Ethnographic evidence The value of applied ethnography in healthcare

The move towards evidence-based healthcare across the industrialised world has raised questions about the nature of evidence, and how good evidence is determined. In response to a hierarchy of evidence in which findings from qualitative research are deemed to be the lowest form, qualitative researchers have underscored the different agendas of qualitative and quantitative research, and the potential for qualitative inquiry to explore complex problems, including the experiential components of healthcare. This paper, which provides a context for the other papers on ethnography in this journal issue, looks at ethnography in the context of this debate. It first offers an overview of what is meant by ethnography, its different forms of practice, and how it relates to qualitative research more broadly. It then looks at how ethnography has been applied in organisational and healthcare settings, before considering the nature of evidence that qualitative inquiry, and particularly ethnographic inquiry, can provide. It argues that, within the qualitative paradigm, ethnography is particularly valuable because of the attention it gives to context and its synthesis of findings from different methods. Moreover, ethnography offers a holistic way of exploring the relationship between the different kinds of evidence that underpin clinical practice.