Mixed up: evidence of integration in health professions education mixed methods research

Mixed methods research (MMR) has emerged as a promising approach for addressing the complex and multifaceted research questions facing health professions education (HPE). In this article, it is argued that evidence of integration - the defining feature of MMR and a key marker of its recent methodological advancements – needs to be made more visible in HPE studies employing MMR designs. Unlike other multi-method approaches that simply report quantitative and qualitative sub-studies in parallel, MMR emphasizes the integration of design elements such as theory, data, and analytical strategies to generate insights that a single approach could not achieve. As the use of MMR becomes more prevalent, examining how integration is reported is both timely and essential for researchers and reviewers, cuing them to understand the where, when, and how of integration. Without explicit attention to integration, the potential of MMR to address HPE’s complex challenges is diminished. To strengthen the case for clearer reporting of integration, a synthesis of recent studies published across five leading HPE journals is reported. The literature synthesis demonstrated a range of evidence of integration from only 4.6% of studies (2/43) at the design stage up to 44.2% of studies (19/43) at the data collection stage. Recommendations are provided to increase the specificity of evidence of purposeful integration across the four stages of a research study: study design, data collection, analysis, and reporting.