Table 3.

Techniques Used to Ensure Qualitative Rigor and Trustworthiness of Findings

Aspect	Technique	Description
Credibility How reflective of reality are the research findings?	Field observation	DK observed patient encounters in heart failure clinics and palliative care home visits during study design.
	Iterative questioning36	We employed deliberate, explicit probes in order to understand participants' responses with greater precision.
	Expert review of protocol	Disciplinary experts assisted in the development of the interview guide and patient vignette.
	Frequent debriefing	Weekly meetings were held between the lead and senior authors to discuss findings and concerns.
Transferability How applicable are the research findings to other contexts or situations?	Contextual review	We performed a detailed literature review to understand the context within which our work falls.
Dependability How reproducible are the research findings?	Audit trail	We maintained an extensive audit trail throughout the analytic process, detailing decision rules and justifications.
Confirmability How objective was the analysis?	Bracketing42	Recognition of investigators' preconceptions and assumptions regarding the phenomena of interest.
	Triangulation	Investigator triangulation (ie, multiple researchers analyzed data) and disciplinary triangulation (ie, researchers represented a variety of related expertise).
	Member checking41	Interview participants were invited to review this manuscript before submission for publication.