Introduction

A pilot study is a preliminary investigation conducted to assess the feasibility of a proposed research project (National Institute for Health and Care Research 2024). It can be conducted as part of a quantitative, qualitative or mixed-methods study (Shakir and ur Rahman 2022), but is most used in quantitative studies (Malmqvist et al 2019). A pilot study enables researchers to assess the effectiveness of their methodologies, test the efficacy of their sampling and data collection strategies, ensure the appropriateness of their instruments and analytical techniques, and identify potential problems (Arroyo-Ávila et al 2020). This information is essential for researchers to make any necessary adjustments to the main study (Watson 2016) and to focus on elements of the research field and design (Lees et al 2022).

Quantitative researchers typically conduct pilot studies before quantitative research to reduce costs and save time (Malmqvist et al 2019). Some authors also advise qualitative researchers to design and conduct pilot studies, to identify and resolve issues that could impede their main studies (Morrison et al 2016, Watson 2016, Whiting et al 2021, Wray et al 2017).

The aim of this article is to propose a new pilot methodology previously undocumented in the literature: ‘integrated pilot work’ (IPW). IPW is a reflexive tool for enhancing qualitative nursing research that differs from other pilot methodologies in that it is an integral part of the design and conduct of the study itself, rather than work conducted before the study.

In the article, I will discuss IPW’s role in research, the value it adds and the debate surrounding it. I will use the example of my doctoral study to illustrate IPW’s application in practice, discussing how it enabled me to conduct my research reflexively and transparently as well as enhance the rigour of the study and its findings. I will also outline four valuable, key contributions it made.

Background Qualitative pilot work

As part of my doctoral research, I conducted a brief search of the literature to identify articles that discussed ‘pilot work’ (PW) in qualitative research. I found the literature uses a variety of terminology and definitions to describe different types of preliminary study (Morrison et al 2016). These included (Arnold et al 2009):

• ‘Pilot work’: Any background research that informs a future study.

• ‘Pilot study’: A study with a specific hypothesis, objective and methodology.

• ‘Pilot trial’: A stand-alone pilot study that includes randomisation of participants.

These multiple roles meant researchers conducted qualitative pilot work (QPW) for a range of reasons:

The authors of all these articles conducted their QPW before larger studies. Some considered QPW to be a useful tool for ensuring rigour; they also emphasised its significance for immersion in the field.

However, their articles provided little information about how they conducted QPW and there is a more general consensus that despite QPW’s value, it is still underused, underdeveloped and poorly documented (Doody and Doody 2015, Ismail et al 2018, Malmqvist et al 2019, Lees et al 2022) – the information authors provide about how they have conducted QPW is often insufficient for others to access their ideas and experiences (Wray et al 2017).

Researchers have an ethical and scientific responsibility to share their experiences and the difficulties they encounter during their studies (van Teijlingen and Hundley 2002). Authors who conduct QPW should therefore provide further guidance about the issues they have identified and the lessons they have learned (Wray et al 2017, Lees et al 2022).

Key points

• Integrated pilot work (IPW) is an innovative methodology that embeds pilot work directly into the conduct of qualitative research, rather than treating it as preliminary work

• IPW enhances qualitative research by refining sampling and recruitment strategies, focusing the object of study, facilitating conceptual reflection, and improving understanding of research processes

• IPW is particularly useful for novice qualitative researchers, providing guidance and confidence in navigating methodological challenges

Qualitative pilot work’s added value

QPW offers notable theoretical and methodological benefits (Smith 2019). My search of the literature revealed six major methodological and ethical benefits of conducting QPW (Lees et al 2022):

1. You can define your ontological and epistemological stance in relation to your research, your data and the way you construct knowledge (Lees et al 2022).

2. You can gain a thorough understanding of the procedures and methods of collecting data that you will use in your research (Wray et al 2017).

3. You can be the main instrument of your research, which creates an opportunity for reflexivity (Lees et al 2022). This can inform your decisions and lead to more effective guidance for your research (Wray et al 2017, Whiting et al 2021, Lees et al 2022).

4. This reflexivity can facilitate your introduction to unfamiliar contexts (Doody and Doody 2015), helping you to develop ‘contextual sensitivity’ – the ability to recognise and account for the social and cultural contexts in which your data are generated and interpreted (Williams-McBean 2019).

5. It provides a robust methodological approach that can strengthen your study’s rigour, the methodology you use and your findings (Ismail et al 2018).

6. It enhances your study’s credibility by providing a transparent, well-defined audit trail that enables you to justify any changes you make to your study and ensures its integrity (Aziz and Khan 2020).

The debate about qualitative pilot work

PW is widely recognised as a valuable research tool, but there has been some debate about its relevance to and appropriateness for qualitative research (Doody and Doody 2015, Williams-McBean 2019). I identified several divergent views about QPW during my search of the literature:

Is it necessary?

Some authors questioned whether PW has a place in qualitative research at all. Ismail et al (2018) and van Teijlingen and Hundley (2002) suggested researchers can conduct qualitative studies without undertaking PW. Morse (1997) and Holloway (2016) also argued PW is inessential – qualitative research’s inherent flexibility means researchers can pursue new areas of enquiry as they emerge (Charmaz 2014); they can also adjust their methodologies during their studies, modifying their research questions or refining interviews in response to their analyses of previous interviews, for example (Ismail et al 2018). This may explain why qualitative researchers rarely undertake PW.

Nevertheless, while PW may not be required in qualitative research, it can enhance it (Morse 1997, Kim 2011, Holloway 2016).

Separate or equal?

The literature differs about whether to include pilot data in a study’s analysis and final report. Researchers have expressed concerns about combining the pilot and the main study’s data during analysis (Schachtebeck et al 2018), as it may lead to ‘study contamination’, particularly in quantitative research (Ismail et al 2018).

Research protocols and instruments may change between the PW and the main study. This could lead to discrepancies between the validated protocols and those used in the pilot (Ismail et al 2018). For example, data obtained during a pilot study using an unreliable or invalid instrument could contaminate any data collected later using an improved version. This could lead to the addition of invalid data to the dataset (Williams-McBean 2019). Watson et al (2007) suggested that researchers should therefore treat pilot data as incidental to avoid these discrepancies.

However, van Teijlingen and Hundley (2002) concluded this was of little concern in qualitative research as researchers can refine, delete or add questions as they collect data. Ismail et al (2018) also argued that undertaking PW results in no significant changes to the main study’s design in most cases.

Integrated pilot work

The debate about QPW means its exact nature and usefulness is unclear (Malmqvist et al 2019); the lack of recognised guidance also leaves qualitative researchers with the challenge of making decisions based on conflicting opinions – a task that is harder for novices (Morrison et al 2016).

The aim of my doctoral research study (Durocher 2024) was to use ‘constructivist grounded theory’ (ConGT) (Charmaz 2014) to co-construct a theory of workplace bullying in nursing practice. ‘Grounded theory’ is a qualitative methodology that enables you to develop a theory firmly ‘grounded’ in the data you collect (Glaser and Strauss 1967). ConGT requires you to also adopt a reflective stance throughout your research, paying particular attention to your decision-making (Charmaz 2014).

PW is crucial for managing contextual information when designing GT studies (Nunes et al 2010) – it provides in-situ training; enables you to develop and test the appropriateness of the tools you have selected for collecting and analysing data; facilitates the assessment of risks associated with research designs; and acts as a ‘relevance filter’ (Nunes et al 2010). As such, it is a valuable tool for using contextual sensitivity to develop ‘theoretical sensitivity’ – being able to conceptualise data to identify a theoretical outcome.

At the beginning of the study, I conceptualised a pilot as an initial exploratory phase but the lack of consensus about QPW led me to consider integrating PW into my study’s methodology (Smith 2019). This would allow me to:

• Take a moment to reflect at the beginning of the study to identify and resolve potential methodological issues that might impede it.

• Gain a deeper understanding of the context in which I would conduct the study.

• Include PW data in the analysis and final report.

• Obtain relevant theoretical and methodological inputs.

IPW made four further, significant contributions to my study.

1. Challenging the sampling and recruitment strategies

When designing the study, I decided to use two strategies to recruit participants: initial purposive sampling; and later, theoretical sampling (Charmaz 2014). Conducting the initial, exploratory, purposive sampling would give me experience of the iterative process of collecting and analysing data before I started theoretical sampling – as Charmaz (2014) noted, ‘initial sampling in GT gets you started; theoretical sampling guides you where you go.’ This initial sampling was therefore the starting point for the IPW.

I did not consider at this stage whether to include the data from the exploratory phase in my final dataset, as I considered both purposive and theoretical sampling to be integral to the study’s methodology.

For my initial sample, I obtained a list of community nurses practising in two urban areas, from an independent public organisation responsible for regulating the nursing profession and ensuring public protection. Following Charmaz (2014), I developed flexible initial inclusion criteria for my study – to be eligible to participate, a nurse had to:

• Be or have been engaged in nursing practice in urban areas in Québec, Canada.

• Be experiencing or have experienced bullying between nurses in community settings, either as targets or as witnesses.

• Be able to speak and understand French.

These criteria enabled me to select and recruit ten relevant participants from the list. I then used principally in-depth, one-to-one interviews to collect data from this cohort.

Thus, IPW had a considerable influence on recruitment. Media coverage of my study even prompted nurses who had experienced bullying in other settings to email me testimonies of their experiences.

Given the extensive nature of this additional data, I asked the ethics committee to approve an amendment to the study protocol that would allow me to include the theoretical sampling, subject to the consent of the participants. In line with the flexible methodology adopted, I decided to include a larger sample of nurses, settings and structures than I had originally planned. My main methods for collecting data from this cohort were in-depth, individual interviews and e-testimonies.

The IPW helped me to refine my sampling and recruitment strategies. The credibility of a study depends on how familiar your participants are with the phenomenon you are investigating (Charmaz 2014). I established credibility by recruiting participants with a wide diversity of experiences and identifying reliable informants who could provide insight into and interpret bullying situations.

My final sample included nurses working in a range of roles, including bedside and leadership roles, in a variety of practice settings, including hospitals and the community. The IPW provided a valuable opportunity to gather the views of nurses in rural areas and to gain a deeper understanding of the nuances of workplace bullying in both urban and rural settings.

2. Delimiting the object of study

QPW also enables you to focus on the phenomenon you have chosen to study, modify or extend it, and deepen your understanding of it (Doody and Doody 2015). Establishing a connection between your study’s participants and the phenomenon you are investigating is one of the criteria Charmaz (2014) proposed for the evaluation of research. Resonance is essential when co-constructing a theory that has meaning for the people involved (Charmaz 2014). It was therefore necessary for me to gain insight into the phenomenon of workplace bullying in the context of nursing practice from the perspective of those directly involved in my study.

This meant I had to define this concept at the outset of my study, even if my initial definition was provisional. A concept can be derived from both literary and lay sources, and researchers must analyse it while developing a theory rather than before (Risjord 2009). It can also be particularly beneficial for the advancement of practical and validated theories – particularly in nursing – to incorporate in the absence of a theory concepts derived from lay language and other practice-based knowledge.

I searched for literature that would provide insight into the concept of ‘bullying between nurses’. I found from this that authors often used interchangeably the terms ‘mobbing’, ‘workplace bullying’ and ‘horizontal violence’ (Crawford et al 2019). This may be due in part to these being the terms used most in the countries where they have conducted their studies (Saunders et al 2007).

I initially chose to use ‘intra-professional violence’ (IPV) because it denotes violence between members of the same profession (Engelbrecht et al 2017). However, it was necessary to consider participants’ understanding of this concept, to ensure I had the most accurate representation possible of the phenomenon I was investigating. It was therefore essential to determine during the initial in-depth, individual interviews that participants clearly understood what I meant by ‘IPV’ and that I focused on the terminology they used to describe this form of violence between nurses.

My interviews with the first ten participants revealed I needed to clarify the concept of the violence I was studying, as the term participants appeared to use most commonly was ‘workplace bullying’. My IPW therefore served to delineate the object I was studying.

3. Engaging in conceptual reflection

The researcher plays a central role in the construction of knowledge in qualitative research due to its subjective nature (Arroyo-Ávila et al 2020). We should also not assume it is possible to know our categories in advance or that they will be in our initial research questions (Charmaz 2014). It is therefore essential to adopt a reflective approach to ensure your results are as accurate and as insightful as possible (Lees et al 2022). Interpreting a situation is inherently reflective and enables you to identify key findings (Whiting et al 2021).

The IPW in my study played a crucial role in facilitating reflection on the co-construction of an initial conceptualisation and informing new directions in my research. It gave me space to reflect on the processes involved in the workplace bullying nurses experienced during professional activities, thereby answering my initial research question.

It also provided an initial conceptualisation of how the ten initial participants interpreted their experiences of workplace bullying. I identified six dimensions: situational conditions; tolerance; reaching a limit; decisions and actions; consequences for personal and professional health and well-being; and career path. These provided initial, albeit tentative ideas and questions to guide further exploration. They also formed the basis for the subsequent theoretical co-construction process.

However, this conceptualisation was insufficiently comprehensive and my initial research questions were somewhat inappropriate in this context. I therefore formulated new research questions based on each of the six initial dimensions, such as: ‘In what contexts do situations of workplace bullying occur in the nursing profession?’

To gain a deeper insight into the issue of workplace bullying in nursing practice, it was necessary to collect and analyse data by gathering the perspectives of other nurses. I therefore conducted theoretical sampling to refine my theoretical conceptualisation by focusing on the variation and diversification of the phenomenon I was investigating.

4. Gaining a better understanding of research process

PW can provide an overview of the elements of your research’s design that you can adjust before you start your study; it can also highlight aspects of the design and conduct that you can revise during the research process (Lees et al 2022). In the case of GT, PW can also provide valuable methodological insights into how to study human activity (Nunes et al 2010).

IPW in line with the recommendations of Pritchard and Whiting (2012) facilitated a forward-thinking rather than retrospective approach to my study. The ongoing assessment of my research allowed me to design and plan the entire project in advance, as well as consider its future trajectory. IPW facilitated the confirmation, refinement and re-evaluation of certain methodological decisions that had previously guided the design of subsequent phases of my research.

Conclusion

In this article, I have argued that IPW is an innovative approach with the potential to make a valuable contribution to the rigour of qualitative nursing research. IPW is a different type of PW as it is not conducted before a main study, as it is an integral part of its design and conduct.

I used it as a reflexive tool at the beginning of my ConGT doctoral study exploring workplace bullying in nursing practice. It played an important role in optimising my sampling and recruitment strategies, identifying a diverse range of experiences and recruiting reliable informants who could provide valuable insights into workplace bullying. IPW helped me to refine my study’s focus by using the concept of ‘workplace bullying’, which is a term derived from lay language and resonates with the individuals involved. IPW also initiated a process of conceptual reflection by co-constructing an initial conceptualisation that informed the subsequent theoretical co-construction process. Finally, it helped to give me a more nuanced understanding of my research procedures, by providing a comprehensive overview of the methodological aspects of design and implementation. This allowed for more informed refinement and adaptation of procedures before and during the research process. These four key contributions highlight the effectiveness of IPW in qualitative research.

Using IPW deepened my understanding of conducting ConGT research and informed my methodological decisions, thereby guiding the trajectory of my doctoral study. The experience has enhanced my research skills and increased my confidence in my chosen methods. Based on these benefits, challenges and lessons learned, I suggest that qualitative researchers – especially those who are relatively inexperienced in qualitative research – consider using IPW as a reflexive tool embedded in a single study.