Dear all
I attach a link below to a literature synthesis that draws from a MNR philosophy but I think also has a realist review tinge. This may either clarify or obfuscate!
All good wishes
Naomi
Naomi Chambers
Professor of Healthcare Management
NHS Leadership Academy Programmes Lead
Manchester Business School
University of Manchester
Harold Hankins 6.38
Booth Street West
Manchester M15 6PB
www.mbs.ac.uk
Office: 0161 2757964
Mobile:- 07973 858398
For enquiries please contact:
[log in to unmask]
+44(0)161 3063472
N Chambers, G Harvey, R Mannion, J Bond and J Marshall (2013) Towards a framework for enhancing the performance of NHS boards
http://t.co/hAnC8PmTQY
Vita ut vitas : comiter everte
From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards [mailto:[log in to unmask]] On Behalf Of Trish Greenhalgh
Sent: 03 December 2013 07:19
To: [log in to unmask]
Subject: Re: Realist / Narrative Review of Patient Education
Most useful discussion. I think the most fundamental difference between MNR and RR is the philosophical assumptions. Realist review makes realist assumptions: there is a social reality that can be understood (but in some ways not direclty 'known'), and that the key to understanding programmes is to understand the C-M-O configurations. MNR asks what assumptions each set of authors made, and tries to understand each primary study through the assumptions made by its own authors. I developed it because when looking at a very diverse set of primary studies on a contested topic, it seemed to me that only some of them could be fitted into the realist frame of thinking. It felt wrong to be trying to squeeze all the studies into a realist box when that was not the original authors' intention.
Many years after I worked up the original meta-narrative method, I discovered that another team, in USA, had independently developed a similar approach which they called 'meta-triangulation review'. This was philosophically very similar to the approach my team had come up with but it was more theory oriented (and hence less interested in getting practical answers for policymakers). Oddly, it might help people understand the difference between RR and MNR by reading the MTR paper and looking at the table of differences I drew up. These approaches are coming from a different place!
Trish Greenhalgh
Professor of Primary Health Care and Dean for Research Impact
Barts and the London School of Medicine and Dentistry
58 Turner St
London E1 2AB
UK
+44 20 7882 7325
[log in to unmask]<mailto:[log in to unmask]>
@trishgreenhalgh
From: Bill Walker <[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]>>, Bill Walker <[log in to unmask]<mailto:[log in to unmask]>>
Date: Monday, 2 December 2013 23:29
To: "[log in to unmask]<mailto:[log in to unmask]>" <[log in to unmask]<mailto:[log in to unmask]>>
Subject: Re: Realist / Narrative Review of Patient Education
Yes, thanks for your response, Gill. I welcome the discussion.
No doubt there are real differences, but are the differences necessarily paradigmatic? Or in other words, are approaches to synthesis based on meta-narratives, and on reasonings, realist-wise, necessarily irreconcilable?
Cheers
Bill
From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards [mailto:[log in to unmask]] On Behalf Of Simon Carroll
Sent: Tuesday, 3 December 2013 10:16 AM
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: Re: Realist / Narrative Review of Patient Education
A great response Gill, and much more thoughtful and charitable than mine...suffice it say that I agree that, at the very least, the question Gerda raises is a teachable moment for this group...it means going more deeply into the paradigmatic differences between realist and meta-narrative approaches. I think part of the confusion is due to what is in fact a major compliment to Trish and Ray: that although they are coming from quite distinct perspectives, both are, above all, curious and respectful scholars, more engaged in advancing understanding than engaging in methodological flame wars. This means that their collaborations have under-emphasized the quite important differences between the two review approaches. If Trish hasn't already written it (a half-serious joke), a paper on the commonalities and differences between the two approaches might be very helpful. Having a background in realist approaches and now just in the midst of completing a meta-narrative review, I would be happy to contribute to furthering the discussion.
Cheers, Simon.
On Mon, Dec 2, 2013 at 2:01 PM, Gill Westhorp <[log in to unmask]<mailto:[log in to unmask]>> wrote:
Hi Gerda
I've just been pondering on what the sources of the confusion might be. Some might be in the confusing use of slashes and dashes (hyphens) in English. Normally (and correctly) one would use a dash to join two things to imply that they've been combined ("realist-meta-narrative") but sometimes people do use a slash when they want to avoid having two hyphens in a word. So we would have to confirm with Dan exactly what he was asking for.
The other source of the confusion might in fact lie in the title of the project and the standards "Realist and meta-narrative synthesis". I hadn't thought about it this way before but technically, the words could indeed imply either "a review which was both realist and meta-narrative" or "two approaches, one realist and the other meta-narrative". It does, however, mean the latter.
I think the easiest way to understand why it would (probably) not be possible to combine them is to think about their PURPOSES and the methods that flow from those purposes. In brief, a realist review seeks to understand how a particular policy or program works and why, therefore, it works in some contexts and not others. A meta-narrative review seeks to understand the approaches that have been taken to researching and understanding something and the different kinds of learning that have resulted from those approaches. I like Trish's example for explaining this. If you ask an anthropologist and an engineer to research 'bridges', they will be interested in different things about bridges (e.g. how people use them as compared to how to stop them falling down), ask different questions, use different methods, and contribute different things to the overall understanding of bridges.
The standards training materials on the website explain this in more detail. (NB There are two sets of standards, one for realist review and one for meta-narrative review - read the introductory sections of both of those for more detail.)
All that said... if anyone had ideas about how the two approaches could in fact be combined, for what questions one might do so, what the implications for methods would be... that would promote a thought provoking discussion, regardless of whether we ended up deciding it could or could not be done! And the process of discussion would no doubt clarify and deepen understanding for many of the participants in the conversation.
Best wishes
Gill
From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards [mailto:[log in to unmask]<mailto:[log in to unmask]>] On Behalf Of Gerda Warnholtz
Sent: Tuesday, 3 December 2013 2:49 AM
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: Re: Realist / Narrative Review of Patient Education
Hi again,
as Dan's question was about a Realist Meta-Narrative Review, and I am about to embark in one, and everyone was talking about Realist Synthesis, I wanted to refocus the question!
If I could get hold of a Realist Meta-Narrative Review (Synthesis), to actually see how one looks like, it would be of great help!
Best wishes to all!
G
________________________________
Mtra. Gerda Warnholtz
Turismo Sostenible y Protección y Rescate del Patrimonio Cultural
Evalaución de Programas de Desarrollo Social y Proyectos
On Monday, December 2, 2013 4:25 AM, Farah Jamal <[log in to unmask]<mailto:[log in to unmask]>> wrote:
Hi there,
Thought this might be useful for some... we've recently published a paper in Qualitative Research - Reviewing conceptualisations of community: reflections on a meta-narrative approach (attached). We discuss the methods and challenges of conducting a meta-narrative review and suggest new avenues for development. We took a unique approach to the method - but the flexibility is what makes it useful!
Best wishes,
Farah
__________________________________
Farah Jamal
Research Fellow
Institute for Health & Human Development
University of East London
UH250, Stratford Campus
Water Lane, London
E15 4LZ
Tel: +44 (0) 208 223 4045<tel:%2B44%20%280%29%20208%20223%204045>
Email: [log in to unmask]<mailto:[log in to unmask]>
Twitter: @FarahJamal7
From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards [mailto:[log in to unmask]] On Behalf Of Trish Greenhalgh
Sent: 02 December 2013 06:34
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: Re: Realist / Narrative Review of Patient Education
Gerda and all
Yes Gill's right. A meta-narrative review is similar to a realist review in that it's theory-driven but different from it in that it doesn't focus on the CMO configurations. Attached the RAMESES standards for meta-narrative review.
Trish
Trish Greenhalgh
Professor of Primary Health Care and Dean for Research Impact
Barts and the London School of Medicine and Dentistry
58 Turner St
London E1 2AB
UK
+44 20 7882 7325<tel:%2B44%2020%207882%207325>
[log in to unmask]<mailto:[log in to unmask]>
@trishgreenhalgh
From: Gill Westhorp <[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]>>, Gill Westhorp <[log in to unmask]<mailto:[log in to unmask]>>
Date: Monday, 2 December 2013 05:09
To: "[log in to unmask]<mailto:[log in to unmask]>" <[log in to unmask]<mailto:[log in to unmask]>>
Subject: Re: Realist / Narrative Review of Patient Education
Hi there Gerda
I don't think there's any such thing as a realist meta-narrative review. Meta-narrative review was developed by Trish Greenhalgh et al for a project where they couldn't get a realist approach to do what they were trying to do - it's a different methodology.
Cheers
Gill
From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards [mailto:[log in to unmask]] On Behalf Of Gerda Warnholtz
Sent: Monday, 2 December 2013 10:31 AM
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: Re: Realist / Narrative Review of Patient Education
Hi everyone,
as far as I can see, there are sevaral realist synthesis being carried out, but no one talks about doing a realist meta-narrative review...
Can anyone tell me where can I get hold of an example of a realist meta-narrative review?
Thanks!
Gerda
________________________________
Mtra. Gerda Warnholtz
Turismo Sostenible y Protección y Rescate del Patrimonio Cultural
Evalaución de Programas de Desarrollo Social y Proyectos
On Sunday, December 1, 2013 12:54 PM, Soo Downe <[log in to unmask]<mailto:[log in to unmask]>> wrote:
Dear all
We are a group funded by the NIHR Public Health Research stream to undertake a realist review of interventions for children and teenagers, to reduce the risk of relationship violence (the PEACH study, led by Prof Nicky Stanley at UCLan), in case this is of interest?
All the best
Soo (Downe)
-----Original Message-----
From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards [mailto:[log in to unmask]<mailto:[log in to unmask]>] On Behalf Of Janet Harris
Sent: 01 December 2013 16:58
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: Re: Realist / Narrative Review of Patient Education
Hi Dan
We're completing a realist review looking at whether peer support influences health literacy. To be submitted to National Institute of Health Research for review prior to publication in a couple of weeks.
Best wishes
Janet Harris
University of Sheffield
Sent from my iPhone
On 30 Nov 2013, at 22:01, Sue's UBC e-mail <[log in to unmask]<mailto:[log in to unmask]>> wrote:
> Hi Daniel,
>
> I am currently conducting a realist synthesis of self-management interventions for disadvantaged populations living with chronic conditions. These are often classified under the broad umbrella of patient education programs (even though the underlying principles of patient engagement and empowerment often differ between education/SM approaches depending on frameworks used). We will be finished in the spring. Would be happy to chat further.
>
> Sue
> UBC
>
> On 2013-11-30, at 1:22 PM, Daniel Moxham <[log in to unmask]<mailto:[log in to unmask]>> wrote:
>
>> Hi there,
>>
>> Does anyone know of any?
>>
>> Many thanks,
>>
>> Dan
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