Dear Sara (and all),
This is a fascinating discussion and I found your presentation very useful and interesting. A couple of points. I remember Trish's point about realism connecting positivism to constructivism from the CARES conference. I disagreed with it then and I disagree with this continuum now.
Positivism and constructivism are connected, as I have argued in my book on Sampling and choosing cases, by the flatness of their ontology and their empiricism. Realism, with its stratified ontology lies above (and below) this continuum between positivism and constructivism, but certainly not between them.
CMOs are constructed, but I think we need to make a distinction between weak constructions and strong constructions. Again, as I argue in Sampling and choosing cases in qualitative research: a realist approach:
Individual cases may be different configurations of context, mechanism, and outcome. Each a tentative realist explanation that links ideas and evidence. These descriptions are only weak constructions and as such we should not be waylaid by acts of assigning evidence and ideas to context, mechanism, and outcome. Fruitless hours can be spent trying to work out if some part of this weak construction is context, or mechanism, or outcome. The effort is far better spent ensuring that evidence and ideas are adequately represented in the strongly explanatory account of the cases in the research. Each case will be carried forward to offer direct support or rejection of theories. Together, the cases purposefully bring together bundles of configurations of ideas and evidence in a system built to compare, juxtapose, judge, and interpret these ideas.
But there is a conundrum in this, which I'm trying to work out--is it all about testing and refining evidence against middle range theories, or is there something more about critical theory at work here. You cite John Snow's case of the brewery workers in Soho later in your presentation. These workers, as Snow notes in his book, drank malt liquor supplied by the brewery and none died of cholera, unlike their unfortunate neighbours who drank water from the Broad Street pump. The inmates of a nearby workhouse with its own pump-well were also saved. Snow collects case after case from epidemic after epidemic in London and throughout England to test his theory that cholera was transmitted in water. The story about maps drawn and water handles taken off in Broad Street are nonsense invented largely by an American epidemiologist Wade Hampton Frost, who rediscovered Snow in the 1930s. Maybe Snow's most appealing work is his natural experiment comparing cholera mortality in populations supplied through different water sources on the Thames. He found the relative risk of contracting cholera from the Lambeth Water Company, which drew its water from within London, was 5.7 times higher than for those who drank water supplied by Southwark and Vauxhall Company drawing its water from above London. Compelling, yet at the same time, William Farr estimated that those living in the Thames basin were over 14 times more likely to die of cholera than those living in the lofty uplands of Hampstead. Farr argued that cholera was carried in the miasma, the effluvia and pollutants that infested the river side of the Thames. Farr's theory held sway. Snow's theory of water borne disease would have to wait for far more conclusive microscopic evidence-Koch's rediscovery of V. cholera in 1883--25 years after Snow's death.
And my conundrum, if I'd been a realist in London in the 1850s I would have gone with William Farr and the miasmic theory of disease. The evidence and theory fit, the weakly constructed theory leads me to worry, like William Farr did, as to where it was safest to be in a cholera epidemic (answer--shooting grouse on the moors of Yorkshire, given that epidemics always happened in August when shooting grouse is what the upper English classes do at that time of year). Or do we need to add contrarian to the list of features realist researchers need to be? In which case I might have followed Snow's lead, gone with the minority view, and held fast to a theory that really did not at the time stand up to the empirical evidence and was only held by a small group of progressive (alternative) and critical clinicians.
Best wishes
Nick
Nick Emmel | School of Sociology and Social Policy | University of Leeds |Leeds |LS2 9JT
+44 (0) 113 343 6958 | Twitter @NickEmmel | Blog http://realistmethods.wordpress.com/
Emmel ND (2013) Sampling and choosing cases in qualitative research: a realist approach. London. Sage. http://goo.gl/yYydFd
-----Original Message-----
From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards [mailto:[log in to unmask]] On Behalf Of Sara Van Belle
Sent: 14 June 2016 08:37
To: [log in to unmask]
Subject: Re: Realism and Erthnography
Dear Justin,
I delivered a presentation (some method musings...) on realist evaluation and methods in anthropology during the MAGIC 2015 conference of European social anthropologists last year (see attached).
Would be great to further exchange...
Enjoy,
Sara Van Belle
Post-Doctoral fellow
Institute of Tropical Medicine, Antwerp, Belgium
From: "Realist and Meta-narrative Evidence Synthesis: Evolving Standards" <[log in to unmask]<mailto:[log in to unmask]>> on behalf of Trish Greenhalgh <[log in to unmask]<mailto:[log in to unmask]>>
Reply-To: "Realist and Meta-narrative Evidence Synthesis: Evolving Standards" <[log in to unmask]<mailto:[log in to unmask]>>, Trish Greenhalgh <[log in to unmask]<mailto:[log in to unmask]>>
Date: Tuesday 14 June 2016 at 06:32
To: "[log in to unmask]<mailto:[log in to unmask]>" <[log in to unmask]<mailto:[log in to unmask]>>
Subject: Re: Realism and Erthnography
Justin and all
Personally, I think COMs are a social construction. There, I've said it.
Good discussion!
Trisha Greenhalgh
Professor of Primary Care Health Sciences
[cid:D9751AC9-943C-462D-9AB4-815500AB7336]
T: +44 (0)1865 617816
PA: Karen Morecroft [log in to unmask]<mailto:[log in to unmask]>
E: [log in to unmask]<mailto:[log in to unmask]>
www.phc.ox.ac.uk<http://www.phc.ox.ac.uk> | @OxPrimaryCare<http://www.twitter.com/oxprimarycare> | @trishgreenhalgh<http://www.twitter.com/oxprimarycare>
Nuffield Department of Primary Care Health Sciences, University of Oxford Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG
From: Justin McNab <[log in to unmask]<mailto:[log in to unmask]>>
Reply-To: "Realist and Meta-narrative Evidence Synthesis: Evolving Standards" <[log in to unmask]<mailto:[log in to unmask]>>, Justin McNab <[log in to unmask]<mailto:[log in to unmask]>>
Date: Tuesday, 14 June 2016 01:24
To: "[log in to unmask]<mailto:[log in to unmask]>" <[log in to unmask]<mailto:[log in to unmask]>>
Subject: Realism and Erthnography
Dear Becky
I am a medical anthropologist currently working in the field implementation science, evaluation etc - for the last 6 years or so around integration and co-ordination of care for the chronically ill.
As a social anthropologist I have been aware, for many years, of the great importance of context (in all its myriad guises and forms) so the realist approach, while interesting, was not the revelation to me it was for some others who work with strict program logic approaches to evaluation etc. I attended the Liverpool CARES conference at the end of 2014 and found it interesting and informative, and was heartened that those employing realist approaches are a broad multi-disciplinary church with room for those right up the positivist end of the scale to those right up the interpretive constructionist end of the spectrum. As a social anthropologist I am, perhaps not surprisingly, more up the interpretive constructionist end of the 'realist scale'.
I very much like your take on the 'realist movement' for want of a better way of putting it. I agree wholeheartedly with your view that CMOs are a tool to think with and aid in the production of knowledge, and clearly, as you also say, that realist approaches are a flexible and interpretive approach to understanding and explaining complex phenomena rather than a method.
Of course, as an anthropologist, I'm not so interested in certainty and a rigid application of a realist approach and identification CMO bundles.
Anyway, all a bit of a rambling introduction to say I am very interested in your ideas on realist approaches to ethnography. I will not be able to attend your workshop (or the CARES conference) this year but would be very interested in any presentations, materials etc you might make publicly available.
Regards
Justin McNab
JUSTIN McNAB | Lecturer in Health Policy | Research Fellow Menzies Centre for Health Policy THE UNIVERSITY OF SYDNEY Level 6 The Hub, Charles Perkins Centre D17 | The University of Sydney | NSW | 2006 T +61 2 9036 7004 E [log in to unmask]<mailto:[log in to unmask]> http://<http://www.menzieshealthpolicy.edu.au/>www.sydney.edu.au/menzies-health-policy
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From: "Realist and Meta-narrative Evidence Synthesis: Evolving Standards" <[log in to unmask]<mailto:[log in to unmask]>> on behalf of "Hardwick, Rebecca" <[log in to unmask]<mailto:[log in to unmask]>>
Reply-To: "Realist and Meta-narrative Evidence Synthesis: Evolving Standards" <[log in to unmask]<mailto:[log in to unmask]>>, "Hardwick, Rebecca" <[log in to unmask]<mailto:[log in to unmask]>>
Date: Friday, 10 June 2016 7:02 pm
To: "[log in to unmask]<mailto:[log in to unmask]>" <[log in to unmask]<mailto:[log in to unmask]>>
Subject: Re: CARES 2016 - Registration now open!
Hi Alan,
Personally, my take on the whole CMO thing, is that CMOs are "just" a tool to think with, to help the researcher in her task of organising her thoughts, with programme theory development and refinement. I think they're an aid to producing knowledge.
I also think that as realist approaches are an approach to understanding and explaining complex phenomena, and not a method per se, then they are open to both flex and interpretation. This is a good thing, but our human tendency is to want certainty, which the CMO configuration can (?mistakenly) offer. That's why I think sometimes it gets the airtime it does.
I am hopeful that there will be use of CMOs in work presented at the conference, as I think the CMO is a useful construct when used in the task of producing knowledge (rather than an end in itself), but like you, I also hope there will be opportunities to reflect on different ways that scientific realism can be interpreted and used. For my part, I will be running a session on a realist approach in ethnography, and currently I think it would be quite unlikely that would only focus on CMOs.
Hope that helps,
Cheers,
Becky.
Rebecca Hardwick
PhD Student
01392 727408
Email: [log in to unmask]<mailto:[log in to unmask]>
From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards [mailto:[log in to unmask]] On Behalf Of Alan Taylor
Sent: 10 June 2016 01:19
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: Re: CARES 2016 - Registration now open!
Hi All,
Thanks for the notice on the workshops. Can I ask a frank question?
I do not find the rigid Context-Mechanism-Outcome formula very useful. It is too static for me to help explain the struggles that take place over and within contexts, mechanisms and outcomes. Nevertheless the (critical) realist approach is an advance that should be valued.
Given this I am wondering if attendance at the CARES conference or workshops would be worth the investment in time and money if only the strict CMO approach is going to be the main theme, or will there be opportunities to explore challenges and development of these methods?
Any views would be most welcome!
Regards,
Alan Taylor
From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards [mailto:[log in to unmask]] On Behalf Of Jagosh, Justin
Sent: Friday, 10 June 2016 8:10 AM
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: CARES 2016 - Registration now open!
Dear Colleagues,
I am pleased to announce that registration is now open for the 2nd International CARES Conference and can be accessed via the University of Liverpool's online store:
ttp://payments.liv.ac.uk/browse/product.asp?compid=1&modid=2&catid=70<https://owa.liv.ac.uk/owa/redir.aspx?REF=6W56RkXqM9oo4fmm7HNJC76aWLVoA-t3ejzdDf9DFKnUrjHorJDTCAFodHRwOi8vcGF5bWVudHMubGl2LmFjLnVrL2Jyb3dzZS9wcm9kdWN0LmFzcD9jb21waWQ9MSZtb2RpZD0yJmNhdGlkPTcw>
if the link doesn't work type:
http://payments.liv.ac.uk
and then 'Conferences &Events' and then 'Events at Liverpool' and then 'CARES'
For Professionals - a reminder that early bird prices end on July 15th.
For Students - the student rate is deeply discounted and there are only 80 spaces. It is in your best interest to register early!
For fee information, please visit the on-line store, or www.liv.ac.uk/cares.<http://www.liv.ac.uk/cares.>
The CARES conference planning committee has assembled a diverse range of pre-conference workshops and a post-conference day to be held at the University of Liverpool, London Campus. Please see attached file for workshop descriptions - and please feel free to circulate in your networks.
Note that you can register for the pre-conference day even if you are not planning on attending the conference - click on 'pre-conference day only' when registering through the on-line store.
Information and special rates for hotel accommodation around the venue will be announced soon! stay tuned...
sincerely,
Justin
2nd International Conference on Realist Evaluation and Synthesis:
Advancing Principles, Strengthening Practice October 2nd - 6th, 2016 University of Liverpool, London Campus Barbican Conference Centre London Justin Jagosh, Ph.D Senior Research Fellow Centre for Advancement in Realist Evaluation and Synthesis (CARES) University of Liverpool, United Kingdom www.liverpool.ac.uk/cares<http://www.liverpool.ac.uk/cares>
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