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Why NVivo Is the Leading Choice for Qualitative Data Analysis Among Researchers
Qualitative data analysis can be a daunting task, especially when dealing with large sets of data. This is where NVivo comes in handy. NVivo is a software package designed to assist researchers in analyzing qualitative data. In this article, we will discuss why NVivo is the leading choice for qualitative data analysis among researchers.
What is NVivo?
NVivo is a software tool developed by QSR International that helps researchers organize and analyze their qualitative data. The software provides a range of features and tools that assist researchers in managing complex data sets, including text, audio, video, and images.
Features of NVivo
One of the key features of NVivo is its ability to handle different types of data formats. The software can handle text-based documents such as emails, interviews, focus group transcripts, and surveys. It also supports multimedia files such as videos and audio recordings.
Another feature that makes NVivo stand out is its coding capabilities. The software allows users to code their data using different methods such as thematic or content analysis. This feature streamlines the process of identifying patterns or themes within the data set.
NVivo also has advanced search capabilities that allow users to search for specific keywords or phrases within their data set quickly. Additionally, it has visualization tools that enable users to create graphs and charts to present their findings visually.
Benefits of Using NVivo
The benefits of using NVivo are numerous. Firstly, it saves time by automating many aspects of the research process; this includes transcribing audio recordings and coding text-based documents.
Secondly, it increases accuracy by reducing errors associated with manual transcription or coding processes; this means that researchers can trust their results more confidently.
Thirdly, it enables collaboration between team members working on a project from different locations; this feature allows individuals to work on the same project simultaneously, increasing productivity.
Lastly, NVivo provides a range of support resources. This includes online tutorials, webinars, and user forums that connect users with other researchers who use the software.
In conclusion, NVivo is an essential tool for researchers looking to analyze qualitative data. Its features and capabilities make it the leading choice for handling complex data sets across a range of disciplines. The benefits of using NVivo include increased accuracy, time-saving automation, collaboration capabilities, and access to support resources. With NVivo, researchers can analyze their data more efficiently and effectively than ever before.
This text was generated using a large language model, and select text has been reviewed and moderated for purposes such as readability.
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- Results & Discussion
Q: How is the conclusion drawn in qualitative research?

Asked by Bill Sheehan on 09 Jul, 2020
Hello Bill – Welcome to the forum!
Straight away, when you say ‘how is the conclusion drawn,’ we trust it means ‘how you reach the conclusion’ rather than ‘how you write the conclusion.’
The first would depend on the findings of the study and how astutely you analyze them. This in turn would depend on how well you have designed the study, carefully inspected the results, and avoided bias to as much extent as possible. For insights into these aspects, you may refer to these resources:
- What are the possible problems that may be encountered in Qualitative Research?
- How can I evaluate qualitative data from different sources consistently and stringently without becoming too subjective and making too many assumptions?
- 7 Biases to avoid in qualitative research
The second meaning – that of ‘writing’ – is simpler, but of course, needs to come from the conclusion(s) you have drawn.
Having said that, the conclusion of a qualitative study can at times be quite detailed. This would depend on the complexity of the study. A questionnaire about likes and dislikes is simpler to score, interpret, and infer than a focus group, interview, or case study. In the case of a simpler study, you may reiterate the key findings of the study in the conclusion. In the case of a more complex study, which involves deeper analysis and may have some (if not significant) margin of error, you will also need to talk about the limitations and implications of the study.
The limitations may be in the area of methodology, participant response, or data collection. While you may have employed a methodology that seemed robust before starting the study, after the study, you may see opportunities for improvement, which you could include in the conclusion.
In quali research, it becomes especially important to talk about implications as you may not be able to draw some/any conclusions with a significant amount of surety. In these cases, you could talk about what the findings seem to suggest and what further studies they could lead to. Quali studies often tend to build on the previous one. [To see just how detailed the conclusion can get, you may refer to this part-documentation of a study .]
Finally, note that the conclusions are usually written in the Discussion section, but at times, can be a separate section (after the Discussion).
For more insights and information on writing the conclusion, you may refer to these resources:
- Is it okay not to have conclusion but only implication in qualitative research?
- What is meant by relevance to clinical practice?
- How to write the most effective results and discussion sections [Course]
Hope that helps. All the best for wrapping up – and then submitting – your paper!

Answered by Irfan Syed on 10 Jul, 2020
- Upvote this Answer

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Writing a Research Paper Conclusion | Step-by-Step Guide
Published on October 30, 2022 by Jack Caulfield . Revised on April 13, 2023.
- Restate the problem statement addressed in the paper
- Summarize your overall arguments or findings
- Suggest the key takeaways from your paper

The content of the conclusion varies depending on whether your paper presents the results of original empirical research or constructs an argument through engagement with sources .
Table of contents
Step 1: restate the problem, step 2: sum up the paper, step 3: discuss the implications, research paper conclusion examples, frequently asked questions about research paper conclusions.
The first task of your conclusion is to remind the reader of your research problem . You will have discussed this problem in depth throughout the body, but now the point is to zoom back out from the details to the bigger picture.
While you are restating a problem you’ve already introduced, you should avoid phrasing it identically to how it appeared in the introduction . Ideally, you’ll find a novel way to circle back to the problem from the more detailed ideas discussed in the body.
For example, an argumentative paper advocating new measures to reduce the environmental impact of agriculture might restate its problem as follows:
Meanwhile, an empirical paper studying the relationship of Instagram use with body image issues might present its problem like this:
“In conclusion …”
Avoid starting your conclusion with phrases like “In conclusion” or “To conclude,” as this can come across as too obvious and make your writing seem unsophisticated. The content and placement of your conclusion should make its function clear without the need for additional signposting.
Prevent plagiarism. Run a free check.
Having zoomed back in on the problem, it’s time to summarize how the body of the paper went about addressing it, and what conclusions this approach led to.
Depending on the nature of your research paper, this might mean restating your thesis and arguments, or summarizing your overall findings.
Argumentative paper: Restate your thesis and arguments
In an argumentative paper, you will have presented a thesis statement in your introduction, expressing the overall claim your paper argues for. In the conclusion, you should restate the thesis and show how it has been developed through the body of the paper.
Briefly summarize the key arguments made in the body, showing how each of them contributes to proving your thesis. You may also mention any counterarguments you addressed, emphasizing why your thesis holds up against them, particularly if your argument is a controversial one.
Don’t go into the details of your evidence or present new ideas; focus on outlining in broad strokes the argument you have made.
Empirical paper: Summarize your findings
In an empirical paper, this is the time to summarize your key findings. Don’t go into great detail here (you will have presented your in-depth results and discussion already), but do clearly express the answers to the research questions you investigated.
Describe your main findings, even if they weren’t necessarily the ones you expected or hoped for, and explain the overall conclusion they led you to.
Having summed up your key arguments or findings, the conclusion ends by considering the broader implications of your research. This means expressing the key takeaways, practical or theoretical, from your paper—often in the form of a call for action or suggestions for future research.
Argumentative paper: Strong closing statement
An argumentative paper generally ends with a strong closing statement. In the case of a practical argument, make a call for action: What actions do you think should be taken by the people or organizations concerned in response to your argument?
If your topic is more theoretical and unsuitable for a call for action, your closing statement should express the significance of your argument—for example, in proposing a new understanding of a topic or laying the groundwork for future research.
Empirical paper: Future research directions
In a more empirical paper, you can close by either making recommendations for practice (for example, in clinical or policy papers), or suggesting directions for future research.
Whatever the scope of your own research, there will always be room for further investigation of related topics, and you’ll often discover new questions and problems during the research process .
Finish your paper on a forward-looking note by suggesting how you or other researchers might build on this topic in the future and address any limitations of the current paper.
Full examples of research paper conclusions are shown in the tabs below: one for an argumentative paper, the other for an empirical paper.
- Argumentative paper
- Empirical paper
While the role of cattle in climate change is by now common knowledge, countries like the Netherlands continually fail to confront this issue with the urgency it deserves. The evidence is clear: To create a truly futureproof agricultural sector, Dutch farmers must be incentivized to transition from livestock farming to sustainable vegetable farming. As well as dramatically lowering emissions, plant-based agriculture, if approached in the right way, can produce more food with less land, providing opportunities for nature regeneration areas that will themselves contribute to climate targets. Although this approach would have economic ramifications, from a long-term perspective, it would represent a significant step towards a more sustainable and resilient national economy. Transitioning to sustainable vegetable farming will make the Netherlands greener and healthier, setting an example for other European governments. Farmers, policymakers, and consumers must focus on the future, not just on their own short-term interests, and work to implement this transition now.
As social media becomes increasingly central to young people’s everyday lives, it is important to understand how different platforms affect their developing self-conception. By testing the effect of daily Instagram use among teenage girls, this study established that highly visual social media does indeed have a significant effect on body image concerns, with a strong correlation between the amount of time spent on the platform and participants’ self-reported dissatisfaction with their appearance. However, the strength of this effect was moderated by pre-test self-esteem ratings: Participants with higher self-esteem were less likely to experience an increase in body image concerns after using Instagram. This suggests that, while Instagram does impact body image, it is also important to consider the wider social and psychological context in which this usage occurs: Teenagers who are already predisposed to self-esteem issues may be at greater risk of experiencing negative effects. Future research into Instagram and other highly visual social media should focus on establishing a clearer picture of how self-esteem and related constructs influence young people’s experiences of these platforms. Furthermore, while this experiment measured Instagram usage in terms of time spent on the platform, observational studies are required to gain more insight into different patterns of usage—to investigate, for instance, whether active posting is associated with different effects than passive consumption of social media content.
If you’re unsure about the conclusion, it can be helpful to ask a friend or fellow student to read your conclusion and summarize the main takeaways.
- Do they understand from your conclusion what your research was about?
- Are they able to summarize the implications of your findings?
- Can they answer your research question based on your conclusion?
You can also get an expert to proofread and feedback your paper with a paper editing service .
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The conclusion of a research paper has several key elements you should make sure to include:
- A restatement of the research problem
- A summary of your key arguments and/or findings
- A short discussion of the implications of your research
No, it’s not appropriate to present new arguments or evidence in the conclusion . While you might be tempted to save a striking argument for last, research papers follow a more formal structure than this.
All your findings and arguments should be presented in the body of the text (more specifically in the results and discussion sections if you are following a scientific structure). The conclusion is meant to summarize and reflect on the evidence and arguments you have already presented, not introduce new ones.
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Organizing Academic Research Papers: 9. The Conclusion
- Purpose of Guide
- Design Flaws to Avoid
- Glossary of Research Terms
- Narrowing a Topic Idea
- Broadening a Topic Idea
- Extending the Timeliness of a Topic Idea
- Academic Writing Style
- Choosing a Title
- Making an Outline
- Paragraph Development
- Executive Summary
- Background Information
- The Research Problem/Question
- Theoretical Framework
- Citation Tracking
- Content Alert Services
- Evaluating Sources
- Primary Sources
- Secondary Sources
- Tertiary Sources
- What Is Scholarly vs. Popular?
- Qualitative Methods
- Quantitative Methods
- Using Non-Textual Elements
- Limitations of the Study
- Common Grammar Mistakes
- Avoiding Plagiarism
- Footnotes or Endnotes?
- Further Readings
- Annotated Bibliography
- Dealing with Nervousness
- Using Visual Aids
- Grading Someone Else's Paper
- How to Manage Group Projects
- Multiple Book Review Essay
- Reviewing Collected Essays
- About Informed Consent
- Writing Field Notes
- Writing a Policy Memo
- Writing a Research Proposal
- Acknowledgements
The conclusion is intended to help the reader understand why your research should matter to them after they have finished reading the paper. A conclusion is not merely a summary of your points or a re-statement of your research problem but a synthesis of key points. For most essays, one well-developed paragraph is sufficient for a conclusion, although in some cases, a two-or-three paragraph conclusion may be required.
Importance of a Good Conclusion
A well-written conclusion provides you with several important opportunities to demonstrate your overall understanding of the research problem to the reader. These include:
- Presenting the last word on the issues you raised in your paper . Just as the introduction gives a first impression to your reader, the conclusion offers a chance to leave a lasting impression. Do this, for example, by highlighting key points in your analysis or findings.
- Summarizing your thoughts and conveying the larger implications of your study . The conclusion is an opportunity to succinctly answer the "so what?" question by placing the study within the context of past research about the topic you've investigated.
- Demonstrating the importance of your ideas . Don't be shy. The conclusion offers you a chance to elaborate on the significance of your findings.
- Introducing possible new or expanded ways of thinking about the research problem . This does not refer to introducing new information [which should be avoided], but to offer new insight and creative approaches for framing/contextualizing the research problem based on the results of your study.
Conclusions . The Writing Center. University of North Carolina; Kretchmer, Paul. Twelve Steps to Writing an Effective Conclusion . San Francisco Edit, 2003-2008.
Structure and Writing Style
https://writing.wisc.edu/wp-content/uploads/sites/535/2018/07/conclusions_uwmadison_writingcenter_aug2012.pdf I. General Rules
When writing the conclusion to your paper, follow these general rules:
- State your conclusions in clear, simple language.
- Do not simply reiterate your results or the discussion.
- Indicate opportunities for future research, as long as you haven't already done so in the discussion section of your paper.
The function of your paper's conclusion is to restate the main argument . It reminds the reader of the strengths of your main argument(s) and reiterates the most important evidence supporting those argument(s). Make sure, however, that your conclusion is not simply a repetitive summary of the findings because this reduces the impact of the argument(s) you have developed in your essay.
Consider the following points to help ensure your conclusion is appropriate:
- If the argument or point of your paper is complex, you may need to summarize the argument for your reader.
- If, prior to your conclusion, you have not yet explained the significance of your findings or if you are proceeding inductively, use the end of your paper to describe your main points and explain their significance.
- Move from a detailed to a general level of consideration that returns the topic to the context provided by the introduction or within a new context that emerges from the data.
The conclusion also provides a place for you to persuasively and succinctly restate your research problem, given that the reader has now been presented with all the information about the topic . Depending on the discipline you are writing in, the concluding paragraph may contain your reflections on the evidence presented, or on the essay's central research problem. However, the nature of being introspective about the research you have done will depend on the topic and whether your professor wants you to express your observations in this way.
NOTE : Don't delve into idle speculation. Being introspective means looking within yourself as an author to try and understand an issue more deeply not to guess at possible outcomes.
II. Developing a Compelling Conclusion
Strategies to help you move beyond merely summarizing the key points of your research paper may include any of the following.
- If your essay deals with a contemporary problem, warn readers of the possible consequences of not attending to the problem.
- Recommend a specific course or courses of action.
- Cite a relevant quotation or expert opinion to lend authority to the conclusion you have reached [a good place to look is research from your literature review].
- Restate a key statistic, fact, or visual image to drive home the ultimate point of your paper.
- If your discipline encourages personal reflection, illustrate your concluding point with a relevant narrative drawn from your own life experiences.
- Return to an anecdote, an example, or a quotation that you introduced in your introduction, but add further insight that is derived from the findings of your study; use your interpretation of results to reframe it in new ways.
- Provide a "take-home" message in the form of a strong, succient statement that you want the reader to remember about your study.
III. Problems to Avoid Failure to be concise The conclusion section should be concise and to the point. Conclusions that are too long often have unnecessary detail. The conclusion section is not the place for details about your methodology or results. Although you should give a summary of what was learned from your research, this summary should be relatively brief, since the emphasis in the conclusion is on the implications, evaluations, insights, etc. that you make. Failure to comment on larger, more significant issues In the introduction, your task was to move from general [the field of study] to specific [your research problem]. However, in the conclusion, your task is to move from specific [your research problem] back to general [your field, i.e., how your research contributes new understanding or fills an important gap in the literature]. In other words, the conclusion is where you place your research within a larger context. Failure to reveal problems and negative results Negative aspects of the research process should never be ignored. Problems, drawbacks, and challenges encountered during your study should be included as a way of qualifying your overall conclusions. If you encountered negative results [findings that are validated outside the research context in which they were generated], you must report them in the results section of your paper. In the conclusion, use the negative results as an opportunity to explain how they provide information on which future research can be based. Failure to provide a clear summary of what was learned In order to be able to discuss how your research fits back into your field of study [and possibly the world at large], you need to summarize it briefly and directly. Often this element of your conclusion is only a few sentences long. Failure to match the objectives of your research Often research objectives change while the research is being carried out. This is not a problem unless you forget to go back and refine your original objectives in your introduction, as these changes emerge they must be documented so that they accurately reflect what you were trying to accomplish in your research [not what you thought you might accomplish when you began].
Resist the urge to apologize If you've immersed yourself in studying the research problem, you now know a good deal about it, perhaps even more than your professor! Nevertheless, by the time you have finished writing, you may be having some doubts about what you have produced. Repress those doubts! Don't undermine your authority by saying something like, "This is just one approach to examining this problem; there may be other, much better approaches...."
Concluding Paragraphs. College Writing Center at Meramec. St. Louis Community College; Conclusions . The Writing Center. University of North Carolina; Conclusions . The Writing Lab and The OWL. Purdue University; Freedman, Leora and Jerry Plotnick. Introductions and Conclusions . The Lab Report. University College Writing Centre. University of Toronto; Leibensperger, Summer. Draft Your Conclusion. Academic Center, the University of Houston-Victoria, 2003; Make Your Last Words Count . The Writer’s Handbook. Writing Center. University of Wisconsin, Madison; Tips for Writing a Good Conclusion . Writing@CSU. Colorado State University; Kretchmer, Paul. Twelve Steps to Writing an Effective Conclusion . San Francisco Edit, 2003-2008; Writing Conclusions . Writing Tutorial Services, Center for Innovative Teaching and Learning. Indiana University; Writing: Considering Structure and Organization . Institute for Writing Rhetoric. Dartmouth College.
Writing Tip
Don't Belabor the Obvious!
Avoid phrases like "in conclusion...," "in summary...," or "in closing...." These phrases can be useful, even welcome, in oral presentations. But readers can see by the tell-tale section heading and number of pages remaining to read, when an essay is about to end. You'll irritate your readers if you belabor the obvious.
Another Writing Tip
New Insight, Not New Information!
Don't surprise the reader with new information in your Conclusion that was never referenced anywhere else in the paper. If you have new information to present, add it to the Discussion or other appropriate section of the paper. Note that, although no actual new information is introduced, the conclusion is where you offer your most "original" contributions in the paper; it's where you describe the value of your research, demonstrate your understanding of the material that you’ve presented, and locate your findings within the larger context of scholarship on the topic.
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Qualitative vs Quantitative Research: Differences and Examples

Understanding the differences between qualitative vs quantitative research is essential when conducting a research project, as both methods underpin the two key approaches in conducting a study.
In recent blogs, we elaborately discussed quantitative and qualitative research methods b ut what is the difference between the two? Which one is the best? Let’s find out.

Qualitative Research In a nutshell
Qualitative research is a research methodology where “quality” or opinion based research is conducted to derive research conclusions. This type of research is often conversational in nature rather than being quantifiable through empirical research and measurements.
Qualitative research: Methods & Characteristics
1. Conversation : A conversation takes place between the researcher and the respondent. This can be in the form of focus groups , in-depth interviews using telephonic / video / face-to-face conversations.
However, with the rise of online platforms, a bulk of qualitative research involves creating and maintaining online community portals for a more quantifiable and recordable qualitative study.
LEARN ABOUT: Qualitative Interview
2. Conclusions : Research conclusions are subjective in nature when conducting qualitative research. The researcher may derive conclusions based on in-depth analysis of respondent attitude, reason behind responses and understanding of psychological motivations.
Quantitative Research In a nutshell
Quantitative research is a research methodology which uses questions and questionnaires to gather quantifiable data and perform statistical analysis to derive meaningful research conclusions.
Quantitative research: Methods & Characteristics
1. Questions : Quantitative research method uses surveys and polls to gather information on a given subject. There are a variety of question types used based on a nature of the research study.
For Example: If you want to conduct a customer satisfaction quantitative research, the Net Promoter Score is one of the critically acclaimed survey questions for this purpose.
2. Distribution : Quantitative research uses email surveys as the primary mode of gathering responses to questions. Alternatively, technology has given rise to offline distribution methods for relatively remote locations using offline mobile data capture apps. For social sciences and psychological quantitative research, social media surveys are also used to gather data.
3. Statistical Analysis : Quantitative research uses a wide range of data analysis techniques such as Conjoint Analysis , Cross Tabulation and Trend Analysis .
Qualitative vs Quantitative Research
Now let’s compare the two research methods in different aspects so that you can choose the right one in your next investigation.:
1. Objective and flow of research
Quantitative research is used in data-oriented research where the objective of research design is to derive “measurable empirical evidence” based on fixed and pre-determined questions. The flow of research, is therefore, decided before the research is conducted.
Where as, qualitative research is used where the objective is research is to keep probing the respondents based on previous answers under the complete discretion of the interviewer. The flow of research is not determined and the researcher / interviewer has the liberty to frame and ask new questions.
2. Respondent sample size
Respondents or sample of a particular panel is much larger for quantitative research such that enough verifiable information is gather to reach a conclusion without opinion bias. In large scale quantitative research, sample size can be in thousands.
Where as, qualitative research inherently uses less sample size because a large sample size makes it difficult of the research to probe respondents. For instance, a typical political focus group study evaluating election candidates involves no more than 5-10 panelists.
3. Information gathering
Quantitative research uses information gathering methods that can be quantified and processed for statistical analysis techniques. Simply put – quantitative research is heavily dependent on “numbers”, data and stats.
LEARN ABOUT: Research Process Steps
Where as, qualitative research uses conversational methods to gather relevant information on a given subject.
4. Post-research response analysis and conclusions
Quantitative research uses a variety of statistical analysis methods to derive quantifiable research conclusions. These are based on mathematical processes applied on the gather data.
Where as, qualitative researc h depends on the interviewer to derive research conclusions based on qualitative conversations held with the respondents. This conclusion is effectively subjective in nature. This is why quantitative research recordings are often reviewed by senior researchers before the final research conclusion is drawn.
Differences between qualitative vs quantitative research

We hope that this information helps you choose your next research method and achieve your goals.
If you want to carry out any qualitative or qualitative research questions , ask about the tools that QuestionPro has available to help you with the qualitative data collection of the data you need. We have functions for all types of research!.
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Writing Conclusions and Recommendations for a Qualitative Research
Having the data analyzed and interpreted, it is time to write the research report. A research report or write-up is prepared after a study was completed. It provides a scientific narration of the research problem and its literature, the procedures undertaken, the presentation, analysis, and interpretation of data, and the conclusions and recommendations drawn out from the findings. The research write-up must be communicated to interested research stakeholders so that the results can be shared and recommendations can be implemented.
Conclusions and Recommendations
What are the guidelines in making conclusions and recommendations? Most research studies end with conclusions and recommendations. Conclusions are abstractions generated from the findings that answer the specific questions. Recommendations, on the other hand, are suggestive statements that put the research findings into practical utility of the stakeholders. They may also be suggestions for further investigation to improve the use of the present research findings by all interested parties.
Guidelines in Writing the Conclusions
In writing the conclusions, the following ideas may be considered:
- Conclusions are inferences, implications, interpretations, general statements, and/or generalizations based upon the results or findings of the study.
- Conclusions should properly answer the specific questions presented at the start of the investigation.
- Conclusions should be expressed in a concise statement that conveys all the important information.
- Conclusions should be stated in a strong, clear, and definite manner.
- Conclusions should pertain only to the subject or topic of the study.
- Conclusions should not include repetitions of the statements in the study.
Guidelines in Writing the Recommendations
In writing recommendations, the following pointers may be taken into account:
- Recommendations should aim to solve problems discovered in the study.
- Recommendations should be based only within the context of the research problem. If it is not within the scope of the study, it is irrelevant.
- Recommendations can be statements signifying continuance of a good practice and for its improvement.
- Recommendations should be doable, attainable, and practical. It must also be logical, rational, and valid.
- Recommendations can be addressed to individuals, agencies, institutions, or offices to whom or which in a proper position to implement them.
- Recommendations should be for further research on the same topic. It can cover other places to confirm and validate the study.
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O’Hara R, Johnson M, Hirst E, et al. A qualitative study of decision-making and safety in ambulance service transitions. Southampton (UK): NIHR Journals Library; 2014 Dec. (Health Services and Delivery Research, No. 2.56.)

A qualitative study of decision-making and safety in ambulance service transitions.
Chapter 8 conclusions and recommendations.
The aim of this study was to explore the range and nature of influences on safety in decision-making by ambulance service staff (paramedics). A qualitative approach was adopted using a range of complementary methods. The study has provided insights on the types of decisions that staff engage in on a day-to-day basis. It has also identified a range of system risk factors influencing decisions about patient care. Although this was a relatively small-scale exploratory study, confidence in the generalisability of the headline findings is enhanced by the high level of consistency in the findings, obtained using multiple methods, and the notable consensus among participants.
The seven predominant system influences identified should not be considered discrete but as overlapping and complementary issues. They also embody a range of subthemes that represent topics for future research and/or intervention.
The apparently high level of consistency across the participating trusts suggests that the issues identified may be generic and relevant to other ambulance service trusts.
In view of the remit of this study, aspects relating to system weaknesses and potential threats to patient safety dominate in the account of findings. However, it should be noted that respondent accounts also provided examples of systems that were said to be working well, for example specific care management pathways, local roles and ways of working and technological initiatives such as IBIS and the ePRF.
- Implications for health care
The NHS system within which the ambulance service operates is characterised in our study as fragmented and inconsistent. For ambulance service staff the extent of variation across the geographical areas in which they work is problematic in terms of knowing what services are available and being able to access them. The lack of standardisation in practice guidelines, pathways and protocols across services and between areas makes it particularly challenging for staff to keep up to date with requirements in different parts of their own trust locations and when crossing trust boundaries. Although a degree of consistency across the network is likely to improve the situation, it is also desirable to have sufficient flexibility to accommodate the needs of specific local populations. There was some concern over the potential for further fragmentation with the increased number of CCGs.
Ambulance services are increasingly under pressure to focus on reducing conveyance rates to A&E; this arguably intensifies the need to ensure that crews are appropriately skilled to be able to make effective decisions over the need to convey or not to convey if associated risks to patients are to be minimised. Our findings highlight the challenges of developing staff and ensuring that their skills are utilised where they are most needed within the context of organisational resource constraints and operational demands. Decisions over non-conveyance to A&E are moderated by the availability of alternative care pathways and providers. There were widespread claims of local variability in this respect. Staff training and development, and access to alternatives to A&E, were identified as priorities for attention by workshop attendees.
One of the difficulties for ambulance services is that they operate as a 24/7 service within a wider urgent and emergency care network that, beyond A&E, operates a more restricted working day. The study findings identify this as problematic for two reasons. First, it fuels demand for ambulance service care as a route to timely treatment, when alternatives may involve delay. Second, it contributes to inappropriate conveyance to A&E because more appropriate options are unavailable or limited during out-of-hours periods. Ultimately, this restricts the scope for ensuring that patients are getting the right level of care at the right time and place. Study participants identified some patient populations as particularly poorly served in terms of alternatives to A&E (e.g. those with mental health issues, those at the end of life, older patients and those with chronic conditions).
The effectiveness of the paramedic role in facilitating access to appropriate care pathways hinges on relationships with other care providers (e.g. primary care, acute care, mental health care, community health care). An important element relates to the cultural profile of paramedics in the NHS, specifically, the extent to which other health professionals and care providers consider the clinical judgements/decisions made by paramedics as credible and actionable. Staff identified this as a barrier to access where the ambulance service is still viewed primarily as a transport service. Consideration could be given to ways of improving effective teamworking and communication across service and professional boundaries.
Although paramedics acknowledged the difficulties of telephone triage, they also identified how the limitations of this system impact on them. Over-triage at the initial call-handling stage places considerable demands on both staff and vehicle resources. A related concern is the limited information conveyed to crews following triage. Initial triage was suggested as an area that warrants attention to improve resource allocation.
The findings highlight the challenges faced by front-line ambulance service staff. It was apparent that the extent and nature of the demand for ambulance conveyance represents a notable source of strain and tension for individuals and at an organisational level. For example, there were widespread claims that meeting operational demands for ambulance services limits the time available for training and professional development, with this potentially representing a risk for patients and for staff. Staff perceptions of risk relating to patient safety extend to issues of secondary risk management, that is, personal and institutional liabilities, in particular risks associated with loss of professional registration. The belief that they are more likely to be blamed than supported by their organisation in the event of an incident was cited by staff as a source of additional anxiety when making more complex decisions. This perceived vulnerability can provoke excessively risk-averse decisions. These issues merit further attention to examine the workforce implication of service delivery changes, including how to ensure that staff are appropriately equipped and supported to deal effectively with the demands of their role.
Paramedics identified a degree of progress in relation to the profile of patient safety within their organisations but the apparent desire within trusts to prioritise safety improvement was felt to be constrained by service demands and available resources. Attempts to prioritise patient safety appear to focus on ensuring that formal systems are in place (e.g. reporting and communication). Concerns were expressed over how well these systems function to support improvement, for example how incident reports are responded to and whether lessons learned are communicated to ambulance staff within and between trusts. Consideration could be given to identifying ways of supporting ambulance service trusts to develop the safety culture within their organisation.
Service users attributed the increased demand for ambulance services to difficulties in identifying and accessing alternatives. They were receptive to non-conveyance options but felt that lack of awareness of staff roles and skills may cause concern when patients expect conveyance to A&E.
- Recommendations for research
The workshop attendees identified a range of areas for attention in relation to intervention and research, which are provided in Chapter 6 (see Suggestions for potential interventions and research ). The following recommendations for research are based on the study findings:
- Limited and variable access to services in the wider health and social care system is a significant barrier to reducing inappropriate conveyance to A&E. More research is needed to identify effective ways of improving the delivery of care across service boundaries, particularly for patients with limited options at present (e.g. those with mental health issues, those at the end of life and older patients). Research should address structural and attitudinal barriers and how these might be overcome.
- Ambulance services are increasingly focused on reducing conveyance to A&E and they need to ensure that there is an appropriately skilled workforce to minimise the potential risk. The evidence points to at least two issues: (1) training and skills and (2) the cultural profile of paramedics in the NHS, that is, whether others view their decisions as credible. Research could explore the impact of enhanced skills on patient care and on staff, for example the impact of increased training in urgent rather than emergency care. This would also need to address potential cultural barriers to the effective use of new skills.
- Research to explore the impact of different aspects of safety culture on ambulance service staff and the delivery of patient care (e.g. incident reporting, communication, teamworking, and training) could include comparisons across different staff groups and the identification of areas for improvement, as well as interventions that could potentially be tested.
- The increased breadth of decision-making by ambulance service crews with advanced skills includes more diagnostics; therefore, there is a need to look at the diagnostic process and potential causes of error in this environment.
- There is a need to explore whether there are efficient and safe ways of improving telephone triage decisions to reduce over-triage, particularly in relation to calls requiring an 8-minute response. This could include examining training and staffing levels, a higher level of clinician involvement or other forms of decision support.
- There is a need to explore public awareness of, attitudes towards, beliefs about and expectations of the ambulance service and the wider urgent and emergency care network and the scope for behaviour change interventions, for example communication of information about access to and use of services; empowering the public through equipping them with the skills to directly access the services that best meet their needs; and informing the public about the self-management of chronic conditions.
- A number of performance measures were identified engendering perverse motivations leading to suboptimal resource utilisation. An ongoing NIHR Programme Grant for Applied Research (RP-PG-0609–10195; ‘Pre-hospital Outcomes for Evidence-Based Evaluation’) aims to develop new ways of measuring ambulance service performance. It is important that evaluations of new performance metrics or other innovations (e.g. Make Ready ambulances, potential telehealth technologies or decision-support tools) address their potential impact on patient safety.
Included under terms of UK Non-commercial Government License .
- Cite this Page O’Hara R, Johnson M, Hirst E, et al. A qualitative study of decision-making and safety in ambulance service transitions. Southampton (UK): NIHR Journals Library; 2014 Dec. (Health Services and Delivery Research, No. 2.56.) Chapter 8, Conclusions and recommendations.
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The conclusion is intended to help the reader understand why your research should matter to them after they have finished reading the paper. A conclusion is not merely a summary of the main topics covered or a re-statement of your research problem, but a synthesis of key points and, if applicable, where you recommend new areas for future research. For most college-level research papers, one or two well-developed paragraphs is sufficient for a conclusion, although in some cases, more paragraphs may be required in summarizing key findings and their significance.
Conclusions. The Writing Center. University of North Carolina; Conclusions. The Writing Lab and The OWL. Purdue University.
Importance of a Good Conclusion
A well-written conclusion provides you with important opportunities to demonstrate to the reader your understanding of the research problem. These include:
- Presenting the last word on the issues you raised in your paper . Just as the introduction gives a first impression to your reader, the conclusion offers a chance to leave a lasting impression. Do this, for example, by highlighting key findings in your analysis that advance new understanding about the research problem, that are unusual or unexpected, or that have important implications applied to practice.
- Summarizing your thoughts and conveying the larger significance of your study . The conclusion is an opportunity to succinctly re-emphasize the "So What?" question by placing the study within the context of how your research advances past research about the topic.
- Identifying how a gap in the literature has been addressed . The conclusion can be where you describe how a previously identified gap in the literature [described in your literature review section] has been filled by your research.
- Demonstrating the importance of your ideas . Don't be shy. The conclusion offers you the opportunity to elaborate on the impact and significance of your findings. This is particularly important if your study approached examining the research problem from an unusual or innovative perspective.
- Introducing possible new or expanded ways of thinking about the research problem . This does not refer to introducing new information [which should be avoided], but to offer new insight and creative approaches for framing or contextualizing the research problem based on the results of your study.
Bunton, David. “The Structure of PhD Conclusion Chapters.” Journal of English for Academic Purposes 4 (July 2005): 207–224; Conclusions. The Writing Center. University of North Carolina; Kretchmer, Paul. Twelve Steps to Writing an Effective Conclusion. San Francisco Edit, 2003-2008; Conclusions. The Writing Lab and The OWL. Purdue University; Assan, Joseph. "Writing the Conclusion Chapter: The Good, the Bad and the Missing." Liverpool: Development Studies Association (2009): 1-8.
Structure and Writing Style
I. General Rules
The function of your paper's conclusion is to restate the main argument . It reminds the reader of the strengths of your main argument(s) and reiterates the most important evidence supporting those argument(s). Do this by stating clearly the context, background, and necessity of pursuing the research problem you investigated in relation to an issue, controversy, or a gap found in the literature. Make sure, however, that your conclusion is not simply a repetitive summary of the findings. This reduces the impact of the argument(s) you have developed in your essay.
When writing the conclusion to your paper, follow these general rules:
- Present your conclusions in clear, simple language. Re-state the purpose of your study, then describe how your findings differ or support those of other studies and why [i.e., what were the unique or new contributions your study made to the overall research about your topic?].
- Do not simply reiterate your findings or the discussion of your results. Provide a synthesis of arguments presented in the paper to show how these converge to address the research problem and the overall objectives of your study.
- Indicate opportunities for future research if you haven't already done so in the discussion section of your paper. Highlighting the need for further research provides the reader with evidence that you have an in-depth awareness of the research problem and that further investigations should take place.
Consider the following points to help ensure your conclusion is presented well:
- If the argument or purpose of your paper is complex, you may need to summarize the argument for your reader.
- If, prior to your conclusion, you have not yet explained the significance of your findings or if you are proceeding inductively, use the end of your paper to describe your main points and explain their significance.
- Move from a detailed to a general level of consideration that returns the topic to the context provided by the introduction or within a new context that emerges from the data.
The conclusion also provides a place for you to persuasively and succinctly restate the research problem, given that the reader has now been presented with all the information about the topic . Depending on the discipline you are writing in, the concluding paragraph may contain your reflections on the evidence presented. However, the nature of being introspective about the research you have conducted will depend on the topic and whether your professor wants you to express your observations in this way.
NOTE : If asked to think introspectively about the topics, do not delve into idle speculation. Being introspective means looking within yourself as an author to try and understand an issue more deeply, not to guess at possible outcomes or make up scenarios not supported by the evidence.
II. Developing a Compelling Conclusion
Although an effective conclusion needs to be clear and succinct, it does not need to be written passively or lack a compelling narrative. Strategies to help you move beyond merely summarizing the key points of your research paper may include any of the following strategies:
- If your essay deals with a critical, contemporary problem, warn readers of the possible consequences of not attending to the problem proactively.
- Recommend a specific course or courses of action that, if adopted, could address a specific problem in practice or in the development of new knowledge.
- Cite a relevant quotation or expert opinion already noted in your paper in order to lend authority and support to the conclusion(s) you have reached [a good place to look is research from your literature review].
- Explain the consequences of your research in a way that elicits action or demonstrates urgency in seeking change.
- Restate a key statistic, fact, or visual image to emphasize the most important finding of your paper.
- If your discipline encourages personal reflection, illustrate your concluding point by drawing from your own life experiences.
- Return to an anecdote, an example, or a quotation that you presented in your introduction, but add further insight derived from the findings of your study; use your interpretation of results to recast it in new or important ways.
- Provide a "take-home" message in the form of a succinct, declarative statement that you want the reader to remember about your study.
III. Problems to Avoid
Failure to be concise Your conclusion section should be concise and to the point. Conclusions that are too lengthy often have unnecessary information in them. The conclusion is not the place for details about your methodology or results. Although you should give a summary of what was learned from your research, this summary should be relatively brief, since the emphasis in the conclusion is on the implications, evaluations, insights, and other forms of analysis that you make. Strategies for writing concisely can be found here .
Failure to comment on larger, more significant issues In the introduction, your task was to move from the general [the field of study] to the specific [the research problem]. However, in the conclusion, your task is to move from a specific discussion [your research problem] back to a general discussion [i.e., how your research contributes new understanding or fills an important gap in the literature]. In short, the conclusion is where you should place your research within a larger context [visualize your paper as an hourglass--start with a broad introduction and review of the literature, move to the specific analysis and discussion, conclude with a broad summary of the study's implications and significance].
Failure to reveal problems and negative results Negative aspects of the research process should never be ignored. These are problems, deficiencies, or challenges encountered during your study should be summarized as a way of qualifying your overall conclusions. If you encountered negative or unintended results [i.e., findings that are validated outside the research context in which they were generated], you must report them in the results section and discuss their implications in the discussion section of your paper. In the conclusion, use your summary of the negative results as an opportunity to explain their possible significance and/or how they may form the basis for future research.
Failure to provide a clear summary of what was learned In order to be able to discuss how your research fits within your field of study [and possibly the world at large], you need to summarize briefly and succinctly how it contributes to new knowledge or a new understanding about the research problem. This element of your conclusion may be only a few sentences long.
Failure to match the objectives of your research Often research objectives in the social sciences change while the research is being carried out. This is not a problem unless you forget to go back and refine the original objectives in your introduction. As these changes emerge they must be documented so that they accurately reflect what you were trying to accomplish in your research [not what you thought you might accomplish when you began].
Resist the urge to apologize If you've immersed yourself in studying the research problem, you presumably should know a good deal about it [perhaps even more than your professor!]. Nevertheless, by the time you have finished writing, you may be having some doubts about what you have produced. Repress those doubts! Don't undermine your authority by saying something like, "This is just one approach to examining this problem; there may be other, much better approaches that...." The overall tone of your conclusion should convey confidence to the reader.
Assan, Joseph. "Writing the Conclusion Chapter: The Good, the Bad and the Missing." Liverpool: Development Studies Association (2009): 1-8; Concluding Paragraphs. College Writing Center at Meramec. St. Louis Community College; Conclusions. The Writing Center. University of North Carolina; Conclusions. The Writing Lab and The OWL. Purdue University; Freedman, Leora and Jerry Plotnick. Introductions and Conclusions. The Lab Report. University College Writing Centre. University of Toronto; Leibensperger, Summer. Draft Your Conclusion. Academic Center, the University of Houston-Victoria, 2003; Make Your Last Words Count. The Writer’s Handbook. Writing Center. University of Wisconsin Madison; Miquel, Fuster-Marquez and Carmen Gregori-Signes. “Chapter Six: ‘Last but Not Least:’ Writing the Conclusion of Your Paper.” In Writing an Applied Linguistics Thesis or Dissertation: A Guide to Presenting Empirical Research . John Bitchener, editor. (Basingstoke,UK: Palgrave Macmillan, 2010), pp. 93-105; Tips for Writing a Good Conclusion. Writing@CSU. Colorado State University; Kretchmer, Paul. Twelve Steps to Writing an Effective Conclusion. San Francisco Edit, 2003-2008; Writing Conclusions. Writing Tutorial Services, Center for Innovative Teaching and Learning. Indiana University; Writing: Considering Structure and Organization. Institute for Writing Rhetoric. Dartmouth College.
Writing Tip
Don't Belabor the Obvious!
Avoid phrases like "in conclusion...," "in summary...," or "in closing...." These phrases can be useful, even welcome, in oral presentations. But readers can see by the tell-tale section heading and number of pages remaining to read, when an essay is about to end. You'll irritate your readers if you belabor the obvious.
Assan, Joseph. "Writing the Conclusion Chapter: The Good, the Bad and the Missing." Liverpool: Development Studies Association (2009): 1-8.
Another Writing Tip
New Insight, Not New Information!
Don't surprise the reader with new information in your conclusion that was never referenced anywhere else in the paper and, as such, the conclusion rarely has citations to sources. If you have new information to present, add it to the discussion or other appropriate section of the paper. Note that, although no actual new information is introduced, the conclusion, along with the discussion section, is where you offer your most "original" contributions in the paper; the conclusion is where you describe the value of your research, demonstrate that you understand the material that you’ve presented, and locate your findings within the larger context of scholarship on the topic, including describing how your research contributes new insights or valuable insight to that scholarship.
Assan, Joseph. "Writing the Conclusion Chapter: The Good, the Bad and the Missing." Liverpool: Development Studies Association (2009): 1-8; Conclusions. The Writing Center. University of North Carolina.
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