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Dear Anna,  you wrote:

 

Hello everyone,

 

I’m a second year PhD student using the realist approach (Pawson & Tilley) to examine how well-being is affected by transition in medical students. I want to ask the group what your thoughts/experiences are on appropriate scope for realist PhDs, i.e. what is manageable within the PhD timeframe (UK based, so 3 years full time)?

 

In my first year I carried out a conceptual review of well-being, i.e. defining what well-being is as a concept, so that I have a clear conceptualisation of it as an outcome. The results of this were that well-being is a dynamic concept consisting of multiple components and situated within layers of context. This suggests that the realist approach would align nicely to enable examination of how contexts (individual, interpersonal, organisational etc.) interact with the process of transition (not an intervention per se, but like a wider messy, complex programme of many small interventions – teaching, induction, socialisation etc.) to either support (or not) medical students’ well-being.

 

The proposed next steps are a realist synthesis of the relevant transition literature in medical education, to refine and test my programme theories. Followed by a realist evaluation involving interviews with key stakeholders (students, educators etc.) to further test and refine the theory. However, having had a look through some of the past threads on here, I have seen comments about some PhDs involving just a realist synthesis/evaluation and not both. So I’m wondering if doing both is unrealistic (especially as I spent my first year doing the conceptual review) and therefore if I would be better off focusing on one or the other?

 

 

Yes, there are indeed many ways to approach using realist methodology in a Ph.D and some people are conducting a realist synthesis or a realist evaluation exclusively while others are using a combined approach.

 

One question you might find useful to reflect on is: What approach to using realist methodology would optimize the originality of the dissertation? For example, if you decided to just stick with a realist synthesis – what is the advantage to doing this over combining review findings with qualitative and focus group data for example? Upon reflection you might determine that an exclusive effort on a synthesis allows you the time to pool from literature in diverse fields including psychology, management, healthcare and also non-scholastic literature (novels, poetry etc.). The process of including diverse literature in realist synthesis takes time – both to search for, and to incorporate in analysis. But the payoff might be that your analyses reflects the kind of inspired insights, frameworks, and guidance notes into the nature and impact of transition in medical training that would otherwise not be developed. You could then conduct interviews in a post-doc project.

 

Alternatively if you are able to complete a realist review phase in, say, 6-8months  you might determine that interviewing relevant stakeholders may provide confirmation on your review findings in a way that leads to new ideas for innovation in medical education and training. In this scenario, what you do not cover in the relatively brief realist review may get covered in interviews. The complementarity and combination of these datasets might prove beneficial and their integration may reflect originality in your work.

 

In the way I’ve just described, I think reflecting on how to best optimize the opportunity you have to make a contribution to this very important area will help you resolve questions on what path to take.

 

Best of luck

Justin

 

Justin Jagosh, Ph.D

Director, Centre for Advancement in Realist Evaluation and Synthesis (CARES)

www.realistmethodology-cares.org

&

Honorary Research Associate

Institute for Psychology, Health and Society

University of Liverpool, UK

 

 

From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards [mailto:[log in to unmask]] On Behalf Of Anna Rosselli
Sent: January 16, 2019 8:34 AM
To: [log in to unmask]
Subject: Appropriate scope for realist PhDs?

 

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Hello everyone,

 

I’m a second year PhD student using the realist approach (Pawson & Tilley) to examine how well-being is affected by transition in medical students. I want to ask the group what your thoughts/experiences are on appropriate scope for realist PhDs, i.e. what is manageable within the PhD timeframe (UK based, so 3 years full time)?

 

In my first year I carried out a conceptual review of well-being, i.e. defining what well-being is as a concept, so that I have a clear conceptualisation of it as an outcome. The results of this were that well-being is a dynamic concept consisting of multiple components and situated within layers of context. This suggests that the realist approach would align nicely to enable examination of how contexts (individual, interpersonal, organisational etc.) interact with the process of transition (not an intervention per se, but like a wider messy, complex programme of many small interventions – teaching, induction, socialisation etc.) to either support (or not) medical students’ well-being.

 

The proposed next steps are a realist synthesis of the relevant transition literature in medical education, to refine and test my programme theories. Followed by a realist evaluation involving interviews with key stakeholders (students, educators etc.) to further test and refine the theory. However, having had a look through some of the past threads on here, I have seen comments about some PhDs involving just a realist synthesis/evaluation and not both. So I’m wondering if doing both is unrealistic (especially as I spent my first year doing the conceptual review) and therefore if I would be better off focusing on one or the other?

 

I have had a look at other realist PhD theses, but there seems to be a lot of variation. Neither my supervisors nor I have experience in conducting realist research so it would be really helpful to gain some insights into what is achievable whilst also being ‘enough’ for a PhD. Being new to the approach this seems hard to gauge as the methodology is quite different to typical projects in my area (occupational psychology – often positivist), which typically would have multiple ‘studies’, so the final thesis will inevitably look quite different to these.

 

Please let me know if I haven’t explained anything clearly – any thoughts/guidance are very much appreciated!

 

Many thanks,

Anna

 

Anna Rosselli

Postgraduate Researcher

Room B90, Medical Education Centre

School of Medicine, University of Nottingham

Queen’s Medical Centre, Nottingham, NG7 2UH

[log in to unmask]

 

https://www.researchgate.net/profile/Anna_Rosselli

https://www.linkedin.com/in/anna-rosselli-43627b82

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