质性研究系列 - 与Fiona Webster博士一起用民族志捕捉动态社会

欢迎收听《言语的力量》播客，通过更好的沟通提升患者护理。欢迎来到《言语的力量》播客新一期节目，我是奥利弗·汤普森。希望大家喜欢前两期关于定性研究系列的节目——第一期是与佩里·塔特曼探讨定性研究入门，上一期则是与简·米尔斯和梅兰妮·伯克斯教授讨论扎根理论。

Welcome to the Words Matter podcast, enhancing patient care through better communication. Welcome to another episode of Words Matter podcast. I am Oliver Thompson. So I hope you enjoyed the previous two episodes of the qualitative research series. The first one introducing qualitative research with Perry Tutterman, and the last one on grounded theory with professors Jane Mills and Melanie Berks.

这些对话让我受益匪浅，我期待继续推进这个系列。再次感谢所有通过Patreon支持节目的听众。如需赞助，请访问patreon.com/thewordsmatterpodcast。若不赞助，您能收听节目并有所收获我也非常高兴。现在让我们继续定性研究的探索之旅。

I really enjoyed the conversations, and I look forward to continuing through the series. And thanks again to all of you who have supported the show via Patreon. If you'd like to make a contribution, you can visit patreon.com forward slash the words matter podcast. If not, I'm just pleased you're listening to the show and taking something of value from it. So we continue our journey in and across qualitative research.

本期节目中，我将与社会学家菲奥娜·韦伯斯特博士探讨民族志研究。菲奥娜是加拿大安大略省伦敦市西部大学的副教授，其研究聚焦慢性疼痛及其他慢性健康状况的社会学问题，尤其擅长运用批判性与制度民族志方法。她发表了大量民族志研究成果，包括发表在《PLOS ONE》上的重磅研究《阿片危机中医务工作的社会组织》，并著有《最佳实践的社会组织与医师工作的制度民族志》一书。

And in today's episode, I'm speaking about ethnography with sociologist Doctor. Fiona Webster. Fiona is an associate professor at Western University, London, Ontario, Canada, And her research interest lies in the sociology of chronic pain and other chronic health conditions with a particular focus on using critical and institutional ethnographic approaches. And Fiona has published extensively using ethnography, including a powerful study on the chronic pain management in primary care titled The Social Organization of Physicians Work in the Mists of the Opioid Crisis, and that was published in the journal PLOS ONE. She's also written a book titled The Social Organization of Best Practice and Institutional Ethnography of Physicians' Work.

我已将菲奥娜的部分论文、著作及节目中提及的文献链接放在节目注释中。本期我们将讨论：民族志的定义及其作为定性研究基石的地位；它如何捕捉实验控制之外复杂自然的社会互动；民族志内部不同的认识论立场；以及哈默斯利在《民族志的问题何在》中提出的方法论与本体论困惑——即天真实在论与相对主义。建议您也阅读格兰特·班菲尔德的反驳文章《民族志真正的问题何在》，其中提出以微妙实在论作为解决方案，这些链接均已附在注释中。

I've linked some of Fiona's papers, her book, and some of the other texts that we discuss in the show notes. So in this episode, we talk about what ethnography is, its problematic history, and its place as ground zero for qualitative research. We talk about ethnography's ability to capture complex, naturally occurring social interactions in contexts that are not subject to experimental control. We talk about the different epistemological postures within ethnography, and we touch on Hammersley's famous critique titled what's wrong with ethnography, which articulates the methodological and ontological confusion which he perceived within ethnography, namely naive realism and relativism. I would suggest that you also read Grant Banfield's rebuttal, what's really wrong with ethnography, where he proposes subtle realism as a solution to the confusion, and I've linked these in the show notes.

我们探讨了民族志研究的具体方法：从参与观察、田野笔记、访谈等数据收集方式，到长期田野浸入的伦理问题及研究对象选择；霍桑效应（被观察者行为改变现象）与民族志观察的关联性；数据分析方法及研究中的反身性思考。对于想深入了解民族志的听众，菲奥娜推荐了经典著作：《宽恕与铭记》《管理医疗失败》《灵病降临》《白衣男孩》，以及自传体民族志《离开男孩们：关于母职、事业、女性主义与爱情的故事》，相关链接已附注。

We talk about the way in which ethnographic research is carried out from data collection, such as participant observation, field notes, and interviews, and some of the ethical issues of prolonged immersion in the field and who can be researched in the research field. We talk about the Hawthorne effect, that is people's change of behavior when they know they're being observed and how this relates or doesn't relate to ethnographic observation. We talk about data analysis and research of reflexivity within an ethnographic study. Finally, for those wanting to learn more about ethnography, Fiona suggests some classic and influential ethnographies, including the books Forgive and Remember, Managing Medical Failure, The Spirit Catches You and You Fall Down, Boys in White, and finally, the autoethnography leaving the boys, a story of motherhood and career, feminism, and romance. And I've linked these texts in the show notes.

与菲奥娜的对话精彩非凡。她对民族志理论与实践的精辟阐释，特别是对制度民族志的深刻见解以及民族志产生的丰富数据，让我跃跃欲试想开展民族志研究。敬请期待后续动态。现在有请菲奥娜·韦伯斯特博士。菲奥娜，欢迎来到节目。

So this was just a wonderful conversation with Fiona. She describes the theory and practice of ethnography perfectly, and her powerful insights into institutional ethnography and the rich data and findings that ethnography generates just really made me want to do some ethnography. So watch this space. So I bring you doctor Fiona Webster. Fiona, welcome to the podcast.

谢谢，很荣幸参与。

Thank you. Pleasure to be here.

这有点像我和安娜·里亚拉关于批判理论的对话，我刚才录制的。这期节目相当即兴。我们大约花了八分钟在推特上组织起来的。是的，你说得很对，是要做一期关于民族志的节目吗？

So this is, again, a bit like my conversation, which I've just recorded with Anna Riala about critical theory. It's quite an impromptu episode. So we organise this again within the space of about eight minutes on Twitter. Yes. Well, you quite rightly said, are you doing an episode on ethnography?

我说我不认识任何民族志学者。你有兴趣吗？你答应了。然后我们就开始了。

And I said, I don't know any ethnographers. Do you fancy it? And you said yes. And here we are.

我们开始了。

Here we are.

确实如此，因为在我看来，民族志是定性研究的鼻祖，是最早的系统性方法之一，人们通过它从社会互动和观察中获取定性数据。所以它完全值得单独做一期节目。谢谢你提醒我。

And it is quite right because to me to my mind, ethnography is the kind of granddaddy or grandmummy of qualitative research, that it was one of the first systematic approaches by which people drew kind of qualitative data from social interactions and observations. So it completely deserves its own episode. So thank you for reminding me.

不客气。你说得对，它实际上是扎根于人类学的第一种定性研究方法，已经有几个世纪的历史了。

You're welcome. And and you're right. It is, in fact, the first qualitative methodology grounded in anthropology. So it's, you know, centuries old.

在我们深入讨论之前，也许你可以简单介绍一下自己，你的学术和研究背景。

So before we go into that, perhaps you could say a little bit about yourself, your academic and research background.

好的，我接受的是社会学训练，职业生涯大部分时间都扎根于医疗环境。我作为科学家在医院工作过，从公共卫生起步，后来与神经科团队、骨科手术合作，更广泛地涉及肌肉骨骼领域，再到初级护理。现在我主要从事护理领域的研究。

Yes, so I'm a sociologist by training, and I've spent most of my career embedded in medical settings. So I've worked as a scientist in hospitals. I've worked from starting in public health. Moved into working with the neurology team, orthopedic surgery, the sort of MSK musculoskeletal field more generally into primary care. And now I'm situated within nursing.

我一直从事嵌入式研究。后来我从临床环境转到了大学环境。对民族志学者来说，这种转变本身就很有意思。

So I've always been embedded. And I've moved out of the clinical settings and into the university settings. So that in itself is an interesting transition for an ethnographer.

你现在的学术职位在哪里？

And where's your current academic post?

在加拿大安大略省伦敦市的西安大略大学。

So it's at Western University in London, Ontario, Canada.

好的。

Okay.

是的，在那里的护理学院。

Yeah, in the School of Nursing there.

我认为一个好的开始方式——至少在我与批判理论角力时很有效——就是我问安娜：如果你要在餐厅、酒馆或酒吧里，向一个完全不了解民族志方法论的人解释什么是民族志，你会怎么简单描述或解释它？

So I think a good way to start, or at least it worked well in my somewhat grapple with critical theory, when I asked Anna, if you were going to explain ethnography to someone that really had no sense about what it was as a methodology, in a restaurant, in a pub, in a bar, what would be the simple explanation to describe or explain what ethnography is?

这个问题很棒。我会说民族志是一种社会科学研究方法，通过深入人们所在的环境，从当地人的视角去理解该环境的社会意义和实践行为。它显然融合了访谈（各种形式的访谈）、观察，以及研究所谓的'人工制品'——即人们使用的物品和生活中留下的痕迹。

That's a great question. I would say that ethnography is a research approach, a social science research approach, whereby we go and immerse ourselves in settings where people are. And we try to understand the social meaning and the practices of that setting from the standpoint of the people who are there. So it obviously merges interviews and different types of interviews with observations, and also looking at what are called artifacts and that are the things that people use, the things that people leave behind as they go about their lives, their work.

正如你一开始提到的，它源自人类学，即对人或文化的研究。这一脉络是怎样的？

And so as you alluded to in the beginning, it comes from anthropology, where there's this study of people or cultures. What's the lineage there?

实际上这是个很有问题的起源。最初，整个人类学的研究方法，本质上是由基督教传教士前往其他文化地区展开的。这种'他者化'由此开始，其目的是证明西方价值观和宗教的优越性。所以这些记录都带有明确政治目的，缺乏反思性。当然，随着人类学发展，特别是六十年代芝加哥学派将其引入社会学后，我们已经远离了那些开端。

So it's actually a very problematic one. Originally, sort of the whole approach of ethnography, you know, it was really essentially Christian missionaries going out to other cultures. So the, you know, the othering began there, and the idea was to prove the superiority of Western values and Western religion. So these were very unreflexive types of accounts that had a particular political purpose. And we've of course moved a very long way away from those beginnings as we move into anthropology and through anthropology to sociology through the Chicago School in the sixties.

因为那些最初的研究者，你说他们是基督教传教士？

Because those original, were they Christian missionaries? Do you say?

是的，完全正确。他们前往非西方地区，记录下我们现在称为田野笔记的内容。但事实上，那些田野笔记深受他们自身信仰体系影响，几乎无法从当地人的视角真实反映文化现状。

Yes, absolutely. Who are going to sort of non Western settings and keeping what we would now call and what gave rise to field notes. So field note accounts. But of course, there is there are field notes accounts really. You know they were so so influenced by their own belief systems that they were barely looking at what was really going on in the culture from the standpoint of the people within it.

他们强行植入自己的价值观。所以这种'天真地去观察'的理念在该领域早已声名狼藉。我们知道人无法做到纯粹观察——我们总是透过自身信仰的滤镜，基于对世界的理论预设来看待事物。

They were imposing their own values, So it's, you know, this idea of naively going and seeing has been in disrepute for a long time in the field. So we know you can't do that. You can't go and see what's going on because we see through the lens of what we believe. We see through the lens of our own theoretical assumptions about the world.

是的，或许我们可以讨论理论在民族志中的作用，以及哪些理论能构建这种研究视角。回到我关于传教士的问题，虽然不想过多讨论他们，但正如你正确指出的，他们可能并不真正致力于融入异文化、尝试以当地方式生活，而是保持距离，试图将自己的观点强加于这个伪研究场域或他们接触的文化。

Yeah, and we can maybe talk about the role of theory and ethnography and what theories can frame that ethnographic perspective. So I think just getting back to my question about the missionaries, I'm not going to spend too much time with the missionaries, but but it would seem to me, yeah, just as you quite rightly said, that they possibly weren't so interested in kind of immersing themselves in the other culture and trying to kind of live, if you like, in that particular way or in that particular social context, but rather being a bit more distant and looking to impose their views or their values on the pseudo research field or the culture that which they were working with.

而且当时许多科学分支都在这样做。这确实是社会达尔文主义盛行的年代——认为所谓文明存在进化阶梯，而西方文明总被视为这个等级体系的顶端。当然，这些观念早已被摒弃，我们认识到透过这种视角进行任何研究都是根本性错误。

And and many branches of science were doing that. Certainly, you know, this is sort of the era where we have also social Darwinism that the idea that there's an, you know, an evolution to, you know, so called civilizations. And as always, with Western civilization being seen as being the top of that hierarchy. So again, these are these are sort of long time ago put aside and we realize the profound error of of conducting any type of research through that lens.

你将其描述为方法论民族志。这显然是一种方法论，而非方法集合或理论等更抽象的概念，而是一种关于开展研究的哲学，对吧？

And you describe it as a methodology ethnography. It's a it's clearly a methodology rather than a collection of methods or something more abstract like a theory, but it's a philosophy about doing research, right?

不，完全正确。如你所知，方法论和方法是截然不同的。我认为总体上，不同质性方法论采用的方法相似，但我们运用它们的方式、分析焦点、认识论和本体论基础，这些研究路径或传统可能截然不同。

No, absolutely. And methodology and methods, as you know, are distinctly separate things. I think in general, the methods are similar across the different qualitative methodologies, but the way we take them up, our analytic focus, the epistemology and the ontology underlying the research approach approaches or traditions can be profoundly different.

那么或许我们可以深入探讨这点。究竟是什么？如果我们尝试将民族志置于其他质性研究方法中来看，它们有相似的数据收集和分析方法，民族志赋予研究者什么独特视角？你在观察什么？比如你在医院科室观察临床医生时。

So maybe we can go into that. What what is it? So if we if we sit, try and situate ethnography in the context of other qualitative approaches, have similar methods of data collection and analysis, what is the perspective that ethnography gives the researcher? What is it that you're looking at? So if you're in your work, for example, in observing clinicians or physicians in hospital departments.

可能有扎根理论学者和现象学家都在观察同一群体。民族志能让你注意到什么？你对什么特别敏感？

You might have grounded theorists or phenomenologists both doing, observing the same group. What is it that ethnography gives you that draws your attention? What are you sensitised to?

民族志真正关注的是文化，关注群体层面的现象。有意思的是你提到的现象学，在某种程度上可以看作连续体的另一端。它关注生活体验，关注经验的本质，更聚焦于个体。所以我从不做现象学研究。

So ethnography is really interested in culture, it's interested in what's happening at the group level phenomenology. It's interesting you mentioned that would be in some ways if there was a continuum on the opposite end of that continuum. It's interested in the lived experience. It's interested in the essence of experience. It's very much more focused on individuals, so it's never So I never do phenomenological work.

虽然我认为现象学中的某些概念对所有质性方法论都产生了影响。

I mean, although there are concepts from phenomenological work that have been, I think, influential across all the qualitative methodologies.

所以社会互动这点非常有趣。它本质上是自然主义的，因为你并不试图控制任何变量，对吗？我在反思自己做过的质性研究，即便是半结构化访谈，仍需安排特定时间地点和问题列表，而民族志的数据收集方法就包括单纯观察事态发展——我这样理解对吗？

So it's really interesting that social interaction. So it's naturalistic to its core in so much as you're not trying to control anything. Is that right? So I guess I'm thinking about qualitative research that I've done, even an interview, semi structured or otherwise, it's still arranging someone to be in a room at a certain time and you've got a list of questions where ethnography, some of the methods of data collection are involved just observing, kind of seeing what plays out or am I going to miss?

不，不，你说得对。但我们更多是从参与程度的角度来思考这个问题。你以参与者的身份沉浸在环境中，而参与和观察的程度是有差异的。我的意思是，根本不存在完全自然主义的调查方式——当我们进行访谈时，我们其实是在与参与者共同构建数据。我们的提问方式会影响人们的回答。

No, no, you're right. But we think about it more in terms of levels of participation. So you're immersed in a participatory way in the setting and there's degrees of the degree to which you are a participant versus an observer. I mean you know there's no such thing as a purely naturalistic inquiry because yes, when we do interviews, we're co constructing data with our participants. What we ask has an influence on how people respond.

同样在民族志研究中，我们选择观察什么、如何进行观察以及分析方式，都会影响最终得出的解释类型。所以我认为不存在完全自然主义的研究形式。其次，与此相关的是，我听到对民族志观察最常见的批评就是所谓的霍桑效应——即人们在被观察时会改变行为。但别忘了，研究者既是观察者也是参与者。

And similarly in ethnographic research, what it is we choose to be observing and how we go about that and how we conduct the analysis will inform what type of interpretation we end up with. So there is no sort of purely naturalistic form of inquiry, I would argue. But second to that, and relatedly, one of the critiques I've heard the most often of ethnographic observation is this question around what's called the Hawthorne effect. And this is the idea that people behave differently when they're being observed. But again, you're observing and participating.

举个例子，当我们在急诊科进行观察时，我们派了一位博士生进去。她穿着白大褂，目的是在不欺骗他人的情况下尽可能不引人注目地融入环境。她长时间驻守在急诊科——白天、周末、夜晚都在场。要知道在急诊科这样忙碌的环境里，人们根本无暇过多关注周围。

So for instance, when we were doing observations in emergency department, we had a PhD student go in. She wore a white coat. She was meant to blend in without deceiving people meant to blend in as unobtrusively as possible in the setting. She was there for prolonged times during the day, on the weekends, at night. And you know in a busy environment like the emergency department, people are not going to be paying that much attention.

经常有研究人员进出进行其他类型的研究，但没人会因此改变自己的行为。所以我不认为会产生那种效应。霍桑效应源自美国霍桑市1920年代的一项工厂研究，他们试图通过观察来加快工人效率——比如当主管靠近时工人是否会加速工作。

There's researchers going in and out for other types of studies. No one's really changing what they do. So I don't think it has that kind of effect. The Hawthorne effect comes from a study that was done in Hawthorne in The States. And I think around the 1920s in a factory where they were trying to get factory workers to speed up how quickly they worked by and they were doing observations around, you know, if a boss person, if a person in authority stood closer to them, would they work faster?

至于这个理论为何被套用到民族志研究上，我说不清楚，但我觉得这种批评很烦人。

So how that ended up being so applied to ethnographic research, I can't tell you, but I find it an annoying criticism.

确实。我认为这是所有质性研究共有的问题。如果你把这视为问题的话——质性研究本质上是社会互动，涉及人们交谈、观察或参与。如果你说参与就会改变互动，那干脆就别做研究了。

Yeah. And I think it's all of qualitative research. And the minute you if you take it to be an issue, qualitative research by and large is social interactions. They involve people talking or observing or participating with other people. The minute you say, the moment you participate, you're going to change that interaction, well, then there's no point interacting.

所以我认为这是研究过程的一部分。你可以争论这点，或者像你提到的，通过某些策略来减轻行为改变——比如穿白大褂，但更重要的是长期沉浸其中，让参与者习惯环境，最终忘记自己正在被研究者观察或互动。

So I think it's part of the process. You can argue it, or maybe you can say, you've already said some of the strategies to kind of mitigate that potential change in behaviour wearing a white coat, but some of it is just prolonged immersion and getting participants used to that environment and essentially they forget that they're being observed or interacted with from a researcher.

是的，完全正确。不过我想从伦理角度说明，获取同意是一个持续的过程。所以对于可能担心这点的听众来说，融入环境的目的是不引人注目，而非欺骗。人们知道你在那里做什么。

Yeah, exactly. Although I do want to say in terms of ethics for me, obtaining consent is an ongoing process. So just for any listeners who might be worried about that, the the the point of sort of blending into your environment is to be an obtrusive. It is not to deceive people. People know what you're doing there.

他们明白你是研究者而非他们中的一员。我认为这一点很重要。但关于霍桑效应的批评——即研究者存在会污染研究——实际上源于科学客观主义，认为我们能绝对认知事物。而定性研究者寻求的并非客观或绝对真理，而是理解人们赋予经验的意义。

They understand your researcher and not really one of them. So I think that's important to note. But the critiques of the Hawthorne effect in this idea that the researchers presence contaminates the research really arises from objectivism in science and the belief that we can know things absolutely. So no qualitative researcher is looking for objective or absolute truth. We're looking to understand the meanings that people assign to their experiences.

这才是关键所在。

That's the point of it.

我们线下简单讨论过二十多年前汉默斯利那场关于民族志缺陷的辩论及其引发的回应。虽然没深入他那24页的批评或著作，但关键问题在于民族志学者如何看待现实——是否存在客观独立现实，还是新现实是被建构或共同建构的？随着时间推移，民族志学者是在这个连续谱上滑动，还是存在不同立场？

We spoke a little bit offline about the debate which happened twenty odd years ago with Hammersley and his argument or his critique of ethnography or what's wrong with ethnography and the responses that which came from that. But we haven't got to go into his 24 page critique or his book, whatever it is. But I suppose one of the key things was about how reality is viewed by ethnographers, whether there's a whether there is a objective, real, independent reality, or there's this new reality is constructed or co constructed. And is it the case that through the course of time, ethnographers have kind of slid across that continuum or are there different positions within ethnography?

不同民族志方法确实基于不同理论范式。但我们已明显远离现实主义——耐人寻味的是，汉默斯利在那24页文件中反复谈论'效度'，这其实是量化或后实证研究的质量标准，不适用于社会科学定性研究。这反映出定性研究目标与汉默斯利质量评估标准之间的错位。不过总体而言，我们已从现实主义转向批判现实主义，再到更批判的路径。

So there's definitely different theoretical paradigms underpinning different ethnographic approaches. But I think we've really moved away from realism and Hammersley strikingly in his 24 page document is he talks about validity. He comes back again and again and validity is a criterion of quality for quantitative or post positivist research, but not for the social science qualitative research approaches. So there's that mismatch I think between the aim of qualitative researches and where Hammersley is going there in terms of evaluating its quality. But I think for the most part, we've moved from a notion of realism to critical realism, to more critical approaches.

当然，我们已进入后结构主义时代，认识到语言不仅是描述性的，更是创造性的。因此现在大多数研究者已不再遵循后实证主义传统。

We've moved into the post structural era, of course, where we understand that words don't just describe, they create, all those types of things. So think most of us, or many of us working now, are not working in a post positivist type of tradition.

那么或许我们可以先了解民族志研究的实施方式。您能否分享些急诊科（大西洋彼岸称ER）的研究经历？比如产生哪些民族志导向的研究问题，采用何种数据收集方法，后续分析过程，或许还能谈谈部分研究发现？

So maybe I suppose to begin to to get a sense of the way in which ethnographic research can be conducted, if you perhaps share some of your own experiences that you've alluded to how you've used ethnography in A and E or ER departments if you're on the other side of The Atlantic, but emergency departments. Just tell us a bit more about that. The the sorts of research questions that were generated with an ethnographic mind, if you like, or framework, and the sorts of approaches to collecting data and the subsequent analysis and maybe even touch on some of the findings?

我在自己的研究中最常使用的方法被称为制度民族志。这是一种批判性的民族志研究方法。有趣的是，制度民族志的创始人多萝西·史密斯是加拿大杰出的社会学家，她将其描述为一种探究方式而非方法论，因为她想避开那种对方法的过度执着。她将其视为理解社会关系或机构在人们日常经验中作用的一种途径。

So the approach that I use most often in my own research is known as institutional ethnography. It's a critical ethnographic approach. It's interesting. Dorothy Smith, developed institutional ethnography, is a Canadian, a leading Canadian sociologist, and she describes this as an approach to inquiry as opposed to a methodology because she wanted to sidestep this sort of obsession if you will with methods. So she describes it as an approach to inquiry and it's a way of understanding and seeing how social relations or the what the role of the institution is in people's everyday experience.

我们总是从具体情境中人们面临的实际问题出发，而非抽象问题。这让我很自然地分享说，我研究的所有问题都来自临床医生、患者及其家属。我并非通过阅读文献自行构思问题，也不是提出抽象议题，而是深入实地与人们交流，发现他们真正面临的困境。

It we always start not in an abstract problem, but in a something that is a problem for people in a particular setting. And that leads nicely into me being able to share that all of the research problems that I've studied actually came from clinicians, patients and their families. So I don't sort of come up with the ideas on my own from reading the literature. I don't come up with abstract problems. I've been immersed in settings and able to talk to people and find out what were problems for them.

这个科室问题是由一位内科医生提出的，他注意到急诊科住院医师与内科住院医师之间存在大量冲突。当时正值安大略省医院（可能全国都如此）极力减少急诊就诊量的特殊时期，英国可能也面临同样情况。于是我们开展了制度民族志研究，我的一位博士生用一半时间跟随急诊住院医师，另一半时间跟随内科住院医师。

So department problem was brought to us by an internal medicine physician who was seeing a lot of conflict happening between emergency room residents and internal medicine residents. At a particular historical moment when Ontario hospitals, probably it was a national phenomenon, were really trying to reduce emergency department visits by patients, right? So that was probably happening in The UK as well. So we went in to conduct an institution ethnography. I had again this PhD student who shadowed emergency department residents for half the time and she shadowed internal medicine residents for half the time.

在倾听过程中，我们发现他们频繁使用'无法应对'这个词来描述某类体弱老年患者，认为他们并不真正需要医疗帮助。当我们开始解构这个术语时，团队里的临床医生反问我们为何关注这个词。这很好地展示了多学科团队如何能互相挑战固有认知——他们习以为常的术语，在我们追溯其使用过程中，揭示了该词如何转移人们对制度性问题的注意力：两组医生都被要求不断加速工作节奏，以致无法保证工作质量。

And as we were listening, we became aware that they kept all of them using this term failure to cope to describe a certain type of elderly frail patient who they felt didn't really didn't really need medical help. So we started unpacking that term and the clinicians on our team were saying to us, oh, like why are you paying attention to that term? So it's a good example of why having multidisciplinary teams allows us to challenge each other's assumptions. So they're so used to this term. They didn't think it was analytically interesting, but what we did when we trace the term is we were able to analyze how that term is used in a way to distract attention away from institutional problems in which both sets of physicians were being asked to speed up, speed up, speed up, speed up so much that they couldn't actually do their work well.

随着工作节奏被迫加快，医生们开始将'无法应对'的患者视为问题根源。实际上，这反映了系统效率低下和优先级设置问题，只是以这种特定话语形式呈现出来。

And so as they were being sped up, they started to focus more on these failure to cope patients as being the source of their problems. So it was really system inefficiencies and system priorities that were sort of discursively presenting themselves in this certain type of way.

能否简单描述下这种跟访观察的形式？比如你那位博士生或研究人员穿着白大褂的样子？抱歉打断。

So maybe just give us a sense of what that shadowing looks like. So you've got a PhD student or a research student. They're in a white coat. Sorry.

是的。我正想说，她本身是位医学人类学家，非常优秀的民族志研究者。

Yeah. And I was going say she was a medical anthropologist, very talented ethnographer in her own right.

所以她就在这个有点疯狂的急诊科或医院部门里，我称之为急症护理急诊科。她要么拿着剪贴板站在角落，要么四处走动。她的那种动态是怎样的？是在试图不被注意到吗？

And so she's in this kind of crazy A and E department or hospital department, acute care emergency department, I'll call it. And so she's kind of standing in the corner with a clipboard or she's kind of moving around. What's her what how does yeah. What's her what's that kind of dynamism like? Is she trying not to be seen?

她是相当直率地融入其中，接近病人吗？她在和临床医生以及该领域的工作人员交谈吗？

Is she quite upfront and gets in the mix and gets close to patients? Is she talking to the clinicians and the people within that field?

完全正确。她并不是默默地走来走去，只是盯着人看，因为那样会显得非常怪异且令人不安。但你知道，很多医学实习生都是这样训练的。影子跟随是民族志研究中常见的策略。所以她只是跟着一位特定的住院医生，在他们行动的过程中，住院医生自然会向她分享他们在做什么，但你知道，如果他们在与病人互动中，她不会开始问一大堆问题。

So absolutely. So she isn't sort of mutely walking around, just staring at people because that would be very, I think, odd and disturbing. But you know, a lot of medical trainees are trained this way. Shadowing is a common strategy in ethnography. So she's just sort of hanging out with a particular resident who as they're moving along is naturally sharing information with her about what they are doing, but you know, she doesn't, you know, if they're in the middle of an interaction with a patient, she doesn't start asking a ton of questions.

就像我们不会在人前做田野笔记一样，我们会等到安静的时刻去写下对刚刚观察到的事情的想法。她低调地进行影子跟随，但在休息时刻——我是说住院医生有喝咖啡的休息时间——她会和住院医生一起去，然后可能会问她一些问题，比如‘你能告诉我刚才那里发生了什么吗？’或者‘我感觉那里有点紧张，你能说说吗？’

Just like we don't take our field notes in front of people, we wait for a quiet moment to go and write down our thoughts about what we've just observed. Unobtrusively she's shadowing, but in off moments I mean you know residents have coffee breaks. She would go with the resident and then she might ask her questions about can you tell me a little bit more about what was going on there? Or it seemed to me that there was a bit of tension there. Can you tell me about that?

所以这是在寻求确认，这些是确认型的问题，诸如此类。

So looking for confirmation, those are confirmatory types of questions, that sort of thing.

所以非常丰富。我是说，这既不仅仅是访谈，也不仅仅是观察或参与观察，而是像你说的那样，是‘混在一起’。

So really rich. Like, it's it's I mean, really I mean, it's neither it's neither just interviews or or neither just observation or participant observation, but it's this, like you said, hanging out.

是的。

Yeah.

与你想要理解或试图解释其互动方式的人们共处。

Hanging out with the people that you want to understand or create some sort of explanation of those interactions.

是的，而且是长期相处。民族志学者常讨论的一个问题就是这些关系的本质。比如退出研究场景时的伦理问题——如果你待了好几个月后突然离开，人们已经习惯你的存在，我们该如何以符合伦理的方式处理这些情况？

Yes. And over an extended period of time. So one of the issues that comes up that ethnographers like to talk about is the nature of those relationships. You know, things like the ethics around exiting settings. You know, people get used to you being there if you've been there for several months and then you're leaving and sort of how do we handle those things in an ethical way?

这很有趣。

Do we Interesting.

没错。如果你每隔一天就一起喝咖啡，反思那些临床时刻发生的事，某种程度上就能建立起友谊和个人联系。

Yeah. Because if you're having a coffee every second day and reflecting on what went on during that kind of clinical moment, you can just create friendships in a way and personal connections.

完全正确。多萝西·史密斯在《制度民族志》中写过制度性同化的风险。当你沉浸得足够久，开始完全通过局内人的视角看待文化时，可能会逐渐丧失自己的独立判断。而正是这种独立判断让你能质疑环境中人们的前提假设，比如那个应对失败的例子。

Absolutely. Dorothy Smith in Institutional Ethnography writes about the risk of institutional capture. And that is when you're immersed for long enough, start seeing the culture, if you will, so much through the eyes of the people already in it that you sort of lose touch with your own sense of it. And it's your own sense of it that allows you question the assumptions that are being made by people within the settings, such as that failure to cope example.

接下来很适合讨论局内人与局外人研究，或者说主位视角——通过长期沉浸在该文化中，你某种程度上会内化其知识体系、价值观和实践方式。但你始终是个局外人，因为你永远无法真正了解人们内心的想法或他们的现实世界。

What might follow nicely is to touch on insider and outsider research or the emic ethic position where you're by spending time and immersing yourself in that culture, you, to some extent, become an insider of the kind of knowledge and values and practices of that culture. But you're also an outsider because you really have no idea about what's going on in people's minds or worlds or realities.

正是如此。某种程度上我们都是既内且外的观察者，需要反思性地理解自己在特定场景中的角色。我总举这个例子：如果我作为护士研究某个临床单元的护理行为，那就是高度参与式的观察，近乎完全融入。

Exactly. So and we're all yes. So we're all insider outsider to some degree, and you need to reflexively sort of understand what your role is in any particular setting. I always give the example of if I was a nurse and I was studying nursing behavior in a particular clinical unit, that is very participatory. That's like full participation.

我不仅研究环境，通过培训和角色，我实际上已成为其中的一部分。显然，我更多时候是以非临床人员的身份从外部研究临床问题。两者并无优劣之分，关键在于我们能否意识到自身在研究中的立场，并思考这对我们所见所闻及数据分析解读的影响。

Not only am I studying the setting, I'm literally part of it by training and role when I study things. I'm obviously often more outside than I am on the inside because I'm studying clinical issues as a non clinician. And neither one is better or worse than the other. All of it comes down to our ability to be aware of our positionality within our research studies and to be able to think through what impact that has on what we're seeing and how we're analyzing and interpreting data.

是的，正如你所说，作为内部人士确实有优势。像我这样以临床医生身份研究本专业，就像一把双刃剑——我既对行业规范、价值观和术语体系（可以说是我的职业文化）特别敏感，这可能是优势；但另一方面，正如你之前的例子所说，有些含义对我而言是理所当然的，我可能不会像局外人那样深入思考这些行为或实践的意义。

Yeah, as you said, as an insider, it affords you. So me as a clinician doing research into my clinical profession, it's a kind of double edged sword that I'm both sensitised to the norms and values and the kind of language which takes place in my my culture, if you like, which might be a benefit because I might be a little bit attuned and familiar with the field. But on the other side, as you were saying in your example previously, that there'll just be assumed meanings of things. And I just that are just second nature to me, and I'm not necessarily taking a moment to really critically think about what these behaviors or practices mean than outsider would.

没错。这正是民族志研究的巨大优势所在——如果你问我课堂上做了什么，我只能说出自己有意识的行为；但若观察我的教学，你会注意到许多我自己都未曾意识到要描述的细节。民族志让我们不仅能听到人们的自我描述，更能看到动态实践。

Exactly. And yes, and that brings me to one of the great benefits of ethnography and ethnographic observation is that, you know if you asked me what I did in the classroom, I only have access to those things I'm aware of doing in the classroom. But if you observed me in the classroom teaching, you would notice different things about what I'm doing that it doesn't even occur to me just to verbalize because I'm not really doing them consciously. So with ethnography we get to see we get to hear not just how people describe what we do. We get to see that in motion.

因此我们得以观察社会情感，我认为这正是其力量所在。

So we get to see the social emotion, and I think that's what gives us its power.

我有几个问题想请教。首先是关于你处理的数据类型——是单纯的田野笔记？还是包括咖啡时间的访谈转录？用研究术语来说（我在这里比个引号手势），完成数据收集后，这些数据具体是什么形态？

And there's a few questions I wanna ask. One is about the sorts of or the nature of the data that you're working with, whether it's just field notes, whether the interviews at the coffee break are transcribed, what is the once you've done this data collection, and I'm using kind of air quotes here, because that's the kind of pretty standard terminology in research. What kind of data, what does the data look like?

数据主要是详尽的田野笔记。因为你要记录对观察现象的认知演变过程，与团队合作时需尽可能精确描述所见。比如我指导观察员时，他们常写'资深医师走进房间'，我就得在页边批注：'你如何判断他是资深医师？'

So the data is field notes and field notes are extensive. So that's quite a lot of data there because you're trying to record your evolving understanding of what you're seeing. You're trying to be when you're working with teams as precise as you can be as to what you're seeing. So when I'm supervising people doing observations, they'll frequently give me field notes that say things like a senior physician walked into the room. And I have to say in the margins, okay, how did you know that it was a senior physician?

他们需要说明这点。之后他们会修改为'一位年长男性进入房间，其他人表现出明显尊重的倾听姿态'。这样很好，因为'资深'可能是他们的假设，这让我能理解他们如何形成这种判断。所以说，撰写优质田野笔记是门需要修炼的艺术。

You need to tell me that. And then they go back and rewrite it and say, an older man walked in the room and the others seemed to listen to him with market respect. And that's good because then I know the fact that he is senior could just be their assumption that allows me to get behind how they're making the assumptions that they do. So it's quite an art to learn how to write. Good field notes you're doing.

你们进行这些临时对话的同时，也在开展正式访谈。然后是实物资料的问题。我所采用的制度民族志方法高度依赖文本。这种方法本身基于一个信念：我们是文本中介的社会，意味着统治关系通过文本来实现。比如院长或大学校长不会直接告诉我作为教授该如何行事，而是通过各种政策文本间接规范我的行为。所以我们也在审视各类文本，而文本的定义可以非常宽泛。

You're having these ad hoc conversations, but then you're also conducting formal interviews And then this issue of artifacts. So institutional ethnography, the approach I use relies a lot on text. It's sort of the approach itself is founded in the belief that we're a text mediated society, meaning that ruling relations occur through text. So the dean or the president of the university doesn't come and tell me how it is I should behave as a professor, but I'm sort of told what it is I should be doing through all the various policies. So we're looking around at text as well, and text can be very sort of broadly defined.

那么你是在对这些观察记录——或者说对观察或互动的反思——与访谈内容进行三角验证吗？你提到可能存在更正式的访谈。你是希望通过三角互证来整合这些材料吗？

And so are you triangulating those the observations or the rather no, rather the reflections about the observations or the interactions plus the interviews? You said there may be some kind of more formal interviews. Are you looking to triangulate this stuff and conversion?

不不不。我特意避免使用'三角验证'这个词，因为它暗示存在某种更绝对或更优越的真相版本。仿佛只要把所有数据碎片拼凑起来就能找到真相。实际上不存在绝对真相，我们审视所有这些材料是为了展开分析。

So no, no, no. So I specifically avoid the word triangulation because again, it implies that there is a more absolute or better version of truth. And if we just, you know, put all our little pieces of data together, we're going to find it. So no, there is no absolute truth, but we are we are looking at all of these things in order to develop our analysis.

关于团队协作方面，人们是作为独立民族志研究者工作，还是多人协作效果更好？

And in terms of group work or is do people work as sole ethnographers or is it work better if there's a few of you that

从人类学或社会学转向卫生服务研究时，学科训练的最大差异之一就是：卫生服务研究中所有工作都以团队形式开展。而若留在传统院系框架内，民族志研究基本是单打独斗。我主要与团队合作，非常幸运能与这些临床团队共事。没有团队协作我根本无法完成工作，因为有时我会钻牛角尖——比如注意到某些现象时，临床团队能帮助理解背景和意义。我和团队临床人员之间形成了有趣的辩证关系。

So one of the first things that one of the biggest differences in disciplinary training between being an end coming out of anthropology or sociology and going into health services research is that in health services research everyone does everything in teams. Ethnography, if you're still in your traditional departmental role, is a solo activity. For the most part, I work with teams and I've I've been extraordinarily lucky with the clinical teams I've had a chance to work with. I really couldn't do the work that I do without being on teams because sometimes I'll be really sort of going down the wrong rabbit hole, so to speak, because I noticed something that the clinical teams are able to sort of put context and meaning around. And it's been an interesting dialectic between myself and the clinicians on the team.

在慢性疼痛研究项目中，我与同一支临床团队、研究团队合作已久，成员包括家庭医生、生命伦理学家、疼痛心理学家和护士。这样多元的临床群体构成使研究工作更加扎实。

I've now for my chronic pain work been working with the same clinical team, the same research team for very long time, and it's comprised of family medicine doctors, bioethicists, pain psychologists, nurses. So I have a really amazing representation of different clinical groups. And that allows the work, I think, to be that much stronger.

我想这其中始终存在一种风险：随着对团队、领域和环境的熟悉，你可能变得麻木，丧失批判性反思能力。必须保持这种警觉，适时抽离以获得客观视角。

And is it, I guess, there's always a risk that you then become that familiarity with the group and the field and that setting kind of desensitizes you that you become not I guess you've got to maintain that critical reflexivity and step out or step away to get some sort of perspective.

在团队中实践反思性是个绝佳方式，因为我们可以互相挑战彼此的假设，而团队反思需要信任基础。你必须确信自己能直言不讳地说出对他人行为及意图的看法和预设，而不必担心因此受到责难或批评。长期合作的团队有助于建立这种信任，但我们绝非群体思维——每个人对数据和现状都有截然不同的视角。

Being in a group is a great way to practice reflexivity because we can challenge each other's assumptions and you need trust to practice reflexivity in a group setting. You have to know that you can actually say what it is you're thinking and assuming about people and their behavior and their meanings without risk sort of being taken to task for that or criticised. So having a long standing team helps with having created that trust. But there is no group think. We all sort of have very different perspectives on data and on what's going on.

那么民族志学者会采用哪些策略来保持反思性？或者...

So what might be some of the strategies that ethnographers go through to be reflexive or to?

我认为这个问题显然关乎反思性对民族志研究的重要性，否则我们只是在记录自己既有的认知框架。策略之一就是持续为观察到的现象寻找替代性解释。需要在实地观察、文献研读和团队讨论之间不断往返，反复追问'这里究竟发生了什么'，同时深度思考自身立场——为何你会以特定方式解读所见现象。

So I think the question is obviously around how important reflexivity is to ethnography, because otherwise all we're doing is going and recording our own existing preexisting beliefs about the way things work. So I think one of the strategies is to constantly be searching for alternate explanations to what we're seeing. You know going back between sort of what you're seeing and reading the literature and talking to others on the team about what is going on here is the question that you're asking a lot and really thinking a lot about your own positionality and why it is you might be seeing the things you believe you're seeing.

这么说来，反思过程部分涉及考量文献的影响：文献在何时介入研究并开始形塑我们的观察？在扎根理论领域，关于文献在数据分析和理论构建中角色的争论已持续数十年。民族志学界是否存在类似讨论——文献该留待最终撰写阶段引用，还是前期用于概念敏感化？当前主流观点是什么？

And so with that, so part of the reflexive process is to think about the literature and to what extent the literature is brought into the study and begins to shape what we're seeing. And in grounded theory, there's, you know, there's decades old arm wrestling going on about the role of the literature in data analysis and and the development of a grounded theory. In ethnography, is there a similar debate that the literature should be kept till the end, the write up, or be used in the beginning to sensitize yourself or being brought in? What's the current discussion?

确实。我认为扎根理论中'无需文献即可开展研究'的观点很荒谬。那样研究者就真成了无知者，这根本说不通。我们应该清醒认识到自身带入研究的理论预设，学术阅读只会提升研究质量。

Yeah. So I think that grounded theory argument that you can come in without literature is silly. So then you'd really be an unknowing researcher, which really makes no sense. So I think we want to be aware of sort of the theoretical assumptions we bring into any study. So reading and scholarship can only aid I think in the quality of a study.

我不认为学术性研究方法会带来负面影响，毕竟...难道不是吗？你观察到的任何现象都无法脱离你的阐释框架独立存在。正是通过理论文献的阅读，我们才得以觉察自身的认知模式和观察视角。这是我的个人见解。

Don't see how being scholarly in your approach can detract because again, isn't. It's not like you're going and seeing there is there is no. There's nothing going on that you can report that exists outside of your interpretation of it. So it's through reading theory and reading literature that we become aware of what we believe and how we're seeing things. So that would be my own take on it.

民族志学者兼人类学家蕾妮·福克斯关于理论有句精彩论述，需要我读出来吗？

Renee Fox, who was an ethnographer and anthropologist, actually has a great quote on theory. Do want me to read it?

拜托，对，对。

Please, yeah, yeah.

是的，因为我经常想起这句话。她说：'渴望进入这一领域时，不带任何先入为主的观念，不预设自己会寻找或发现什么，以实现科学客观性的纯粹概念，这既无必要也不现实。如果真能像白板一样进入田野，指望让田野自己发声，很可能离开时你仍是一块白板。'所以我特别喜欢这个比喻——你进去了，却什么都没学到。

Yeah, because I think of this quote a lot. She says, Aspiring to enter the field devoid of any preconceived ideas of what one may be looking for, expect to find, in order to fulfill a purist conception of scientific objectivity is neither warranted or realistic. If it were possible to go into the field as a tabula rasa with the aim of letting the field speak, it is likely one would exit the field in the same state. So I love that. You'd go in, you'd learn nothing.

而且，我觉得凯西·查马兹（建构主义扎根理论学者）用的那个说法大概是

And, yeah, and I think that the phrase that's used by I think it's Kathy Chamaz, who's a constructivist grounded theory is something like

没错。

Yes.

'开放的头脑，而非空空如也的脑袋'。你不可避免地会带着理论、经验和先验知识进入田野，但可以保持惊奇感和开放态度，对那些出乎意料的事物保持惊喜。

An open mind but not an empty head. So you you cannot help but go into the field laden with theory and experiences and kind of a priori knowledge and views. But you can have a sense of wonderment and openness to be surprised about things that you otherwise wouldn't have expected to to take place or to to kind of find out.

我太喜欢这种'惊奇感'的概念了。我总是告诉新生：我做的每项质性研究或民族志研究，都发现了完全意料之外的东西。民族志研究根本无法预测走向，这让伦理审查委员会的研究者很头疼——他们总想确切知道你会发现什么，而你只能说'我真的不知道'。你只能说是与这个宽泛主题相关，但具体形态完全无法预知。

I love that idea of the wonderment. I always say to new students that I've actually never conducted a qualitative or ethnographic study where I didn't find things out that I had did not expect to find in any which way at all. You can't predict where you're going in an ethnographic study, which has caused all kinds of headaches for researchers with REB boards who want to know exactly sort of what you're going to find and you have to say, I don't know. I really don't know. So, you know, something in relation to this broad topic, but I have no idea what specific shape that's going to take.

确实。比如在你观察临床互动的工作中，扎根理论有个'理论性抽样'概念——研究开始时你可能只想观察或访谈 clinicians，但随着分析和理论发展，数据会引导你去接触意想不到的人群，比如兽医或飞行员，来完善理论视角。这种抽样变化在民族志里存在吗？或许民族志根本不用抽样？听起来你们的资料收集方式完全不同？

Yeah. And so in terms of the so, for example, in your work observing clinical interactions, in grounded theory, there's this notion of theoretical sampling where you would where you'd start out the study thinking, well, I want to observe or collect data or interview clinicians, let's say. But then at some point in your analysis and your theory development, you begin to ask questions of your data, which suggests you might need to speak to people you had no idea, you know, vets or, I don't know, airline pilots or something helps to give some theoretical perspective and to fill in aspects of the theory. Is there that change in sampling? And maybe even sampling doesn't work with ethnography because it doesn't sound like you're sampling in the same way that you would if you're collecting data?

是的，在制度民族志中，我们实际上讨论的是对制度过程进行抽样，这正是我们试图做的。我们通过与当地环境中的人交谈来推进研究。当我们试图整合协调他们经历的因素时，就会开始与其他人交谈。比如从ICU护士到医院行政人员，再到政策制定者，逐步向上追踪，通过观察超本地层面来理解当地环境中的情况。我认为许多传统民族志仅停留在描述层面，局限于当地环境。

Yeah, in institutional ethnography, we actually talk about sampling an institutional process, is really what we're trying to do. We proceed by sort of speaking to someone in a local setting. And then as we're trying to put together what is coordinating the experience that they're having, then you do start speaking to others. You do move from, let's say nurses in an ICU to talking to a hospital administrator to talking to policymakers and sort of you're moving up trying to trace what's happening in that local setting by looking toward the extra local. I think a lot of traditional ethnography is that are descriptive would just stay within a local setting.

这完全没问题。但除非你确切知道谁会在那个当地环境中、你可能与谁交谈，否则无法预测。

That's absolutely fine. But you can't predict unless you know for certain who's going to be in that local setting, who it is you might be speaking with.

所以我在思考——假设你在急诊科，民族志研究者跟随一位临床医生。房间一侧可能正发生着患者与医生的互动，然后家属或清洁工进来，又引发了新的互动。

And so everyone so I'm just trying to think. So you're in the A and E department. You've got your ethnographic researcher shadowing one of the clinicians. There's stuff happening in one side of the the room, let's say, or setting between a patient and a clinician. And then someone else walks in, a family member or the cleaner, and that sparks off another interaction.

是否所有人都算研究对象？比如清洁工没签同意书，但其互动可能产生有价值信息，却因未获同意而不能记录？这种情况如此不可控，你们如何界定研究参与者的范围？

Is it the case that everyone's fair game that they're all part of this research study? Or is it the case that the cleaner didn't sign the consent form, but yet might bring something, you know, something might be generated from his or her interaction, but you can't notice it because they haven't consented we had? Because I guess it's so it's potentially so uncontrolled. How do you decide who's part of this research and who's not?

这是个好问题。我不打算从伦理角度具体回答。但你们确实有分析重点，我们会制定观察指南，文献中有多种指导方法。这类似于半结构化访谈指南，但更侧重于明确观察目标。

That's a great question. So I'm not going to I'm going step away from answering that as an ethical issue specifically. But I mean, you do have an analytic focus. We do develop observation guides to start, and there's lots of different direction in the literature around how to do that. It's similar in some ways to a semi structured interview guide, but it's giving guidance around what you're going to be looking for.

你描述的第一种观察方式称为'广泛扫描'——观察所有发生的事，再从中识别分析价值。但比如我们进入急诊科时就有明确重点：研究内科住院医师与急诊科住院医师的互动关系。

So the first way you described of observing is what's called broad sweep. So you're sort of looking at anything and everything that's going on, and from there trying to determine what might be analytically interesting. But we went into, for instance, our emergency departments. We did have a focus. We wanted to look at the interaction between internal medicine residents and emergency department residents so that that was the primary focus.

伦理上我们不允许记录患者相关信息。虽然观察到医患互动，但完全不记录笔记，因为患者不属于研究范围。

Ethically, we weren't allowed to record anything about patients. While we observed patient interaction, we kept no notes because patients were not part of the study.

所以你没有做笔记？没有。但不管怎样，是的，资料就在那里某个地方。

So you didn't keep notes? No. But nonetheless, yeah, it's in there somewhere.

但我们对那项研究中医生与患者之间的互动并不特别感兴趣。所以，你知道，你的问题没有固定答案，但你会逐渐明白自己的分析重点是什么，以及它如何引导你。要知道，当你长期沉浸在一个环境中——比如我读博士时，三年都泡在一个特定场景里——那是很长的时间，我和每个人都打过交道。而且我在做制度民族志研究，所以我有意接触尽可能多与我的研究现象（急性卒中护理组织）相关的人。

But we weren't specifically interested the interaction the physician and the patient for that study. So I, you know, there's no there's no hard and fast answer to your question, but you know, you sort of learn sort of what your analytic focus is, how that might guide you. But you know, when you're immersed in a setting for a very long time and like so for my PhD, I was immersed for three years in a particular setting. You know, that's a very long time and so I interacted with everybody. And I was also doing institutional ethnography so I was purposefully trying to speak to as many people as possible who were involved in any way in my phenomenon of interest, which was the organization of care for acute stroke.

好的。我想最后再探讨几个话题。首先是简要说明数据生成后的分析过程，是否有民族志定性数据分析的独特之处。其次要标记的是能为民族志研究提供信息的理论视角，你提到过批判性基础方法或批判性启发方法。

Okay. And I think some final topics I if it's okay to touch on. One was perhaps giving a sense of the sorts of data analysis which takes place once the the data is generated, whether there's anything particularly distinctive of ethnographic qualitative data analysis. The second thing, to earmark, is something around the the theoretical perspectives which can inform ethnographic research. You mentioned critical critically based approaches or critically informed approaches.

先说分析部分。当你生成了这些数据（主要是田野笔记，可能还有些访谈记录）后，该怎么处理？

So the first thing is just about the analysis. So once you've generated this data, largely field notes, maybe some interviews, what do you do with it?

好问题。首先你的表述很有趣。实际上分析和解释从研究一开始就进行了。甚至在确定研究问题时，我们就已经在做解释性工作。所以观察的同时，分析就已经开始。

Good question. So first of all, the way you phrase that is interesting. So we're the analysis, the interpretation starts at the very outset of the study. Even even in determining a research question, we start to be interpretive. So as you're observing, you're beginning analysis.

这种分析是为了逐步形成对研究场景中与研究问题相关现象的理解。它不是等到所有观察结束后才进行，而是贯穿全程。我认为这是所有质性研究的优势之一——我们边收集数据边分析。人们的分析方法各不相同。

And the analysis there is to develop an evolving understanding of what's going on in a particular setting in relation to your research question. So it doesn't happen at the end once you've done all the observations that's happening as you go along. And that's one of the strengths I think of all qualitative research, right? Is that we're analyzing concurrently to data collection. People analyze their data in different ways.

没有固定模式。民族志研究通常旨在对某事物进行描述，一种理论丰富且信息密集的描述，以揭示特定场景或现象中不为人知的方面。因此你不必拘泥于布朗和克拉克的主题分析法（编码和提炼主题）。有些民族志研究者会这么做，我有时也这样做。

There is no one set way. We're moving in ethnography most often toward a description of something, a sort of theoretically rich and information rich description to capture something that isn't commonly known about a particular setting or phenomenon. So in that way you don't have to move to sort of like the Brown and Clark thematic analysis of, you know, coding and developing themes. Some ethnographers will do that. I've done that at times.

在制度民族志研究中，我们拥有不同的分析工具。我们会讨论如何识别一个情境中的'问题域'——这与该情境中人们自述面临的问题有所不同。我们会探寻意识形态与情境构建之间的断裂，以及实际发生的情况。以我的博士研究为例，在考察急性卒中救治体系时，我审视了循证医学及其意识形态层面的内涵，然后观察其实际运作方式，发现理论与实践之间存在巨大鸿沟。

Also with institutional ethnography, we have different analytic tools. We talk about identifying a problematic of a setting which is different than the problem people in that setting describe that they're facing. We talk about looking for disjunctures between sort of the ideologies and forming a setting and what's really happening. To make that more clear again in my PhD looking at the organization of acute stroke care, looked at evidence based medicine and sort of what that implied at an ideological level. And then I looked at how that was actually practiced and there was a huge disjunctures between the theory and the practice there.

因此我无法逐一详述每种分析策略，但研究者确实拥有多种方法可选。这在某种程度上取决于他们开展研究时的理论预设。

So I can't go into sort of every analytic strategy, but there's a wide range that is available to researchers. And that will partially depend on what their theoretical assumptions are going into the work.

是的。但你提到分析方法的系统性存在显著差异这点很有趣——我能想象有些人会逐行编码，建立宽泛的类别体系；而另一些人则采用更为流动、演进式的分析形式，可能结构化程度较低。这样描述是否准确？

Yeah. But it's interesting how you said that there's a real variation in the kind of systematicity in regards to the analysis that you can go, I would imagine, people doing coding line by line, you know, development of broad categories, but then you've got a much more kind of fluid evolving form of analysis where it's probably less structured. Would that be fair that

嗯，可能结构化程度确实较低，但严谨性并未降低，对吧？因为...

Well, yeah, possibly less structured, but not less rigorous, right? Because right?

因为...是的...我并不是在暗示...

Because Yeah. Know. Wasn't suggesting that was

没错。因为你仍在持续思考你的数据——无论是田野笔记、实物资料还是访谈记录。你始终致力于构建解释框架和描述体系，这必然涉及某种程度的分类命名，或借助理论来理解研究发现。

yeah. Yeah. Because you're you're still thinking about your your data, whether it's field notes or looking at artifacts or interviews. You're you're constantly thinking with a view to create an explanation, a description of it. And that involves some degree of categorization or calling things certain things or finding theories to help you make sense of what you're finding.

最后如果时间允许——或许可以放在结尾部分——能否简要提及批判取向民族志研究的几种流派？当前是否存在某些主导性的理论视角正在推动特定分析模式或问题意识？比如是否存在女性主义民族志或其他批判性研究范式？

And then finally, if you're able to, it's with time to put this at the end, but just maybe allude to the sorts of kind of flavors of ethnographic research in terms of critically based. Are there particularly strong perspectives that people are currently taking into the theoretical kind of frameworks which are driving forms of analysis or certain questions? So I'm, are there feminist forms of ethnography and kind of critically based ones or?

你知道，关于民族志这种方法，人们常问的一个问题是，因为它传统上主要是描述性的，'这有什么用？能产生什么影响？' 我想到了查尔斯·博斯克的作品《宽恕与铭记》，那是一部关于患者安全和医疗失误的民族志研究。实际上，它是对医疗失误的民族志研究。这项研究引发了患者安全运动，在北美影响巨大。

You know, one of the things you get asked about an approach like ethnography, because it's largely traditionally descriptive, Oh, how is this useful? What kind of impact does this have? And I think about Charles Bosque's work, Forgive and Remember, which was an ethnography of patient safety and medical errors. Actually, was an ethnography of medical errors. It led to the patient safety movement, which was huge in North America.

我不确定它是否跨越大西洋传到英国，很可能有。这场运动影响深远。可以说，它正是由那部经典的民族志研究所点燃的。我认为我们从民族志中学到了很多，能够批判性地揭穿人们的假设，通过展示'看，这才是实际情况'。

I don't know if it made it across the pond to The UK, probably. Huge movement. And that was literally to, I think arguably, sparked from that ethnographic classic. I think we've learned a lot from ethnographies in terms of critically being able to debunk the assumptions people are making by saying, Look, here's what is actually happening on the ground.

今天我们录制时，定性播客系列中的《扎根理论》一集刚刚发布。我采访了澳大利亚的扎根理论学者简·米尔斯和梅兰妮·伯克斯。简提到了霍华德·贝克尔关于《男孩与白人》的研究。

So as we record this today, the Grounded Theory episode is released for the series of qualitative podcasts. And I spoke to Jane Mills and Melanie Berks, who are grounded theorists based in Australia. And Jane mentioned Howard Becker's work on Boys and White.

是的，《男孩与白人》，那是医学教育领域的经典，社会学经典之作。

Yeah, Boys and White. It's a classic around medical education, a sociological classic.

是的，我之前不知道，所以谷歌了一下。但我问她的问题是：扎根理论兴起于六十年代中期，那时定性研究——请别介意——相对缺乏结构，就像你描述的，民族志定性研究更偏向有机方式。然后扎根理论出现，试图将其系统化、规范化...

Yeah, wasn't aware, so I Googled it. But she I think the question I put to her was, grounded theory arose at a time in the mid sixties where qualitative research wasn't don't take don't take offense, was unstructured in so much as as you've described it, there's a a more organic way of doing ethnographic qualitative research. And then grounded theory came along and looked to kinda systematise this and make it rigid for the-

更实证主义。

More positivist.

没错，但不一定变得更好。不过对某些人来说，这正是吸引力所在——那些想要满足科学家和实证主义者的人。所以这又回到了我们最初讨论的：民族志在定性研究及其发展历程中占据着重要地位。

Yeah, but yeah, I'm not the same for the better. But for some that would have been an appeal, people that wanted to satisfy the scientists and the positivists. So yeah, it was just that comment that it comes back to what we're talking about at the beginning, that ethnography has had a prime place in qualitative and the development of qualitative work.

是的，完全正确。《白衣男孩》绝对是一部经典之作。有趣的是，有位女性写了本名为《告别男孩们》的书，这是她作为外科女医生的自传体民族志记录，讲述了她因医学界的父权结构而离开这个领域的故事。所以我认为我们需要重写《白衣男孩》。这本书成书于女性几乎不被允许进入医学院的年代，书名由此而来。

Yes, absolutely. And Boys in White is definitely a classic. You know, and interestingly, a woman wrote a book called Walking Out on the Boys, which was an auto ethnographic account of her time as a woman in surgery and how she left the field due to sort of the patriarchal structure of medicine. So I think we need to redo Boys and White. It was also written at a time when women weren't really allowed into medical school, hence the title.

但自那以后，出现了许多我认为极具影响力且优秀的民族志方法论著作——顺带一提，这类研究特别适合写成书籍。要把长篇民族志研究压缩成论文实在太难了，对吧？你会遗漏太多细节。

But since then there's been like so many, I think profoundly influential and great pieces of work using ethnographic methods and they really, by the way, lend themselves to books. It's very hard to put a sort of a long ethnographic study into a paper. Right? You're you're leaving out so much detail.

我正在看你那篇关于+1的论文（我会把链接放在节目备注里），看起来大概有16页的样子。是的，然后...

I'm just looking at your paper now. The one on plus one, which I'll I'll link in the show notes, which I think is 16 pages, it looks like. So Yeah. And that and

就是这样。要知道，我们当时不得不和审稿人争论，因为他们要求删掉我们所有丰富的描述性数据。我们觉得那些恰恰是研究中最有趣的部分，但他们只想要结论和大量关于方法论的问题。

that was them. You know, we we had to fight with the reviewers because all of our rich descriptive data, they made us cut out. Yeah. We're like, That's, you know, that's that's that's the the most interesting part for us of the work. But they really wanted, you know, conclusions and a lot of questions about the methodology.

非常注重程序性细节，极其严格的流程要求。

A lot of procedural, real procedural focus.

但你说删掉了所有丰富的描述？我看你们研究结果部分的引文篇幅相当可观。通常非民族志的质性研究只会用几行文字来支撑分析性论点，但你们的论文——我猜其他民族志论文也是——呈现的是更完整的叙事。

But you say it's you cut out all the rich description. Looking at the size of the quotations in the findings, they're pretty hefty. Whereas often you just get a couple of non ethnographic qualitative work, just a couple of lines to illustrate analytical claims that the research is making. But in your paper, and I'm imagining other ethnographic papers, they're much larger narratives.

没错。而且你要知道，这篇论文里基本没体现民族志田野调查的部分。如果是写给人类学期刊，整个研究呈现方式都会不同——不会采用背景-方法-结果-讨论的结构，而是直接向读者讲述你的调查过程和发现的故事。

Yes. And they're also because you can imagine, what doesn't get into that paper too much is the ethnographic fieldwork piece. If you're if you were writing to an anthropology journal, the whole way the study is written up would be different. So we wouldn't be in that sort of background methods findings discussion. You are you'd literally be sharing the story of what you did and what you found out with the reader.

你带着它们一起，这样会更具有叙事性，而不是这些类似临床期刊的格式。这是其中之一，这也是我作为一名多年来在健康领域工作的社会学家所面临的矛盾之一，你知道，有时不得不压抑自己作为社会学者的部分，以使作品适合发表在临床期刊上。但我故意这样做，作为我试图推动变革的政治承诺的一部分。如果我写的作品只发表在非临床期刊上，那些我认为应该读到它的人，那些有能力做出改变的人，可能永远看不到它。

You take them along, it'd be more narrative and less in these sort of clinical journal formats. And that's one of the things, that's one of the tensions for me being a sociologist working in. Health Carol all these years is is, you know, around having to fight sometimes the sociological part of me in order to make the work fit into clinical journals. But I do that on purpose as part of my political commitment to trying to make change. If wrote the work I did and put it only in non clinical journals and the people who I feel I would want to read it, the people who are in a position to make change would never see it.

我认为很多社会科学家都会这么做。

And I think a lot of social scientists do that.

但我在想，最后，对于那些可能想采用民族志作为研究方法，或者只是想将民族志研究应用于临床实践或工作环境的听众，你有什么建议或指导可以给他们吗？

But I wonder, finishing up, there are any pieces of advice or guidance that you would give listeners that potentially might want to engage in ethnography as a research approach, or perhaps if they're just looking to engage in ethnographic research to use in their clinical practice or their work setting, what would they be?

这是个很好的问题。最近我最常给学生们的建议是：阅读。与其一开始就对民族志方法论论文感兴趣，不如先阅读一些在你最感兴趣的领域已经完成的民族志研究。我觉得人们在这方面做得不够。你需要感受这些类型的发现是否与你有共鸣？

You know, that's a great question. Here's the advice I've taken to giving people, students the most often these days, which is read. So rather than read methodology papers to begin interested in ethnography, read some of the ethnographic studies that have been done in whatever area it is that interests you the most. And I think people don't do that enough. And so you need to get a feeling for do these types of findings speak to me?

它们是否触动你？你觉得这些内容有用吗？我认为这是选择你可能使用的定性研究方法的最佳方式。然后你可以进一步理解方法论部分和方法部分。但我不建议从方法开始。

Do they resonate with me? Is this something I find useful? And I think that's the best way to sort of choose what type of qualitative approach you might use. And then you can go into sort of understanding the methodological pieces better and the methods pieces. But I wouldn't start with the methods.

我推荐你读《原谅与记住》这样的经典杰作。还有很多我没提到的作品。有一部非常精彩的作品，我会称之为民族志研究，虽然作者并非民族志学者，叫做《灵病与坠落》。它讲述了一个移民家庭与他们病重孩子在美国医疗体系中的遭遇，是一个极其感人且深刻的记录。

Would recommend you read like Forgive and Remember is like such a brilliant classic. There are so many that I'm not mentioning. There was a beautiful, I would call it ethnographic work. It wasn't done by an ethnographer called The Spirit Catches You and You Fall Down. And it was an incredibly moving and profound account of the story of an immigrant family who had a very ill child and their encounter with the North American, I mean American medical system.

这是一部非凡的作品。好的。

And it's an extraordinary piece of work. Okay.

好的，我会把它找出来并链接到节目说明里。

Yeah. I'll and dig that out and link it in the show notes.

是的，因为那确实是一项很棒的工作，但类似的实在太多了。

Yeah. Cause it is a really great piece of work, but there are so many.

菲奥娜，非常感谢你。

Fiona, thank you so much.

谢谢你，奥利弗。非常愉快。说实话，我很喜欢这个系列。顺便问一下，你为什么要做这个系列？我一直想问你这个问题，因为我太喜欢这个系列了，这个主意太棒了。

Thank you, Oliver. It's been a pleasure. And really, I love By the way, why are you doing this series? I wanted to ask you that because I love this series. What a great idea.

我做这个系列是因为十年前我读博士时，正从量化背景转向质性研究。那时候播客还不流行，现在质性研究的播客依然很少。偶尔我会在苹果播客上搜索'质性研究'或'扎根理论'，几乎找不到相关内容。我觉得这是个好机会，不仅能梳理各种研究方法（虽然无法涵盖全部），重点介绍一些主流方法，对我自己也是一次学习之旅。

I'm doing it because when I was doing my PhD and transitioning from a largely quantitative background to a qualitative background, I did my PhD ten years ago where podcasting wasn't really a thing, and there still isn't much in the way of qualitative podcasts. Occasionally go on to Apple Podcasts and type in quality research or grounded theory. Almost nothing comes up. It just seemed to me like a really good idea to try and lay out not all the different approaches, but just some of the major ones. And for me to have a bit of a journey myself.

我太喜欢这个系列了！我打算把它用作教学材料。让学生听到这些不同的观点，多好的教学工具啊，对吧？

Well, I love it. I'm going to use the series with my students. I mean, what a great teaching tool, right, for people to hear these different perspectives.

非常感谢你。

Thank you so much.

谢谢你，奥利弗。

Thank you, Oliver.

如果你喜欢本期播客，请访问www.wordsmattereducation.com查看所有节目笔记、资源和博客，并了解关于背痛相关的语言与沟通在线课程。我们下次见。

If you enjoyed this podcast, visit www.wordsmattereducation.com for all the show notes, resources, and blogs, and check out the online course in language and communication in relation to back pain. And I'll see you next time.