Realist reviews are conducted to answer research questions about how and why a program does or does not work by exploring the contexts and mechanisms that lead to captured evidence of outcomes. Realist reviews begin with a theory of change designed from program documentation, existing literature, or expert stakeholder experience. Realist reviews result in refined theories that influence future iteration of program design and implementation.
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STRENGTHS + WEAKNESSES
Aims to evaluate the effectiveness of interventions in context
Answers questions about what intervention works, for whom, how, and in what circumstances?
Understanding mechanisms is the core feature of realist review, but there is no consensus on a single definition
Synthesizing both quantitative and qualitative data can be challenging
Data analysis and synthesis is time intensive
Identifying context, mechanism, and outcome configurations can be challenging
Supporting Documents to Download
Pawson R. Evidence-Based Policy: A Realist Perspective. London, UK: Sage Publications; 2006.
Pawson R, Greenhalgh T, Harvey G, Walshe K. Realist review—a new method of systematic review designed for complex policy interventions. J Health Ser Res Policy. 2005;10(suppl 1):21-34. doi:10.1258/1355819054308530
The RAMESES Projects. Accessed March 30, 2022. https://www.ramesesproject.org/
Wong G, Westhorp G, Pawson R, Greenhalgh T. Realist synthesis: RAMESES training materials. Accessed March 30, 2022. https://www.ramesesproject.org/media/Realist_reviews_training_materials.pdf
Wong G, Greenhalgh T, Westhorp G, Buckingham J, Pawson R. RAMESES publication standards: realist syntheses. BMC Med. 2013;11:21. doi:10.1186/1741-7015-11-21
MEDED SPECIFIC GUIDES
Wong G, Greenhalgh T, Westhorp G, Pawson R. Realist methods in medical education research: what are they and what can they contribute? Med Educ. 2012;46(1):89-96. doi:10.1111/j.1365-2923.2011.04045.x
EXAMPLES OF REALIST REVIEWS
Ajjawi R, Kent F, Broadbent J, Tai J, Bearman M, Boud D. Feedback that works: a realist review of feedback interventions for written tasks [published online ahead of print March 2, 2021]. Studies Higher Educ. doi:10.1080/03075079.2021.1894115
Brennan N, Bryce M, Pearson M, Wong G, Cooper C, Archer J. Towards an understanding of how appraisal of doctors produces its effects: a realist review. Med Educ. 2017;51(10):1002-1013. doi:10.1111/medu.13348
Kent F, Hayes J, Glass S, Rees CE. Pre-registration interprofessional clinical education in the workplace: a realist review. Med Educ. 2017;51(9):903-917. doi:10.1111/medu.13346
Rees CE, Lee SL, Huang E, et al. Supervision training in healthcare: a realist synthesis. Adv Health Sci Educ Theory Pract. 2020;25(3):523-561. doi:10.1007/s10459-019-09937-x
Sholl S, Ajjawi R, Allbutt H, et al. Balancing health care education and patient care in the UK workplace: a realist synthesis. Med Educ. 2017;51(8):787-801. doi:10.1111/medu.13290
ROLA AJJAWI, PHD
Rola Ajjawi, PhD, is Associate Professor Education Research at the Centre for Research in Assessment and Digital Learning, Deakin University, Australia where she leads a program of research investigating clinical supervision, feedback and belonging. She draws from a range of methodological and theoretical perspectives to understand the hidden social, cultural and relational factors that influence becoming a healthcare professional.
FIONA KENT, PHD
Fiona Kent, PhD, is the Director Collaborative Care and Work Integrated Learning in the Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia. She completed her Masters in Health Professional Education investigating patient perspectives of student led care and her PhD in interprofessional student education. Her work and research focuses on the development and evaluation of interprofessional curriculum.