Exploiting Exceptions to Enhance Interpretive Qualitative Health Research: Insights from a Study of Cancer Communication

Although it has long been understood that a well-constructed data set ought to be filled with complexities and contradictions, observations that challenge or contradict analytic interpretations are not often given sufficiently serious attention in the methodological qualitative health literature. When researchers attempt to produce comprehensive or “holistic” findings, they all too often set aside or gloss over the negative cases that fail to conform to their emerging interpretive generalizations. In this article, the authors challenge fellow qualitative health researchers to engage actively in identifying and exploiting both actual and theoretical exceptions as a valuable analytic strategy. They argue that heightened sensitivity for negative cases uncovers the assumptive claims deriving from our various methodological orientations and illuminates alternative explanations. They propose that thoughtful attention to contradictory or challenging observations can deepen our expectations about the kinds of knowledge products that qualitative research ought to yield, thereby helping us advance the credibility of our findings and the ultimate utility of our empirical conclusions.