focused interview in qualitative research

Chapter 12. Focus Groups

Introduction.

Focus groups are a particular and special form of interviewing in which the interview asks focused questions of a group of persons, optimally between five and eight. This group can be close friends, family members, or complete strangers. They can have a lot in common or nothing in common. Unlike one-on-one interviews, which can probe deeply, focus group questions are narrowly tailored (“focused”) to a particular topic and issue and, with notable exceptions, operate at the shallow end of inquiry. For example, market researchers use focus groups to find out why groups of people choose one brand of product over another. Because focus groups are often used for commercial purposes, they sometimes have a bit of a stigma among researchers. This is unfortunate, as the focus group is a helpful addition to the qualitative researcher’s toolkit. Focus groups explicitly use group interaction to assist in the data collection. They are particularly useful as supplements to one-on-one interviews or in data triangulation. They are sometimes used to initiate areas of inquiry for later data collection methods. This chapter describes the main forms of focus groups, lays out some key differences among those forms, and provides guidance on how to manage focus group interviews.

Focus Groups: What Are They and When to Use Them

As interviews, focus groups can be helpfully distinguished from one-on-one interviews. The purpose of conducting a focus group is not to expand the number of people one interviews: the focus group is a different entity entirely. The focus is on the group and its interactions and evaluations rather than on the individuals in that group. If you want to know how individuals understand their lives and their individual experiences, it is best to ask them individually. If you want to find out how a group forms a collective opinion about something (whether a product or an event or an experience), then conducting a focus group is preferable. The power of focus groups resides in their being both focused and oriented to the group . They are best used when you are interested in the shared meanings of a group or how people discuss a topic publicly or when you want to observe the social formation of evaluations. The interaction of the group members is an asset in this method of data collection. If your questions would not benefit from group interaction, this is a good indicator that you should probably use individual interviews (chapter 11). Avoid using focus groups when you are interested in personal information or strive to uncover deeply buried beliefs or personal narratives. In general, you want to avoid using focus groups when the subject matter is polarizing, as people are less likely to be honest in a group setting. There are a few exceptions, such as when you are conducting focus groups with people who are not strangers and/or you are attempting to probe deeply into group beliefs and evaluations. But caution is warranted in these cases. [1]

As with interviewing in general, there are many forms of focus groups. Focus groups are widely used by nonresearchers, so it is important to distinguish these uses from the research focus group. Businesses routinely employ marketing focus groups to test out products or campaigns. Jury consultants employ “mock” jury focus groups, testing out legal case strategies in advance of actual trials. Organizations of various kinds use focus group interviews for program evaluation (e.g., to gauge the effectiveness of a diversity training workshop). The research focus group has many similarities with all these uses but is specifically tailored to a research (rather than applied) interest. The line between application and research use can be blurry, however. To take the case of evaluating the effectiveness of a diversity training workshop, the same interviewer may be conducting focus group interviews both to provide specific actionable feedback for the workshop leaders (this is the application aspect) and to learn more about how people respond to diversity training (an interesting research question with theoretically generalizable results).

When forming a focus group, there are two different strategies for inclusion. Diversity focus groups include people with diverse perspectives and experiences. This helps the researcher identify commonalities across this diversity and/or note interactions across differences. What kind of diversity to capture depends on the research question, but care should be taken to ensure that those participating are not set up for attack from other participants. This is why many warn against diversity focus groups, especially around politically sensitive topics. The other strategy is to build a convergence focus group , which includes people with similar perspectives and experiences. These are particularly helpful for identifying shared patterns and group consensus. The important thing is to closely consider who will be invited to participate and what the composition of the group will be in advance. Some review of sampling techniques (see chapter 5) may be helpful here.

Moderating a focus group can be a challenge (more on this below). For this reason, confining your group to no more than eight participants is recommended. You probably want at least four persons to capture group interaction. Fewer than four participants can also make it more difficult for participants to remain (relatively) anonymous—there is less of a group in which to hide. There are exceptions to these recommendations. You might want to conduct a focus group with a naturally occurring group, as in the case of a family of three, a social club of ten, or a program of fifteen. When the persons know one another, the problems of too few for anonymity don’t apply, and although ten to fifteen can be unwieldy to manage, there are strategies to make this possible. If you really are interested in this group’s dynamic (not just a set of random strangers’ dynamic), then you will want to include all its members or as many as are willing and able to participate.

There are many benefits to conducting focus groups, the first of which is their interactivity. Participants can make comparisons, can elaborate on what has been voiced by another, and can even check one another, leading to real-time reevaluations. This last benefit is one reason they are sometimes employed specifically for consciousness raising or building group cohesion. This form of data collection has an activist application when done carefully and appropriately. It can be fun, especially for the participants. Additionally, what does not come up in a focus group, especially when expected by the researcher, can be very illuminating.

Many of these benefits do incur costs, however. The multiplicity of voices in a good focus group interview can be overwhelming both to moderate and later to transcribe. Because of the focused nature, deep probing is not possible (or desirable). You might only get superficial thinking or what people are willing to put out there publicly. If that is what you are interested in, good. If you want deeper insight, you probably will not get that here. Relatedly, extreme views are often suppressed, and marginal viewpoints are unspoken or, if spoken, derided. You will get the majority group consensus and very little of minority viewpoints. Because people will be engaged with one another, there is the possibility of cut-off sentences, making it even more likely to hear broad brush themes and not detailed specifics. There really is very little opportunity for specific follow-up questions to individuals. Reading over a transcript, you may be frustrated by avenues of inquiry that were foreclosed early.

Some people expect that conducting focus groups is an efficient form of data collection. After all, you get to hear from eight people instead of just one in the same amount of time! But this is a serious misunderstanding. What you hear in a focus group is one single group interview or discussion. It is not the same thing at all as conducting eight single one-hour interviews. Each focus group counts as “one.” Most likely, you will need to conduct several focus groups, and you can design these as comparisons to one another. For example, the American Sociological Association (ASA) Task Force on First-Generation and Working-Class Persons in Sociology began its study of the impact of class in sociology by conducting five separate focus groups with different groups of sociologists: graduate students, faculty (in general), community college faculty, faculty of color, and a racially diverse group of students and faculty. Even though the total number of participants was close to forty, the “number” of cases was five. It is highly recommended that when employing focus groups, you plan on composing more than one and at least three. This allows you to take note of and potentially discount findings from a group with idiosyncratic dynamics, such as where a particularly dominant personality silences all other voices. In other words, putting all your eggs into a single focus group basket is not a good idea.

How to Conduct a Focus Group Interview/Discussion

Advance preparations.

Once you have selected your focus groups and set a date and time, there are a few things you will want to plan out before meeting.

As with interviews, you begin by creating an interview (or discussion) guide. Where a good one-on-one interview guide should include ten to twelve main topics with possible prompts and follow-ups (see the example provided in chapter 11), the focus group guide should be more narrowly tailored to a single focus or topic area. For example, a focus might be “How students coped with online learning during the pandemic,” and a series of possible questions would be drafted that would help prod participants to think about and discuss this topic. These questions or discussion prompts can be creative and may include stimulus materials (watching a video or hearing a story) or posing hypotheticals. For example, Cech ( 2021 ) has a great hypothetical, asking what a fictional character should do: keep his boring job in computers or follow his passion and open a restaurant. You can ask a focus group this question and see what results—how the group comes to define a “good job,” what questions they ask about the hypothetical (How boring is his job really? Does he hate getting up in the morning, or is it more of an everyday tedium? What kind of financial support will he have if he quits? Does he even know how to run a restaurant?), and how they reach a consensus or create clear patterns of disagreement are all interesting findings that can be generated through this technique.

As with the above example (“What should Joe do?”), it is best to keep the questions you ask simple and easily understood by everyone. Thinking about the sequence of the questions/prompts is important, just as it is in conducting any interviews.

Avoid embarrassing questions. Always leave an out for the “I have a friend who X” response rather than pushing people to divulge personal information. Asking “How do you think students coped?” is better than “How did you cope?” Chances are, some participants will begin talking about themselves without you directly asking them to do so, but allowing impersonal responses here is good. The group itself will determine how deep and how personal it wants to go. This is not the time or place to push anyone out of their comfort zone!

Of course, people have different levels of comfort talking publicly about certain topics. You will have provided detailed information to your focus group participants beforehand and secured consent. But even so, the conversation may take a turn that makes someone uncomfortable. Be on the lookout for this, and remind everyone of their ability to opt out—to stay silent or to leave if necessary. Rather than call attention to anyone in this way, you also want to let everyone know they are free to walk around—to get up and get coffee (more on this below) or use the restroom or just step out of the room to take a call. Of course, you don’t really want anyone to do any of these things, and chances are everyone will stay seated during the hour, but you should leave this “out” for those who need it.

Have copies of consent forms and any supplemental questionnaire (e.g., demographic information) you are using prepared in advance. Ask a friend or colleague to assist you on the day of the focus group. They can be responsible for making sure the recording equipment is functioning and may even take some notes on body language while you are moderating the discussion. Order food (coffee or snacks) for the group. This is important! Having refreshments will be appreciated by your participants and really damps down the anxiety level. Bring name tags and pens. Find a quiet welcoming space to convene. Often this is a classroom where you move chairs into a circle, but public libraries often have meeting rooms that are ideal places for community members to meet. Be sure that the space allows for food.

Researcher Note

When I was designing my research plan for studying activist groups, I consulted one of the best qualitative researchers I knew, my late friend Raphael Ezekiel, author of The Racist Mind . He looked at my plan to hand people demographic surveys at the end of the meetings I planned to observe and said, “This methodology is missing one crucial thing.” “What?” I asked breathlessly, anticipating some technical insider tip. “Chocolate!” he answered. “They’ll be tired, ready to leave when you ask them to fill something out. Offer an incentive, and they will stick around.” It worked! As the meetings began to wind down, I would whip some bags of chocolate candies out of my bag. Everyone would stare, and I’d say they were my thank-you gift to anyone who filled out my survey. Once I learned to include some sugar-free candies for diabetics, my typical response rate was 100 percent. (And it gave me an additional class-culture data point by noticing who chose which brand; sure enough, Lindt balls went faster at majority professional-middle-class groups, and Hershey’s minibars went faster at majority working-class groups.)

—Betsy Leondar-Wright, author of Missing Class , coauthor of The Color of Wealth , associate professor of sociology at Lasell University, and coordinator of staffing at the Mission Project for Class Action

During the Focus Group

As people arrive, greet them warmly, and make sure you get a signed consent form (if not in advance). If you are using name tags, ask them to fill one out and wear it. Let them get food and find a seat and do a little chatting, as they might wish. Once seated, many focus group moderators begin with a relevant icebreaker. This could be simple introductions that have some meaning or connection to the focus. In the case of the ASA task force focus groups discussed above, we asked people to introduce themselves and where they were working/studying (“Hi, I’m Allison, and I am a professor at Oregon State University”). You will also want to introduce yourself and the study in simple terms. They’ve already read the consent form, but you would be surprised at how many people ignore the details there or don’t remember them. Briefly talking about the study and then letting people ask any follow-up questions lays a good foundation for a successful discussion, as it reminds everyone what the point of the event is.

Focus groups should convene for between forty-five and ninety minutes. Of course, you must tell the participants the time you have chosen in advance, and you must promptly end at the time allotted. Do not make anyone nervous by extending the time. Let them know at the outset that you will adhere to this timeline. This should reduce the nervous checking of phones and watches and wall clocks as the end time draws near.

Set ground rules and expectations for the group discussion. My preference is to begin with a general question and let whoever wants to answer it do so, but other moderators expect each person to answer most questions. Explain how much cross-talk you will permit (or encourage). Again, my preference is to allow the group to pick up the ball and run with it, so I will sometimes keep my head purposefully down so that they engage with one another rather than me, but I have seen other moderators take a much more engaged position. Just be clear at the outset about what your expectations are. You may or may not want to explain how the group should deal with those who would dominate the conversation. Sometimes, simply stating at the outset that all voices should be heard is enough to create a more egalitarian discourse. Other times, you will have to actively step in to manage (moderate) the exchange to allow more voices to be heard. Finally, let people know they are free to get up to get more coffee or leave the room as they need (if you are OK with this). You may ask people to refrain from using their phones during the duration of the discussion. That is up to you too.

Either before or after the introductions (your call), begin recording the discussion with their collective permission and knowledge . If you have brought a friend or colleague to assist you (as you should), have them attend to the recording. Explain the role of your colleague to the group (e.g., they will monitor the recording and will take short notes throughout to help you when you read the transcript later; they will be a silent observer).

Once the focus group gets going, it may be difficult to keep up. You will need to make a lot of quick decisions during the discussion about whether to intervene or let it go unguided. Only you really care about the research question or topic, so only you will really know when the discussion is truly off topic. However you handle this, keep your “participation” to a minimum. According to Lune and Berg ( 2018:95 ), the moderator’s voice should show up in the transcript no more than 10 percent of the time. By the way, you should also ask your research assistant to take special note of the “intensity” of the conversation, as this may be lost in a transcript. If there are people looking overly excited or tapping their feet with impatience or nodding their heads in unison, you want some record of this for future analysis.

I’m not sure why this stuck with me, but I thought it would be interesting to share. When I was reviewing my plan for conducting focus groups with one of my committee members, he suggested that I give the participants their gift cards first. The incentive for participating in the study was a gift card of their choice, and typical processes dictate that participants must complete the study in order to receive their gift card. However, my committee member (who is Native himself) suggested I give it at the beginning. As a qualitative researcher, you build trust with the people you engage with. You are asking them to share their stories with you, their intimate moments, their vulnerabilities, their time. Not to mention that Native people are familiar with being academia’s subjects of interest with little to no benefit to be returned to them. To show my appreciation, one of the things I could do was to give their gifts at the beginning, regardless of whether or not they completed participating.

—Susanna Y. Park, PhD, mixed-methods researcher in public health and author of “How Native Women Seek Support as Survivors of Intimate Partner Violence: A Mixed-Methods Study”

After the Focus Group

Your “data” will be either fieldnotes taken during the focus group or, more desirably, transcripts of the recorded exchange. If you do not have permission to record the focus group discussion, make sure you take very clear notes during the exchange and then spend a few hours afterward filling them in as much as possible, creating a rich memo to yourself about what you saw and heard and experienced, including any notes about body language and interactions. Ideally, however, you will have recorded the discussion. It is still a good idea to spend some time immediately after the conclusion of the discussion to write a memo to yourself with all the things that may not make it into the written record (e.g., body language and interactions). This is also a good time to journal about or create a memo with your initial researcher reactions to what you saw, noting anything of particular interest that you want to come back to later on (e.g., “It was interesting that no one thought Joe should quit his job, but in the other focus group, half of the group did. I wonder if this has something to do with the fact that all the participants were first-generation college students. I should pay attention to class background here.”).

Please thank each of your participants in a follow-up email or text. Let them know you appreciated their time and invite follow-up questions or comments.

One of the difficult things about focus group transcripts is keeping speakers distinct. Eventually, you are going to be using pseudonyms for any publication, but for now, you probably want to know who said what. You can assign speaker numbers (“Speaker 1,” “Speaker 2”) and connect those identifications with particular demographic information in a separate document. Remember to clearly separate actual identifications (as with consent forms) to prevent breaches of anonymity. If you cannot identify a speaker when transcribing, you can write, “Unidentified Speaker.” Once you have your transcript(s) and memos and fieldnotes, you can begin analyzing the data (chapters 18 and 19).

Advanced: Focus Groups on Sensitive Topics

Throughout this chapter, I have recommended against raising sensitive topics in focus group discussions. As an introvert myself, I find the idea of discussing personal topics in a group disturbing, and I tend to avoid conducting these kinds of focus groups. And yet I have actually participated in focus groups that do discuss personal information and consequently have been of great value to me as a participant (and researcher) because of this. There are even some researchers who believe this is the best use of focus groups ( de Oliveira 2011 ). For example, Jordan et al. ( 2007 ) argue that focus groups should be considered most useful for illuminating locally sanctioned ways of talking about sensitive issues. So although I do not recommend the beginning qualitative researcher dive into deep waters before they can swim, this section will provide some guidelines for conducting focus groups on sensitive topics. To my mind, these are a minimum set of guidelines to follow when dealing with sensitive topics.

First, be transparent about the place of sensitive topics in your focus group. If the whole point of your focus group is to discuss something sensitive, such as how women gain support after traumatic sexual assault events, make this abundantly clear in your consent form and recruiting materials. It is never appropriate to blindside participants with sensitive or threatening topics .

Second, create a confidentiality form (figure 12.2) for each participant to sign. These forms carry no legal weight, but they do create an expectation of confidentiality for group members.

In order to respect the privacy of all participants in [insert name of study here], all parties are asked to read and sign the statement below. If you have any reason not to sign, please discuss this with [insert your name], the researcher of this study, I, ________________________, agree to maintain the confidentiality of the information discussed by all participants and researchers during the focus group discussion.

Signature: _____________________________ Date: _____________________

Researcher’s Signature:___________________ Date:______________________

Figure 12.2 Confidentiality Agreement of Focus Group Participants

Third, provide abundant space for opting out of the discussion. Participants are, of course, always permitted to refrain from answering a question or to ask for the recording to be stopped. It is important that focus group members know they have these rights during the group discussion as well. And if you see a person who is looking uncomfortable or like they want to hide, you need to step in affirmatively and remind everyone of these rights.

Finally, if things go “off the rails,” permit yourself the ability to end the focus group. Debrief with each member as necessary.

Further Readings

Barbour, Rosaline. 2018. Doing Focus Groups . 2nd ed. Thousand Oaks, CA: SAGE. Written by a medical sociologist based in the UK, this is a good how-to guide for conducting focus groups.

Gibson, Faith. 2007. “Conducting Focus Groups with Children and Young People: Strategies for Success.” Journal of Research in Nursing 12(5):473–483. As the title suggests, this article discusses both methodological and practical concerns when conducting focus groups with children and young people and offers some tips and strategies for doing so effectively.

Hopkins, Peter E. 2007. “Thinking Critically and Creatively about Focus Groups.” Area 39(4):528–535. Written from the perspective of critical/human geography, Hopkins draws on examples from his own work conducting focus groups with Muslim men. Useful for thinking about positionality.

Jordan, Joanne, Una Lynch, Marianne Moutray, Marie-Therese O’Hagan, Jean Orr, Sandra Peake, and John Power. 2007. “Using Focus Groups to Research Sensitive Issues: Insights from Group Interviews on Nursing in the Northern Ireland ‘Troubles.’” International Journal of Qualitative Methods 6(4), 1–19. A great example of using focus groups productively around emotional or sensitive topics. The authors suggest that focus groups should be considered most useful for illuminating locally sanctioned ways of talking about sensitive issues.

Merton, Robert K., Marjorie Fiske, and Patricia L. Kendall. 1956. The Focused Interview: A Manual of Problems and Procedures . New York: Free Press. This is one of the first classic texts on conducting interviews, including an entire chapter devoted to the “group interview” (chapter 6).

Morgan, David L. 1986. “Focus Groups.” Annual Review of Sociology 22:129–152. An excellent sociological review of the use of focus groups, comparing and contrasting to both surveys and interviews, with some suggestions for improving their use and developing greater rigor when utilizing them.

de Oliveira, Dorca Lucia. 2011. “The Use of Focus Groups to Investigate Sensitive Topics: An Example Taken from Research on Adolescent Girls’ Perceptions about Sexual Risks.” Cien Saude Colet 16(7):3093–3102. Another example of discussing sensitive topics in focus groups. Here, the author explores using focus groups with teenage girls to discuss AIDS, risk, and sexuality as a matter of public health interest.

Peek, Lori, and Alice Fothergill. 2009. “Using Focus Groups: Lessons from Studying Daycare Centers, 9/11, and Hurricane Katrina.” Qualitative Research 9(1):31–59. An examination of the efficacy and value of focus groups by comparing three separate projects: a study of teachers, parents, and children at two urban daycare centers; a study of the responses of second-generation Muslim Americans to the events of September 11; and a collaborative project on the experiences of children and youth following Hurricane Katrina. Throughout, the authors stress the strength of focus groups with marginalized, stigmatized, or vulnerable individuals.

Wilson, Valerie. 1997. “Focus Groups: A Useful Qualitative Method for Educational Research?” British Educational Research Journal 23(2):209–224. A basic description of how focus groups work using an example from a study intended to inform initiatives in health education and promotion in Scotland.

• Note that I have included a few examples of conducting focus groups with sensitive issues in the “ Further Readings ” section and have included an “ Advanced: Focus Groups on Sensitive Topics ” section on this area. ↵

A focus group interview is an interview with a small group of people on a specific topic.  “The power of focus groups resides in their being focused” (Patton 2002:388).  These are sometimes framed as “discussions” rather than interviews, with a discussion “moderator.”  Alternatively, the focus group is “a form of data collection whereby the researcher convenes a small group of people having similar attributes, experiences, or ‘focus’ and leads the group in a nondirective manner.  The objective is to surface the perspectives of the people in the group with as minimal influence by the researcher as possible” (Yin 2016:336).  See also diversity focus group and convergence focus group.

A form of focus group construction in which people with diverse perspectives and experiences are chosen for inclusion.  This helps the researcher identify commonalities across this diversity and/or note interactions across differences.  Contrast with a convergence focus group

A form of focus group construction in which people with similar perspectives and experiences are included.  These are particularly helpful for identifying shared patterns and group consensus.  Contrast with a diversity focus group .

Introduction to Qualitative Research Methods Copyright © 2023 by Allison Hurst is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License , except where otherwise noted.

An official website of the United States government

Official websites use .gov A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS A lock ( Lock Locked padlock icon ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

• Publications
• Account settings
• Advanced Search
• Journal List

Zooming into Focus Groups: Strategies for Qualitative Research in the Era of Social Distancing

Lekshmi santhosh, juan c rojas, patrick g lyons.

• Author information
• Article notes
• Copyright and License information

Correspondence and requests for reprints should be addressed to Patrick G. Lyons, M.D., M.Sc., Division of Pulmonary and Critical Care Medicine, John T. Milliken Department of Medicine, Washington University School of Medicine, 4523 Clayton Ave, CB 8052, St. Louis, MO 63110. E-mail: [email protected] .

These authors contributed equally to this work.

Corresponding author.

Received 2020 Sep 11; Accepted 2020 Dec 1; Collection date 2021 Jun.

This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ). For commercial usage and reprints, please contact Diane Gern ( [email protected] ).

Qualitative research methods are important and have become increasingly prominent in medical education and research. The reason is simple: many pressing questions in these fields require qualitative approaches to elicit nuanced insights and additional meaning beyond standard quantitative measurements in surveys or observatons. Among the most common qualitative data collection methods are structured or semistructured in-person interviews and focus groups, in which participants describe their experiences relevant to the research question at hand. In the era of physical and social distancing because of the novel coronavirus disease (COVID-19) pandemic, little guidance exists for strategies for conducting focus groups or semistructured interviews. Here we describe our experience with, and recommendations for, conducting remote focus groups and/or interviews in the era of social distancing. Specifically, we discuss best practice recommendations for researchers using video teleconferencing programs to continue qualitative research during the COVID-19 pandemic.

Keywords: qualitative research, videoconferencing, social distancing

Qualitative research focuses on exploring individuals’ perspectives related to specific research questions, issues, or activities ( 1 ). Frequently, structured interviews or focus groups are tools employed for data collection for qualitative research. In-person interviews are ideal, although phone and digital alternatives may be considered ( 2 , 3 ). However, little guidance exists for strategies for conducting focus groups or semistructured interviews in the era of physical and social distancing with the coronavirus disease (COVID-19) pandemic. In this article, we describe some strategies for conducting focus groups or structured interviews with the use of video conferencing platforms ( Figure 1 ). Video conferencing may provide researchers and research participants with a convenient and safe alternative to in-person qualitative research, albeit with some important limitations and considerations.

Key strategies to ensure successful remote focus groups and interviews. IRB = institutional review board.

Throughout 2019, we collaborated on a series of stakeholder focus groups to explore clinician experiences with patient handoffs between the intensive care unit and the wards. These focus groups, conducted in-person at our respective academic medical centers, helped us delineate key strengths and “pain points” of our handoff processes and identify facilitators and barriers to the user-centered design and implementation of a new process ( 4 ). We had scheduled subsequent in-person focus groups for this iterative design and testing process to take place in Spring 2020. However, we were forced to recalibrate our plans based on the rapidly changing COVID-19 situation and the situations of our intended participants (internal medicine residents). This article provides some practical guidance and reflections based on our experiences conducting semistructured focus groups using a videoconference platform with internal medicine residents at three academic medical centers. We outline our recommendations by describing the process of these remote focus groups, from planning and recruitment to the execution and technical troubleshooting of the videoconference.

Setting the Stage

More than ever, healthcare professionals are overtaxed because of increased clinical responsibilities; new or altered clinical environments and workflows; and increased burdens of administrative, educational, and investigatory work conducted by phone, e-mail, and video conference ( 5 – 7 ). Because of the school and childcare facility closures, many healthcare professionals may be engaged in nonclinical work while simultaneously caring for their children or supervising remote learning ( 8 ). With this in mind, we recommend that researchers carefully consider the timing of planned focus groups or interviews to maximize participation and minimize the strain on potential participants. Whenever possible, researchers should seek input on optimal timing and duration from potential participants.

The flexibility of video conferencing may potentially allow researchers to recruit participants by eliminating transportation and transit time barriers and allows for increased flexibility to consider scheduling focus groups or interviews at nontraditional times to accommodate the participants’ schedules.

Overall, we recommend that focus groups are conducted over video rather than audio if unable to be done in-person. Audio-only experiences are inherently more challenging than remote video sessions; it is difficult to tell when participants are speaking but muted, to identify an individual speaker among many participants, and to interpret tone and body language. In addition, audio-only encounters often limit crosstalk, which can enhance the depth of responses. We acknowledge that video is less private than audio, but it may be more private than in-person (e.g., a participant may decline to enroll in an in-person interview or group around a sensitive topic if they do not wish to be seen physically entering or exiting a known research room). Consent must specify whether audio alone is being recorded, or whether video and audio are both recorded.

Most importantly, before recruitment and consent, researchers should identify which video teleconferencing platform (e.g., Zoom, Google Meet, or Microsoft Teams) is best suited for the project ( Table 1 ); because these platforms share many of the same capabilities (e.g., screencasting/sharing and audio recording), this decision may be based on institutional adoption or availability.

Overview of several common videoconferencing platforms

Definition of abbreviation : HIPAA = Health Insurance Portability and Accountability Act.

Recruitment and Consent

Although some local institutional review board (IRB) procedures may have changed in response to COVID-19, qualitative research projects with human participants still require IRB review for determination of exempt status or formal approval. Researchers should obtain IRB approval to record the audio from the focus group or structured interview if a recording is desired.

Recruitment is likely to be predominantly virtual, in the form of e-mail “blasts” describing the study and providing the information needed for informed consent. After completing recruitment and selecting a video conferencing platform for the proposed research, we recommend providing attendees a password-protected electronic invitation to ensure the privacy of the session. In addition, it is helpful when this invitation includes an attached electronic calendar “event,” which can allow potential participants to quickly cross reference their electronic calendars, which are increasingly full of virtual meetings. Gray and colleagues found that participants wanted to synchronize these invitations with their electronic calendars and preferred the interview be limited to 1 hour at most, to avoid fatigue and schedule disruption ( 9 ). Zoom and other similar platforms offer a straightforward option for participants to add the session to their personal electronic calendars automatically. We recommend this method of invitation to increase convenience for participants who are increasingly accustomed to daily schedules of virtual meetings.

As with in-person focus groups, there is likely to be a “U-shaped” relationship between the number of participants and the volume and depth of insights gained within a session; too few participants may prevent dialogue and limit progress toward thematic saturation or uncovering new insights, whereas too many participants will preclude opportunities for deeper follow-up and will limit the amount of time that any single participant may contribute. Most commonly available videoconference platforms permit audience sizes of 50 or more, which far exceeds the number of participants a typical focus group would contain.

Presession Technical Preparation

It is crucial that researchers familiarize themselves with the interface and options of their chosen videoconference platform, both to maximize the effectiveness of their session facilitation and to improve their ability to solve common technical difficulties that may arise. This preparation should take place on the computing device that the researcher intends to use for research sessions to ensure that video, audio volume, and internet speed are adequate to host a successful video conference meeting. We recommend recording a practice session to become familiar with recording logistics and file storage locations, and to ensure the device’s microphone records clearly enough for participants’ hearing and transcription. Beyond the opportunity to troubleshoot the virtual platform, this practice session may also serve the second purpose of familiarizing the facilitator with the discussion questions.

Of note, researchers should evaluate the adequacy of their devices’ storage capabilities, given the large file sizes required to record audio and video. Many universities provide network storage solutions to members of their academic community, which may help facilitate storing large files. Importantly, if the research participants are patients, any recorded data (i.e., audio, video, and transcripts) are considered protected health information. These data require additional privacy considerations, especially around storage and electronic transfer. Because commercial video chat platforms may host or store files on their servers, the research team should ensure, ahead of time, that any commercial video chat platform used for research meets both the Health Insurance Portability and Accountability Act and institutional standards for secure data storage.

After successful completion of the trial run as a host, we recommend contacting the study participants before the session to ensure that any technical questions or concerns are addressed.

Introducing the Session

Initializing a virtual meeting is, in many ways, similar to initializing an in-person meeting. Like physical meetings, attendees may “trickle in” late because of preceding scheduled events or technical difficulties. We recommend allowing 1–5 minutes at the session’s beginning to account for late arrivals and to address technical issues if any are apparent. Once individuals are in the meeting, the facilitator can “lock” the session so uninvited attendees do not “Zoom-bomb.” In addition, researchers can further protect their meeting by using a Waiting Room, if available. Videoconference waiting rooms are virtual staging areas, which prevents attendees from joining a meeting until permitted, either individually or in a group, to enter. The facilitator should introduce the focus group or structured interviews just as they would an in-person session, including assurances regarding confidentiality, an overview of the session’s objectives, and an explicit statement of the session’s ground rules. The facilitator should obtain permission to record the focus group or structured interview and provide attendees the opportunity to leave the meeting if they do not consent to the recording. Finally, we recommend that researchers consider using a visual cue on a shared slide to remind them to initiate recording before beginning the session’s questions. Ideally, having two individuals record the meeting helps ensure redundancy so that if one individual has recording issues, the copy is preserved.

Depending on the size of the focus group or structured interview, the facilitator may wish to describe, at the meeting’s beginning, how attendee opinions will be solicited. For example, focus group participants can “unmute” themselves to speak or use the “raise hand” function on the meeting service. We recommend discouraging the use of the “chat” function because chat box contents are not recorded unless explicitly read aloud. If attendees do type in the chat box during the session, we recommend that the facilitator read the chat box contents aloud to capture these insights in the recording and transcript. Last, consider asking attendees to share their video feeds so participants and leaders can view attendee facial expressions and identify visual cues when individuals are about to speak (or are speaking, but are inadvertently muted). However, we recognize that this recommendation could limit participation by attendees without video-capable devices and/or put undue stress or burden on attendees who may be simultaneously parenting or multitasking. Above all, researchers should encourage attendees to make choices that will maximize their comfort with the session, and thus, maximize their contributions to the discussion.

During the Session

In general, remote qualitative inquiry sessions should follow a structure similar to that of face-to-face sessions. The facilitator should use effective moderation techniques online just as they would in-person. We have found that having an additional research team member serve as a scribe and timekeeper is helpful, if available. This teammate could also serve as a backup host if the primary host has unresolvable technical issues. Facilitators guiding semistructured interviews should ask follow-up probing questions and avoid sharing their own opinion, asking closed or leading questions, and other missteps that contribute to bias.

Within these general guidelines, however, the research team should be cognizant of the ways in which remote interactions differ from a live discussion. For instance, participants may be either more (e.g., because of additional perceived anonymity) or less (e.g., because of multitasking) likely to interact on videoconference, which may require proactive facilitation (e.g., direction questions or probes to individual participants). Similarly, a proactive facilitator may wish to be particularly attentive for openings to ask probing or follow-up questions, as some data suggest that online qualitative inquiry provides less opportunity for probing and follow-up ( 10 ). Furthermore, microphone technology is likely to preclude the degree of crosstalk seen in many face-to-face focus groups, which could limit the depth and quality of dialogue elicited. This lack of crosstalk may inhibit the ability to develop social norms, which are often a key factor distinguishing focus groups from individual structured interviews. It is not known whether facilitator behaviors or factors like focus group size can modify these limitations, although certain characteristics of focus group questions (e.g., open-ended) appear to yield richer discussion and data ( 10 ). Finally, if an audio-only focus group is the only option, we suggest using a visual model (e.g., a map or list of participants) to remind the facilitator of focus group participants, so notes can be transcribed visually under each participant.

Researchers should consider the need to maintain the privacy and potential anonymity of all participants, as outlined in the project’s IRB protocol. This consideration should also include any potential protected health information if the participants are patients. If strict anonymity is required, avoid stating participants’ names during the recording. If deidentification during transcription or review is appropriate, using the names of participants may increase the connection between the facilitator and the respondent, allowing for greater psychological safety.

After the Session

Concluding a virtual interview or focus group is similar to concluding an in-person session of the same type. The researchers should thank participants for their time, particularly given the stressors of the pandemic. In addition, we recommend discussing criteria for possible follow-up discussions. After ending the recording, ensure the file is saved to a secure location. Use professional transcription software to transcribe the audio recording from the focus group. Analyze the data with the qualitative framework outlined in the study design stage.

Because qualitative analysis of remote interviews and focus groups is typically conducted on transcribed audio, the decision to use a video platform often has little impact on data analysis. However, in some situations, the recorded video may prove advantageous. For example, the inclusion of video might facilitate the differentiation of speakers or clarification of unclear words during transcription or transcript reviews. Similarly, video might provide context around pauses, hand gestures, or facial expressions. Whether remote sessions have the same Hawthorne-esque effect on participants (i.e., do they behave in a particular way because of their awareness of being observed) is unknown. For instance, it is possible that participants behave differently when observed on video as compared with an audio-only (e.g., telephone) experience, or as compared with an in person session. One implication of this possibility could involve the perceived acceptability of multitasking or split attention; not infrequently, video participants elect not to share their individual video feeds.

Common Pitfalls and Strategies for Success

Qualitative interviews and focus groups, regardless of the setting, are subject to certain pitfalls along with a project’s progression from research question to analysis and dissemination. For instance, suboptimal recruitment practices (e.g., lack of advertisement) may limit enrollment, whereas incomplete or rushed interview scripts may not elicit complete or nuanced insights from participants. For remote interviews or focus groups, distance and technology may present additional obstacles (or interact with known risks), which can threaten a project’s success ( Table 2 ). Overall, the virtual qualitative experience offers a tradeoff between participant availability and an increased number of potential distractions. Whether these potential threats to qualitative insight are worth access to participants who might be unable to attend face-to-face sessions is likely to vary across research questions and teams of investigators. In general, these pitfalls can be avoided or mitigated with careful preplanning, practice sessions, and deliberate attention to areas of risk.

Potential remote focus group pitfalls and related strategies for success

Definition of abbreviation s: IRB = institutional review board; HIPAA = Health Insurance Portability and Accountability Act.

Conclusions

We hope that these practical tips can help with conducting rigorous qualitative inquiry through remote focus groups or structured interviews in the era of physical and social distancing.

Supplementary Material

Supported by an APCCMPD, CHEST, and ATS Education Research Award (L.S.).

Author Contributions : Conception and design: P.G.L. Drafting of the article: L.S., J.C.R., and P.G.L. Critical revision of the article for important intellectual content: L.S., J.C.R., and P.G.L. Final approval of the article: L.S., J.C.R., and P.G.L. Administrative, technical, or logistic support: P.G.L.

Author disclosures are available with the text of this article at www.atsjournals.org .

• 1. Teherani A, Martimianakis T, Stenfors-Hayes T, Wadhwa A, Varpio L. Choosing a qualitative research approach. J Grad Med Educ. 2015;7:669–670. doi: 10.4300/JGME-D-15-00414.1. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 2. Gill P, Baillie J. Interviews and focus groups in qualitative research: an update for the digital age. Br Dent J. 2018;225:668–672. doi: 10.1038/sj.bdj.2018.815. [ DOI ] [ PubMed ] [ Google Scholar ]
• 3. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19:349–357. doi: 10.1093/intqhc/mzm042. [ DOI ] [ PubMed ] [ Google Scholar ]
• 4. Rojas J, Lyons P, Garcia B, Thomashow M, Santhosh L. Design thinking to create user-centered intensive care unit-ward handoffs at three academic hospitals. Am J Respir Crit Care Med. 2020;201:A1401. [ Google Scholar ]
• 5. Mahul-Mellier AL. Screams on a Zoom call: the theory of homeworking with kids meets reality. Nature. doi: 10.1038/d41586-020-01296-7. [online ahead of print] 1 May 2020; DOI: 10.1038/d41586-020-01296-7. [ DOI ] [ PubMed ] [ Google Scholar ]
• 6. Morawo A, Sun C, Lowden M. Enhancing engagement during live virtual learning using interactive quizzes. Med Educ. 2020;54:1188. doi: 10.1111/medu.14253. [ DOI ] [ PubMed ] [ Google Scholar ]
• 7. Sasangohar F, Jones SL, Masud FN, Vahidy FS, Kash BA. Provider burnout and fatigue during the COVID-19 pandemic: lessons learned from a high-volume intensive care unit. Anesth Analg. 2020;131:106–111. doi: 10.1213/ANE.0000000000004866. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 8. Gabster BP, van Daalen K, Dhatt R, Barry M. Challenges for the female academic during the COVID-19 pandemic. Lancet. 2020;395:1968–1970. doi: 10.1016/S0140-6736(20)31412-4. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 9. Gray LM, Wong-Wylie G, Rempel GR, Cook K. Expanding qualitative research interviewing strategies: Zoom video communications. Qual Rep. 2020;25:1292–1301. [ Google Scholar ]
• 10. Davies L, LeClair KL, Bagley P, Blunt H, Hinton L, Ryan S, et al. Face-to-face compared with online collected accounts of health and illness experiences: a scoping review. Qual Health Res. 2020;30:2092–2102. doi: 10.1177/1049732320935835. [ DOI ] [ PubMed ] [ Google Scholar ]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

• View on publisher site
• PDF (690.2 KB)
• Collections

Similar articles

Cited by other articles, links to ncbi databases.

• Download .nbib .nbib
• Format: AMA APA MLA NLM

Add to Collections