Article link:
https://doi.org/10.1177/0001839218804527

Question 1. Data Collection and Analysis. You are well known for conducting several comparative ethnographies (e.g. Kellogg, 2009; 2014). Can you tell us more about how you proceed with designing comparative ethnographic studies? What are some of the most valuable lessons you have learned across your projects?

I think that all ethnographies are in some way comparative. In many cases, the comparison is around what happened in one’s field site versus what we might have expected to have happened given the current literature.

For the type of matched-case comparative ethnography I conduct, one of the most important things is determining what cases to use. I try to match my cases on any independent variables in the current literature that have been shown to be important to explaining my particular outcome of interest. So, for example, my study of the implementation of reform in medical trainee work hours focuses on a new regulation due to be introduced into multiple hospitals at the same time. I chose to study the hospitals Advent and Bayshore because they were matched on things like size of residency training program, performance history, organization type, and types of diseases addressed. If one of these hospitals had historically outperformed the other, I would not have studied the two of them. Because, then, if I had found any difference in outcomes in reform implementation between the two, it could have been due to a difference in hospital general performance rather than a difference in what I found to be important (e.g. relational spaces).

For this reason, I select cases that are matched on all of the things that we might expect to be important for my outcome of interest. Then, if I find a difference, it is a difference that others have not already identified.

Your analytical approach seems to be inspired by grounded theory, but you have also used and extended prior theory (e.g. from social movements) to construct theoretical explanations. What kind of thoughts do you have about balancing grounded versus existing theory? Relatedly, can you tell us about your process for finding explanatory literature or concepts, such as “Subordinates’ Favorable Structural Position”?

It might be easiest for me to answer this question using a specific example. In my paper about subordinate activation tactics, what was most interesting to me was how subordinates seemed to be able to exert a lot of influence over the daily work practices of the doctors with whom they worked despite having very little formal authority in the setting. So, I looked to the literature to see if I could find some concept that would help me extend my thinking along these lines. I presented this paper in an internal MIT working group, and one of my colleagues suggested that what I was finding regarding the subordinates’ influence sounded like it was due to their structural power vis-à-vis the doctors. So, I went and did some reading on structural power. This concept was helpful to me because it pointed me to the kinds of things that might allow less powerful groups to influence more powerful ones. In particular, this literature helped me realize that there were particular aspects of the subordinates’ structural position that increased their ability to accomplish informal influence with the doctors with whom they worked (e.g. they occupied a central position in the doctors’ workflow, performed tasks that were critical to doctors’ daily work, were central in the doctors’ peer network, and were positioned between the patients and the doctors).

As part of my analytic process, I usually cycle through many, many concepts like the structural power concept before I come up with one that is particularly useful for explaining the phenomenon that I’m trying to explain. I suppose that some people might be daunted by needing to get up to speed on all of these different literatures. But, for me, this is one of the most fun things about ethnography. It gives me an excuse to read broadly outside my home literatures such as work and occupations or law and organizations.

Of course, if you had asked me this question during the review process, I might not have been so upbeat about the need to cycle through multiple different literatures. 🙂

Question 2. Presentation of Findings. Ethnography provides a rich account of daily work but sometimes it’s hard to tell what is important or less important for the case you are trying to make. What do your first drafts usually look like in terms of analysis? Can you tell us about your process of what makes it into the final draft?

I do a lot of my analysis through memo writing. So I write lots and lots of 2 to 3 page memos exploring different ideas. In these memos, I often include data from my field notes or interviews. Most of these data never make it into any draft of a paper, due to space constraints, but they are important for helping me to build my theoretical model.  

My next step is usually putting together a presentation for some kind of informal working group. By the time I actually write the first draft of a paper, I have a theoretical model that I have derived from my analyses and refined with working group feedback. The data I choose to include in a first draft is that which provides empirical support for this model.

Through the review process, I often modify the model based on reviewer feedback and questions, so I often need to include additional data to support the modified model.

In a hospital environment, there are various occupational and organizational groups and roles. How do you choose the point of view for presenting the data? For example, how did you think about balancing managers and MAs perspectives on this paper?

The point of view I choose depends on the model that I’m supporting with my data. So, for example, one of the main ideas in the subordinate activation tactics paper is that subordinates can activate their favorable structural position to influence powerful professionals. To support this main idea, I provide data from the subordinates’ perspective explaining how they influenced the doctors to change their work practices, and from the doctors demonstrating that they were influenced by the subordinates. Another main idea is that managers can give subordinates particular positional tools that facilitate subordinates’ activation of their structural power. To support this main idea, I provide data from the managers’ perspective explaining how they provided the subordinates with these positional tools.

Question 3. Theoretical Contribution. Including this article, your theory sections are always very clear and concise. What makes a good theory section for you when it comes to qualitative field research?

I don’t think I can generalize about what makes a good theory section; I’ve seen lots of different approaches work very well. What I typically try to do in my theory sections is frame my literature review around my outcome of interest. For example, my outcome of interest in the Subordinate Activation Tactics paper is micro-level institutional change in professional organizations. So, in that literature review, I review the prior literature on how micro-level institutional change can be accomplished in professional organizations.

When I first started writing papers, I often started by framing the paper around my own answer to the research question rather than around my outcome of interest. In the Subordinate Activation Tactics paper, that would have meant starting out my literature review with the concept of structural power. Over time, I’ve learned that I can more clearly show my theoretical contribution by starting out my literature review with what others have said is important to explaining the outcome I’m interested in rather than what I am arguing is important to explaining that outcome.

In this article the theory section is built around the role of managers in micro-level institutional change, while in the discussion you also expand towards network position and vicarious learning. Can you tell us more about how you proceed to make contributions to different literatures?

Because I usually bring in a new concept like structural power or network activation to explain my findings, in the Discussion section I like to show how my findings communicate back to those literatures as well as to my own. So, in the Subordinate Activation Tactics paper, my findings contribute not only to my area of interest, which is micro-level institutional change in professional organizations, but also to our understanding of network activation. In particular, my study adds to our understanding of upward influence by suggesting that influence agents (e.g., managers) with an unfavorable structural position vis-à-vis targets (e.g., doctors) can accomplish informal influence triadically rather than dyadically.

Regarding the section on vicarious learning in my Discussion section, that section is in the paper because one of the reviewers was particularly interested in my contributions to that literature. I always think that it’s a good thing if one of my reviewers thinks that I have a contribution to make to their own literature in addition to my own. I think it might be confusing to put multiple different literatures upfront in the paper, but putting them in the back of the paper allows me to communicate my findings to multiple different audiences.

Question 4. Conclusion. Finally, is there something else you would like to share about the research process?

Yes. I’ll share some of my favorite sayings from my wonderful advisor Lotte Bailyn:

• The most creative research comes out of going against the tide
• One person’s random error is another’s Nobel Prize
• What can you learn by where it doesn’t fit?
• Do something you really care about
• Give something back to your subjects
• Whenever you have an idea, write it down
• Write a little bit every day

Thank you.

References

Kellogg, K. C. 2009. “Operating Room: Relational Spaces and Microinstitutional Change in Surgery.” American Journal of Sociology, 115: 657-711.

Kellogg, K. C. 2014. “Brokerage Professions and Implementing Reform in an Age of Experts.” American Sociological Review, 79: 912-941.

Kellogg, K. C. 2019 “Subordinate Activation Tactics: Semi-professionals and Micro-level Institutional Change in Professional Organizations.” Administrative Science Quarterly, 64: 928-975.