Ethnography and Participant Observation
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Ethnography and participant observation are derived from the field of anthropology, where the goal is to understand the larger cultural system through observer immersion. The degree of immersion can vary, as can some of the data collection methods, but the overall strategy includes interacting with all aspects of the context. Usually ethnography requires considerable time, multiple observations, interviews, and living and working in the situation if possible. It also includes reading historical documents, exploring artifacts in current use (e.g., memos and minutes), and generally striving to understand a community. These methods are particularly useful in a clinical setting, where understanding the culture is essential.50,59
Less intensive ethnographic methods are also possible and reasonable for health IT evaluations. Focused ethnography is a method of observing actions in a particular context. For example, nurses were observed during patient care handoffs and their interactions with electronic health records were recorded. From these observations, design implications for handoff forms were derived.60,61