describe what questions each approach tries to answer and the methods used to investigate memory.

Abstract

Introduction

As a research methodology, phenomenology is uniquely positioned to help health professions education (HPE) scholars learn from the experiences of others. Phenomenology is a form of qualitative enquiry that focuses on the report of an individual's lived experiences within the world. Although information technology is a powerful arroyo for enquiry, the nature of this methodology is often intimidating to HPE researchers. This article aims to explain phenomenology past reviewing the key philosophical and methodological differences between two of the major approaches to phenomenology: transcendental and hermeneutic. Agreement the ontological and epistemological assumptions underpinning these approaches is essential for successfully conducting phenomenological enquiry.

Purpose

This review provides an introduction to phenomenology and demonstrates how it can be practical to HPE research. We illustrate the two main sub-types of phenomenology and item their ontological, epistemological, and methodological differences.

Conclusions

Phenomenology is a powerful enquiry strategy that is well suited for exploring challenging issues in HPE. Past building a better understanding of the nature of phenomenology and working to ensure proper alignment between the specific research question and the researcher's underlying philosophy, we hope to encourage HPE scholars to consider its utility when addressing their research questions.

A Qualitative Infinite highlights research approaches that push readers and scholars deeper into qualitative methods and methodologies. Contributors to A Qualitative Infinite may: advance new ideas virtually qualitative methodologies, methods, and/or techniques; debate current and historical trends in qualitative research; arts and crafts and share nuanced reflections on how data collection methods should be revised or modified; reflect on the epistemological bases of qualitative enquiry; or fence that some qualitative practices should terminate. Share your thoughts on Twitter using the hashtag: #aqualspace

Introduction

Human beings, who are nigh unique in having the ability to learn from the experience of others, are also remarkable for their credible disinclination to do so.—Douglas Adams

Despite the fact that humans are one of few animals who tin larn from the experiences of others, we are often loath to do so. Perhaps this is considering we assume that like circumstances could never befall us. Perhaps this is because we presume that, if placed in the same situation, we would make wiser decisions. Perhaps it is because nosotros presume the subjective experience of an individual is non as reliably informative as objective information collected from external reality. Regardless of the assumptions grounding this apprehension, information technology is essential for scholars to acquire from the experiences of others. In fact, it is a foundational premise of research. Inquiry involves the detailed study of a subject field (i. eastward., an individual, groups of individuals, societies, or objects) to observe information or to achieve a new understanding of the subject [ane]. Such detailed study often requires understanding the experiences of others so that we can glean new insights nearly a item phenomenon. Scholars in health professions education (HPE) are savvy to the need to learn from the experiences of others. To maximize the effectiveness of feedback, of workplace-based learning, of clinical reasoning, or of any other of a myriad of phenomena, HPE researchers demand to be able to carefully explore and learn from the experiences of others. What oft curtails these efforts is a lack of methodology. In other words: HPE researchers need to know how to learn from the experiences of others.

Phenomenology is a qualitative enquiry approach that is uniquely positioned to support this enquiry. Nevertheless, equally an approach for engaging in HPE research, phenomenology does not take a stiff post-obit. It is piece of cake to run into why: To truly understand phenomenology requires developing an appreciation for the philosophies that underpin information technology. Those philosophies theorize the pregnant of human being experience. In other words, engaging in phenomenological research requires the scholar to become familiar with the philosophical moorings of our interpretations of human experience. This may exist a daunting task, just Douglas Adams never said learning from the experiences of others would be easy.

The questions that phenomenology can reply, and the insights this kind of research tin provide, are of foundational importance to HPE: What is the experience of shame and the touch of that experience for medical learners [2]? What does information technology hateful to be an empathetic clinician [3]? What is the medical learner'due south experience of failure on high stakes exams [4]? How do experienced clinicians learn to communicate their clinical reasoning in professional person practice [5]? Answers to such questions plant the underpinnings of our field. To answer such questions, we can use phenomenology to learn from the experiences of others.

In this manuscript, we delve into the philosophies and methodologies of two varieties of phenomenology: hermeneutic and transcendental. Our goal is not to simplify the complexities of phenomenology, nor to argue that all HPE researchers should use phenomenology. Instead, we advise that phenomenology is a valuable approach to inquiry that needs to have a place in HPE'southward body of research. We will place these two approaches in the context of their philosophical roots to illustrate the similarities and differences betwixt these means of engaging in phenomenological research. In so doing, we hope to encourage HPE researchers to thoughtfully engage in phenomenology when their research questions necessitate this enquiry approach.

What is phenomenology?

In simple terms, phenomenology can be defined equally an approach to research that seeks to describe the essence of a miracle by exploring it from the perspective of those who have experienced information technology [half-dozen]. The goal of phenomenology is to describe the meaning of this experience—both in terms of what was experienced and how information technology was experienced [half dozen]. There are different kinds of phenomenology, each rooted in different means of conceiving of the what and how of human experience. In other words, each approach of phenomenology is rooted in a different schoolhouse of philosophy. To choose a phenomenological research methodology requires the scholar to reverberate on the philosophy they cover. Given that there are many different philosophies that a scientist can encompass, it is non surprising that there is broad set of phenomenological traditions that a researcher can draw from. In this manuscript, we highlight the transcendental and the hermeneutic approaches to phenomenology, but a broader phenomenological mural exists. For instance, the Encyclopedia of Phenomenology, published in 1997, features articles on seven dissimilar types of phenomenology [7]. More than gimmicky traditions take besides been adult that bridge the transcendental/hermeneutic divide. Several of these traditions are detailed in Tab. 1 [8,ix,10].

Tabular array 1 Clarification of three contemporary approaches to phenomenology

Full size table

To empathize whatever of these approaches to phenomenology, it is useful to remember that most approaches hold a similar definition of phenomenology's object of study. Phenomenology is unremarkably described as the written report of phenomena equally they manifest in our experience, of the way we perceive and sympathise phenomena, and of the pregnant phenomena have in our subjective experience [11]. More simply stated, phenomenology is the report of an individual's lived experience of the world [12]. By examining an feel every bit it is subjectively lived, new meanings and appreciations tin be developed to inform, or even re-orient, how we understand that experience [13].

From this shared understanding, we now address how transcendental (descriptive) phenomenology and hermeneutic (interpretive) phenomenology approach this study in unlike ways. These approaches are summarized in Tab. 2.

Table 2 Comparing of transcendental and hermeneutic phenomenology

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Transcendental phenomenology

Phenomenology originates in philosophical traditions that evolved over centuries; however, most historians credit Edmund Husserl for defining phenomenology in the early on 20th century [14]. Agreement some of Husserl'southward academic history tin can provide insight into his transcendental approach to phenomenology. Husserl's initial work focused on mathematics equally the object of study [15], but then moved to examine other phenomena. Husserl's approach to philosophy sought to equally value both objective and subjective experiences, with his body of piece of work 'culminating in his interest in "pure phenomenology" or working to find a universal foundation of philosophy and science [13].' Husserl rejected positivism's absolute focus on objective observations of external reality, and instead argued that phenomena every bit perceived by the individual'south consciousness should exist the object of scientific study. Thus, Husserl contended that no assumptions should inform phenomenology's inquiry; no philosophical or scientific theory, no deductive logic procedures, and no other empirical scientific discipline or psychological speculations should inform the inquiry. Instead, the focus should be on what is given directly to an individual's intuition [16]. As Staiti recently argued, this attitude towards phenomenology is alike to that of 'a natural scientist who has simply discovered a previously unknown dimension of reality [17].' This shift in focus requires the researcher to render 'to the self to discover the nature and pregnant of things [eighteen].' As Husserl asserted: 'Ultimately, all 18-carat and, in particular, all scientific knowledge, rests on inner evidence [19].' Inner prove—that is, what appears in consciousness—is where a phenomenon is to be studied. What this means for Husserl is that subjective and objective noesis are intimately intertwined. To understand the reality of a phenomenon is to understand the miracle as it is lived by a person. This lived experience is, for Husserl, a dimension of being that had yet to be discovered [17]. For Husserl, phenomenology was rooted in an epistemological attitude; for him, the critical question of a phenomenological investigation was 'What is it for an individual to know or to exist witting of a miracle [twenty]?' In Husserl's conception of phenomenology, any experienced phenomenon could be the object of written report thereby pushing assay beyond mere sensory perception (i. e. what I see, hear, bear upon) to experiences of thought, retentiveness, imagination, or emotion [21].

Husserl contended that a lived experience of a phenomenon had features that were normally perceived by individuals who had experienced the phenomenon. These ordinarily perceived features—or universal essences—can be identified to develop a generalizable description. The essences of a phenomenon, according to Husserl, represented the true nature of that miracle. The claiming facing the researcher engaging in Husserl'south phenomenology, so, is:

To describe things in themselves, to permit what is earlier ane to enter consciousness and be understood in its meanings and essences in the light of intuition and self-reflection. The process involves a blending of what is actually nowadays with what is imagined as present from the vantage bespeak of possible meanings; thus, a unity of the real and the ideal [18].

In other words, the challenge is to engage in the study of a person's lived experience of a phenomenon that highlights the universal essences of that phenomenon [22]. This requires the researcher to suspend his/her own attitudes, beliefs, and suppositions in society to focus on the participants' experience of the phenomenon and identify the essences of the miracle. I of Husserl'south great contributions to philosophy and scientific discipline is the method he adult that enables researchers 'to suspend the natural mental attitude as well as the naïve understanding of what nosotros call the human mind and to disclose the realm of transcendental subjectivity as a new field of inquiry [17].'

In Husserl's' transcendental phenomenology (likewise sometimes referred to equally the descriptive approach), the researcher's goal is to accomplish transcendental subjectivity—a country wherein 'the impact of the researcher on the enquiry is constantly assessed and biases and preconceptions neutralized, so that they exercise not influence the object of study [22].' The researcher is to stand autonomously, and not allow his/her subjectivity to inform the descriptions offered by the participants. This lived dimension of experience is best approached by the researcher who can achieve the land of the transcendental I—a land wherein the objective researcher moves from the participants' descriptions of facts of the lived experience, to universal essences of the phenomenon at which point consciousness itself could exist grasped [23]. In the state of the transcendental I, the researcher is able to access the participants' experience of the phenomenon pre-reflectively—that is 'without resorting to categorization on conceptualization, and quite oftentimes includes what is taken for granted or those things that are common sense [13].' The transcendental I brings no definitions, expectations, assumption or hypotheses to the study; instead, in this state, the researcher assumes the position of atabula rasa, a blank slate, that uses participants' experiences to develop an agreement of the essence of a phenomenon.

This state is accomplished via a series of reductions. The first reduction, referred to as the transcendental stage, requires transcendence from the natural attitude of everyday life through epoche, also chosen the procedure of bracketing. This is the process through which the researchers set aside—or bracket off as one would in a mathematical equation—previous understandings, past knowledge, and assumptions near the phenomenon of interest. The previous understandings that must be set aside include a broad range of sources including: scientific theories, knowledge, or explanation; truth or falsity of claims made by participants; and personal views and experiences of the researcher [24]. In the 2d phase, transcendental-phenomenological reduction, each participant's experience is considered individually and a complete description of the phenomenon'southward meanings and essences is synthetic [eighteen]. Next is reduction via imaginative variation wherein all the participants' descriptions of conscious experience are distilled to a unified synthesis of essences through the process of free variation [25]. This process relies on intuition and requires imagining multiple variations of the phenomenon in lodge to arrive at the essences of the miracle [25]. These essences get the foundation for all cognition most the miracle.

The specific processes followed to realize these reductions vary across researchers engaging in transcendental phenomenology. Ane unremarkably used transcendental phenomenological method is that of psychologist Clark Moustakas, and other approaches include the works of: Colaizzi [26], Giorgi [27], and Polkinghorne [28]. Regardless of the approach used, to engage rigorously in transcendental phenomenology, the researcher must exist vigilant in his/her bracketing work so that the researcher'due south individual subjectivity does not bias data analysis and interpretations. This is the challenge of reaching the state of the transcendental I where the researcher's own interpretations, perceptions, categories, etc. do not influence the processes of reduction. It is important to notation that modernistic philosophers continue to wrestle with Husserl's notions of bracketing. If bracketing is successfully achieved, the researcher sets aside the world and the entirety of its content—including the researcher'southward physical torso [17]. While dedication to this bracketing is challenging to maintain, Husserl asserts that it is necessary. Suspending reliance on and foundations in physical reality is the only mode to abandon our human experiences in such a way as to find the transcendent I. Researchers might infringe [29] practices from other qualitative research methods to attain this goal. For instance, a study could be designed to have multiple researchers triangulate [thirty] their reductions to confirm appropriate bracketing was maintained. Alternatively, a study could involve validation of information [eighteen] via member checking [31] to ensure that the identified essences resonated with the participants' experiences.

Husserl'due south transcendental phenomenology has been employed by HPE researchers. For case, in 2012, Tavakol et al. studied medical students' understanding of empathy by engaging in transcendental phenomenological research [32]. The authors note that medial students' loss of empathy equally they transition from pre-clinical to clinical training is well documented in the medical literature [33], and has been establish to negatively affect patients and the quality of healthcare provided [34]. Tavakol et al. [32] used a descriptive phenomenological approach (i. east. using the methodology of Colaizzi and Giorgi) to report on the phenomenon of empathy every bit experienced past medical students during the course of their training. The authors identified ii cardinal factors impacting empathic ability: innate capacity for empathy and barriers to displaying empathy [32].

Hermeneutic phenomenology

Hermeneutic phenomenology, also known as interpretive phenomenology, originates from the work of Martin Heidegger. Heidegger began his career in theology, but and then moved into academia equally a student of philosophy. While Heidegger's philosophical research began in alignment with Husserl'southward work, he later challenged several primal aspects of Husserl'due south transcendental phenomenology. A foundational break from his predecessor was the focus of phenomenological enquiry. While Husserl was interested in the nature of knowledge (i. e., an epistemological focus), Heidegger was interested in the nature of being and temporality (i. eastward., an ontological focus) [21]. With this focus on human experience and how information technology is lived, hermeneutic phenomenology moves abroad from Husserl's focus on 'acts of attending, perceiving, recalling and thinking well-nigh the world [13]' and on man beings as knowers of phenomenon. In contrast, Heidegger is interested in human beings as actors in the world and and so focuses on the relationship between an individual and his/her lifeworld. Heidegger'due south term lifeworld referred to the idea that 'individuals' realities are invariably influenced by the world in which they alive [22].' Given this orientation, individuals are understood as always already having an agreement of themselves within the world, even if they are not constantly, explicitly and/or consciously aware of that understanding [17]. For Heidegger, an individual's witting feel of a miracle is not split up from the globe, nor from the individual's personal history. Consciousness is, instead, a formation of historically lived experiences including a person'southward individual history and the culture in which he/she was raised [22]. An individual cannot pace out of his/her lifeworld. Humans cannot experience a phenomenon without referring back to his/her background understandings. Hermeneutic phenomenology, then, seeks 'to understand the deeper layers of human experience that lay obscured beneath surface awareness and how the individual's lifeworld, or the world equally he or she pre-reflectively experiences it, influences this experience [35].' Hermeneutic phenomenology studies individuals' narratives to understand what those individuals experience in their daily lives, in their lifeworlds.

But the hermeneutic tradition pushes beyond a descriptive understanding. Hermeneutic phenomenology is rooted in interpretation—interpreting experiences and phenomena via the private'due south lifeworld. Here, Heidegger's background in theology tin can be seen every bit influencing his approach to phenomenology. Hermeneutics refers to the interpretation of texts, to theories developed from the demand to translate literature from unlike languages and where access to the original text (e. g., the Bible) was problematic [36]. If all man experience is informed by the individual's lifeworld, and if all experiences must exist interpreted through that background, hermeneutic phenomenology must go beyond description of the phenomenon, to the interpretation of the phenomenon. The researcher must be aware of the influence of the private'due south background and account for the influences they exert on the individual's experience of being.

This is not to say that the individual'south subjective experience—which is inextricably linked with social, cultural, and political contexts—is pre-determined. Heidegger argued that individuals have situated freedom. Situated freedom is a concept that asserts that 'individuals are free to brand choices, only their freedom is not accented; it is confining past the specific conditions of their daily lives [22].' Hermeneutic phenomenology studies the meanings of an individual's beingness in the world, as their experience is interpreted through his/her lifeworld, and how these meanings and interpretations influence the choices that the individual makes [13]. This focus requires the hermeneutic phenomenologist to interpret the narratives provided by research participants in relation to their private contexts in guild to illuminate the fundamental structures of participants' understanding of being and how that shaped the decisions made by the private [37].

Another key aspect that distinguishes hermeneutic phenomenology is the part of the researcher in the inquiry. Instead of bracketing off the researcher's subjective perspective, hermeneutic phenomenology recognizes that the researcher, like the research subject, cannot be rid of his/her lifeworld. Instead, the researcher's past experiences and knowledge are valuable guides to the enquiry. It is the researcher's education and knowledge base of operations that lead him/her to consider a miracle or experience worthy of investigation. To ask the enquiry to take an unbiased approach to the information is inconsistent with hermeneutic phenomenology's philosophical roots. Instead, researchers working from this tradition should openly acknowledge their preconceptions, and reflect on how their subjectivity is part of the analysis procedure [16].

The interpretive work of hermeneutic phenomenology is not bound to a single set of rule-bound analytical techniques; instead, it is an interpretive process involving the interplay of multiple analysis activities [35]. In general, this procedure:

Starts with identifying an interesting phenomenon that directs our attending towards lived experience. Members of the research team so investigate experience equally it is lived, rather than as it is conceptualized, and reflect on the essential [phenomenological] themes that narrate the participant'due south experience with the miracle, simultaneously reflecting on their own experiences. Researchers capture their reflections in writing and and then reflect and write again, creating continuous, iterative cycles to develop increasingly robust and nuanced analyses. Throughout the analysis, researchers must maintain a strong orientation to the phenomenon under report (i.east., avoid distractions) and attend to the interactions betwixt the parts and the whole. This final step, also described as the hermeneutic circle, emphasizes the practice of deliberately because how the data (the parts) contribute to the evolving understanding of the phenomena (the whole) and how each enhances the meaning of the other [35].

In the hermeneutic approach to phenomenology, theories can help to focus inquiry, to brand decisions about inquiry participants, and the style research questions can be addressed [22]. Theories can also exist used to assist understand the findings of the report. One scholar whose date with hermeneutic phenomenology is widely respected is Max van Manen [38]. Van Manen acknowledges that hermeneutic phenomenology 'does not allow itself be deceptively reduced to a methodical schema or an interpretative prepare of procedures [39].' Instead, this kind of phenomenology requires the researcher to read deeply into the philosophies of this tradition to grasp the project of hermeneutic phenomenological thinking, reading, and writing.

A recent study published by Bynum et al. illustrates how hermeneutic phenomenology may be employed in HPE [2]. In this paper, Bynum et al. explored the phenomenon of shame as an emotion experienced by medical residents and offer insights into the effects of shame experiences on learners. As a means in scholarly research, this study demonstrates how hermeneutic phenomenology can provide insight into complex phenomena that are inextricably entwined in HPE.

Conclusion

Incorporating phenomenological research methodologies into HPE scholarship creates opportunities to learn from the experiences of others. Phenomenological inquiry can broaden our understanding of the complex phenomena involved in learning, behaviour, and communication that are germane to our field. But success in these efforts is dependent upon both improved awareness of the potential value of these approaches, and enhanced familiarization with the underlying philosophical orientation and methodological approaches of phenomenology. Perhaps near critically, HPE scholars must construct research processes that align with the tenets of the methodology chosen and the philosophical roots that underlie it. This alignment is the cornerstone for establishing inquiry rigour and trustworthiness.

Following a specific checklist of verification activities or mandatory processes cannot beacon the quality and rigour of a particular phenomenological study. Instead, beyond maintaining fidelity between research question, paradigm, and selected methodology, robust phenomenological inquiry involves deep date with the data via reading, reflective writing, re-reading and re-writing. In Moustakas's approach to transcendental phenomenology, the researcher reads the data, reduces the data to meaning units, re-reads those reductions to and then engage in thematic clustering, compares the information, writes descriptions, and so on in an ongoing process of continually engaging with the data and writing reflections and summaries until the researcher can describe the essence of the lived feel [18]. In hermeneutic phenomenology, scholars describe engaging in a hermeneutic circumvolve wherein the researcher reads the data, constructs a vague agreement, engages in reflective writing, then re-engages with the text with revised understandings [twoscore]. In cycles of reading and writing, of attention to the whole of the text and the parts, the hermeneutic researcher constructs an understanding of the lived feel. In both traditions, deep date with the data via reading, writing, re-reading and re-writing is foundational. While this engagement work is not standardized, Polkinghorne suggests that rich descriptions of phenomenological research might be characterized by qualities such every bit vividness, richness, accuracy, and elegance [41]. While we question how these qualities might be evaluated in a qualitative study, they ostend that attention to the depth of appointment in reading and writing of the phenomenological data is a necessary condition for rigour.

Phenomenology is a valuable tool and research strategy. For those who are not familiar with its philosophical underpinnings or methodological application, it can seem challenging to apply to HPE scholarship. We hope this manuscript will serve to relieve some of the anticipation in considering the use of phenomenology in future piece of work. We believe that the advisable application of phenomenology to HPE's enquiry questions volition help us to advance our understanding by learning from the experiences of others.

Disclaimer

The views expressed herein are those of the authors and do not necessarily reflect those of the Uniformed Services Academy of the Wellness Sciences, the Usa Department of Defence or other federal agencies.

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Funding

Intramural Grant, Uniformed Services University

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Affiliations

1. Department of Medicine, Uniformed Services University, Bethesda, MD, USA

   Brian E. Neubauer & Lara Varpio

2. Full general Internal Medicine Service, Walter Reed National Military Medical Center, Bethesda, MD, United states of america

   Brian E. Neubauer

3. Department of Preventative Medicine and Biostatistics, Uniformed Services Medical Center, Bethesda, Physician, The states

   Catherine T. Witkop

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Correspondence to Brian East. Neubauer.

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Neubauer, B.Eastward., Witkop, C.T. & Varpio, L. How phenomenology can aid us learn from the experiences of others. Perspect Med Educ 8, 90–97 (2019). https://doi.org/ten.1007/s40037-019-0509-two

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• Published: 05 Apr 2019

• Issue Date: April 2019

• DOI : https://doi.org/10.1007/s40037-019-0509-two

Keywords

• Transcendental phenomenology
• Hermeneutic phenomenology
• Qualitative

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