A brief introduction to realist synthesis

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A brief introduction to realist synthesis

• Geoff Wong

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Overview

• Objectives
• What is realist synthesis / review?
• Why do we need yet another approach?
• What assumptions underpin realist synthesis?
• Summary

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Objectives

• By the end of this presentation I hope you will
  have an understanding of
• what a realist synthesis is
• what assumptions underpin realist synthesis
• when you might use realist synthesis.

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What is a realist synthesis?

• Realist Synthesis - Theory driven systematic
  review (secondary research)
• Goal is more explanation and understanding than
  judgment and summation
• More a logic of enquiry- a way of analysing and
  making sense of data using a realist lens.

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Why do we need yet another research review
method?

• Because of complex interventions a realist
  perspective
• Volitions Reliant on people to make choices
• Implementation Long implementation chains
• Context Outcomes change under differing contexts
• Time What has happened previously shapes what
  will happen next
• Outcomes multiple, planned and unplanned and
  even contested
• Rivalry Interventions compete with one another
  in the real world
• Emergence interventions begets change which
  causes more change

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A simplified diagram of a complex intervention!
L
F
H
J
A
B
C
D
E
G
I
K
Intervention
M
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Assumptions underpinning realist synthesis

• Ontologically how we believe the world to be
  constituted
• Developed from critical realism
• A stratified and filtered world
• About identifying, understanding and explaining
  causation through generative mechanisms

All this may be explained by one or more
(middle-range) theories
Context influences which mechanism(s) fires
Mechanism(s)
B
A
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Assumptions underpinning realist synthesis

• Epistemologically what counts as knowledge and
  how can we come to know it
• Knowledge is built up gradually, is partial and
  conditional but corrigible
• Knowledge should be judged by assessing the
  processes and assumptions by which it is produced
• Theories are right because they are (for
  example) coherent, plausible and repeatedly
  successful

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Assumptions underpinning realist synthesis

• Methodologically
• Uses a realist lens to analyse and make sense
  of data
• Theory-driven
• Realist programme theory
• Middle-ranged theories to explain outcomes of
  interest
• Requires focussing and prioritisation of what to
  study
• Making and testing inferences from the data
• Uses any data that can inform inferences
• Iterative

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Summary

• Realist research is based on a explicit
  philosophy of science.
• Ontologically
• Stratification the world has depth
• Generative causation through mechanisms
• Epistemologically
• Partial and corrigible knowledge, built up
  gradually and judged by assessing the processes
  and assumptions by which it is produced
• Methodologically
• Ontology and epistemology should inform
  methodology (and not the other way round)

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Realism is a way of looking at and making
coherent sense of this messy world we live in.
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Thanks for your attention

• Suggested readings
• Pawson R. Evidence-based Policy. A Realist
  Perpective. London Sage, 2006.
• Pawson, R., Greenhalgh, T., Harvey, G., and
  Walshe, K. Realist Synthesis an introduction.
  http//www.ccsr.ac.uk/methods/publications/documen
  ts/RMPmethods2.pdf . 2004. ESRC Research Methods
  Programme.
• Wong G, Greenhalgh T, Westhorp G, Pawson R.
  Realist methods in medical education research
  what are they and what can they contribute?
  Medical Education 2012, 461, 8996
• Wong G, Greenhalgh T, Pawson R. Internet-based
  medical education a realist synthesis of what
  works, for whom and in what circumstances BMC
  Medical Education 2010, 1012 (2 February 2010)
• Wong, G., Pawson, R., Owen, L. Policy guidance on
  threats to legislative interventions in public
  health a realist synthesis BMC Public Health
  2011, 11, 222
• Klee R. Introduction to the philosophy of
  science. Cutting nature at its seams. New York
  Oxford University Press, 1997
• If you are interested in undertaking a realist
  synthesis please email megrckwong_at_gmail.com
• Or
• Join us on the RAMESES Project
• www.jiscmail.ac.uk/RAMESES