Reporting Grounded Theory: Is COREQ Enough?

Abstract

Exploring patient experiences of clinical nursing is an important aspect of clinical research. Grounded theory is an excellent way of addressing complex, naturalistic clinical nursing issues to improve care by better understanding the social processes involved in the illness journey, health event or care episode. Ensuring that such grounded theory research is robust and rigorous is important as it will influence clinical practice.

The EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network was established in 2006 at the Centre for Statistics in Medicine, University of Oxford, with the goal of improving the reliability and value of health research literature by promoting transparent and accurate reporting (Moher et al. 2008). Since its inception, the EQUATOR Network has become a central reference point in academic publishing, especially in health-related disciplines, leading the five main scientific publishing groups to rely on EQUATOR guidelines to shape the author guidelines for indexed journals, assess manuscript quality and guide the reporting process (Smith et al. 2018). As a result, the reporting checklists hosted on the EQUATOR website have become essential tools for authors, reviewers and editors in the scientific community.

The EQUATOR Network hosts an extensive array of reporting guidelines, including highly specific checklists tailored to various study designs (Bond and Hopewell 2015). The resources in the EQUATOR website are organised to allow authors to select the most appropriate checklist based on the study design (EQUATOR Network 2025). However, as shown in Table 1, most of these checklists focus on quantitative methodologies, while for qualitative research, among the tools available on the website (Table 1), qualitative researchers tend primarily to use two main tools: the COREQ (Consolidated Criteria for Reporting Qualitative Research) (Tong et al. 2007) and the SRQR (Standards for Reporting Qualitative Research) (O'Brien et al. 2014). Although these two guidelines were designed to be broadly applicable to qualitative studies, their generic nature has led to several limitations.

COREQ, the most frequently used, focuses primarily on studies involving interviews and focus groups, but has been criticised for promoting a narrow model of qualitative research and for encouraging methodological incongruence when applied across diverse qualitative approaches. Its limited attention to theoretical positioning and its prescriptive use of certain practices reduce its suitability as a universal reporting tool (Braun and Clarke 2024). Similarly, the SRQR is comprehensive in scope but lacks specificity, offering no clear criteria for defining rigour, which limits its usefulness for assessing the quality of qualitative studies or their findings—particularly across diverse epistemological and methodological orientations (Smith et al. 2018). These limitations have sparked an ongoing debate in the qualitative research community. Scholars have questioned not only the adequacy of the existing checklists (King 2021) but also the very appropriateness of using checklist-based approaches for qualitative reporting (Morse 2021).

Given the inherent variability, flexibility and interpretive nature of qualitative methodologies, many argue that rigid checklist frameworks may oversimplify or misrepresent the richness of qualitative inquiry (King 2021). While reporting guidelines are undeniably useful, there is a growing recognition of the need for more nuanced and epistemologically coherent tools (Morse 2021). An important contribution in this direction was proposed by Braun and Clarke, who developed a reporting approach known as BQQRG (Big Q Qualitative Reporting Guidelines) (Braun and Clarke 2025). Their method attempts to overcome the quantitative logic embedded in most checklists by offering a more qualitative-sensitive structure, grounded in epistemological consistency and linguistic alignment with qualitative paradigms.

The BQQRG is a reflective and subjective guide designed to support the methodological quality and coherence of Big Q qualitative research, offering a thoughtful and pedagogical alternative to standardised checklists, such as COREQ and SRQR. The tool thus aims to offer a broad and cross-cutting perspective, encompassing all the key elements that characterise Big Q qualitative research. It identifies practices that are consistent with this research tradition, as well as those that should be avoided. Intentionally flexible in nature, the tool outlines a set of foundational research principles that should remain consistent across all Big Q studies, regardless of contextual factors. Therefore, it serves both pedagogical and strategic purposes: helping less experienced researchers navigate qualitative reporting and providing a tool to resist inappropriate editorial or peer-review demands (Braun and Clarke 2025). Another key area that warrants attention may be the need to differentiate reporting tools tailored to specific qualitative designs.

Just as quantitative research encompasses a variety of study designs—each with distinct methodological and theoretical foundations—qualitative research is similarly diverse, with unique ontological assumptions, methodological procedures and key authors shaping each tradition (Smith et al. 2018). We believe that recognising and respecting this diversity will enhance the quality and credibility of qualitative manuscripts. Reporting tools that are better aligned with the specificities of each design could provide more meaningful guidance for authors, supporting both the writing and review processes. To explore this issue further, we propose a comparative reflection between the GUREGT (Guideline for Reporting and Evaluating Grounded Theory Research Studies) (Hansen and Grimshaw-Aagaard 2018), specifically developed for grounded theory studies, and the non-specific COREQ.

A preliminary comparison between GUREGT and more general checklists, such as COREQ, reveals several substantial differences in structure, focus and epistemological alignment. Both tools adopt a more rigid structure compared with the BQQRG and, in terms of item wording, often employ terminology that does not always align harmoniously with the qualitative research context (e.g., both tools use the term ‘data collection’). However, there are substantial differences between the two. COREQ clearly reflects a structure modelled on quantitative research checklists, with minimal effort to incorporate considerations specific to qualitative inquiry. Its recommendation for use in studies employing interviews or focus groups—data collection strategies that are not universally used in qualitative research—significantly limits its applicability, ultimately requiring a high degree of generalisation and lack of specificity in its items.

GUREGT, on the contrary, focuses specifically on the three main methodological approaches to grounded theory. This focus ensures a clear ontological and epistemological orientation, which resonates throughout the tool and provides internal coherence to its content. Each item in the checklist is explained and contextualised in relation to these approaches. As a result, researchers choosing to adopt this tool are likely to be guided by relevant and comprehensive prompts that are well aligned with the selected methodology. Although the specific guideline appears to better address the reporting needs of grounded theory researchers, our exploratory review of the literature suggests that it has not been widely adopted.

We conducted a search on PubMed using the free-text term ‘grounded theory’, filtering the results by title and abstract only, and focusing on publications from 2018 onward, the year in which GUREGT was published. The search returned 8389 records. It is worth noting that not all of these are empirical studies that adopted the grounded theory methodology; the results also include, for example, articles discussing how to conduct grounded theory research, as well as editorials and discussion papers. However, when checking on Google Scholar how many times the paper by Hansen and Grimshaw-Aagaard (2018) has been cited, we found that, out of 79 citations, only eight referred to its use for reporting a grounded theory study. In 43 cases, the paper was used to guide the writing of GT-based studies; in six cases, it was cited in methodological papers; in five cases, it was used in review contexts for quality appraisal; in five cases, it was cited in research protocols; and finally, 12 citing articles could not be retrieved or were not written in English. This suggests that most authors of grounded theory studies tend to use tools, such as COREQ and SRQR when it comes to reporting their studies.

This pattern may be partially explained by the fact that authors are often encouraged—explicitly or implicitly—to adopt the reporting tools recommended by journals, which in turn tend to align with those listed on the EQUATOR Network, a situation which highlights a critical gap and points to the need for the EQUATOR Network to integrate qualitative-specific reporting tools. Whether through the development of new guidelines or the refinement of existing ones, it is essential to broaden the current repertoire to reflect more accurately the methodological diversity of qualitative research. At the same time, it is crucial that the development of such tools remains grounded in, and explicitly integrates, the foundational principles articulated by Braun and Clarke (2025), which should serve as a common and enduring reference point for all scholars engaged in qualitative inquiry. While we focused here on grounded theory as a case example—given the existence of a dedicated reporting tool—the considerations outlined are relevant to all qualitative research designs.

We therefore encourage experts in qualitative methodology to keep contributing to the development or formal recognition of tailored reporting guidelines that reflect the epistemological and methodological specificities of different qualitative approaches. Importantly, we advocate for the inclusion of such tools within the EQUATOR Network, to ensure their visibility and accessibility. This would support researchers in producing transparent, rigorous and contextually appropriate reports of qualitative studies in clinical nursing and healthcare-related research, ultimately contributing to the overall improvement of their scientific quality and impact—and subsequently, influencing clinical practice in a robust manner.

The authors declare no conflicts of interest.