REVIEW ARTICLE

Mixed-method Research: A Basic Understanding

Disha Nagpal1, Ida Kornerup2, Monica P Gibson3

A b s t r ac t​
Aim and objective: Describe the basics of the mixed-method type of research.
Background: Traditionally, the research has been quantitative in nature which provided measures for the parameter of interest. This was
followed by the era of qualitative research which helped in a detailed understanding of a phenomenon. This is especially important in healthcare
research as it also gives an account of the individual interaction with their environment which is a significant contributor to health. Around the
1970s, the concept of combining both these approaches was used in social sciences. Recently, this mixed-method approach was integrated
into health research and educators. However, there has been a continuing debate on the basic nature of this research design. Thus, a complete
understanding of this type of research is important.
Review results: Various authors described various purposes of the mixed-method approach. The main ones being triangulation, complementarity,
development, initiation, and expansion. Theoretical drives, timings, and point of integration are the three factors that need to be considered for
the development of studies using this design. Throughout times, different classifications for mixed-method studies have evolved, however, the
most accepted one, based on the utility and internal consistency is the classification by Creswell and Clarke. They describe four major designs
for mixed-method research as triangulation design, embedded design, explanatory design, and exploratory design. The application, principle,
variants, strengths, challenges, and examples of each have been described extensively in this article.
Conclusion and clinical significance: Mixed-method approach is a valuable research type as it capitalizes on the strength of both qualitative
and quantitative research. It is of significance in health research as it gives a broader range of perspectives to the complex phenomena studied.
Thus, proper knowledge of the basics is required to accurately combine and interpret findings of the qualitative and quantitative aspects. This
article is a contribution to this basic understanding of mixed-method research.
Keywords: Explanatory, Integration, Mixed-method, Qualitative, Quantitative.
CODS Journal of Dentistry (2020): 10.5005/jp-journals-10063-0065

B ac kg r o u n d​ 1,3
Department of Periodontics, School of Dentistry, Faculty of Medicine
Evolution of Mixed-method Approach and Dentistry, University of Alberta, Canada
2
Quantitative research was the only known research design in the Department of Pediatric Dentistry, School of Dentistry, Faculty of
19th century and was, therefore, most used.1 Quantitative data Medicine and Dentistry, University of Alberta, Canada
provide a measurement orientation in which data can be collected Corresponding Author: Disha Nagpal, Department of Periodontics,
from numerous individuals and assessed trends across large School of Dentistry, Faculty of Medicine and Dentistry, University of
Alberta, Canada, Phone: +1 204-899-4459, e-mail: dnagpal@ualberta.
geographic regions.2 At the turn of the 20th century, the theory of
ca
qualitative analysis came into being.1 Qualitative research provides
comprehensive details recorded in the participants’ voices and How to cite this article: Nagpal D, Kornerup I, Gibson MP. Mixed-
method Research: A Basic Understanding. CODS J Dent 2020;12(1):
contextualizes the contexts in which they have experiences and the
11–16.
meanings of their experiences.2 Between 1900 and 1950, there was
Source of support: Nil
a primary historical moment as described by Denzin and Lincoln
(2005) for qualitative research. It was then shortly after this era, that Conflict of interest: None
the concept was introduced of mixing the two approaches.1,3 Jick
(1979) first proposed the idea of combining methods as a way of
finding convergence between qualitative and quantitative methods This term is defined by Tashakkori and Creswell as “research
within the social sciences.4,5 Since the 1960s, research into mixed in which the investigator collects and analyzes data, integrates
methods has become more popular in many disciplines including the findings, and draws inferences using both qualitative and
health sciences and education.1 quantitative approaches or methods in a single study or a program
of inquiry”.7
R e v i e w R e s u lts and D i s c u s s i o n​ Mixed-method vs Multimethod
What is Mixed-method Research? Mixed-method research is kin of multimethod research which
Mixed-method research is the form of study in which a researcher combines either only numerous qualitative approaches or
contains elements of qualitative and quantitative research various quantitative approaches.8 Multimethod design involves
methods (e.g., using both qualitative and quantitative viewpoints, implementing two or more research methods in one project, each
a compilation of data, analysis, critical thinking techniques) for clear performed precisely and complete in itself. Then, the results are
understanding and substantiation functions.6 triangulated into a complete whole.9

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 Mixed-method Research: A Basic Understanding

Purpose/rationale theoretical drive. It is helpful to have this drive mentioned in the

The aim of research on mixed-methods, of integrating qualitative title of the article, whenever possible. There has been criticism of
and quantitative components of analysis, is to extend and reinforce the concept of the theoretical drive as stated by Morse and Niehaus.
the findings of a report. We see a theoretical move, for instance, as a characteristic not of
The following five reasons for mixing in mixed research whole analysis, but a research question, or, more specifically, an
methods were explained by Greene and Hall (2010):8,10 understanding of a research question. In case a study has multiple
research questions, there may be several theoretical drives for it.8,13
• Triangulation for confluence, confirmation, congruity of results Thus, Johnson et al.4 describe three different drives that mixed-
from different approaches. method research can have:
• Complementarity for evolution, improvement, visual, elucidation
of the results from different approaches. • Qualitative dominant (or qualitatively driven).
• Development requires using one method’s outcomes to help • Quantitative dominant (or quantitatively driven).
create or advise the other method in which development is • Qualitative-quantitative continuum (or, equal status).
normally expected to include sampling and execution, as well
Timings
as reviewing decisions.
• Initiation to facilitate the analysis of paradoxes and contradictions, This refers to when both the qualitative and quantitative
new insights into systems, the reformulation of questions, or the components of the study are carried out.
outcomes of one approach with questions or outcomes of the There are two phases to the timing: simultaneity and
other approach. dependence.13
• Expansion means widening the scale and length of investigations • Based on simultaneity, these can be either sequential or
by using particular methods for different components of the concurrent.
survey. The quantitative aspect takes place before the qualitative
Further, in 2006, Bryman11 articulated more specific grounds component in a sequential arrangement or vice versa. On
for conducting mixed-method research. The list was a breakdown the contrary, both components are implemented (almost)
of Greene et al. (1989)12 categories and also, several aspects were simultaneously in a concurrent configuration.According to Morse
added, such as the following: protocol (1991), a “+” between components represents concurrence
(e.g., QUAL + quan), while a “ ” between the components represents
• Credibility—Using both methods improves the appropriateness sequential (QUAL quan).14
of findings. Another way to illustrate is the use of the upper and lower case
• Context—Refers to instances where the blend is justified in terms letters. The former denotes the core component and the latter is
of qualitative research providing contextual understanding secondary or supplemental.
along with either generalizable, externally applicable findings • Based on the dependence of the two components, these can
or unique relationships identified through a survey between be either dependent or independent.
variables.
• Illustration—Refers to the use to explain quantitative results of In the former, the data analysis results of the first component
qualitative data. This stimulates the “dry” quantitative data.11 determine the fulfillment of the second component, whereas in
• Utility or maximizing the utility of the outcomes—Refers to a the latter, the implementation of the data is not contingent on the
suggestion that the combination of the two methods will be results of the other component. The study also has the choice of
more beneficial to clinicians as it is more likely to be popular independently conducting the data analysis or not.
among journals with an emphasis on applied research. Generally, sequential is considered to be dependent and
• Confirm and discover—This involves constructing hypotheses concurrent to be independent. However, simultaneity and
using qualitative data and using quantitative analysis within a dependence should be considered two different aspects of
specific project to test them. timing. Thus, a study can be sequential and independent where
• Diversity of views—This incorporates two somewhat variable the data for different components is gathered sequentially,
reasons: through quantitative and qualitative analysis, however, the implementation of one component does not depend
incorporating the perspectives of researchers and participants, on data analysis of the first. Likewise, it can be concurrent and
and identifying the relationships between variables through dependent. It is the researcher’s purpose to determine whether a
quantitative research, while also revealing similarities through concurrent-dependent design, a concurrent-independent design,
qualitative research between research participants. a sequential-dependent design, or a sequential-independent
design is required to answer a specific research question(s) in a
particular case. 8
Factors to be Considered for the Development of
Different Mixed-method Research Designs Point of Integration
These are the points to be kept in mind while deciding which design So-called the point of interface, it is that juncture where both the
to use for the mixed-method analysis. qualitative and quantitative components are brought together.
As defined by Guest, the point of integration is defined as “any
Theoretical Drive point in a study where two or more research components are mixed
Like any other research design, a mixed-method study also or connected in some way”.15
has an overall theoretical drive. The theoretical drive had two In a mixed-method study design, these are known to occur at
components—the “core” component and the supplemental several levels. In a true sense, integration is a better term to describe
component. The former has a major component in the overall this rather than just mixing.

12 CODS Journal of Dentistry, Volume 12 Issue 1 (January–June 2020)

 Mixed-method Research: A Basic Understanding

Various integration points have been described by various • Multiphase design—In a research program that examines a total
authors. expected plan, more than two phases or both sequential and
For instance, Morse and Niehaus16 identified two possible concurrent strands are integrated over some time.
integration stages: at the level of the results and the level of the
Creswell and Clark emphasized that while there is a multitude of
analysis.
types as defined by many leading authors’ research, it is important
In the former, the second portion’s outcomes were applied to
to note that there are a variety of features and many names used
and merged into the first element. To promote this process, it is
by different authors. This leads to the conclusion that these
possible to use a joint show reporting all of the quantitative and
classifications have more similarities than variations.18
qualitative outcomes and a consolidated statement. However, in
Thus, because of these similarities, Creswell and Clark presented
the latter, the first analytical phase of a qualitative portion follows
a practical and internally consistent classification that had four
a second analytical phase in which the topics found in the first
major mixed-method designs, with variants within each type. These
analytical phase are quantified.
are the triangulation design, the embedded design, the explanatory
Other investigators like Teddlie and Tashakkori distinguished four
design, and the exploratory design.18
different stages of an investigation: the conceptualization stage, the
These are explained below in details under common
methodological experimental stage (data collection), the analytical
subheadings:
experimental stage (data analysis), and the inferential stage.17
By these authors, throughout all four stages, merging is feasible.
Nonetheless, to distinguish those ways of mixing, the four possible Triangulation Design
integration points employed by these writers are still too crude. Use
Experiential mixing can take various forms, such as using cognitive This concept is used to compare statistical findings in quantitative
interviews to refine a questionnaire (tool development) or choosing terms directly with qualitative findings or to verify or extend
people for an interview based on the results of the questionnaire quantitative results with qualitative data. Morse described that this
(sampling).17 could be used to acquire additional separate data on the related
A few of the basic ways to integrate the different elements are topic to best understand the research problem.14
as follows: It gives the means to corroborate the varying strengths and
non-overlapping shortcomings of quantitative methods (extensive
• Combining the two data sets.
sample size, trends, generalization) with those of qualitative
• Determining from the results of one data set, the collection of
methods (limited N, details, in-depth).20
the second information pool.
• Embedding one sort of information into a broader design or Procedure
procedure.
It is a one-phase system in which researchers apply quantitative
• Using a framework to tie the sets of data together (theoretical
and qualitative methods of equal status over the same timeframe.
or program).18
It typically requires the compilation and analysis of quantitative
Generally, mixing can take place at either one or all of the and qualitative data at the same time, but separately, so that the
following research steps: aim, research questions, theoretical drive, researcher can better understand the research issue.
methodology, data analysis, and results. The researcher tries to combine both data sets, usually by
putting together the different outcomes in the interpretation or
Mixed-method Research Designs by manipulating data to allow the convergence during the analysis
Considering all these factors, a variety of research designs have of the two data types.
been described.
Tashakkori and Teddlie (2003) presented an exhaustive list of Variants
35 mixed-method research designs.1,19 The different variants are the convergence model, the data
Following are the six “major mixed methods design” as transformation model, the validating quantitative data model, and
commonly used designs, described by Creswell and Plano Clark.18 the multilevel model.
• Convergent parallel design—Both the aspects are carried
Strengths Including Advantages
out separately, and the results are incorporated in the
comprehensive analysis. Good for the beginners in mixed-method research.
• Explanatory sequential design—Collecting and analyzing the Efficient architecture in which both data types are gathered at
data quantitatively is the first phase which is followed by the roughly the same point during one phase of the research.
qualitative aspect of the study. The qualitative data are used The individuals with both quantitative and qualitative
here to clarify the initial quantitative outcomes. proficiency can be included in the research type as both the
• Exploratory sequential design—It begins with accumulating quantitative and qualitative data are gathered and evaluated
the qualitative data which is followed by the collection of separately.
quantitative data to explore the initial qualitative results.
• Embedded design—This is a conventional qualitative or Disadvantages
quantitative design, a section of some other form is introduced Demands proficiency and effort as the data is gathered
to improve the overall design. simultaneously and the fact both the aspects of the study are
• Transformative design—A conceptual transforming structure equally important.
forms the qualitative and quantitative dimension of connection, The consequences of no agreement between the quantitative
priority, timing, and mixing, and qualitative results must be considered. At times, these

CODS Journal of Dentistry, Volume 12 Issue 1 (January–June 2020) 13

 Mixed-method Research: A Basic Understanding

disparities can be difficult to overcome and may need other quantifiable generalizations, so a cross-sectional survey of dentists
supplementary data to be gathered. was also undertaken.

Example Explanatory Design

Such a study design would include a longitudinal study of parents Use
and children’s experience in pediatric clinics at a dental school This model aims to help explain or generate initial quantitative
using in-depth interviews and collecting quantitative data using findings from qualitative data.
questionnaires where they can rate their experiences on a Likert For a study in which a researcher requires qualitative data to
scale, at the same visit. The experiences identified by the interviews explain significant (or meaningless) findings, outdated results, or
can be corroborated in the quantitative questionnaire. Thus, the unexpected results, it is appropriate.14 This approach can also be
use of qualitative and quantitative measures will add to the depth used when a researcher chooses to create groups with the groups
as well as the scope of findings. based on quantitative data23 and subsequent qualitative analysis
or to use quantitative participant attributes to direct a qualitative
Embedded Design process of purposeful sampling.18
Use
Variants
This is a mixed-method design in which the study is mainly based
on one data type and the other data set has a secondary role.21 Two variants: the follow-up explanations model and the participant
This model assumes that a single set of data is not appropriate, that selection model. While both models have an initial quantitative
different questions need to be answered, and that different data phase followed by a qualitative phase, the relation between the two
types are necessary for each type of question. phases varies, with one concentrating on the findings to be tested
in more detail and the other focusing on the relevant participants
Procedure to be chosen.18
This incorporates the various sets of data at the design level, one
form of data being enclosed in a design framed by the other type
Strengths/advantages
of data.22 Both the quantitative and qualitative data is gathered, Easy to execute as it is two-phased and in different phases, the
however, within the overall architecture, one of the data types plays researcher performs the two methods and collects only one type
a complementary role. of data at a time.
Such study models can use either a single-phase or a two-phase Also, an individual researcher can carry on such a study and
approach for the embedded data. In addition, the quantitative and does not need a research team.
qualitative data are used to answer different research questions With regards to writing the report, this as straightforward as it
within the study. can be written in two phases and it has a clear characteristic.
This design is ideal for multi-phase as well as single mixed-
Variants method studies.
Experimental model and the correlational model. Quantitative researchers also like this design as this mostly
starts with a strong quantitative background.
Strengths/advantages
Can be used when there is not adequate time to conduct the Challenges
research. Overall, this method is a time-consuming process.
Can be used by beginners as one part has more emphasis than The researchers need to understand that the qualitative process
the other. (depending on the significance) may be more time-consuming than
May also be pleading to fund agencies since the design’s key the quantitative phase and can be limited to a few participants
objective is typically quantitative, such as an experiment or a in the qualitative phase. Again, sufficient time for the qualitative
correlational analysis. phase must be planned.
For both stages, the researcher must determine whether to have
Challenges the same participant or those from the same group for both phases,
The aim of gathering qualitative (or quantitative) data should be or select participants from the same population for both phases.
well specified.
Also, the primary and secondary purposes should be well- Example
identified. If a study is designed to understand the clinical reasoning of the
It can be challenging to integrate the results when the two undergraduate dental students (third and fourth year) for diagnosis
methods are used to address multiple research questions. and treatment planning of periodontal cases, this will involve a
mixed-method approach. Clinical reasoning is instrumental to
Example the learning of healthcare professionals. It is a cognitive process
The research conducted by Dyer and Robinson23 is an example and thus, involves not only quantitative but qualitative aspects.
of this design where they explored the variables that could affect Hence, it would be a good example to study using a mixed-method
the provision of general health promotion through seven different approach.
health interventions by dental teams in a general dental practice in The first aspect of the study is quantitative to measure the
South Yorkshire. The authors used a mixed-method study because reasoning skills of the students with respect to the experts and also
qualitative methods suit topics such as this where there is little to compare between the third and final years to see if the year of
preexisting knowledge. However, qualitative research cannot make training has any impact on their reasoning abilities. The results of

14 CODS Journal of Dentistry, Volume 12 Issue 1 (January–June 2020)

 Mixed-method Research: A Basic Understanding

this phase will further be investigated in detail by the qualitative This method can be used for both multiphase and single
phase which means to understand why or why not the year of studies.
training affected the students’ clinical reasoning, interviews will
be conducted. Challenges
If we look closely at this process and explain it in terms of the The two-phase approach requires a significant amount of time to
factors required to design the mixed-method approach, as outlined incorporate.
at the beginning of this article, it will include: Researchers need to consider the aspect and build time into
the schedule for their analysis.
Theoretical Drive Researchers will explore whether the same individuals at both
There is a core component and a supplemental component of the the qualitative and quantitative phases should serve as participants.
study. Both quantitative and qualitative aspects relate equally to the The researcher will determine the data to use from the
awareness of this method for this review. Thus, this study would be qualitative process to create the quantitative method and how to
considered a qualitative-quantitative continuum, (or equal status) use the data to produce quantitative measures.
in terms of theoretical drive. Procedures should be followed to ensure the validity and
reliability of scores produced on the instrument.
Timings
Example
• In terms of the sequence: The quantitative phase is followed by
The research has described the experience of the parents of the
the qualitative stage, hence, sequential.
children feeling fearful for a dental visit. If a study is designed to
• In terms of dependency: The qualitative phase explains the
scale the stress of these parents, an exploratory mixed-method
results from the quantitative phase, so dependent.
approach will be needed.
First, the data will be collected qualitatively from these parents.
Point of Integration The themes emerging from the data will then be used to create a
In this study, it would occur at the methodological phase as well scale, which is tested for reliability and validity.
as the inferential stages. In the inferential stage, the results of both
these aspects will be integrated to answer the research question.
Thus, this is an example of an explanatory sequential mixed-
C o n c lu s i o n and Clinical Significance
method study design. Mixed-method studies are important to understand a process
completely. Mixed-method studies are gaining popularity in health-
Exploratory Design related research. Extensive work has been done in medicine and
Use nursing education using a mixed-method study design. However,
This two-phase exploratory design is used to help improve or its application to dental research is emerging especially among
inform the second (quantitative) method through the results of educators and policymakers. This literature review gives an insight
the first (qualitative) process. This design assumes that for one of into the basics needed to design and execute a mixed-method
many reasons an exploration is needed: metrics or instruments study.
are either not available or not suitable, the variables are uncertain,
or there is no guidance system or theory. As this approach begins References
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