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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: Simon Carroll <[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]>>, Simon Carroll <[log in to unmask]<mailto:[log in to unmask]>> Date: Saturday, 20 September 2014 07:35 To: "Realist and Meta-narrative Evidence Synthesis: Evolving Standards" <[log in to unmask]<mailto:[log in to unmask]>> Subject: Re: the "so what?" question in meta-narrative reviews Hi Gill, Nice summary of the issues. I think you are correct about both (not so) naive wonderings. I don't think MNR necessarily has the same attitude toward 'causality', as it is at least, in principle, neutral between different research traditions, some of which (in many cases, depending on review topic) are explicitly in the 'non-causal' camp. For example, much of the interpretive tradition in social science rejects the idea that the concept of 'causality' should be central in trying to understand what is happening in the social world. In fact, some reject the explanatory model in toto, preferring adequate description as the aim of inquiry. Of course, the realist would argue that this rejectionism is based on accepting the positivist conceptualization of 'causality' and 'explanation', which is all very well for the realist; however, MNR doesn't (at least in my reading) take a position here. What I like about MNR is, that it not only does what you say by presenting both what separate traditions offer and by synthesizing across them in order to give overall conclusions, it allows what I think of as 'submerged' research traditions to come to the fore. Often, from a sociology of scientific knowledge perspective, certain research traditions gain a foothold and become the dominant strain in relation to particular topics for a variety of reasons not related to some kind of intrinsic epistemological merit; MNR allows us to bring a fresh lens to alternative traditions that may offer unique insights, yet are not well known, or receive much less prominence. I think a great example of how MNR can do this is in Trish and colleagues work on electronic patient records. Anyway, nice to have some discussion of MNR as I'm reflecting on how to write up some publications! Cheers, Simon On Fri, Sep 19, 2014 at 4:29 PM, Gill Westhorp <[log in to unmask]<mailto:[log in to unmask]>> wrote: Dear All Two naïve wonderings from a non-MNR practitioner. 1. I loved Nick's bit about interest in causation but I wonder - is that as applicable in MNR as it is in realist approaches? 2. My understanding of MNR is that it looks across research traditions. I wonder whether thinking about what each of those separate traditions 'traditionally offers' would help in thinking through what the synthesis itself might provide for funders and end-users? My assumption in wondering this is that a synthesis would identify both the separate traditions' offerings and something in addition to that - hence making it an attractive value-for-money proposition. Cheers Gill -----Original Message----- From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards [mailto:[log in to unmask]<mailto:[log in to unmask]>] On Behalf Of Nick Emmel Sent: Saturday, 20 September 2014 1:25 AM To: [log in to unmask]<mailto:[log in to unmask]> Subject: Re: the "so what?" question in meta-narrative reviews Dear All, Just been reading David Byrne's paper, Thoughts on a pedagogy OF complexity (2014) Complicity 11(2):40-50 while preparing a talk for a bunch of clinical trialists (once more into the breach, dear friends, once more!) about what is realist evaluation. This adds to Trish, Marie-Hélène, and others very useful and practical advice, with a thought at least, I hope incorporating 'causal accounts' [is] 'what makes [realist theories] scientific narratives as opposed to mere recountings of what has happened. Their essential characteristic is that they are stories of how things have come to be as they are. The causal focus enables us, we hope, to be able to say something about how things might be in the future because understanding of causes is fundamental for social interventions to achieve desired outcomes.' Best wishes Nick Dr Nick Emmel School of Sociology and Social Policy University of Leeds Leeds LS2 9JT +44 (0) 113 343 6958 EMMEL ND (2013) SAMPLING AND CHOOSING CASES IN QUALITATIVE RESEARCH: A REALIST APPROACH LONDON SAGE http://goo.gl/YOpct0 ________________________________________ 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]>] Sent: 19 September 2014 16:31 To: [log in to unmask]<mailto:[log in to unmask]> Subject: Re: the "so what?" question in meta-narrative reviews Agree with Marie-Helene’s suggestions below, but also, to avoid getting ’stuck’ in a MNR, keep asking “what does the client [funder/sponsor/policymaker] want out of this review?”. And try to present your emerging findings periodically to an interdisciplinary group of peers. The challenge with reviewing literature from heterogeneous sources is avoiding that sense of ’swamp’ where there seems to be no clear research traditions (and an excess of theory-hopping) in the primary data. Have you seen the resources page from the RAMESES project – see training materials and quality standards. http://www.ramesesproject.org/index.php?pr=Project_outputs 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]><mailto:[log in to unmask]<mailto:[log in to unmask]>> @trishgreenhalgh From: Marie-Hélène Paré <[log in to unmask]<mailto:[log in to unmask]><mailto:[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]><mailto:[log in to unmask]<mailto:[log in to unmask]>>>, Marie-Hélène Paré <[log in to unmask]<mailto:[log in to unmask]><mailto:[log in to unmask]<mailto:[log in to unmask]>>> Date: Friday, 19 September 2014 17:08 To: "Realist and Meta-narrative Evidence Synthesis: Evolving Standards" <[log in to unmask]<mailto:[log in to unmask]><mailto:[log in to unmask]<mailto:[log in to unmask]>>> Subject: Re: the "so what?" question in meta-narrative reviews Dear Paula, Thanks for your output. I completed a meta-narrative review on community participation in health programs which you can see the content here<https://www.academia.edu/6543339/Meta-narrative_review_on_community_par ticipation_in_health>. You can listen to the webinar on YouTube video here<https://www.youtube.com/watch?v=GlXSd0I6F1Q>. It was the qualitative arm of a mixed method, doctorate study. I am a firm believer that meta-narrative reviews contribute to practical outcomes – such as decision making frameworks you’re referring to - when the output they produce contributes to shed light theoretically or epistemologically to the research topic. Perhaps one way to help you thinking in that direction is to brainstorm the following questions: 1. What [conceptual / theoretical] problem will my findings [partially] help to solve? 2. How will my findings help understanding better the phenomenon? 3. What form / shape could my findings take? 4. How can they be used? By whom? And when? The output of my synthesis was a typology of community participation and, in that sense, it is a tool that help thinking how participation is enacted across a spectrum of participation manifestations. It is a tool of reference that, I hope, will guide better assessment and reporting of participation. Best of luck, Marie-Hélène _____________________________________ Marie-Hélène Paré Consultant in Qualitative Data Analysis Lecturer in Qualitative Methods Open University of Catalonia Barcelona, Spain T office: + 34 93 246 46 90<tel:%2B%2034%2093%20246%2046%2090> T mobile: + 34 600 71 64 74<tel:%2B%2034%20600%2071%2064%2074> E [log in to unmask]<mailto:[log in to unmask]> W Academia.edu<http://uoc.academia.edu/MarieH%C3%A9l%C3%A8nePar%C3%A9>|NVivo<h ttp://www.qsrinternational.com/training-and-events_training-and-consultancy_ directory_detail.aspx?view=89<http://www.qsrinternational.com/training-and-events_training-and-consultancy_ directory_detail.aspx?view=89>> P És necessari imprimir aquest missatge? -----Original Message----- From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards [mailto:[log in to unmask]<mailto:[log in to unmask]>] On Behalf Of Paula Rowland Sent: 19 September 2014 15:29 To: [log in to unmask]<mailto:[log in to unmask]><mailto:[log in to unmask]<mailto:[log in to unmask]>> Subject: the "so what?" question in meta-narrative reviews Hello all, Thank you for the opportunity to join this interesting list serve! I have really enjoyed reading through the various threads. Rather than continue to lurk from my small corner of the world in Toronto, I've decided to enter the conversation by asking a question. I've been working in health care for a while, but am a very recent PhD. My research is in the intersections of policy and practice within health care organizations. I pull from theory and methods from organizational studies and sociology. My current research is on "patient engagement" at the level of health care organizations. I am drafting a proposal for a knowledge synthesis. I would like to get my mind around the various paradigms and research traditions that are constituting historical and current literature on "patient engagement" for the purpose of informing organizational policies and programs. As a social scientist, the tensions and paradoxes involved in the different ways the "patient" is constructed (as a citizen and a consumer), how implementation of these programs are considered (sometimes as a transactional exchange of knowledge, sometimes as a process of relationships, sometimes both), and how these programs are evaluated (I have seen attempts at quasi-experiemental designs that would 'black-box' the entire process of engagement and treat the advisor as a variable that is either present or not) --- it is abundantly clear to me that exploring these tensions and how they manifest in organizational programs is a useful exercise. I would like to try my hand a meta-narrative review to help me unpack some of these tensions. In looking at the funding body I am apply to (CIHR), I see that they have only funded 1 meta-narrative review. I imagine that I need to do a particularly good job of explaining why my questions are important, why the methodology makes sense, and how important the research will be. To that end, I am finding myself in a translation problem. The value of the research is very clear to me. But --- I wonder if I am doing enough to explain the potential impact to the reviewers. They are likely to be a mix of policy makers and traditional systematic reviewers. Does anyone have any experience and/or readings they could share that would help me describe the potential impact/importance of a meta-narrative review? I am looking for some help thinking through the "so what" question so that my rationale is more clear. I think it might be a bit lost in my jargon and enthusiasm right now. Other CIHR funded reviews tended to produce decision making frameworks. I am not sure I can sign up for that kind of output???? If not, how do I explain the potential significance of the research in the absence of such tangible, concrete tools? Thanks in advance for any direction. And I am very much looking forward to ongoing conversation with this group! Cheers Paula