Volume 92, February 2026, 104259Author links open overlay panel, , Section snippetsInsider or outsider?

The fundamental first steps in planning qualitative observation are to define the boundaires of the observational field and the researcher’s positioning within it.[1,2] As an ‘insider’, researchers assume dual identities as a researcher and clinician, enabling data collection simultaneously with practice.[3] The advantage of being an insider is the researcher can draw upon familiarity with colleagues and the context to optimise data collection. These dual identities, however, can lead to

Structured or Unstructured?

How data are collected must also be considered. Structured observation may involve use of a checklist to guide focused data collection according to predetermined domains of interest and observable actions or processes,[5] optimising consistency across observation episodes.[6] For example, in a study exploring childrens’ pain experiences, a structured observation schedule was used to focus data collection on the child’s appearance, non-verbal communication and contextual factors.[7].

Where a

Who to Consent?

In critical care, consent processes can be ethically complex because of concerns about patients’ decision-making capacity and family member vulnerability. Thus, even though qualitative observation does not involve an intervention, researchers should carefully consider consent implications. A detailed research protocol defining the purpose of observation, who is to be observed, the observation field, and ethical and moral boundaries of the research is essential.[1,5] Even where the purpose might

Researcher vulnerability

Researchers vulnerability must also be considered. Depicted as a ‘triangle of vulnerability’ (Fig. 1), researchers are at risk of vicarious trauma from witnessing suffering, moral distress from observing care they may not agree with, and role strain from blurred role boundaries.[1,3,11] Bearing witness to sensitive disclosures beyond the scope of the research[12] and attempts to maniplulate the researcher,[2] may also add to distress, burnout, and difficulty disengaging from the observation

Implications for critical care research

Observational research offers a powerful means of making visible the complexities of care in critical care settings, capturing dimensions of practice that are often invisible through other methods. Yet its value depends on careful attention to methodological rigour and ethical integrity. Clear decisions about the focus of observation, robust consent processes, thoughtful strategies for data capture, and safeguards for participants and researchers are essential. We encourage researchers to

CRediT authorship contribution statement

Karin Plummer: Conceptualization, Writing – original draft, Writing – review & editing. Ann Bonner: Conceptualization, Writing – original draft, Writing – review & editing. Melissa J Bloomer: Conceptualization, Writing – original draft, Writing – review & editing.

Funding

Nil.

Declaration of competing interest

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Melissa J Bloomer is associate editor for Intensive & Critical Care Nursing and was not involved in the editorial review or the decision to publish this article. The other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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