THE LADDERING TECHNIQUE

A way to conduct interviews

Tina Blegind Jensen Aarhus School of Business Denmark

What is it?
Laddering is an interview technique used in semistructured interviews. Laddering is a method that helps you elicit the higher or lower level abstractions of the concepts that people use to organize their world. The method is performed by using probes. Probing means to peel back the layers of the informants experience. Laddering and probing is used to: understand the way in which the informant sees the world (Reynolds & Gutman, 1988).

In which situations?
Laddering is used within two streams of research: Consumer research and organization research Consumer research to elicit consumers preferences towards certain products or services. Consumers preferences are categorized into three dimensions: Attributes of a product/service Consequences Values Example: Cola light

In which situations?
Organization research to elicit values and decision making structures in organizations. The laddering method can be used to elicit values among managers or employees (e.g. work conditions among employees).

Preferences are categorized into means and ends.

Example: Work conditions for employees

How is it performed?
It is performed on the basis of a one-to-one interviewing technique. In consumer research, you start out by focusing on a certain product or service and its attributes. In organization research, you start out by focusing on certain aspects related to a specific work situation/event. Probes are oriented towards why-questions, i.e.: Why is that (attribute/aspect) important to you?

Example consumer research

The example is based on a salty-snack study. The consumer is asked about the products attributes. On the basis of the attributes, you start probing: Why is that (attribute) important to you? E.g.:
Self-esteem Better figure Dont get fat Eat less Strong taste Flavored chip (V) (C) (C) (C) (A) (A)

And then you draw a map (HVM) that show the different concepts and relations (ladders).

In my PhD project
Not a productrather an event. Focus is on an implementation of an Electronic Patient Record (EPR) in a Danish hospital. Interviews with nurses and doctors. What do nurses and doctors consider as important aspects in the EPR implementation and why. Laddering and probing as a method to study user perceptions.

In my PhD project
21 cards were composed before the interview, each containing an activity or aspect in the EPR implementation process at a more or less abstract level, e.g.: User training Support Work stations etc. On the basis of the cards, the informant was asked: What do you understand by? or what is implied by? And then: Why is that [aspect] important to you?

Interview passage EPR user training:

Interviewer: What do you understand by EPR user training? Nurse: That the teacher is able to teach me the most basic functionalities in the system. Interviewer: What do you understand by the most basic functionalities in the system? Nurse: How to write a nursing note, save it and be able to find it again. But these functionalities also concern procedures regarding the overall hospitalization of the patient. Interviewer: Why is it important that the teacher is able to teach you these functionalities in the system? Nurse: Because it makes me confident when I have to use the system later on. Then I know that I will be able to carry out my work as a nurse. Interviewer: What do you mean by feeling confident and why is it important that you feel confident when using the system? Nurse: Well, I wish to provide the best possible patient care

Summary ladder:

Best possible patient care Carry out my job as a nurse Feel confident about using the system Being thought the most basic functionalities in the system The teachers competences

Optimal nursing and patient care Be motivated and engaged Avoid lacking behind with your work Ergonomic correct and pleasant work environment Control own profession Avoid waiting time Have influence on the process/ Ensure participate in access to decision EPR/no queuing up making Ensure ergonomic work stations Documenting the notes the right place in the system Opportunity to ask questions and get answers Maintain Keep notes up-toFeel confident date and not pass on quality of the having the super notes (a work load to Avoid users/colleagues/ frustration uniform colleagues EPR manual on the documentation) ward Avoid double registration of data on paper Focus on patients - use time on patients Feel familiar / confident with IT and EPR system Secure work procedures and optimal patient course of hospitalization

Ensure faster/ more effective/ shorter implementation process

Facilitate work procedures and not waste time on administrative tasks Avoid wasted time for yourself and colleagues Avoid printing out the record/ work procedures without use of paper

Possibility to solve a problem at once/ get help

A useful supplement Form a clear to user picture of the training implementation process and of expectations Presence of super users or colleagues (in every shift)

Familiar with the speciality/ training and help is adjusted to users levels

Get support on technical aspects

A useful supplement when super users or colleagues are not present

Opportunity to optimize work procedures and EPR layout

Obtain basic knowledge about computers

Create Obtain better sufficient overview knowledge Avoid too about the many log-on/ EPR system log-off procedures Integration between EPR and supporting systems

Get Set-up Enough of work EPR work information stations stations about the project

Professional skills of super users and teachers

Educational ability of super users and teachers

IT skills of super users

EPR manual

Possibility to change EPR layout

Supplementary training

Basic EPR user computer training training

No paper record (only EPR)

Why use this technique?

The laddering interview technique is a structured approach. You get to know what is important to the informants and why it is important; the values. The informants become very reflective. The informants are able to relate to this way of thinking (e.g. focus group interview). Remember to listen to the informants and let them talk about other aspects that are not mentioned on the cards.

Interview with Margunn

Mention three things that are important for you when conducting an interview