Love and breakup letter methodology: A new research technique for medical education

In everyday life, feelings are important to us, influencing our decision-making and motivating our actions. This is equally true within medicine and medical education, where feelings influence key aspects such as clinical decision-making, empathy, resilience, professional identity, reflection, team dynamics, career choices and questions of prejudice and bias. Feelings are therefore legitimate targets in medical education research, but asking research participants to talk openly about feelings can be challenging for participants and researchers alike. Within the disciple of User Experience (UX)-a relatively new research discipline used in the world of technology-researchers also seek to understand their customer's feelings, which are central to aspects of brand loyalty and choice of software platforms. UX researchers have developed innovative ways to explore feelings, in particular through the use of Love and Breakup Methodology (LBM)-participants are asked to write love and breakup letters to the product or app under study, and the letters are then used to guide the focus group discussion that follows. Methods: In this article, we describe the theoretical underpinnings of LBM, including ontological considerations. We also consider how LBM can be successfully used in medical education research and outline how we have adapted it in our own research studies and programme evaluations. Conclusions: Love and breakup letters are creative ways of understanding participants' positive and negative emotions about the matter under study. LBM has been utilised extensively by UX researchers in technology, but has been little used in medical education. It has rich potential to enhance research approaches to aspects of medicine that are influenced by feelings, including empathy and resilience, team working and many other aspects of professional practice. Although principally a focus group research tool, it can be adapted to other approaches, including questionnaire surveys and individual interviews.