Meet the Qualitative Researcher: Jia Liu

Jia is an ESRC LISS DTP funded post-doc research fellow at KCL in the Department of Inflammation Biology in the Faculty of Life Sciences and Medicine. Before her post-doc she was a PhD student at KCL working in the GKT School of Medical Education.

Sohail: Please tell me a bit about your research.

Jia: For my PhD I looked at how medical students developed their cultural competency in healthcare settings. I used ethnography. After completing my PhD, I have worked on two projects. One is looking at student attainment of healthcare students, particularly students from Black, Asian and Minority Ethnic (BAME) backgrounds. That’s a mix methods research project that used focus groups and also interviews and surveys. Currently, I am working on a project that looks at the emotional impacts of patients living with axial Spondylarthritis. We are using diaries, interviews and focus groups.

Sohail: What got you interested in health?

Jia: It’s actually not on purpose! After my master’s in media and communications at LSE, I worked as a lecturer at the Dalian Maritime University in China in the School of Foreign language and International Studies. It was a very interesting experience, and my post was primarily teaching focussed.

There was no single event that meant I ended up doing qualitative research in the field of healthcare. To me it was a natural process. I remember when I was working in the university in China I was allocated with a module on cross-cultural communication. When I started teaching the module, I realised the different health beliefs that exist. I became intrigued in research in this filed, and therefore I applied for the medical school at KCL.

Sohail: Why are you specifically interested in cross-cultural health conceptions?

Jia: I think it’s a really important topic. If you look at the statistics and news reports, they are all showing that patients are having different healthcare outcomes based on their social backgrounds. The healthcare system has challenges to provide culturally appropriate and efficient care for patients from disadvantaged backgrounds, including patients from a different cultural background. When talking about culture here, I’m referring not only to race and ethnicity but the multifaceted individual cultural characteristics such one’s gender, age, religion, sexuality, and educational background. For example, everyone is talking about COVID. Vaccine wise, critiques were saying that when they were testing the vaccine, there aren’t many people from ethnic minority backgrounds that were recruited, so one may wonder what implications will this have? For example, will this have impact on a lower vaccine uptake among BAME patients? And what differences would be within the BAME group due to their individual sociocultural backgrounds?

Also, there’s still a proportion of people living here do not speak English. It can be quite difficult if you don’t know the language or the local healthcare system. Healthcare professionals need to be culturally competent to provide equal care to people from all backgrounds. So, for my research, I am looking at the healthcare curriculum. Starting from education to help influence healthcare.

Sohail: How does your personal background influence your thinking?

Jia: I acknowledge my personal cultural background has impacted my research. Though I would argue that that would apply to every researcher! I’m a foreigner, though I’ve lived in London for many years. I still feel a strong connection with my home culture, which is Chinese. When doing research in the healthcare context, I tend to subconsciously compare patients’ experiences in different cultural contexts. For example, healthcare in the UK is very different from my home country. I would argue that healthcare in China is more efficient, but the development value-based medicine, such as cultural competence, may still be quite a new idea. In comparison, here in the UK healthcare settings, empathy and clinical communication are well emphasised but the downside is that there is long waiting time to get treatment. The system (e.g. primary care, secondary care, referral) is also very complex to navigate for someone who is not originally from this culture. So, it can be a challenge for people with no prior exposure to seek help in the English healthcare system, particularly for those with limited English skills.

For example, I know that there are some young Chinese international students, they have completed a bachelor’s degree and staying here for three or four years. But they have not registered with a GP. They do not know what a GP is. So, I asked them “what do you do when you get sick?” They told me that they bring essential medicine from their home country. I think a lot of people survive in this way.

Sohail: What are you planning on doing in the future?

Jia: I’m currently a postdoctoral research fellow, funded by ESRC LISS DTP. I’m proposing a comparative piece of research looking at cultural competence education in a Chinese medical school and a UK medical school. I’ve already got a partner university in China, and this is something I’m looking forward to pursuing. I know in China, I know a lot of foreigners are unsatisfied with their healthcare experience, because not all information was provided in English, so they feel they have to get someone to help them or call an ambulance. So different challenges in different cultures, which I think will make this research an important piece of work.

Sohail: Final bonus question! You are a mixed methods researcher. What do you prefer doing, qualitative research or quantitative research?

Jia: That’s a difficult question! “Like who do you like more, your mother or your father?” I enjoy doing qualitative research. It’s nice to work with people and for quantitative research you basically work with numbers. For example, I enjoyed doing ethnography for my PhD, but I do acknowledge that it can be potentially an intrusive methodology so the researcher may experience some reluctance from the participants. So, though I enjoyed doing this research method, I think in the process there are a lot of challenges, and it can be potentially embarrassing. After I finished my ethnographic data collection, I felt a big relief! But when I look at the results, they are so rewarding by providing such a level of details. So, I think it is really up to what you are after. If you want to see the big picture or emerging trends, quantitative methods can do its magic too. But if you are interested in human experiences, particularly with its complexities and nuances, definitely go for qualitative methods!