RES 6033 Module 3 Coding and Thematic Analysis Example

From Transcript to Theme: Coding Three Practice Interviews About a Rural Hospital's Obstetric Unit Decision and Developing Initial Themes With Reflexive Thematic Analysis

Student Name

American College of Education

RES6033: Qualitative Research Designs

Module 3 Assignment

Instructor Name

October 26, 2026

Introduction

Module 2 produced an interview protocol for a multiple case study of rural hospital boards deciding the fate of their birthing services. For this module, I conducted three practice interviews with leaders at one hospital, which I call Hospital A. The three, a chief executive, a board member and a family physician who had delivered babies there, agreed to the practice interviews for coursework only, and their words are condensed and altered here so that no one can be identified; the data will not be used in the dissertation. This paper shows how the transcripts were coded, how codes were grouped into candidate themes and how those themes were reviewed and named.

Choosing an Analytic Approach

I used reflexive thematic analysis. Braun and Clarke (2006) set out six phases: getting to know the data, coding it, looking for candidate themes, checking them against the data, settling on a name and a definition for each, and writing up. In later work, Braun and Clarke (2019) emphasized that themes are not hidden in the data waiting to be found but are developed by the researcher through engagement with it, which makes the researcher's reflexivity part of the method rather than a threat to be removed. That stance fits my position as an executive who has made this kind of decision. In the full case study, thematic analysis within each case will be followed by cross-case comparison.

Phase 1: Familiarization

I transcribed each interview myself, then read each transcript twice, first straight through and then with notes in the margin. After each reading I wrote a short memo on what struck me. The first memo after the physician's interview noted that she described the decision almost entirely through particular deliveries, while the chief executive described it through spreadsheets and meetings. That contrast in how people told the story became important later.

Phase 2: Generating Codes

Codes were written close to the data, often using participants' own words. Three excerpts show the process.

Chief executive: "By the second year we were doing about 90 deliveries and paying four people to be on call for every one of them. I kept showing the board the same chart." Codes: low volume, fixed cost of call coverage, repeating the financial case.

Board member: "Nobody on the board wanted to be the one who closed it. We kept asking for one more study." Codes: avoiding ownership of the decision, delay as strategy, requests for more data.

Family physician: "When our last surgeon who could do a C-section retired, the question wasn't whether we'd close, it was how long we could pretend we wouldn't." Codes: loss of surgical backup, inevitability, pretending.

Across the three transcripts I generated 31 codes. Each was entered in a codebook with a short definition, an example excerpt and a note on when to use it and when not to, which keeps codes consistent as the data grow.

Phase 3: Searching for Themes

I printed the 31 codes on slips of paper and sorted them into piles by shared meaning, then photographed each arrangement and wrote a memo explaining it. The first sort produced six piles: money, staffing, the board, the community, safety and timing. A second sort, after rereading the transcripts, showed that several piles were describing the same thing from different angles. Loss of surgical backup, a staffing code, and inevitability, a timing code, both described a moment when the decision was effectively made by events rather than by people. That observation reorganized the piles.

Phase 4: Reviewing Themes

Candidate themes were checked twice: against their coded excerpts, to see whether the excerpts fit together, and against the full transcripts, to see whether the theme reflected the interviews as wholes. One candidate theme, community anger, failed the second check. Although every participant mentioned it, it described the aftermath rather than the decision, and it belonged in a different research question. I moved it to a memo for later rather than discard it. Another candidate, money, was too broad to say anything; it split into the fixed cost of coverage, which belonged with staffing, and the board's need for financial justification, which belonged with delay.

Phases 5 and 6: Defining and Naming Themes

I developed three themes through review, each defined in a sentence and named in words close to the data.

The decision before the decision. Participants described a point, usually the loss of a surgeon or anesthesia provider, after which closure was effectively settled, and the formal process that followed confirmed rather than made the choice. The physician's phrase, how long we could pretend we wouldn't, captures it.

Waiting for permission. The board delayed by commissioning studies and requesting more data, which participants understood as a way to avoid owning a painful decision. The chief executive's repeated chart and the board member's one more study describe the same pattern from two sides of the table.

Two stories of one decision. Administrators told the story through numbers and meetings; clinicians told it through patients and particular nights. The gap between these two ways of telling it may explain why clinicians felt excluded from a process administrators believed was open.

How the Themes Answer the Research Questions

The three themes speak to both research questions. The decision before the decision answers RQ1, about process, by showing that the formal steps followed a turning point rather than producing it; in the full study, the board minutes and staffing records should show whether that turning point appears in the documents as clearly as in the interviews. Waiting for permission also addresses RQ1, describing how the board managed time. Two stories of one decision bears on RQ2, about considerations, because administrators and clinicians appear to have weighed different things, the cost of coverage on one side and safety on difficult nights on the other. With only one hospital and three interviews, these themes are starting points to be tested in other cases, not findings.

Keeping the Analysis Traceable

Nowell et al. (2017) argued that thematic analysis meets trustworthiness criteria only when each phase leaves a record that others can follow. Mine includes the transcripts, the codebook with definitions, the memos written after each reading and sort, photographs of the code arrangements and a log of changes to themes with reasons, such as the decision to move community anger out of the set. A colleague in my doctoral cohort reviewed the codebook against one transcript and questioned two codes, one of which I revised. These records will form the audit trail in the full study.

Reflexive Notes

My own experience shaped the analysis. I recognized the second theme immediately, because I had shown a board the same chart many times, and I had to ask whether I was seeing it in the data or bringing it to the data. Rereading the board member's full transcript, I found the theme supported in her own words, but I recorded my reaction in a memo so that a reader of the final study can weigh it.

Conclusion

Coding three practice interviews produced 31 codes and, after two sorts and two rounds of review, three themes: the decision before the decision, waiting for permission and two stories of one decision. The process showed the value of reviewing themes against full transcripts and of recording every change. Module 4 develops the trustworthiness and ethics plan for the full study.

References

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa

Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health, 11(4), 589-597. https://doi.org/10.1080/2159676X.2019.1628806

Nowell, L. S., Norris, J. M., White, D. E., & Moules, N. J. (2017). Thematic analysis: Striving to meet the trustworthiness criteria. International Journal of Qualitative Methods, 16(1), 1-13. https://doi.org/10.1177/1609406917733847