The latter half of the essay shows the uses and misuses of validity studies in selected health services research and the current debate on national health insurance. Examples derive from concepts central to a geography of health-care behavior and well-being. The paper begins by discussing methods used in conceptualizing and operationalizing variables in quantitative and qualitative research design. Instead, the argument is couched in a postmodernist hermeneutic sense which questions the validity of one discourse of investigation over another. In doing so, the paper aims to move the methodological debate beyond the simple dichotomies of quantitative vs qualitative approaches and logical positivism vs phenomenology. Its premise is that our definitions of key terms and concepts must be reinforced throughout the design of research should our knowledge and understanding be enhanced. Its main argument is that qualitative research can be strengthened if the differences between instrumental and apparent validity are better understood that the current research in medical geography suggests. The insights garnered here will move novice researchers and doctoral students to a better conceptual grasp of the complexity of reliability and validity and its ramifications for qualitative inquiry.This essay examines methodological problems concerning the conceptualization and operationalization of phenomena central to medical geography. Recommendations are made for use of the term rigor instead of trustworthiness and the reconceptualization and renewed use of the concept of reliability and validity in qualitative research, that strategies for ensuring rigor must be built into the qualitative research process rather than evaluated only after the inquiry, and that qualitative researchers and students alike must be proactive and take responsibility in ensuring the rigor of a research study. A synthesis of the historical development of validity criteria evident in the literature during the years is explored. Elaborating on epistemological and theoretical conceptualizations by Lincoln and Guba, strategies congruent with qualitative perspective for ensuring validity to establish the credibility of the study are described. This article presents the concept of rigor in qualitative research using a phenomenological study as an exemplar to further illustrate the process. There is also a continuing debate about the analogous terms reliability and validity in naturalistic inquiries as opposed to quantitative investigations. Issues are still raised even now in the 21st century by the persistent concern with achieving rigor in qualitative research.
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