A brief introduction to realist synthesis

Geoff Wong

Overview

• Objectives

• What is realist synthesis / review?

• Why do we need ‘yet another’ approach?

• What assumptions underpin realist synthesis?

• Summary

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.

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.

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

A simplified diagram of a complex intervention!

Intervention

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

Mechanism(s)

Context influences which mechanism(s) ‘fires’

All this may be explained by one or more (middle-range) theories

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

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

SummaryRealist research is based on a explicit philosophy of science.

1. Ontologically:• Stratification – the world has ‘depth’• Generative causation through mechanisms

2. Epistemologically:• Partial and corrigible knowledge, built up gradually and judged by

assessing the processes and assumptions by which it is produced

3. Methodologically• Ontology and epistemology should inform methodology (and not

the other way round)

Realism is a way of looking at and making coherent sense of this ‘messy’ world we live in.

Thanks for your attentionSuggested 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/documents/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, 46:1, 89–96

• 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, 10:12 (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 me:grckwong@gmail.com

OrJoin us on the RAMESES Project

www.jiscmail.ac.uk/RAMESES