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Rational, aims, and objectives Qualitative research has been promoted as an important component of the evaluation of complex interventions to support the scale up and spread of health service interventions, but is currently not being maximized in practice. We aim to identify and explore the sociocultural and structural factors that impact the uses (and misuses) of qualitative research in the evaluation of complex health services interventions. Methods We conducted a qualitative analysis of data collected in a multiple case study of the evaluation and scale up and spread of three health service intervention. Results Our findings demonstrate the challenges of meaningfully integrating qualitative research in evaluation programmes lead by clinicians with limited qualitative expertise and operating within an environment dominated by biomedical research, even with methodological support. Conclusions Based on these findings we encourage ongoing engagement of qualitative researchers in evaluation programmes to begin to refine our methodological understanding, while also suggesting changes to medical education and evaluation funding models to create fertile environments for interdisciplinary collaborations.

This study uses a Foucauldian discourse analysis to explore media reporting on the role of nurses as being consistently positioned ‘heroes’ during COVID‐19. In so doing, it highlights multiple intersecting discourses at play, with the caring discourse acting as a central one in negatively impacting nurses' ability to advocate for safe working conditions during a public health emergency. Drawing on media reports during the outbreak of COVID‐19 in Ontario, Canada in the spring of 2020 and on historical information from SARS, this study seeks to establish caring as a discourse and examine if the caring discourse impedes nurses' ability to protect themselves from harm. The results of this analysis explicate how public media discourses that position nurses as caring, sacrificial and heroic may have impacted their ability to maintain their personal safety as a result of the expectations put upon the nursing profession.

Context We rely upon formal accreditation and curricular standards to articulate the priorities of professional training. The language used in standards affords value to certain constructs and makes others less apparent. Leveraging standards can be a useful way for educators to incorporate certain elements into training. This research was designed to look for ways to embed the teaching and practice of compassionate care into Canadian family medicine residency training. Methods We conducted a Foucauldian critical discourse analysis of compassionate care in recent formal family medicine residency training documents. Critical discourse analysis is premised on the notion that language is connected to practices and to what is accorded value and power. We assembled an archive of texts and examined them to analyse how compassionate care is constructed, how notions of compassionate care relate to other key ideas in the texts, and the implications of these framings. Results There were very few words, metaphors or statements that related to concepts of compassionate care in our archive. Even potential proxies, notably the doctor–patient relationship and patient-centred care, were not primarily depicted in ways that linked them to ideas of compassion or caring. There was a reduction in language related to compassionate care in the 2013 standards compared with the standards published in 2006. Conclusions Our research revealed negative findings and a relative absence of the construct of compassionate care in our archival documents. This work demonstrates how a shift in curricular focus can have the unintended consequence of making values that are taken for granted less visible. Given that standards shape training, we must pay attention not only to what we include, but also to what we leave out of formal documents. We risk losing important professional values from training programmes if they are not explicitly highlighted in our standards.