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Looking Sharp and Taking Notes:observation and note-taking in the fieldpresented by Joe Wasserman
Step 1: Jot BrieflyYou can’t capture everything that you observe.Focus on the interesting things.It’s better to have more detail about one event than scarce detail about many.If you write constantly, you can’t observe context.Make shorthand notes (include keywords) that will jog your memory later.Leave extra space in your fieldnotes to fill in more detail soon (Step 2).
Things to Listen ForNaturally occurring descriptions“Teaching” or “orienting”Discussion/evaluation of an event you observed or a text that is interpretedStoriesExplanations and theories
Things to Watch ForBody language, facial expressionsInteractions (between people, between systems, etc.)Movement, where things happenWhat do things look like, sound like, smell like?Describe the environment
Context creates full understandingWho, what, where, when, how:How clinicians use the system (not just a list of features).Who: Communication, interaction, and social relations between people.What kinds of data are entered, accessible through the system, and used for CDS.How using the EHR intersects with communication and workflow.When a physician gets paged.Not only what people say, but how they say it (e.g. framing, body language, attitude) and to whom.
Step 2: Add DetailsUse down-time during the day to fill in your brief, shorthand fieldnotes with detail enough to elaborate them into rich descriptions later (Step 3).
Step 3: Expand Brief Fieldnotes into Rich Descriptive NarrativesElaborate your brief notes and initial observations into richnarrativedescriptions that make the reader feel like they are there.Write full sentences that anyone can understand.Create a descriptive narrative.Add additional details and description that you can remember from your observations that you were unable to capture while taking notes at the time.
When to write up?You won’t be able to creative a cohesive narrative of your observations if you put it off, so expand upon and type up fieldnotes before going to sleep the same day.Finish write up at the latest by the next morning (if not before bed), before doing more observations.Type your fieldnotes as soon as possible, ideally within 24 hours.Add enough detail throughout the day (Step 2) to make typing up your fieldnotes into detailed descriptions more productive.
Distinguish observation from interpretationYour fieldnotes should emphasize observation over interpretation.
Ask yourself how you know something to distinguish interpretation from observation.
Example: ‘The client was hostile.’ vs. ‘When Judy…told the client that she could not just do whatever she wanted to do, the client began to yell, screaming that Judy couldn’t control her life and then told her to go to hell. The client stomped out of the room and Judy was standing there with her mouth open, looking amazed.’Adapted from Patton 2002:304Make clear how you know something. Did you see it? Were you told it?
Include things that observers said and did to which participants responded and reacted (e.g. questions).If a passage is unclear, we can’t use it for analysisClearly distinguish observations from interpretations and expectations in a way that others can understand.Use square brackets and your initials to mark your interpretations and expectations.Example: [JW: interpretive comment]Only use “quotation marks” to mark verbatim quotes.

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Fieldnote Workshop

  • 1. Looking Sharp and Taking Notes:observation and note-taking in the fieldpresented by Joe Wasserman
  • 2. Step 1: Jot BrieflyYou can’t capture everything that you observe.Focus on the interesting things.It’s better to have more detail about one event than scarce detail about many.If you write constantly, you can’t observe context.Make shorthand notes (include keywords) that will jog your memory later.Leave extra space in your fieldnotes to fill in more detail soon (Step 2).
  • 3. Things to Listen ForNaturally occurring descriptions“Teaching” or “orienting”Discussion/evaluation of an event you observed or a text that is interpretedStoriesExplanations and theories
  • 4. Things to Watch ForBody language, facial expressionsInteractions (between people, between systems, etc.)Movement, where things happenWhat do things look like, sound like, smell like?Describe the environment
  • 5. Context creates full understandingWho, what, where, when, how:How clinicians use the system (not just a list of features).Who: Communication, interaction, and social relations between people.What kinds of data are entered, accessible through the system, and used for CDS.How using the EHR intersects with communication and workflow.When a physician gets paged.Not only what people say, but how they say it (e.g. framing, body language, attitude) and to whom.
  • 6. Step 2: Add DetailsUse down-time during the day to fill in your brief, shorthand fieldnotes with detail enough to elaborate them into rich descriptions later (Step 3).
  • 7. Step 3: Expand Brief Fieldnotes into Rich Descriptive NarrativesElaborate your brief notes and initial observations into richnarrativedescriptions that make the reader feel like they are there.Write full sentences that anyone can understand.Create a descriptive narrative.Add additional details and description that you can remember from your observations that you were unable to capture while taking notes at the time.
  • 8. When to write up?You won’t be able to creative a cohesive narrative of your observations if you put it off, so expand upon and type up fieldnotes before going to sleep the same day.Finish write up at the latest by the next morning (if not before bed), before doing more observations.Type your fieldnotes as soon as possible, ideally within 24 hours.Add enough detail throughout the day (Step 2) to make typing up your fieldnotes into detailed descriptions more productive.
  • 9. Distinguish observation from interpretationYour fieldnotes should emphasize observation over interpretation.
  • 10. Ask yourself how you know something to distinguish interpretation from observation.
  • 11. Example: ‘The client was hostile.’ vs. ‘When Judy…told the client that she could not just do whatever she wanted to do, the client began to yell, screaming that Judy couldn’t control her life and then told her to go to hell. The client stomped out of the room and Judy was standing there with her mouth open, looking amazed.’Adapted from Patton 2002:304Make clear how you know something. Did you see it? Were you told it?
  • 12. Include things that observers said and did to which participants responded and reacted (e.g. questions).If a passage is unclear, we can’t use it for analysisClearly distinguish observations from interpretations and expectations in a way that others can understand.Use square brackets and your initials to mark your interpretations and expectations.Example: [JW: interpretive comment]Only use “quotation marks” to mark verbatim quotes.
  • 13. Careful description avoids ethnocentrismEthnocentrism (using one culture to interpret another)Privileging one viewpoint in the scene (example: patient is ‘non-compliant’ or ‘in denial’)Dismissing insider meaning (example: clinicians ‘are wrong’ about how the system works)Evaluating deviations from ‘the ideal’ (example: what seem like poor treatment decisions)A priori theoretical categories driving data collection & interpretation“Both questions and answers should be discovered from informants.” (Spradley 1979:84)
  • 14. SummaryTake brief notes and jot keywords in the field to jog your memory later.Add details throughout the day.Include context: who, what, where, when, and how!Expand and type fieldnotes into rich, descriptive narratives as soon as possible.Clearly [bracket interpretations] and “quote verbatim quotations.”Focus on observations, not interpretations.Include yourself: how you know something and how you interact with participants.