Exploring sensitive topics in assessment research through vignette-based interviewing

Assessment research often involves working with sensitive data, that can mean potential reputation risks to individuals and institutions. Additionally, eliciting emotionally charged personal experiences while protecting the psychological safety of participants can be challenging. While vignettes are increasingly being used in medical education and public health research to elicit data through the presentation of ethical dilemmas, their application to explore sensitive topics, particularly in assessment and more specifically Objective Structured Clinical Examination (OSCE) research, is new. Our research questions were: How can vignette-based interviewing be systematically developed and validated to explore sensitive topics such as test-wiseness in OSCEs? (2) What methodological and ethical value does this data elicitation approach offer for generating insights into this topic?

Using a five phases model, we have outlined our process of construction, validation, methodological alignment, and deployment of vignettes. We highlight the integration of vignettes with semi-structured interview method and the need for ongoing feedback, reflection and adaptation of vignettes. We undertook thirteen vignette-based interviews with a diverse range of participants, including medical students, graduate doctors, educators with experience in designing, assessing, and running OSCEs, as well as individuals involved in leadership roles and fitness-to-practice panels.

Using qualitative data from our exemplar study, we demonstrate the use of vignette-based interviewing method using four themes: plausibility, dialogicality, flexibility, and narrativity. Outlining example excerpts and analytical insights, we explain how vignette data could strengthen the validity and add insights to interview data, particularly useful in exploring sensitive topics in OSCE research. We have also discussed the advantages of using vignettes within a social constructionist approach, highlighting elicitation of shared beliefs and social norms, and, in terms of interpretation of vignette data, the exploration of competing and complementary constructions and power relations.

Vignette-based interviewing method offers a means to conduct inquiry that is both ethically defensible and allows for a rich investigation, especially valuable in studying topics that are difficult to access through conventional methods. We highlight the importance of careful alignment of selected methods with the overall research design and paradigms, as well as reflexivity and transparency in reporting how and why vignettes were developed and adopted.