailed and extensive.

Strauss and Corbin ( 1990 ) offer a general model, which they denote as “coding paradigm”, and which is supposed to provide a general frame for analyzing relationships between the categories and concepts. The coding paradigm has already been described in more detail in Sect.  4.3.3.2 .

Although the coding families and the coding paradigm are only very general and widely accepted perspectives on social reality, it is important to be aware that the coding families and the coding paradigm are themselves theoretical framings or orientations, which are utilized within grounded theory in order to develop theory. Thus, the development of theory is not independent, but is structured by the theoretical assumptions and relations provided by the coding families and the coding paradigm. Both encompass a particular perspective on social reality.

Due to the sociological background of Glaser and Strauss, the epistemological interest of grounded theory lies in predicting and explaining behavior and social processes. Accordingly, the coding paradigm focuses on action and interaction in social contexts and related strategies (Tiefel 2005 ). The causal assumptions that are inherent in the coding paradigm structure the development of theory as a whole. Accordingly, Kelle ( 2005 ) advises researchers, which “may feel that this approach goes contrary to their requirements and would be well advised to construct an own coding paradigm rooted in their own theoretical tradition” (para. 21). Tiefel ( 2005 ) also argues that especially in educational research, the coding paradigm of grounded theory is not universally applicable. She even goes one step further and suggests an alternated coding paradigm, which captures dimensions of individual construction of meaning in the dialectic between the individual and the social context (see Sect.  4.4.1.1 ). In mathematics education research, there are also studies that are based on a grounded theory methodology, but which altered the coding paradigm according to their needs. Two examples are presented in Sects.  4.4.1.2 and 4.4.1.3 .

4.1 Examples from Studies in Which the Coding Paradigm Was Changed

The following section provides a little insight into three studies in which the coding paradigm was altered. Tiefel ( 2005 , cf. Sect.  4.4.1.1 ) offers an amendment for learning and educational science; Vollstedt ( 2011 , cf. Sect.  4.4.1.2 ) and Rezat ( 2009 , cf. Sect.  4.4.1.3 ) are studies from mathematics education.

4.1.1 A Modification of the Coding Paradigm from the Perspective of Learning and Educational Theory

As Tiefel ( 2005 ) explicates, Strauss and Corbin offer with their coding procedures a technique that relates structures, actions, and subjectivity with each other. A special focus is put on the processes involved. Being sociologists, their spotlight is primarily on the prediction and explanation of (social) action and (societal) processes. The phenomena that they are especially interested in are, thus, closely linked to a pragmatistic understanding of an activistic significance of objects, which is raised by people’s action or work and which can be changed by interaction and over time. Thus, in this disciplinary context, theories that are grounded in data aim at the explanation of conditions, meanings and significances, as well as procedures that influence people in different situations and areas of their active construction of the world.

Tiefel ( 2005 ) continues that educational science also defines the analysis of interdependencies between biographic and structural processes by means of selected contexts and situations. Nevertheless, its cognitive interest focuses rather on the desire to understand individual decisions and actions. Thus, research in educational science also concentrates rather on the reconstruction of biographical processes in their interdependence with social relativities. Thus, in her research on processes of learning and education as well as the professional biography of an educational consultant, Tiefel ( 2005 ) developed a coding paradigm for processes of learning and education with a special focus on questions of understanding. She proposes the following three perspectives:

Perspective of meaning (especially referring to the reconstruction of the self-perception): How does the informant present him-/herself? What does the person say about him-/herself? What is not mentioned? Which orientations (norms, values, sciences, commonplaces etc.) are relevant for the informant?

Perspective of structure (especially referring to the reconstruction of the world view): Which conditions are shown as important or relevant for the possibilities and the spheres of action of the self? Which ideas, positions, and assumptions give orientation? Which social relations, institutional or social/historical connections are marked as being important for the self?

Courses of action: Which activities/interactions does the informant describe? Which options are noticed and how are they dealt with? Are the strategies rather active or passive, target-oriented or tentative seeking?

Tiefel’s ( 2005 ) suggestion for the modification of the coding paradigm with respect to learning and educational sciences is probably closer to the needs of many researchers in mathematics education than Strauss and Corbin’s ( 1990 ) coding paradigm. However, there are still areas where it does not provide the structure needed to grasp the relevant information to answer the research questions. Therefore, the following two sections provide insight into two studies that further adapted the coding paradigms to their needs to be able to develop a dense grounded theory.

4.1.2 Personal Meaning When Dealing with Mathematics in a School Context

The claim for meaning in education has been raised for many years and meaningful learning is assumed to be a central impetus (Biller 1991 ) as well as one of the major goals (Vinner 2007 ) of education. Hence, one of the challenges of education in general as well as of mathematics education in particular is to find convincing answers to the quest for meaning. Subsequently, to make learning meaningful for the students, we need to ask the students what is meaningful to them rather than imposing some kind of meaning that might be meaningful from a normative perspective, but can hardly be related to the students’ biography (Meyer 2008 ). Howson ( 2005 ) therefore distinguishes between two different aspects of meaning, “namely, those relating to relevance and personal significance (e.g., ‘What is the point of this for me?’) and those referring to the objective sense intended (i.e., signification and referents)” (p. 18). Hence, “even if students have constructed a certain meaning of a concept, that concept may still not yet be ‘meaningful’ for him or her in the sense of relevance to his/her life in general” (Kilpatrick et al. 2005 , p. 14). In her research, Vollstedt ( 2011 ) therefore took the students’ perspective when she was interested in the aspects of the learning process that make learning mathematics meaningful for them. To emphasize the focus on the learner’s perspective, the term personal meaning was coined to designate those aspects that are personally relevant for the students, i.e., the first aspect of meaning that was described by Howson above (cf. also Vollstedt and Duchhardt, in press).

One aim of the study was to develop a grounded theory about what personal meanings students construct when they are involved with mathematical contents in a school context. A second aim was to put a special focus on the role of the cultural background of the classroom situation. Therefore, the interview study was conducted in Germany and in Hong Kong. The two places were chosen as examples of a Western and a Confucian Heritage Culture (CHC, cf. Leung et al. 2006 ) to make sure to have quite distinct cultural backgrounds for teaching and learning mathematics.

Data gathered for the study comprised video recordings of three mathematics classrooms (9th and 10th grade) for one week in each place together with field notes taken by the researcher. The videos were used for a sequence of stimulated recall (Gass and Mackey 2000 ) at the beginning of each interview with volunteers from the classes (see Vollstedt 2011 or 2015 for further details).

In the process of axial coding it turned out that neither Strauss and Corbin’s ( 1990 ) nor Tiefel’s ( 2005 ) coding paradigm really fitted the data and the research questions. Therefore, the coding paradigm was also adapted to the individual needs of Vollstedt’s study in the following way: At first, there was a long and intense discussion with fellow researchers from the Graduate Research Group on Educational Experience and Learner Development at the University of Hamburg about how personal meaning might be constructed, and which aspects seemed to be relevant for its construction. In the final model it is assumed that there is an individual in a certain situation in which he/she is dealing with mathematics in a school context, e.g., the student Johanna is studying mathematics at home. The situational context, i.e., the context of the learning situation in terms of topic as well as classroom situation/home, is a crucial factor for the construction of personal meaning and of particular importance in this study as there was a special focus on cultural background of the teaching and learning situation. In this situation, there are certain preliminaries that are part of Johanna, such as her personal background, i.e., aspects that cannot be influenced by herself, including her socio-economic or migration background. In addition, personal traits, i.e., aspects that concern her self, are relevant. They comprise concepts that are discussed in various scientific fields such as educational psychology (self-concept, self-efficacy), mathematics education (beliefs), and educational science (developmental tasks). Based on these preliminaries, Johanna then constructs personal meaning with relation to the learning content and context. Depending on the result of this construction, different consequences can occur. Johanna might for instance appraise the situation with respect to her personal goals so that different actions might follow, e.g., she might not understand the contents she is dealing with and will therefore ask her neighbour for help. Or she might think that mathematics is not as important as spending time with her friends so that she will stop working on her tasks.

The relational framework given in Fig.  4.1 shows the diagram of how the aspects described above might be interrelated to describe the construction of personal meaning. It provided the basis for the coding paradigm used by Vollstedt ( 2011 ). For each category that was developed throughout the coding process, it was attempted to fit it in this model and relate it with other relevant concepts. Thus, finally, it was possible to describe preliminaries and consequences for each core category, i.e., personal meaning, that was developed in this study (see Vollstedt 2011 , 2015 ).

Relational framework of personal meaning (cf. Vollstedt 2011 )

Taking a closer look at this coding paradigm, reveals that there are relations to both versions of coding paradigms provided by either Strauss and Corbin ( 1990 ) or Tiefel ( 2005 ). Vollstedt’s ( 2011 ) situation embraces aspects from Strauss and Corbin’s ( 1990 ) context and intervening strategies , whereas some aspects of the latter are also part of Vollstedt’s preliminaries . Consequences are similar in both paradigms. Strauss and Corbin’s causal conditions and action/interaction strategies were not found to be relevant in Vollstedt’s study as they are directed towards the phenomenon, i.e., a kind of personal meaning. In Vollstedt’s theory, consequences occur after the individual has constructed a personal meaning, so that actions from her framework—being part of the consequences —are something different than action/interaction strategies from Strauss and Corbin. With respect to Tiefel’s ( 2005 ) aspects, on the one hand the perspective of meaning is similar to aspects that are described in the preliminaries like personal background and/or personal traits . The perspective of structure and the courses of action on the other hand relate to situation and preliminaries , and consequences respectively. Nevertheless, although nearly all aspects are somehow integrated in Vollstedt’s ( 2011 ) coding paradigm, neither Strauss and Corbin’s ( 1990 ) nor Tiefel’s ( 2005 ) coding paradigm would have grasped the particularities of the phenomenon under study. It is interesting to see, though, that Vollstedt’s approach is very close to the modifications made by Corbin and Strauss ( 2015 ) in the fourth edition of “Basics of qualitative research”. There, they reduced the aspects of the coding paradigm to conditions, actions - interactions , and consequences or outcomes . Still, having a sociological perspective, the focus is on actions and interactions whereas in Vollstedt’s research, educational processes are the focus. But nevertheless, as her coding paradigm also primarily looks at preliminaries and consequences from the context and individual’s perspective, the similarities of the two approaches cannot be overlooked.

4.1.3 Learning Mathematics with Textbooks

Rezat ( 2009 ) developed a grounded theory on how students learn mathematics autonomously with their mathematics textbooks. Theory development is grounded in data on the specific parts that students used on their own in their textbooks, and on students’ explanations of why they used these parts. He further conducted interviews with selected students in order to better understand how they proceeded when learning mathematics with their textbooks. Finally, he observed the mathematics lessons for the period of the study and took field notes (Rezat 2008 ).

The grounded theory comprises activities, in which students utilize their mathematics textbooks and students’ utilization schemes of the textbook within these activities. Rezat ( 2009 ) finds that students refer to their mathematics textbook related to four activities:

solving tasks and problems in order to get assistance from the textbook,

consolidation activities in order to use the contents of the book for practicing and consolidation,

acquiring mathematical knowledge that has not been a matter in class, and

activities associated with interest in mathematics.

These activities clarify the causal conditions under which textbook use occurs as well as attributes of the context of the investigated phenomenon, autonomous learning mathematics with the textbook . In terms of activity 1, this means that the causal condition for using the textbook is that students are working on a task or a problem (that might originate from the textbook or some other source) and they need assistance for solving it. The causal condition for textbook use related to activity 2 is students’ aspiration to practice and consolidate their mathematical knowledge/competencies. The inclination to acquire new mathematical knowledge or competencies is the causal condition for textbook use related to activity 3 and students’ interest in mathematics motivates textbook use related to activity 4.

Although the coding paradigm of grounded theory according to Strauss and Corbin ( 1990 ) allows for a general analysis of students’ actions and interactional strategies with their textbooks associated with the four activities, Rezat ( 2009 ) argues that the instrumental approach (Rabardel 2002 ) provides theoretical concepts and relations that grasp students’ interactions with their textbook better than the general focus on actions and interactional strategies of the coding paradigm in grounded theory. Therefore, he enhances the coding paradigm by including the instrumental approach (Rabardel 2002 ). Instead of analyzing actions and interactional strategies he analyses students’ “instrumentalization” und “instrumentation” (Rabardel 2002 ) of the mathematics textbook within the different learning activities. While the analysis of the instrumentalization of the mathematics textbook relates to functions that users attribute to the textbook within the activities, the analysis of instrumentation relates to the development of utilization schemes. The latter are characterized by “1. goals and anticipations; 2. rules of action, information seeking, and control; 3. operational invariants; 4. possibilities of inference” (Vergnaud 1998 , p. 173). Based on this conceptualization of schemes, Rezat reconstructs different utilization schemes of students using their textbook within the different activities. For example, he finds three different utilization schemes related to consolidation activities: (1) position-dependent practicing ; (2) block-dependent practicing ; and (3) salience depended practicing (Rezat 2013 ). The three schemes differ in particular in terms of their operational invariants. Position-dependent practicing is based on the operational invariant that contents of the textbook that is useful for practicing can be found at a certain relative position to other contents in the textbook, e.g. tasks that are appropriate for practicing are adjacent to tasks that the teacher explicitly asked the students to work on. On the contrary, block-dependent practicing is based on the selection of a specific structural element of the textbook such as tasks, rules (in a box) or worked examples for practicing. Finally, salience-dependent practicing is based on an operational invariant that takes salient visual features of the contents as the main criteria for selection of contents from the textbook.

On the one hand, the instrumental approach and the notion of utilization schemes is included in the study as a means to increase theoretical sensitivity and to describe the cognitive aspects of students’ actions and interactions with their textbooks. On the other hand, the concepts of the instrumental approach provide a language, which can be used to describe students’ actions and interactions with their textbooks from a cognitive perspective as exemplified in the three utilization schemes related to students’ consolidation activities with mathematics textbooks.

In the study by Rezat ( 2009 ), parts of the very general coding paradigm are substituted by a well elaborated theory. Consequently, the question has to be raised if this is actually still a grounded theory study or if a well-developed theory already existed before. However, a well-developed theory about the phenomenon under study, namely students’ autonomous learning of mathematics with their textbooks, had not existed before the study. Therefore, grounded theory appears to be an adequate overall methodology of the study. In order to grasp specific aspects of the phenomenon under study in more detail, Rezat ( 2009 ) refers to existing and more general theory, which is not solely linked to the phenomenon under study. While Rabardel’s ( 2002 ) theory conceptualizes human interactions with (technological) artefacts in general, Rezat ( 2009 ) develops a theory of students’ learning of mathematics with their textbooks. Therefore, his approach seems to reconcile theory development and building on existing theory. While the overall goal of the study is to develop a grounded theory related to a particular phenomenon, theory development builds on more general existing theories, which seems to be a helpful approach in order to focus and describe particular elements of the developing theory. Thus, existing theory seems to be included in the grounded theory wherever it appears to be useful in the developing theory.

5 Concluding Remarks

In this chapter, we gave a cursory introduction to grounded theory methodology and methods. We briefly described the coding procedures, the notions of theoretical sensitivity , theoretical sampling , and theoretical saturation and how these components serve the main aim of grounded theory, namely to develop a theory that is empirically grounded in the data. We recommend that the (early career) researcher, who has become curious and wants to start developing grounded theory, also refers to the original sources. These describe the techniques and procedures of grounded theory in much more detail. As already pointed out at the beginning of this chapter, some of them were even written for early career researchers.

Our chapter might support the early career researcher in becoming aware of differences between the two main schools of grounded theory—grounded theory in the tradition following the foundations of Glaser or of Strauss, respectively. These differences are mainly rooted in the role of theory within grounded theory. We pointed out that the role of theory is actually an inherent epistemological issue in grounded theory methodology. We further provided examples of studies that challenge this issue by adjusting the coding paradigm according to the needs of the phenomenon under study. However, in these cases, the researcher has to justify whether the study remains a grounded theory study. We see this as just another challenge to the theoretical sensitivity of the researcher. And theoretical sensitivity is the core ability a researcher has to bring to, cultivate within, and gain from the endeavor of developing a grounded theory.

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Vinner, S. (2007). Mathematics education: Procedures, rituals and man’s search for meaning. Journal of Mathematical Behaviour, 26 (1), 1–10. https://doi.org/10.1016/j.jmathb.2007.03.004 .

Vollstedt, M. (2011). Sinnkonstruktion und Mathematiklernen in Deutschland und Hongkong. Eine rekonstruktiv-empirische Studie [Personal meaning and the learning of mathematics: A reconstructive-empirical study]. Wiesbaden: Vieweg + Teubner.

Vollstedt, M. (2015). To see the wood for the trees: The development of theory from empirical data using grounded theory. In A. Bikner-Ahsbahs, C. Knipping, & N. Presmeg (Eds.), Doing qualitative research: Methodologies and methods in mathematics education. Advances in mathematics education series (pp. 23–48). Heidelberg: Springer. https://doi.org/10.1007/978-94-017-9181-6_2 .

Vollstedt, M., & Duchhardt, C. (in press). Assessment and structure of secondary students’ personal meaning related to mathematics. In M. S. Hannula, G. C. Leder, F. Morselli, M. Vollstedt, & Q. Zhang (Eds.), Affect in mathematics education: Fresh perspectives on motivation, engagement, and identity. ICME-13 Monographs. Cham: Springer.

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Vollstedt, M., Rezat, S. (2019). An Introduction to Grounded Theory with a Special Focus on Axial Coding and the Coding Paradigm. In: Kaiser, G., Presmeg, N. (eds) Compendium for Early Career Researchers in Mathematics Education . ICME-13 Monographs. Springer, Cham. https://doi.org/10.1007/978-3-030-15636-7_4

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Grounded theory, mixed methods, and action research

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• Lorelei Lingard , associate professor and BMO Financial Group professor in health professions education research 1 ,
• Mathieu Albert , assistant professor 2 ,
• Wendy Levinson , Sir John and Lady Eaton professor and chair and physician in chief, Sunnybrook Health Sciences Centre 3
• 1 SickKids Learning Institute and Department of Paediatrics 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 Psychiatry and Wilson Centre for Research in Education, University of Toronto
• 3 Department of Medicine, University of Toronto
• Correspondence to: L Lingard lorelei.lingard{at}utoronto.ca

These commonly used methods are appropriate for particular research questions and contexts

Qualitative research includes a variety of methodological approaches with different disciplinary origins and tools. This article discusses three commonly used approaches: grounded theory, mixed methods, and action research. It provides background for those who will encounter these methodologies in their reading rather than instructions for carrying out such research. We describe the appropriate uses, key characteristics, and features of rigour of each approach.

Grounded theory: what is it and when is it used?

Grounded theory was developed by Glaser and Strauss.[1] Its main thrust is to generate theories regarding social phenomena: that is, to develop higher level understanding that is “grounded” in, or derived from, a systematic analysis of data. Grounded theory is appropriate when the study of social interactions or experiences aims to explain a process, not to test or verify an existing theory. Researchers approach the question with disciplinary interests, background assumptions (sometimes called “sensitising concepts”[2]) and an acquaintance with the literature in the domain, but they neither develop nor test hypotheses. Rather, the theory emerges through a close and careful analysis of the data.

What are the key features of grounded theory?

Key features of grounded theory are its iterative study design, theoretical (purposive) sampling, and system of analysis.[3] An iterative study design entails cycles of simultaneous data collection and analysis, where analysis informs the next cycle of data collection. In a study of the experience of caring for a dying family member, for instance, preliminary analysis of interviews with family care providers may suggesta theme of “care burdens,” and this theme could be refined by interviewing participants who are at variouspoints in the care trajectory, who might offer different perspectives. Analysis of the subsequent phase of data collection will lead to further adaptations of the data collection process to refine and complicate the emerging theory of care burdens. In keeping with this iterative design, the sampling process proceeds on theoretical grounds: the sample is not set at the outset but is selected purposefully as the analysis progresses; participants are chosen for their ability to confirm or challenge an emerging theory.

The central principle of data analysis in grounded theory research is constant comparison. As issues of interest are noted in the data, they are compared with other examples for similarities and differences. Through the process of constant comparison, for which a number of formal approaches are available,[4] emerging theoretical constructs are continually being refined through comparisons with “fresh” examples from ongoing data collection, which produces the richness that is typical of grounded theory analysis.

Iterative study design, theoretical sampling, and system of analysis are intimately related. An iterative study design requires theoretical sampling for iterations to be meaningful, and constant comparative analysis allows the integration of new and existing data in this iterative cycle, towards a well grounded theory. Therefore, a study must use all three of these features to allow the emergence of new conceptual models—such as “clinical oversight” (box 1)—that extend beyond conventional thinking.

Box 1 Grounded theory study

A study of clinical supervision using interviews and observations took place in the emergency departments and inpatient teaching wards (general internal medicine) in two teaching hospitals.[5] Its aim was to understand how clinical teachers in these settings balanced the goals of supervising trainees to ensure patient safety and allowing trainees sufficient independence to develop their competence. In an era of increasing concern for patient safety, the authors aimed to develop a conceptual model of clinical supervision to inform and guide policy and research.

The principal author (a licensed physician) and a trained research assistant conducted non-participant observations of 12 internal medicine and emergency medicine teaching teams during regular clinical activities. Observations focused on the interactions among trainees and teachers. During and after the observation phase they interviewed 65 team members (teachers, trainees, and nurses) about supervision.

The researchers used an iterative approach to analyse field notes and interview transcripts on an ongoing basis throughout the study. This allowed them to pursue emergent themes in subsequent data collection. Saturation sampling was used, in which observations and interviews stopped when no new, dominant issues were emerging in the dataset. Triangulation among multiple datasets (observations in four distinct settings, interviews with teachers and trainees) provided the basis for a comprehensive model of the range and pattern of supervision strategies (clinical oversight) used by clinical teachers on these teams.

Mixed methods: what is it and when is it used?

Mixed methods research combines elements from both qualitative and quantitative paradigms to produce converging findings in the context of complex research questions. There are tensions between these methods in terms of their values and processes, but these very tensions can generate new insights. In medicine, mixed methods have arisen in the wake of attention to the psychosocial determinants of health and the human aspects of medical care. For instance, a study of quality of care in people with diabetes might measure the frequency of foot and eye examinations, or glycated haemoglobin (HgA 1c ) concentrations, and interviews with patients might address barriers to achieving these goals.

What are the key features of mixed methods?

The mixing of methods may happen within one study or across several studies in a research programme. The strategy for mixing methods must be explicit and justified in terms of the sequence of methods (concurrent, qualitative first, or quantitative first), the priority among methods (equal, or either method prioritised), and the nature and timing of integration (full or partial, during data collection, analysis, or interpretation).[6] A study of nurses’ perceptions of medical error might first distribute an attitude survey, followed by focus groups, so that the focus groups can be organised to include participants with a range of attitudes for the purposes of exploring the implications of varying attitudes towards error. In this study, the methods are integrated during data collection and analysis, with the quantitative method first in the sequence and the qualitative method prioritised in terms of the dominant aim of the research.

Central to the effectiveness of a mixed methods study is a clear and strategic relationship among the methods in order to ensure that the data converge or triangulate to produce greater insight than a single method could. Because qualitative and quantitative methods derive from different traditions, mixed methods research must take care to negotiate back and forth between these different approaches rather than dichotomising their values and methods. Qualitative research emphasises an inductive-subjective-contextual approach and quantitative research emphasises a deductive-objective-generalising approach, but these broad tendencies are neither absolute nor mutually exclusive.[7] Good mixed methods research negotiates these tendencies by articulating how and why criteria from both paradigms are integrated.

Box 2 Mixed methods study

A study of caregiver burden sought to extend understanding of the social experience of mothering children with disabilities.[8] It aimed to explore in depth the nature of the burdens perceived and the possibility of benefits of the maternal care giving role through a concurrent, mixed method approach. It surveyed 81 mothers of children with disabilities and followed up with in-depth interviews with a purposeful sample of seven of these mothers 1-3 years after the survey.

Interviewees were selected on the basis of the degree to which they represented the diversity of background characteristics among survey participants. In interviews, mothers were asked to share the stories of their children’s births and diagnoses and their own and their children’s interactions with family members, neighbours, friends, service providers, and members of the wider community. They were not specifically queried about stigma, burden, or perceived benefits (designated survey items) but were asked to talk about how their parenting experiences had affected them.

Data from the survey and the interviews were triangulated in the analysis in order to produce greater insight than would be gained by a single method. For instance, while the survey results emphasised the sociostructural constraints that produce a burden of care, the interview results illustrate that, despite these sociostructural constraints, most mothers perceive valuable benefits in having a child with a disability. These perceived benefits can be negatively affected by perceived stigma.

Action research: what is it and when is it used?

In action research studies (also referred to as community based research, participatory action research, or collaborative inquiry),[9] research is not done on or with participants; research is designed, carried out, and integrated by the participants in partnership with the researchers. Based in emancipatory social theory and designed to democratise the research process, action research is an iterative process in which researchers and practitioners act together in the context of an identified problem to discover and effect positive change within a mutually acceptable ethical framework. For example, researchers and community leaders might explore approaches to obesity prevention through surveys or interviews conducted in local churches, community centres, or schools. Because it embraces a tension between local solutions and transferable knowledge, action research can help make results of such research more generally applicable.[10]

What are the key features of action research?

The key features of action research include its collaborative nature, its egalitarian approach to power and education in the research process, and its emphasis on taking action on an issue. The extensive collaboration between researchers and partners in action research must extend across each stage of research, from identifying the problem to disseminating the results. This collaboration entails shared control of the agenda and also involves reciprocal education to improve researchers’ and research partners’ understanding of one another’s positions and contributions. Finally, the study must blend scientific inquiry with social action by creating knowledge that is relevant to the research partners’ needs and interests. For instance, in an action research project for preventing falls in a long term care facility, researchers and staff would collaboratively define the problem and the research design; the staff might conduct interviews with colleagues and patients, and the solutions that are decided and implemented will be based on the needs and priorities of the staff.

Box 3 Action research study

A study of the impact of interprofessional care coordinators took place in the general and emergency medicine service of an inner London hospital trust.[11] The study sought to explore the characteristics and impact of the development of the new role of interprofessional care coordinator (IPCC) on the working of the interprofessional team in an acute medical inpatient setting. In the context of changing models of service delivery in UK health and social care, the authors aimed to understand the impact of a new support worker role on the work of existing practitioners.

Data were collected using a variety of methods, including 37 individual semistructured interviews and 16 focus groups with IPCCs, managers, and interprofessional team colleagues; 24 half day observations of IPCCs; field notes from two years of participant observation; and systematic analysis of relevant documents from the hospital trust.

The study unfolded within three main action research cycles. In each cycle, the lead investigator worked collaboratively with participants to consider findings to date, decide what (if any) changes were needed in response to the findings, and take forward any developments that had been agreed. These main cycles were “communicating about the IPCC role,” “exploring issues of accountability,” and “improving interprofessional working.” Further data were collected to illuminate the process and outcomes of change within each of the cycles.

These methods can be useful in answering clinical and health delivery research questions in ways that challenge conventional thinking, offer multidimensional insights, and provide local solutions. Box 4 lists key elements to look for in research papers written using each of these approaches.

Box 4 Key elements to look for in research papers

Grounded theory.

Does the research question indicate that a theory is needed?

Is the study designed to support iterative data collection and analysis in a context of theoretical sampling?

Does the discussion explain how the theory responds to the original research question?

Mixed methods

Is the research question appropriate for mixed methods or would a single method suffice?

Is the relation among the methods clear in terms of their sequence, priority, and integration?

Does the discussion relate the findings to a complex understanding of a multifaceted phenomenon?

Action research

Does the research question arise from a situated problem that is best understood through a collaborative research partnership?

Are the research agenda and activities shared by researchers and partners?

Do the results meet the partners’ needs in a collaborative and equitable manner? Is the identified problem acted on in a substantive way?

Further reading

Creswell J. Research design: qualitative, quantitative and mixed methods approaches . 2nd ed. Thousand Oaks, CA: Sage, 2003.

Green LW, George MA, Daniel M, et al. Guidelines for participatory research in health promotion. In: Minkler M, Wallerstein N, eds. Community based participatory research for health . San Francisco, CA: Jossey-Bass, 2003:419-28.

Meyer J. Action research. In: Pope C, Mays N, eds. Qualitative research in health care . 3rd ed. Malden, MA: Blackwell, 2006:121-42.

Strauss A, Corbin J. Grounded theory in practice . Thousand Oaks, CA: Sage, 1997.

Winter R, Munn-Giddings C. A handbook for action research in health and social care . London: Routledge, 2001.

Hall W, Callery P. Enhancing the rigor of grounded theory: incorporating reflexivity and relationality. Qualitative Health Research 2001;11:257-72.

Kennedy T, Lingard L. Making sense of grounded theory. Medical Education 2006;40:101-8.

McGhee G, Marland GR, Atkinson J. Grounded theory research: literature reviewing and reflexivity. Journal of Advanced Nursing 2007;60:334-42.

Morgan D. Practical strategies for combining qualitative and quantitative methods: applications to health research. Qualitative Health Research 1998;8:362-76.

Summary points

Understanding the appropriate uses and key features of qualitative methodologies can help readers in critically appraising the literature

Grounded theory, mixed methods, and action research are commonly used in health research

Each methodology is appropriate for particular research questions and contexts, yielding insights of relevance to clinical and health delivery issues

Cite this as: BMJ 2008;337:a567

• Related to doi: , 10.1136/bmj.a288
• doi: , 10.1136/bmj.a1020
• doi: , 10.1136/bmj.a879
• doi: , 10.1136/bmj.a949
• doi: 10.1136/bmj.a1035

This is the second 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 terms, see the first article in this series.

Contributors: LL, MA, and WL researched, wrote, and revised the article. LL is guarantor.

Funding: None.

Competing interests: None declared.

Provenance and peer review: Commissioned; externally peer reviewed.

• Glaser B, Strauss A. The discovery of grounded theory: strategies for qualitative research . Chicago: Aldine, 1967 .
• Blumer H. Symbolic interactionism: perspective and method . Englewood Cliffs, NJ: Prentice Hall, 1968 .
• Kennedy T, Lingard L. Making sense of grounded theory. Med Educ 2006 ; 40 : 101 -8. OpenUrl CrossRef PubMed Web of Science
• Strauss A, Corbin J. Basics of qualitative research: techniques and procedures for developing grounded theory . 2nd ed. Thousand Oaks, CA: Sage, 1998 .
• Kennedy TJ, Lingard L, Baker GR, Kitchen L, Regehr G. Clinical oversight: conceptualizing the relationship between supervision and safety. J Gen Intern Med 2007 ; 2 : 1080 -5. OpenUrl
• Creswell J. Research design: qualitative, quantitative and mixed methods approaches . 2nd ed. Thousand Oaks, CA: Sage, 2003 .
• Morgan DL. Paradigms lost and paradigms regained: methodological implications of combining qualitative and quantitative methods. J Mixed Methods Res 2007 ; 1 : 48 -76. OpenUrl CrossRef
• Green SE. “We’re tired, not sad”: benefits and burdens of mothering a child with a disability. Soc Sci Med 2007 ; 64 : 150 -63. OpenUrl CrossRef PubMed Web of Science
• Gibson N, Gibson G, Macaulay A. Community-based research: negotiating research agendas and evaluating outcomes. In: Morse J, Swanson J, Kuzel A, eds. The nature of qualitative evidence . Thousand Oaks, CA: Sage, 2001 :161-84.
• Meyer J. Action research. In: Pope C, Mays N, eds. Qualitative research in health care . 3rd ed. Malden, MA: Blackwell Publishing, 2006 :121-42.
• Bridges J, Meyer J, Glynn M, Bentley J, Reeves S. Interprofessional care co-ordinators: the benefits and tensions associated with a new role in UK acute health care. Int J Nurs Stud 2003 ; 40 : 599 -607. OpenUrl CrossRef PubMed Web of Science

• Correspondence
• Open access
• Published: 09 September 2011

How to do a grounded theory study: a worked example of a study of dental practices

• Alexandra Sbaraini 1 , 2 ,
• Stacy M Carter 1 ,
• R Wendell Evans 2 &
• Anthony Blinkhorn 1 , 2  

BMC Medical Research Methodology volume  11 , Article number:  128 ( 2011 ) Cite this article

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Qualitative methodologies are increasingly popular in medical research. Grounded theory is the methodology most-often cited by authors of qualitative studies in medicine, but it has been suggested that many 'grounded theory' studies are not concordant with the methodology. In this paper we provide a worked example of a grounded theory project. Our aim is to provide a model for practice, to connect medical researchers with a useful methodology, and to increase the quality of 'grounded theory' research published in the medical literature.

We documented a worked example of using grounded theory methodology in practice.

We describe our sampling, data collection, data analysis and interpretation. We explain how these steps were consistent with grounded theory methodology, and show how they related to one another. Grounded theory methodology assisted us to develop a detailed model of the process of adapting preventive protocols into dental practice, and to analyse variation in this process in different dental practices.

Conclusions

By employing grounded theory methodology rigorously, medical researchers can better design and justify their methods, and produce high-quality findings that will be more useful to patients, professionals and the research community.

Peer Review reports

Qualitative research is increasingly popular in health and medicine. In recent decades, qualitative researchers in health and medicine have founded specialist journals, such as Qualitative Health Research , established 1991, and specialist conferences such as the Qualitative Health Research conference of the International Institute for Qualitative Methodology, established 1994, and the Global Congress for Qualitative Health Research, established 2011 [ 1 – 3 ]. Journals such as the British Medical Journal have published series about qualitative methodology (1995 and 2008) [ 4 , 5 ]. Bodies overseeing human research ethics, such as the Canadian Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans, and the Australian National Statement on Ethical Conduct in Human Research [ 6 , 7 ], have included chapters or sections on the ethics of qualitative research. The increasing popularity of qualitative methodologies for medical research has led to an increasing awareness of formal qualitative methodologies. This is particularly so for grounded theory, one of the most-cited qualitative methodologies in medical research [[ 8 ], p47].

Grounded theory has a chequered history [ 9 ]. Many authors label their work 'grounded theory' but do not follow the basics of the methodology [ 10 , 11 ]. This may be in part because there are few practical examples of grounded theory in use in the literature. To address this problem, we will provide a brief outline of the history and diversity of grounded theory methodology, and a worked example of the methodology in practice. Our aim is to provide a model for practice, to connect medical researchers with a useful methodology, and to increase the quality of 'grounded theory' research published in the medical literature.

The history, diversity and basic components of 'grounded theory' methodology and method

Founded on the seminal 1967 book 'The Discovery of Grounded Theory' [ 12 ], the grounded theory tradition is now diverse and somewhat fractured, existing in four main types, with a fifth emerging. Types one and two are the work of the original authors: Barney Glaser's 'Classic Grounded Theory' [ 13 ] and Anselm Strauss and Juliet Corbin's 'Basics of Qualitative Research' [ 14 ]. Types three and four are Kathy Charmaz's 'Constructivist Grounded Theory' [ 15 ] and Adele Clarke's postmodern Situational Analysis [ 16 ]: Charmaz and Clarke were both students of Anselm Strauss. The fifth, emerging variant is 'Dimensional Analysis' [ 17 ] which is being developed from the work of Leonard Schaztman, who was a colleague of Strauss and Glaser in the 1960s and 1970s.

There has been some discussion in the literature about what characteristics a grounded theory study must have to be legitimately referred to as 'grounded theory' [ 18 ]. The fundamental components of a grounded theory study are set out in Table 1 . These components may appear in different combinations in other qualitative studies; a grounded theory study should have all of these. As noted, there are few examples of 'how to do' grounded theory in the literature [ 18 , 19 ]. Those that do exist have focused on Strauss and Corbin's methods [ 20 – 25 ]. An exception is Charmaz's own description of her study of chronic illness [ 26 ]; we applied this same variant in our study. In the remainder of this paper, we will show how each of the characteristics of grounded theory methodology worked in our study of dental practices.

Study background

We used grounded theory methodology to investigate social processes in private dental practices in New South Wales (NSW), Australia. This grounded theory study builds on a previous Australian Randomized Controlled Trial (RCT) called the Monitor Dental Practice Program (MPP) [ 27 ]. We know that preventive techniques can arrest early tooth decay and thus reduce the need for fillings [ 28 – 32 ]. Unfortunately, most dentists worldwide who encounter early tooth decay continue to drill it out and fill the tooth [ 33 – 37 ]. The MPP tested whether dentists could increase their use of preventive techniques. In the intervention arm, dentists were provided with a set of evidence-based preventive protocols to apply [ 38 ]; control practices provided usual care. The MPP protocols used in the RCT guided dentists to systematically apply preventive techniques to prevent new tooth decay and to arrest early stages of tooth decay in their patients, therefore reducing the need for drilling and filling. The protocols focused on (1) primary prevention of new tooth decay (tooth brushing with high concentration fluoride toothpaste and dietary advice) and (2) intensive secondary prevention through professional treatment to arrest tooth decay progress (application of fluoride varnish, supervised monitoring of dental plaque control and clinical outcomes)[ 38 ].

As the RCT unfolded, it was discovered that practices in the intervention arm were not implementing the preventive protocols uniformly. Why had the outcomes of these systematically implemented protocols been so different? This question was the starting point for our grounded theory study. We aimed to understand how the protocols had been implemented, including the conditions and consequences of variation in the process. We hoped that such understanding would help us to see how the norms of Australian private dental practice as regards to tooth decay could be moved away from drilling and filling and towards evidence-based preventive care.

Designing this grounded theory study

Figure 1 illustrates the steps taken during the project that will be described below from points A to F.

Study design . file containing a figure illustrating the study design.

A. An open beginning and research questions

Grounded theory studies are generally focused on social processes or actions: they ask about what happens and how people interact . This shows the influence of symbolic interactionism, a social psychological approach focused on the meaning of human actions [ 39 ]. Grounded theory studies begin with open questions, and researchers presume that they may know little about the meanings that drive the actions of their participants. Accordingly, we sought to learn from participants how the MPP process worked and how they made sense of it. We wanted to answer a practical social problem: how do dentists persist in drilling and filling early stages of tooth decay, when they could be applying preventive care?

We asked research questions that were open, and focused on social processes. Our initial research questions were:

What was the process of implementing (or not-implementing) the protocols (from the perspective of dentists, practice staff, and patients)?

How did this process vary?

B. Ethics approval and ethical issues

In our experience, medical researchers are often concerned about the ethics oversight process for such a flexible, unpredictable study design. We managed this process as follows. Initial ethics approval was obtained from the Human Research Ethics Committee at the University of Sydney. In our application, we explained grounded theory procedures, in particular the fact that they evolve. In our initial application we provided a long list of possible recruitment strategies and interview questions, as suggested by Charmaz [ 15 ]. We indicated that we would make future applications to modify our protocols. We did this as the study progressed - detailed below. Each time we reminded the committee that our study design was intended to evolve with ongoing modifications. Each modification was approved without difficulty. As in any ethical study, we ensured that participation was voluntary, that participants could withdraw at any time, and that confidentiality was protected. All responses were anonymised before analysis, and we took particular care not to reveal potentially identifying details of places, practices or clinicians.

C. Initial, Purposive Sampling (before theoretical sampling was possible)

Grounded theory studies are characterised by theoretical sampling, but this requires some data to be collected and analysed. Sampling must thus begin purposively, as in any qualitative study. Participants in the previous MPP study provided our population [ 27 ]. The MPP included 22 private dental practices in NSW, randomly allocated to either the intervention or control group. With permission of the ethics committee; we sent letters to the participants in the MPP, inviting them to participate in a further qualitative study. From those who agreed, we used the quantitative data from the MPP to select an initial sample.

Then, we selected the practice in which the most dramatic results had been achieved in the MPP study (Dental Practice 1). This was a purposive sampling strategy, to give us the best possible access to the process of successfully implementing the protocols. We interviewed all consenting staff who had been involved in the MPP (one dentist, five dental assistants). We then recruited 12 patients who had been enrolled in the MPP, based on their clinically measured risk of developing tooth decay: we selected some patients whose risk status had gotten better, some whose risk had worsened and some whose risk had stayed the same. This purposive sample was designed to provide maximum variation in patients' adoption of preventive dental care.

Initial Interviews

One hour in-depth interviews were conducted. The researcher/interviewer (AS) travelled to a rural town in NSW where interviews took place. The initial 18 participants (one dentist, five dental assistants and 12 patients) from Dental Practice 1 were interviewed in places convenient to them such as the dental practice, community centres or the participant's home.

Two initial interview schedules were designed for each group of participants: 1) dentists and dental practice staff and 2) dental patients. Interviews were semi-structured and based loosely on the research questions. The initial questions for dentists and practice staff are in Additional file 1 . Interviews were digitally recorded and professionally transcribed. The research location was remote from the researcher's office, thus data collection was divided into two episodes to allow for intermittent data analysis. Dentist and practice staff interviews were done in one week. The researcher wrote memos throughout this week. The researcher then took a month for data analysis in which coding and memo-writing occurred. Then during a return visit, patient interviews were completed, again with memo-writing during the data-collection period.

D. Data Analysis

Coding and the constant comparative method.

Coding is essential to the development of a grounded theory [ 15 ]. According to Charmaz [[ 15 ], p46], 'coding is the pivotal link between collecting data and developing an emergent theory to explain these data. Through coding, you define what is happening in the data and begin to grapple with what it means'. Coding occurs in stages. In initial coding, the researcher generates as many ideas as possible inductively from early data. In focused coding, the researcher pursues a selected set of central codes throughout the entire dataset and the study. This requires decisions about which initial codes are most prevalent or important, and which contribute most to the analysis. In theoretical coding, the researcher refines the final categories in their theory and relates them to one another. Charmaz's method, like Glaser's method [ 13 ], captures actions or processes by using gerunds as codes (verbs ending in 'ing'); Charmaz also emphasises coding quickly, and keeping the codes as similar to the data as possible.

We developed our coding systems individually and through team meetings and discussions.

We have provided a worked example of coding in Table 2 . Gerunds emphasise actions and processes. Initial coding identifies many different processes. After the first few interviews, we had a large amount of data and many initial codes. This included a group of codes that captured how dentists sought out evidence when they were exposed to a complex clinical case, a new product or technique. Because this process seemed central to their practice, and because it was talked about often, we decided that seeking out evidence should become a focused code. By comparing codes against codes and data against data, we distinguished the category of "seeking out evidence" from other focused codes, such as "gathering and comparing peers' evidence to reach a conclusion", and we understood the relationships between them. Using this constant comparative method (see Table 1 ), we produced a theoretical code: "making sense of evidence and constructing knowledge". This code captured the social process that dentists went through when faced with new information or a practice challenge. This theoretical code will be the focus of a future paper.

Memo-writing

Throughout the study, we wrote extensive case-based memos and conceptual memos. After each interview, the interviewer/researcher (AS) wrote a case-based memo reflecting on what she learned from that interview. They contained the interviewer's impressions about the participants' experiences, and the interviewer's reactions; they were also used to systematically question some of our pre-existing ideas in relation to what had been said in the interview. Table 3 illustrates one of those memos. After a few interviews, the interviewer/researcher also began making and recording comparisons among these memos.

We also wrote conceptual memos about the initial codes and focused codes being developed, as described by Charmaz [ 15 ]. We used these memos to record our thinking about the meaning of codes and to record our thinking about how and when processes occurred, how they changed, and what their consequences were. In these memos, we made comparisons between data, cases and codes in order to find similarities and differences, and raised questions to be answered in continuing interviews. Table 4 illustrates a conceptual memo.

At the end of our data collection and analysis from Dental Practice 1, we had developed a tentative model of the process of implementing the protocols, from the perspective of dentists, dental practice staff and patients. This was expressed in both diagrams and memos, was built around a core set of focused codes, and illustrated relationships between them.

E. Theoretical sampling, ongoing data analysis and alteration of interview route

We have already described our initial purposive sampling. After our initial data collection and analysis, we used theoretical sampling (see Table 1 ) to determine who to sample next and what questions to ask during interviews. We submitted Ethics Modification applications for changes in our question routes, and had no difficulty with approval. We will describe how the interview questions for dentists and dental practice staff evolved, and how we selected new participants to allow development of our substantive theory. The patients' interview schedule and theoretical sampling followed similar procedures.

Evolution of theoretical sampling and interview questions

We now had a detailed provisional model of the successful process implemented in Dental Practice 1. Important core focused codes were identified, including practical/financial, historical and philosophical dimensions of the process. However, we did not yet understand how the process might vary or go wrong, as implementation in the first practice we studied had been described as seamless and beneficial for everyone. Because our aim was to understand the process of implementing the protocols, including the conditions and consequences of variation in the process, we needed to understand how implementation might fail. For this reason, we theoretically sampled participants from Dental Practice 2, where uptake of the MPP protocols had been very limited according to data from the RCT trial.

We also changed our interview questions based on the analysis we had already done (see Additional file 2 ). In our analysis of data from Dental Practice 1, we had learned that "effectiveness" of treatments and "evidence" both had a range of meanings. We also learned that new technologies - in particular digital x-rays and intra-oral cameras - had been unexpectedly important to the process of implementing the protocols. For this reason, we added new questions for the interviews in Dental Practice 2 to directly investigate "effectiveness", "evidence" and how dentists took up new technologies in their practice.

Then, in Dental Practice 2 we learned more about the barriers dentists and practice staff encountered during the process of implementing the MPP protocols. We confirmed and enriched our understanding of dentists' processes for adopting technology and producing knowledge, dealing with complex cases and we further clarified the concept of evidence. However there was a new, important, unexpected finding in Dental Practice 2. Dentists talked about "unreliable" patients - that is, patients who were too unreliable to have preventive dental care offered to them. This seemed to be a potentially important explanation for non-implementation of the protocols. We modified our interview schedule again to include questions about this concept (see Additional file 3 ) leading to another round of ethics approvals. We also returned to Practice 1 to ask participants about the idea of an "unreliable" patient.

Dentists' construction of the "unreliable" patient during interviews also prompted us to theoretically sample for "unreliable" and "reliable" patients in the following round of patients' interviews. The patient question route was also modified by the analysis of the dentists' and practice staff data. We wanted to compare dentists' perspectives with the perspectives of the patients themselves. Dentists were asked to select "reliable" and "unreliable" patients to be interviewed. Patients were asked questions about what kind of services dentists should provide and what patients valued when coming to the dentist. We found that these patients (10 reliable and 7 unreliable) talked in very similar ways about dental care. This finding suggested to us that some deeply-held assumptions within the dental profession may not be shared by dental patients.

At this point, we decided to theoretically sample dental practices from the non-intervention arm of the MPP study. This is an example of the 'openness' of a grounded theory study potentially subtly shifting the focus of the study. Our analysis had shifted our focus: rather than simply studying the process of implementing the evidence-based preventive protocols, we were studying the process of doing prevention in private dental practice. All participants seemed to be revealing deeply held perspectives shared in the dental profession, whether or not they were providing dental care as outlined in the MPP protocols. So, by sampling dentists from both intervention and control group from the previous MPP study, we aimed to confirm or disconfirm the broader reach of our emerging theory and to complete inductive development of key concepts. Theoretical sampling added 12 face to face interviews and 10 telephone interviews to the data. A total of 40 participants between the ages of 18 and 65 were recruited. Telephone interviews were of comparable length, content and quality to face to face interviews, as reported elsewhere in the literature [ 40 ].

F. Mapping concepts, theoretical memo writing and further refining of concepts

After theoretical sampling, we could begin coding theoretically. We fleshed out each major focused code, examining the situations in which they appeared, when they changed and the relationship among them. At time of writing, we have reached theoretical saturation (see Table 1 ). We have been able to determine this in several ways. As we have become increasingly certain about our central focused codes, we have re-examined the data to find all available insights regarding those codes. We have drawn diagrams and written memos. We have looked rigorously for events or accounts not explained by the emerging theory so as to develop it further to explain all of the data. Our theory, which is expressed as a set of concepts that are related to one another in a cohesive way, now accounts adequately for all the data we have collected. We have presented the developing theory to specialist dental audiences and to the participants, and have found that it was accepted by and resonated with these audiences.

We have used these procedures to construct a detailed, multi-faceted model of the process of incorporating prevention into private general dental practice. This model includes relationships among concepts, consequences of the process, and variations in the process. A concrete example of one of our final key concepts is the process of "adapting to" prevention. More commonly in the literature writers speak of adopting, implementing or translating evidence-based preventive protocols into practice. Through our analysis, we concluded that what was required was 'adapting to' those protocols in practice. Some dental practices underwent a slow process of adapting evidence-based guidance to their existing practice logistics. Successful adaptation was contingent upon whether (1) the dentist-in-charge brought the whole dental team together - including other dentists - and got everyone interested and actively participating during preventive activities; (2) whether the physical environment of the practice was re-organised around preventive activities, (3) whether the dental team was able to devise new and efficient routines to accommodate preventive activities, and (4) whether the fee schedule was amended to cover the delivery of preventive services, which hitherto was considered as "unproductive time".

Adaptation occurred over time and involved practical, historical and philosophical aspects of dental care. Participants transitioned from their initial state - selling restorative care - through an intermediary stage - learning by doing and educating patients about the importance of preventive care - and finally to a stage where they were offering patients more than just restorative care. These are examples of ways in which participants did not simply adopt protocols in a simple way, but needed to adapt the protocols and their own routines as they moved toward more preventive practice.

The quality of this grounded theory study

There are a number of important assurances of quality in keeping with grounded theory procedures and general principles of qualitative research. The following points describe what was crucial for this study to achieve quality.

During data collection

1. All interviews were digitally recorded, professionally transcribed in detail and the transcripts checked against the recordings.

2. We analysed the interview transcripts as soon as possible after each round of interviews in each dental practice sampled as shown on Figure 1 . This allowed the process of theoretical sampling to occur.

3. Writing case-based memos right after each interview while being in the field allowed the researcher/interviewer to capture initial ideas and make comparisons between participants' accounts. These memos assisted the researcher to make comparison among her reflections, which enriched data analysis and guided further data collection.

4. Having the opportunity to contact participants after interviews to clarify concepts and to interview some participants more than once contributed to the refinement of theoretical concepts, thus forming part of theoretical sampling.

5. The decision to include phone interviews due to participants' preference worked very well in this study. Phone interviews had similar length and depth compared to the face to face interviews, but allowed for a greater range of participation.

During data analysis

1. Detailed analysis records were kept; which made it possible to write this explanatory paper.

2. The use of the constant comparative method enabled the analysis to produce not just a description but a model, in which more abstract concepts were related and a social process was explained.

3. All researchers supported analysis activities; a regular meeting of the research team was convened to discuss and contextualize emerging interpretations, introducing a wide range of disciplinary perspectives.

Answering our research questions

We developed a detailed model of the process of adapting preventive protocols into dental practice, and analysed the variation in this process in different dental practices. Transferring evidence-based preventive protocols into these dental practices entailed a slow process of adapting the evidence to the existing practices logistics. Important practical, philosophical and historical elements as well as barriers and facilitators were present during a complex adaptation process. Time was needed to allow dentists and practice staff to go through this process of slowly adapting their practices to this new way of working. Patients also needed time to incorporate home care activities and more frequent visits to dentists into their daily routines. Despite being able to adapt or not, all dentists trusted the concrete clinical evidence that they have produced, that is, seeing results in their patients mouths made them believe in a specific treatment approach.

Concluding remarks

This paper provides a detailed explanation of how a study evolved using grounded theory methodology (GTM), one of the most commonly used methodologies in qualitative health and medical research [[ 8 ], p47]. In 2007, Bryant and Charmaz argued:

'Use of GTM, at least as much as any other research method, only develops with experience. Hence the failure of all those attempts to provide clear, mechanistic rules for GTM: there is no 'GTM for dummies'. GTM is based around heuristics and guidelines rather than rules and prescriptions. Moreover, researchers need to be familiar with GTM, in all its major forms, in order to be able to understand how they might adapt it in use or revise it into new forms and variations.' [[ 8 ], p17].

Our detailed explanation of our experience in this grounded theory study is intended to provide, vicariously, the kind of 'experience' that might help other qualitative researchers in medicine and health to apply and benefit from grounded theory methodology in their studies. We hope that our explanation will assist others to avoid using grounded theory as an 'approving bumper sticker' [ 10 ], and instead use it as a resource that can greatly improve the quality and outcome of a qualitative study.

Abbreviations

grounded theory methods

Monitor Dental Practice Program

New South Wales

Randomized Controlled Trial.

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Acknowledgements

We thank dentists, dental practice staff and patients for their invaluable contributions to the study. We thank Emeritus Professor Miles Little for his time and wise comments during the project.

The authors received financial support for the research from the following funding agencies: University of Sydney Postgraduate Award 2009; The Oral Health Foundation, University of Sydney; Dental Board New South Wales; Australian Dental Research Foundation; National Health and Medical Research Council Project Grant 632715.

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Alexandra Sbaraini, Stacy M Carter & Anthony Blinkhorn

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Authors' contributions

All authors have made substantial contributions to conception and design of this study. AS carried out data collection, analysis, and interpretation of data. SMC made substantial contribution during data collection, analysis and data interpretation. AS, SMC, RWE, and AB have been involved in drafting the manuscript and revising it critically for important intellectual content. All authors read and approved the final manuscript.

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Additional file 1: Initial interview schedule for dentists and dental practice staff. file containing initial interview schedule for dentists and dental practice staff. (DOC 30 KB)

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Additional file 2: Questions added to the initial interview schedule for dentists and dental practice staff. file containing questions added to the initial interview schedule (DOC 26 KB)

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Additional file 3: Questions added to the modified interview schedule for dentists and dental practice staff. file containing questions added to the modified interview schedule (DOC 26 KB)

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Sbaraini, A., Carter, S.M., Evans, R.W. et al. How to do a grounded theory study: a worked example of a study of dental practices. BMC Med Res Methodol 11 , 128 (2011). https://doi.org/10.1186/1471-2288-11-128

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Article Contents

Introduction, distinguishing features of grounded theory, the role and timing of the literature review.

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Grounded theory: what makes a grounded theory study?

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Carley Turner, Felicity Astin, Grounded theory: what makes a grounded theory study?, European Journal of Cardiovascular Nursing , Volume 20, Issue 3, March 2021, Pages 285–289, https://doi.org/10.1093/eurjcn/zvaa034

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Grounded theory (GT) is both a research method and a research methodology. There are several different ways of doing GT which reflect the different viewpoints of the originators. For those who are new to this approach to conducting qualitative research, this can be confusing. In this article, we outline the key characteristics of GT and describe the role of the literature review in three common GT approaches, illustrated using exemplar studies.

Describing the key characteristics of a Grounded theory (GT) study.

Considering the role and timing of the literature review in different GT approaches.

Qualitative research is a cornerstone in cardiovascular research. It gives insights in why particular phenomena occur or what underlying mechanisms are. 1 Over the past 2 years, the European Journal of Cardiovascular Nursing published 20 qualitative studies. 2–21 These studies used methods such as content analysis, ethnography, or phenomenology. Grounded theory (GT) has been used to a lesser extent.

Grounded theory is both a methodology and a method used in qualitative research ( Table 1 ). It is a research approach used to gain an emic insight into a phenomenon. In simple terms, this means understanding the perspective, or point of view, of an ‘insider’, those who have experience of the phenomenon. 22 Grounded theory is a research approach that originated from the social sciences but has been used in education and health research. The focus of GT is to generate theory that is grounded in data and shaped by the views of participants, thereby moving beyond description and towards theoretical explanation of a process or phenomenon. 23

Grounded theory as a method and methodology

One of the key issues with using GT, particularly for novices, is understanding the different approaches that have evolved as each specific GT approach is slightly different.

The tradition of GT began with the seminal text about classic GT written by Glaser and Strauss, 24 but since then GT has evolved into several different types. The approach to GT chosen by the researcher depends upon an understanding of the epistemological underpinnings of the different approaches, the match with the topic under investigation and the researcher’s own stance. Whilst GT is frequently used in applied health research, very few studies detail which GT approach has been used, how and why. Sometimes published studies claim to use GT methodology but the approaches that form the foundation of GT are not reported. This may be due to the word limit in academic journals or because legitimate GT approaches have not been followed. Either way, there is a lack of clarity about the practical application of GT. The purpose of this article is to outline the distinguishing characteristics of GT and outline practical considerations for the novice researcher regarding the place of the literature review in GT.

There are several distinguishing features of GT, as outlined by Sbaraini et al. 25 The first is that GT research is conducted through an inductive process. This means that the researcher is developing theory rather than testing it and must therefore remain ‘open’ throughout the study. In essence, this means that the researcher has no preconceived ideas about the findings. Taking an inductive approach means that the focus of the research may evolve over time as the researchers understand what is important to their participants through the data collection and analysis process.

With regards to data analysis, the use of coding is initially used to break down data into smaller components and labelling them to capture the essence of the data. The codes are compared to one another to understand and explain any variation in the data before they are combined to form more abstract categories. Memos are used to record and develop the researcher’s analysis of the data, including the detail behind the comparisons made between categories. Memos can stimulate the researcher’s thinking, as well as capturing the researcher’s ideas during data collection and analysis.

A further feature for data analysis in a GT study is the simultaneous data analysis and sampling to facilitate theoretical sampling. This means that as data analysis progresses participants are purposefully selected who may have characteristics or experiences that have arisen as being of interest from data collection and analysis so far. Questions in the topic guide may also be modified to follow a specific line of inquiry, test ideas and interpretations, or fill gaps in the analysis to build an emerging substantive theory. This evolving and non-linear methodology is to allow the evolution of the study as indicated by data, rather than analysing at the end of data collection. This approach to data analysis supports the researcher to take an inductive approach as discussed above.

Theoretical sampling facilitates the construction of theory until theoretical saturation is reached. Theoretical saturation is when all the concepts that form the theory being developed are well understood and grounded in data. Finally, the results are expressed as a theory where a set of concepts are related to one another and provide a framework for making predictions. 26 These key features of GT are summarized in Table 2 .

Distinguishing features of a GT study (adapted from Sbaraini et al. 25 )

The identification of a gap in the published literature is typically a requirement of successful doctoral studies and grant applications. However, in GT research there are different views about the role and timing of the literature review.

For researchers using classic Glaserian GT, the recommended approach is that the published literature should not be reviewed until data collection, analysis and theory development has been completed. 24 The rationale for the delay of the literature review is to enable the researcher to remain ‘open’ to discover theory emerging from data and free from contamination by avoiding forcing data into pre-conceived concepts derived from other studies. Furthermore, because the researcher is ‘open’ to whichever direction the data takes they cannot know in advance which aspects of the literature will be relevant to their study. 27

In Glaserian GT, the emerging concepts and theory from data analysis inform the scope of the literature review which is conducted after theory development. 24 This approach to the literature review aligns with the rather positivist stance of Glaser in which the researcher aims to remain free of assumptions so that the theory that emerges from the data is not influenced by the researcher. Reviewing the literature prior to data analysis would risk theory being imposed on the data. Perhaps counterintuitively, Glaser does recommend reading literature in unrelated fields to understand as many theoretical codes as possible. 28 However, it is unclear how this is different to reading literature directly related to the topic and could potentially still lead to the contamination of the theory arising from data that delaying the literature review is intended to avoid. It is also problematic regarding the governance processes around research, whereby funders and ethics committees would expect at least an overview of the existing literature as part of the justification for the study.

A study by Bergman et al. 29 used a classic Glaserian GT approach to examine and identify the motive of power in myocardial infarction patients’ rehabilitation process. Whilst the key characteristics of GT were evident in the way the study was conducted, there was no discussion about how the literature review contributed to the final theory. This may have been due to the word limit but illustrates the challenges that novice researchers may have in understanding where the literature review fits in studies using GT approaches.

In Straussian GT, a more pragmatic approach to the literature view is adopted. Strauss and Corbin 30 recognized that the researcher has prior knowledge, including that of the literature, before starting their research. They did not recommend dissociation from the literature, but rather that the literature be used across the various stages of the research. Published literature could identify important areas that could contribute to theory development, support useful comparisons in the data and stimulate further questions during the analytical process. According to Strauss and Corbin, researchers should be mindful about how published work could influence theory development. Whilst visiting the literature prior to data collection was believed to enhance data analysis, it was not thought necessary to review all the literature beforehand, but rather revisit the literature at later stages in the research process. 30

A study published by Salminen-Tuomaala et al. 31 used a Straussian GT approach to explore factors that influenced the way patients coped with hospitalization for acute myocardial infarction. The authors described a reflexive process in which the researcher noted down their preconceived ideas about the topic as part of the data analysis process. The literature review was conducted after data analysis.

The most recent step in the evolution of GT is the move towards a constructivist epistemological stance advocated by Charmaz. 32 In simple terms, this means that the underlying approach reflects the belief that theories cannot be discovered but are instead constructed by the researcher and their interactions with the participants and data. As the researcher plays a central role in the construction of the GT, their background, personal views, and culture will influence this process and the way data are analysed. For this reason, it is important to be explicit about these preconceptions and aim to maintain an open mind through reflexivity. 32 Therefore, engaging in a preliminary literature review and using this information to compare and contrast with findings from the research undertaken is desirable, alongside completing a comprehensive literature review after data analysis with a specific aim to present the GT.

A study published by Odell et al. 33 used the modified GT approach recommended by Charmaz 32 to study patients’ experiences of restenosis after Percutaneous Coronary Intervention. The authors described the different GT approaches and key features of GT methodology which clearly informed the conduct of the study. However, there was no detail about how the literature review was used to shape the data analysis process and findings.

A solution: be clear on the approach taken to the literature review and why

Despite the clear differences in the approach to the literature review in GT, there appears to be a lack of precise guidance for novice researchers regarding how in depth or exhaustive a preliminary literature review should be. This lack of guidance can lead to a variety of different approaches as evidenced in the GT studies we have cited as examples, which is a challenge for the novice researcher. This uncertainty is further compounded by the concurrent approach to data collection and analysis which allows for the research focus to evolve as the study progresses. The complexity of the research process and the role and timing of the literature review is summarized in Figure 1 .

Literature review in Grounded Theory.

Taking a pragmatic approach, researchers will need to familiarize themselves with the literature to receive funding and approval for their study. This preliminary literature review can be followed up after data analysis by a more comprehensive review of the literature to help support the theory that was developed from the data. The key is to ensure transparency in reporting how the literature review has been used to develop the theory. The preliminary literature review can be used to set the scene for the research as part of the introduction, and the more extensive literature review can then be used during the discussion section to compare the theory developed from the data with existing literature, as per Probyn et al. 34

Whilst this pragmatic approach aligns with Straussian GT and Charmaz’s constructivist GT, it is at odds with Glaserian GT. Therefore, if Glaserian GT is chosen, the researcher should be explicit about deviation and provide a rationale.

Word count for journal articles is often a limiting factor in how much detail is included in why certain methodologies are used. Submitting detail about the methodology and rationale behind it can be presented as online supplementary material, thereby allowing interested readers to access further information about how and why the research was executed.

The use of GT as a methodology and method can shed light on areas where little knowledge is already known, generating theory directly from data. The traditional format of a published article does not always reflect the iterative approach to the literature review and data collection and analysis in GT. This can generate tension between how the research is presented in relation to how it was conducted. However, one simple way to ensure clarity in reporting is to be transparent in how the literature review is used.

The authors received no financial support for the research, authorship or publication of this article.

Conflict of interest : The authors declare that there are no conflicts of interest.

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