Medical students' perceptions of their development of 'soft skills' Part I : A qualitative research methodology

Background Following the introduction of a new, integrated, problem-oriented undergraduate medical curriculum at the University of Pretoria (UP) in 1997, a research project was undertaken to study interpersonal skills, professional attitudes, teamwork, ethics and related topics - which have come to be known collectively as 'soft skills'. This contribution is the first of two articles on the professional socialisation of medical students and their development of 'soft skills'. It describes the particular qualitative methodology developed for, and applied to, the study of soft skills among medical students at UP. Methods This paper describes the aim of the study, reasons for adopting a qualitative research approach to achieve this aim, the theoretical orientation underpinning the qualitative approach that we considered most suitable, the design, the sampling, the data management and analysis, and the methods that we deployed to ensure the credibility of the findings. Research Design The aim of the study was to explore the subjective meanings that students attributed to soft skills, as they understood them. These subjective meanings involve the way students interact meaningfully with fellow students, lecturers and other individuals participating in the medical and clinical education programme, and the way they construct shared conceptualisations of soft skills and medical education in their lives and social world. A qualitative approach was considered most appropriate, as this study set out to uncover subjective and diverse meanings that do not necessarily amount to generalisable truths. The particular qualitative strategy or design used was that of an extended case study, or 'casing', within the modernist theoretical orientation of symbolic interactionism. Elements of process evaluation were incorporated into the design to account for the process of curriculum reform within which this study was embedded. We recruited participants for this study from two cohorts of students. The first group, who completed their studies in 2001, had followed the traditional curriculum, while the second group, who completed their programme in 2002, had followed the reformed curriculum. The data collection tools were face-to-face individual interviews, focused group interviews and solicited autobiographical sketches. The utilisation of more than one method or data source enabled triangulation or cross-checking of findings. We followed an inductive reasoning approach, which means that we did not search for data to test any hypotheses that had been formulated prior to commencing the study, but focused instead on building constructs that were grounded in or reflected intimate familiarity with the students'world. Conclusion The modernist qualitative research approach enabled us to uncover, describe and illuminate the subjective points of view on soft skills as expressed by final-year medical students before and after curriculum reform. More specifically, by carrying out an extended case study we were able to perform a process evaluation of the curriculum reform in terms of soft skills and the professional socialisation of the students. This paper outlines how qualitative research methods enabled us to capture and explore aspects of the inner life (social worlds) of these students. Whether they would be the same, similar or different in another setting are questions for further exploration or research - questions prompted by our study in a manner that illuminates the qualities that may be inherent in these subjective meanings.