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Getting real: Life IS messy!

March 27, 2012 Leave a comment

Remember a few years ago when Bissell came out with the tag line ‘Life is messy, clean it up’?  I LOVED that campaign and also the sentiment behind it.  Because the truth is, life IS messy.  And consequently, real answers to questions about daily life are often not very cut and dry.

I’m sometimes asked about how ‘reliable’ or ‘valid’ ethnographic research is.  Validity is easy to address because you can’t get more ‘valid’ than real life.  Sure, people don’t always act EXACTLY like they would if you weren’t there.  Almost all research impacts how people behave, and ethnography is no exception.  But, over the years, we have collected lots of evidence (participants yelling at each other, people telling us about things even their spouse didn’t know about them, etc.) that we do get closer to real life than most other research methodologies.

But when it comes to reliability, ethnographers approach the issue a little bit differently.  For example, think about the last 10 times you went grocery shopping.   There were probably some patterns in the way that you did it.  You probably went to the same place (at least most of those times), you probably started at the same end of the store, you probably had a list (or didn’t have a list), etc.  But, there was probably a good deal of variation too, and a lot of the variation was probably attributable to the context of the trip.  For example, did you go shopping alone or with someone else? Did you go shopping on a Tuesday evening or a Saturday afternoon?  Where you stopping by to pick up an ingredient you had forgotten or were you going to the store for the first time in a month?  All of these trips to the store can constitute ‘typical’ grocery shopping within a single household, but each can demonstrate very different types of patterns, and therefore can produce results that can appear a little bit unreliable.  But that is because real life is complex and variable.

There are actually very few behaviors that get routinized to the degree that there is little or no variation in the way they are done.  So for me, the question is not ‘is your ethnographic project reliable’, it is ‘how well does your ethnographic project capture the way(s) this thing is done’?  It is obviously important to make sure we get to see what is typical, but we also want to make sure we get to see variation and why it exists.  And this is important to try to understand both within and between households/people.

One of the things that concerns me a lot about my discipline (business/corporate ethnography) is that many people are now doing ‘ethnographic research’ without any real attention to the importance of context and the range of complexity that context brings to behavior.  They assume that ‘context’ is covered by being there and watching people do something.  But for me, context is so much more than that.  Obviously the place where the thing happens is an important context to see and understand, but there are generally hundreds if not thousands of other contextual variables that come into play around any particular behavior. The skilled ethnographer will be cataloging and trying to understand as many of those as possible.  And as you can see, this can get very messy, very quickly.  But there is no reason to panic, the skilled ethnographer is also really good at systematically organizing those variables into an understandable story. I believe that the REAL value of ethnography is in its ability to explain the messiness of life and human behavior and to pull out the patterned similarities AND the patterned differences in how a thing is done.

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Reconstructing Reality: What do you see?

March 20, 2012 Leave a comment

Social scientists and philosophers have been arguing about ‘reality’ for a while now.  There are generally two approaches to how reality is understood and measured by social scientists.  Those taking a positivistic approach believe that although people may ‘see’ things differently, there is an objective reality.  On the other hand, those taking a phenomenological approach assume multiple realities to any given situation.  As an ethnographer, I generally skew toward the phenomenological viewpoint.  I realize that not all versions of reality hold up equally well, but I have seen many instances of people creating their own reality around their experiences and around products/services.

I usually use the classic film ‘The Gods Must be Crazy’ to help illustrate this concept.  So, in the film, there is a pilot that is flying over the Kalahari Desert and he drinks a coke and then throws the bottle out of the window of his plane.  A man named Xi finds the coke bottle and assumes that it is a gift from the gods and he and his tribe find TONS of uses for the bottle—it is a tool, it is a toy, it is a musical instrument, etc.  In other words, they construct an alternate reality around the bottle.  And so the movie is a parable to illustrate how one man’s trash can become another man’s treasure.

This is one way in which the social construction of reality comes to life in my work.  I do see many instances of people finding all kinds of interesting (but unintended) uses for products.  They might fashion an expensive piece of electronic equipment into a workbench or they might use a medical device in ways that are not consistent with instructions, but which fit better into their particular needs.  In these situations, my job becomes one in which I help my client understand not only WHAT they are doing, but WHY.  This often requires me to walk a delicate line.  Generally, my client has given a lot of thought to design and they have created a product that does what it is designed to do pretty well.  However, sometimes I have to help them understand that it isn’t all about what this product does.  Sometimes it is more important to understand the social world in which the product lives and how their vision of what the product should be might not be consistent with the reality in which the product lives.

For example, many years ago, we were hired by a manufacturer of high-end electronic equipment.  This company had given A LOT of thought to their product line and were really, really proud of all of the bells and whistles their products had.  But after spending a few weeks in the field, observing and talking to the people who used their products, I realized that the bells and whistles were not only NOT appreciated by the customers, they were often feared!  Many consumers lived in constant fear that someone else would change some of the settings on this device and then they would have to spend hours trying to figure out how to reset it.  There was clearly a disconnect in the ‘reality’ of what this thing was and especially around what the expectations of it were.  For my client, the real VALUE of their product and what they believed really differentiated their brand from others were the bells and whistles (this was evidenced by their advertising, but also by the angry response we got from designers and engineers when we presented our findings)!  But for the consumer, the value of the thing was that it turned on when it was supposed to and allowed them to do their job without being too complicated or distracting them from their real task.

As I said before, not all versions of ‘reality’ are tolerated equally, but it does pay to try to understand how your product might fit into the reality of daily life and how your customer might be constructing their own story about exactly what your product is and especially how (and for what) it is valued.

Why I like hanging with the frogs

March 16, 2012 Leave a comment

I always tell clients that one of the benefits of an ethnographic approach is that you get really close to the action or the ‘thing’ that you want to learn about.  And I do mean REALLY close.  I often compare an ethnographic research study to a telephoto snapshot.  Imagine you are at a football game and you want to capture an understanding about what is happening in the stadium.  You have a couple of options at your disposal.  You can take a wide-angle photo and capture the entire stadium.  In this photo you will see EVERYTHING, but you won’t be able to see ANYTHING very clearly. Or you can take a telephoto picture and capture a specific area of the stadium.  In this photo you will see only a small portion of what is going on in the stadium, but you will see that in detail and with clarity.  The wide-angled photo is the kind of picture you get with large quantitative studies, and the telephoto picture is what you get with an ethnographic study.  Both representations of the stadium are accurate and useful. In fact, they are complimentary.  Ideally you would consult both before coming to any conclusions about what is happening at the football stadium.

I have a lot of respect for my statistics gathering colleagues (in fact I used to teach statistics).  I like to know what they are learning because it helps to provide context for my fieldwork and sometimes even provides a framework for project design or analysis.  But I really get excited about capturing that telephoto image.

Another way to think about this difference in perspective is to use the analogy of a frog’s eye view versus a bird’s eye view.  Statistics give us a high level view of what is happening, from far away.  Whereas an ethnographic approach gives us a frog’s eye view.  In order to get the frog’s eye view, you usually need to get down in the thick of things and that is why I love being an ethnographer.  I think it is so exciting to see things happen in real time and to be able to understand it all in the context in which it occurs.  Real life is often unpredictable, messy, exciting, and frustrating, and ethnography helps to bring all of this to life.  Over the course of my career I’ve had a frog’s eye view of so many interesting things and this has proven invaluable to me and my clients because it allows me to uncover insights and perspective that just can’t be obtained in any other way.  For example, there is just no better way to understand the world of teenage gamers than to hang out with them for a summer and to try to get into their world.  Yep, I got to do that!   Or to hear the first hand stories and experience the daily life routines and rituals of people who are living with chronic pain and literally SEE how their world has shrunk into their living room or kitchen.  Sure sometimes I get a little mud on me, but that is part of the experience and I wouldn’t trade it for anything.

Categories: Uncategorized

Getting to two cups of tea

March 13, 2012 6 comments

A few years ago we were hired to observe doctors and nurses inserting central venous catheters in hospitals and clinics in order to identify opportunities for reducing the possibility of infection.  We had been working on the project for a few months and had observed in several areas within hospitals and clinics, but were really needing to understand how things might be different in the pre-surgery area of hospitals.  We had worked hard to go through all of the proper channels and had finally secured permission to observe in the pre-surgery area.  We had institutional review board permission and had spoken to the nurse in charge of the pre-surgery area several times and thought we were ready to go.

We arrived at the hospital bright and early, excited for our first day of fieldwork.   After meeting the head nurse and being given a tour of the area, I asked who actually did the catheter insertions in the pre-surgery area and was told that the department of anesthesiology did the insertions.  I asked if they had been informed about what we were doing and was told ‘I don’t think so.’  Years of experience washed over me as I realized this was NOT GOOD, so I headed for an impromptu meeting with the chair of the anesthesiology department.  He was cordial and listened intently about the goals of our project and the process we had gone through to obtain permission.  When I was finished, he exploded.  He let me know that this was just the latest in a long line of events that proved how little his department was valued by the hospital.  He assured me that he didn’t hold me responsible and told me that I seemed like a very nice lady.  BUT he could not allow us to observe any catheter insertions on that day because he needed to do some research, see who had dropped the ball and inform the other doctors about what was going on.  He promised to touch base with me later to update me.  That afternoon, I received a call from the department chair’s assistant telling me we were cleared to observe insertions the next day. She said a memo had been sent out and everyone would be expecting us.  I was thankful to only have lost one day of fieldwork.

The next morning, we arrived at the hospital early and when the first catheter insertion hit the floor we were ready. We had asked permission of the patient and the resident who was doing the insertion.  We were in the middle of the insertion when the attending physician walked in and motioned for us to step into the hall.  He asked what we were doing and I told him it was fine, we had permission from the chair of the department and that there had been a memo circulated about the matter.  He informed me that he had read the memo and asked me if I had (I had not).  He pointed out that the memo clearly stated we were not allowed to observe residents.  My heart sank.  I walked outside and called the chair of the department who was working off-site on that day.  It was then that I discovered the value of inserting someone’s name during a reprimand.  Dr. X said ‘I hold you responsible, Melinda.’  ‘You should have read the memo, Melinda’ (I hadn’t been given a copy of the memo). ‘I will call you later to discuss whether we can work this out.’  We left the hospital completely deflated.  We had now lost two full days of insertion observation, approximately 24 hours of data collection.  That afternoon, the department chair called me and told me we could return the next day.  His assistant had forwarded me the memo and we reviewed the perimeters and rules of our observation.  I took some Advil and tried to refocus my thoughts.

On the third day, we arrive at the hospital earlier than before, we wanted to get settled in and be ready for any and all opportunities for insertion observation.  On that day, because the caseload was low, there was only one doctor performing insertions.  It just so happened this was the same doctor who had exposed us on the second day and he was NOT interested in participating in our study. We again spent the entire day observing the comings and goings of the pre-surgery area, but no catheter insertions.

On the fourth day, we returned, hoping against hope that things would be better.  The first few doctors doing insertions declined to participate in our study, so we had another couple of hours to make general observations.  I was beginning to panic.  What if we didn’t get to see any insertions.  How was I going to explain THAT to the client.  Just before noon, one of the doctors came and sat down next to me and asked me to explain exactly what we were doing.  I gave him my 3-minute elevator pitch on our work, the project, etc.  He seemed to relax a little bit and asked me if I had ever read the book ‘Three Cups of Tea’.  I told him I had not and he gave me a quick overview of the book.  He explained that it was written by a guy who got sick while mountain climbing and was forced to remain in a village with strangers until he recovered.  The title of the book came from the Balti proverb that explains how tea rituals move you from stranger status (first cup) to honored guest (second cup), and then to family member (third cup).  The doctor patted me on the back and said he had just wanted to share that idea with me and then invited me to watch him do an insertion.  For the rest of the afternoon and into the next day, my partner and I couldn’t keep up with the insertions that we were invited to observe.  We were invited to watch virtually all of the insertions that were happening on the floor and were also invited to watch insertions that occurred in other departments and in patients’ rooms.  We were invited into the break room and asked to have lunch with a few doctors.  We ended up with more instances of observation and interviews than we had originally planned.

As I left the hospital on the last day, I was relieved and excited to begin the process of breaking my observations down and figuring out the patterns that separated catheter insertion in the pre-surgery area from the other areas that we had observed.  But it wasn’t until a few days later as I was reviewing my fieldnotes from the first three days that that I realized what a wonderful gift I had been given by things not going according to plan.  I had been given the opportunity to observe the context of the pre-surgery area for hours without having to focus on the technical aspects of catheter insertion.  I had noted a lot about the patterns of interaction and the flow and movement of patients and staff within the pre-surgery area.  This allowed me to really place my specific observations about the challenges that doctors faced in inserting catheters in the pre-surgery area into a more understandable context.

When I reached the point in my fieldnotes where I had written about the doctor telling me about ‘Three Cups of Tea’, I realized that there had been a hidden message.  At the time, I thought he was telling me about the book because I was a sociologist and he thought I would appreciate the story.  It was only later that I realized that by telling me the story, he was inviting me to my second cup of tea.  While sitting in the pre-surgery area for days, we had become a fixture and had transcended the ‘stranger’ status and became if not an honored guest, at least an ‘okay observer’ (as evidenced by the number of invitations we received for observation and interviews).

This experience taught me two things:  1) Never forget to look for the opportunities that are presented when things go wrong.   2)  Remember how different your access and perspective is when you are having the first cup of tea versus the second cup of tea.  And always try to get to the second cup of tea before leaving the field.

I’m often asked if it is really possible to do ‘real’ ethnography while working within the kinds of timelines that working in business contexts require.   That conversation will be saved for another blog post, but for now I will say that it is often possible to get to the second cup of tea pretty quickly if you are a skilled ethnographer.  In fact, I’m often at two cups of tea within the first few hours of spending time with someone.  You would be really surprised how much rapport and intimacy can be built when someone realizes that you really ARE interested in their story.

Keeping our balance in a world of rapid change: Lessons from ‘Fiddler on the Roof’

March 5, 2012 Leave a comment

 

When I used to teach introduction to sociology and sociology of marriage and family, I always had my classes watch the movie “Fiddler on the Roof”.  It was a great way to bring to life many of the sociological concepts that we were learning in class. In that one movie, there are probably more than 100 sociological lessons, and the music is pretty fantastic too.

My favorite part of the whole movie is the opening sequence.  The main character, Tevye, asks and answers the question:  “How do we keep our balance?”  “That I can tell you in one word.”  “Tradition.”  “Here in Anatevka, we have traditions for everything.”  “How to sleep, how to eat, how to work, how to wear clothes.”  “You may ask, ‘how did this tradition get started?’’  “I’ll tell you. . . .I don’t know”  “But it’s a tradition, and because of our traditions, every one of us knows who he is, and what God expects him to do.”

Truer words were never spoken, and in my line of work, I see Tevye’s observation in action all the time.   We could easily replace the word ‘tradition’ with the word ‘norm.’  No matter who the person, or what the context, behavior and ideas are driven and ruled by norms.  And this is the case, long after we have forgotten (or perhaps even before we have learned) the reason for the norm.  Norms are powerful forces that let each of us know who we are and what is expected of us.  The number and diversity of norms that each person follows every day is staggering.

My job as an ethnographer is to try to get a handle on the norms driving the thing I’m hired to understand.  Whether it is how people cook dinner or how one reacts to being diagnosed with a chronic disease, norms are ever present in determining how people think and behave.  There are often well-established patterns in how things are done and even in how people think about and place value upon things, so many norms are obvious and often slap us in the face as soon as we spend a little time watching and listening.  However, other norms are a little more subtle, and the patterns are not always so obvious until we see someone doing it differently or spend some time in analysis, really breaking down and organizing observations.

But the thing is, even the most obvious norms are often not so obvious unless you train yourself to look for them.  Although we all follow cultural norms each day, for the most part, we do it on automatic pilot. The classic sociological example used to bring this concept to life is to ask people to think about what they do when they enter an elevator.  There are some very rigid rules for behavior on elevators.  You must face the front, go to the alternate corner if someone else is already on the elevator, keep conversation to a minimum, etc.  Most of us do not remember reading a manual on elevator etiquette, but very few people ever violate these norms.  And why do you think that is?  T-R-A-D-I-T-I-O-N!

I learned a lot about the power of tradition a few years ago when I was in the Philippines studying how moms took care of their babies.  I had spent the afternoon with a young mom (who also happened to be a biologist) and her one-year old son.  We had spent a lot of our time talking about what was important to her as a mother, and how she made decisions about how to care for her son. She told me that she was very modern, but her own mother was very old-fashioned, and this often caused conflict when they were negotiating how her son was to be cared for.  One of the things that they didn’t agree on was whether he should be seen by a pediatrician or a traditional healer when he was ill.    My participant told me that because she was a scientist, she knew that modern medicine was based on scientific principals and that traditional medicine was based on superstitions and that she didn’t put much stock in superstitions.

I had been playing with the little boy, but after a few hours, it was time for me to leave, and when I walked out the door, the little boy started to cry.  Because I’m a Western mom, I thought I should walk away as quickly as possible because I had been taught the ‘get out of sight, and you will be out of mind’ approach to dealing with crying children.    As I rounded the corner, the mom came running after me and explained that she needed me to come back to her house.  She told me that her son was very upset and she was concerned that he would get sick, so she needed me to place some of my saliva on her son’s tummy.  Saliva from the offending person was the antidote to ward off potential illness.  I of course obliged and then said goodbye again.

At first I thought maybe I had misunderstood the conversation with the mom and her seemed rejection of traditional practices and beliefs.  But after seeing some other mothers, I realized there was a pattern when it came to western versus traditional medicine and that these norms were interlocked with rapid change and younger women’s desires to be more ‘modern.’  This all resulted in a complicated system of ideals, values, and behaviors that actually contained several seeming contradictions.   In a nutshell, times were a-changing BUT many of the behavioral norms were lagging behind the changes in ideals.  And so it turned out that the mother who seemed to WANT to reject traditional medicine, but who didn’t want to take a chance on her son getting ill, wasn’t unusual and wasn’t really a contradiction once the puzzle was put together and the power of TRADITION was factored in.