Mixed methods’ is a research approach whereby researchers collect and analyses both

quantitative and qualitative data within the same study. Growth of mixed methods research in
nursing and healthcare has occurred at a time of internationally increasing complexity in
healthcare delivery. Mixed methods research draws on potential strengths of both qualitative and
quantitative methods, allowing researchers to explore diverse perspectives and uncover
relationships that exist between the intricate layers of our multifaceted research questions. As
providers and policy makers strive to ensure quality and safety for patients and families,
researchers can use mixed methods to explore contemporary healthcare trends and practices
across increasingly diverse setting.

What is mixed methods research?

Mixed methods research is the type of research in which a researcher or team of researchers
combines elements of qualitative and quantitative research approaches (e. g., use of qualitative
and quantitative viewpoints, data collection, analysis, inference techniques) for the broad
purposes of breadth and depth of understanding and corroboration.

A mixed methods design as a product has several primary characteristics that should be
considered during the design process. As shown in Table 1, the following primary design
“dimensions” are emphasized in this article: purpose of mixing, theoretical drive, timing, point of
integration, typological use, and degree of complexity. These characteristics are discussed below.
We also provide some secondary dimensions to consider when constructing a mixed methods
design (Johnson and Christensen 2017).

Mixed methods research requires a purposeful mixing of methods in data collection, data
analysis and interpretation of the evidence. The key word is ‘mixed’, as an essential step in the
mixed methods approach is data linkage, or integration at an appropriate stage in the

research process. Purposeful data integration enables researchers to seek a more panoramic view
of their research landscape, viewing phenomena from different viewpoints and through diverse
research lenses.
For example, in a randomized controlled trial (RCT) evaluating a decision aid for women
making choices about birth after caesarean, quantitative data were collected to assess knowledge
change, levels of decisional conflict,birth choices and outcomes. Qualitative narrative

data were collected to gain insight into women’s decision-making experiences and factors that
influenced their choices for mode of birth. In contrast, multimethod research uses a single

research paradigm, either quantitative or qualitative. Data are collected and analysed using
different methods within the same paradigm. For example, in a multimethods qualitative study
investigating parent–professional shared decision-making regarding diagnosis of suspected shunt
malfunction in children, data collection included audio recordings of admission consultations and
interviews 1week post consultation, with interactions analysed using conversational analysis and
the framework approach for the interview data.

Purpose

The overall goal of mixed methods research, of combining qualitative and quantitative research
components, is to expand and strengthen a study’s conclusions and, therefore, contribute to the
published literature. In all studies, the use of mixed methods should contribute to answering
one’s research questions.

Ultimately, mixed methods research is about heightened knowledge and validity. The design as
a product should be of sufficient quality to achieve multiple validities legitimation (Johnson and
Christensen 2017; Onwuegbuzie and Johnson 2006), which refers to the mixed methods research
study meeting the relevant combination or set of quantitative, qualitative, and mixed methods
validities in each research study.

Given this goal of answering the research question(s) with validity, a researcher can nevertheless
have various reasons or purposes for wanting to strengthen the research study and its
conclusions. Following is the first design dimension for one to consider when designing a study:
Given the research question(s), what is the purpose of the mixed methods study?

A popular classification of purposes of mixed methods research was first introduced in 1989 by
Greene, Caracelli, and Graham, based on an analysis of published mixed methods studies. This
classification is still in use (Greene 2007). Greene et al. (1989, p. 259) distinguished the
following five purposes for mixing in mixed methods research:

1. Triangulation seeks convergence, corroboration, correspondence of results from different

methods;

2. Complementarity seeks elaboration, enhancement, illustration, clarification of the results from

one method with the results from the other method;

3. Development seeks to use the results from one method to help develop or inform the other
method, where development is broadly construed to include sampling and implementation, as
well as measurement decisions;

4. Initiation seeks the discovery of paradox and contradiction, new perspectives of frameworks,
the recasting of questions or results from one method with questions or results from the other
method;

5. Expansion seeks to extend the breadth and range of inquiry by using different methods for
different inquiry components.
In the past 28 years, this classification has been supplemented by several others. On the basis of
a review of the reasons for combining qualitative and quantitative research mentioned by the
authors of mixed methods studies, Bryman (2006) formulated a list of more concrete rationales
for performing mixed methods research (see Appendix). Bryman’s classification breaks down
Greene et al.’s (1989) categories into several aspects, and he adds a number of additional aspects,
such as the following:

(a) Credibility – refers to suggestions that employing both approaches enhances the integrity of
findings.

(b) Context – refers to cases in which the combination is justified in terms of qualitative research
providing contextual understanding coupled with either generalizable, externally valid findings
or broad relationships among variables uncovered through a survey.

(c) Illustration – refers to the use of qualitative data to illustrate quantitative findings, often
referred to as putting “meat on the bones” of “dry” quantitative findings.

(d) Utility or improving the usefulness of findings – refers to a suggestion, which is more likely
to be prominent among articles with an applied focus, that combining the two approaches will be
more useful to practitioners and others.

(e) Confirm and discover – this entails using qualitative data to generate hypotheses and using
quantitative research to test them within a single project.

(f) Diversity of views – this includes two slightly different rationales – namely, combining
researchers’ and participants’ perspectives through quantitative and qualitative research
respectively, and uncovering relationships between variables through quantitative research while
 also revealing meanings among research participants through qualitative research. (Bryman,
p. 106)

Views can be diverse (f) in various ways. Some examples of mixed methods design that include
a diversity of views are:

 Iteratively/sequentially connecting local/idiographic knowledge with

national/general/nomothetic knowledge;
 Learning from different perspectives on teams and in the field and literature;
 Achieving multiple participation, social justice, and action;
 Determining what works for whom and the relevance/importance of context;
 Producing interdisciplinary substantive theory, including/comparing multiple perspectives and
data regarding a phenomenon;
 Juxtaposition-dialogue/comparison-synthesis;
 Breaking down binaries/dualisms (some of both);
 Explaining interaction between/among natural and human systems;
 Explaining complexity.

The number of possible purposes for mixing is very large and is increasing; hence, it is not
possible to provide an exhaustive list. Greene et al.’s (1989) purposes, Bryman’s (2006)
rationales, and our examples of a diversity of views were formulated as classifications on the
basis of examination of many existing research studies. They indicate how the qualitative and
quantitative research components of a study relate to each other. These purposes can be used post
hoc to classify research or a priori in the design of a new study. When designing a mixed
methods study, it is sometimes helpful to list the purpose in the title of the study design.
Types of mixed methods designs

Mixed methods research comprises different types of design categories, including explanatory,
exploratory, parallel and nested (embedded) designs.summarises the characteristics of each
design, the process used and models of connecting or integrating data. For each type of research,
an example was created to illustrate how each study design might be applied to address similar
but different nursing research aims within the same general nursing research area.

Explanatory sequential

In an explanatory sequential design, your quantitative data collection and analysis occurs first,
followed by qualitative data collection and analysis.

You should use this design if you think your qualitative data will explain and contextualize your
quantitative findings.

For example

You analyze the accident statistics first and draw preliminary conclusions about which areas are
most dangerous. Based on these findings, you conduct interviews with cyclists in high-accident
areas and analyze complaints qualitatively.
You can utilize the qualitative data to explain why accidents occur on specific roads, and take a
deep dive into particular problem areas.

Exploratory sequential

In an exploratory sequential design, qualitative data collection and analysis occurs first,
followed by quantitative data collection and analysis.

You can use this design to first explore initial questions and develop hypotheses. Then
you can use the quantitative data to test or confirm your qualitative findings.

Example:

Exploratory sequential design. You first interview cyclists to develop an initial understanding of
problem areas, and draw preliminary conclusions. Then you analyze accident statistics to test
whether cyclist perceptions line up with where accidents occur.

Convergent parallel

In a convergent parallel design, you collect quantitative and qualitative data at the same time and
analyze them separately. After both analyses are complete, compare your results to draw overall
conclusions.

Example:
Convergent parallel design In your research on cycling safety in Amsterdam, you undertake both
sides of your research simultaneously:

 On the qualitative side, you analyze cyclist complaints via the city’s database and on
social media to find out which areas are perceived as dangerous and why.
 On the quantitative side, you analyze accident reports in the city’s database to find out
how frequently accidents occur in different areas of the city.

When you finish your data collection and analysis, you then compare results and tie your
findings together.

Embedded

In an embedded design, you collect and analyze both types of data at the same time, but within a
larger quantitative or qualitative design. One type of data is secondary to the other.

This is a good approach to take if you have limited time or resources. You can use an embedded
design to strengthen or supplement your conclusions from the primary type of research design.

Example:

Embedded design As part of a quantitative study testing whether the number of cyclist
complaints about an area correlates with the number of accidents, you could “embed” a series of
qualitative interviews with cyclists who submitted complaints to further strengthen your
argument. The bulk of your research remains quantitative.

What are the steps for conducting mixed methods research?

There is no clear-cut procedure for conducting a study using mixed methods. However, you
can conduct mixed methods research by following the steps below:

Determine whether mixed methods research is appropriate

The first step is to determine whether mixed methods research is appropriate for answering
your questions and offer the best kind of evidence you need for your research study.

Determine your purpose

Determine the purpose you want to achieve by using mixed methods research design. Is it to
use the results from one data type to corroborate, expand, develop, or complement the other?

Select the most appropriate design

Select the most appropriate design out of the three types of mixed methods research designs.

 Convergent design is suitable when you need both qualitative and quantitative data,
have limited time to collect the data, and must gather the required data in one visit.

 Explanatory design is appropriate if the research problem is quantitatively oriented

and the variables and instruments required for the research are available.

 Exploratory design is best when the variables are unknown and the instruments
needed are not available. This is also the best mixed methods research approach to use
if there is no guiding theory for the study.

Collect qualitative and quantitative data.

Collect the qualitative and quantitative data you’ll analyze. Check our our guide to qualitative
methods to learn about different ways to collect qualitative data.

Analyze the collected data.

Analyze the collected data. You can use the Delve qualitative data analysis tool to quickly and
rigorously analyze your qualitative data. You can then export the data into spreadsheets to
analyzed it along with your quantitative data.

Write the research report

Validate and interpret the data and write your research report.

What are the strengths and challenges in using mixed methods?

Selecting the right research method starts with identifying the research question and study aims.
A mixed methods design is appropriate for answering research questions that neither quantitative
nor qualitative methods could answer alone.Mixed methods can be used to gain a better
understanding of connections or contradictions between qualitative and quantitative data; they
can provide opportunities for participants to have a strong voice and share their experiences
across the research process, and they can facilitate different avenues of exploration that enrich
the evidence and enable questions to be answered more deeply. Mixed methods can facilitate
greater scholarly interaction and enrich the experiences of researchers as different

perspectives illuminate the issues being studied. The process of mixing methods within one
study, however, can add to the complexity of conducting research. It often requires more
resources (time and personnel) and additional research training, as multidisciplinary research
teams need to become conversant with alternative research paradigms and different approaches

to sample selection, data collection, data analysis and data synthesis or integration.

What should be considered when evaluating mixed methods research?

When reading mixed methods research or writing a proposal using mixed methods to answer a
research question, the six questions below are a useful guide.

1. Does the research question justify the use of mixed methods?

2. Is the method sequence clearly described, logical in flow and well aligned with study aims?
3. Is data collection and analysis clearly described and well aligned with study aims?

4. Does one method dominate the other or are they equally important?

5. Did the use of one method limit or confound the other method?

6. When, how and by whom is data integration (mixing) achieved?

converge, this strengthens the validity of your conclusions. This process is called triangulation
When to use mixed methods research

Mixed methods research may be the right choice if your research process suggests that
quantitative or qualitative data alone will not sufficiently answer your research question. There
are several common reasons for using mixed methods research:

 Generalizability: Qualitative research usually has a smaller sample size, and thus is not
generalizable. In mixed methods research, this comparative weakness is mitigated by the
comparative strength of “large N,” externally valid quantitative research.
 Contextualization: Mixing methods allows you to put findings in context and add richer
detail to your conclusions. Using qualitative data to illustrate quantitative findings can
help “put meat on the bones” of your analysis.
 Credibility: Using different methods to collect data on the same subject can make your
results more credible. If the qualitative and quantitative data.

Advantages of mixed methods research

“Best of both worlds” analysis

Combining the two types of data means you benefit from both the detailed,
contextualized insights of qualitative data and the generalizable, externally valid insights
of quantitative data. The strengths of one type of data often mitigate the weaknesses of
the other.

For example, solely quantitative studies often struggle to incorporate the lived
experiences of your participants, so adding qualitative data deepens and enriches your
quantitative results.
Solely qualitative studies are often not very generalizable, only reflecting the experiences
of your participants, so adding quantitative data can validate your qualitative findings.

Method flexibility

Mixed methods are less tied to disciplines and established research paradigms. They offer
more flexibility in designing your research, allowing you to combine aspects of different
types of studies to distill the most informative results.

Mixed methods research can also combine theory generation and hypothesis
testing within a single study, which is unusual for standalone qualitative or quantitative
studies.

Disadvantages of mixed methods research

Workload

Mixed methods research is very labor-intensive. Collecting, analyzing, and synthesizing

two types of data into one research product takes a lot of time and effort, and often
involves interdisciplinary teams of researchers rather than individuals. For this reason,
mixed methods research has the potential to cost much more than standalone studies.

Differing or conflicting results

If your analysis yields conflicting results, it can be very challenging to know how to
interpret them in a mixed methods study. If the quantitative and qualitative results do not
agree or you are concerned you may have confounding variables, it can be unclear how to
proceed.

Due to the fact that quantitative and qualitative data take two vastly different forms, it can
also be difficult to find ways to systematically compare the results, putting your data at
risk for bias in the interpretation stage.
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