looking forward to your help/comments! vicky
Very interesting research questions! Here are some thoughts.
1. Your research questions and aims seem like 2-3 different papers to me and it seems like a lot to fit into a single paper. Specifically, I feel like your aim describing the processes that are currently in place does not necessarily fit with your aims looking at patient and provider attitudes.
2. In terms of the compatibility of the research questions and field sites/subjects, I notice that you specifically chose post-operative patients to interview. I think it would be more interesting and you may potentially get different and more useful results if you looked at pre-operative patients. I suspect that people's pre-operative attitudes are not the same as their post-operative attitudes once they have survived the operation. You also likely lose the sickest patients who did not survive their operations and who may actually be the patients most in need of the ACP discussion. I think this may be a truer representation of the population you want to capture for your research questions.
3. In terms of methods, I think the interviews for patients and providers and direct observation for process makes sense. It may also be helpful to do interviews with clinic leaders or representatives to learn about what the standard process in the clinic is supposed to be (if there is one) prior to observation.
Hope this is helpful. It sounds really interesting!
Vicky, this is super nicely written and formatted (which really makes a difference!) As I was reading, I was wondering whether it is possible that there isn't really an advance care planning process in clinics. I agree about the observation, and not sure if you thought of either audio/video-recorded or in person observation of the actual discussions between surgeons and patients - this would be very informative. I would recommend switching the order of your aims so that you observe first, and then interview, so you could ask patients and clinicians about specific visits and what they did / didn't discuss. What do you think?