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Realist evaluation: an immanent critique.

Sam Porter1

  • 1School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.

Nursing Philosophy : an International Journal for Healthcare Professionals
|September 23, 2015
PubMed
Summary
This summary is machine-generated.

This study critiques realist evaluation, highlighting issues in defining mechanisms and contexts for nursing research. It proposes a more consistent realist approach for better operationalization and improved intervention evaluation.

Keywords:
Pawsoncritical realismnursing evaluationresearch methodologysocial mechanism

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Area of Science:

  • Health Services Research
  • Program Evaluation
  • Nursing Research

Background:

  • Realist evaluation is a complex framework used to understand how interventions work.
  • Nursing researchers face challenges operationalizing key realist evaluation concepts like mechanism and context.
  • Existing realist evaluation models contain ambiguities and inconsistencies.

Purpose of the Study:

  • To critically analyze the core concepts of realist evaluation: mechanisms, contexts, and outcomes.
  • To identify and address ambiguities, inconsistencies, and contradictions within the realist evaluation model.
  • To develop an internally consistent realist evaluation approach for nursing researchers.

Main Methods:

  • Critical analysis of realist evaluation literature.
  • Examination of conceptual ambiguities in mechanism and context operationalization.
  • Critique of the fact/value distinction in outcome assessment.

Main Results:

  • Identified significant challenges in operationalizing 'mechanism' and 'context' in nursing research due to model inconsistencies.
  • Highlighted issues such as empiricist/idealist positions, determinism/voluntarism oscillation, and agency/structure subsumption.
  • Argued that the fact/value distinction in outcomes neglects the perspectives of those affected by interventions.

Conclusions:

  • The current realist evaluation model presents significant barriers for nursing researchers.
  • Addressing conceptual ambiguities and the fact/value distinction is crucial for a more effective realist evaluation.
  • A refined, internally consistent realist approach is needed to enhance its practical application in nursing research.