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existing not in isolation, but as inseparable from the wider context of their everyday lives. Students at university are not separate from the wider social context in which they live; they bring the context of their lives with them, and their experience of university occurs within this context. Each student will have a unique university experience, while at the same time sharing similar experiences with other students. Similarly, service users and patients bring the wider context of their lives with them to the healthcare setting, and this shapes and colours their experience of health and illness. Social scientists are concerned for the most part with understanding the unique world in which the individual lives. While social scientists may use numerical data to inform their enquiry, emphasis is placed on understanding the world of the ‘other’ rather than explaining that world. Social scientists use interpretivist approaches to gain access to an individual’s experience and perception of reality. Social scientists are interested in qualitative expression, rather than quantitative measurement. Consequently, interpretivist researchers use qualitative approaches to data collection. ch_01.indd 8 13/09/2013 16:24 Understanding the language of research 9 Critical realism Critical realism recognises that observation is always fallible and prone to error; therefore theory can always be revised. The critical realist is critical of our ability to know reality with any degree of certainty. Of importance to the critical realist is the idea of holding fast to an attempt to get it right about reality rather than uncovering the truth, simply because we may never know the truth for sure. A critical realist will attempt to use multiple methods (triangulation) to observe and measure reality in an effort to understand what is happening in the real world. These varying methods may have different types of errors within them; you may have your view of the world based on your experience and I will have mine. For example, you may observe the practice of your colleagues as being different from what you understand as good practice based on what has been taught in the classroom setting. In essence, this is the theory–practice gap, so often alluded to. Practitioners often refer to this as the reality of practice. Our view is that in order to make sense of the reality of practice and to maintain the integrity or truthfulness required for good practice, one must first know with a degree of certainty the evidence for a particular practice, in order to ‘hold fast’ to your view of what constitutes best practice. While your perception will not change, you may come to understand the perspective of the other person, recognising it as constructed by their experience. Thus you will be well placed to influence not only your practice but the practice of others for the better. Critical realism allows multiple fallible sources to get a better view of what is going on by acknowledging that all observations, including those of scientists, are theory-laden and biased by experience. At this point you may well be asking how we can conduct research in any objective way if we allow multiple sources to inform our understanding of what is occurring (the phenomenon being studied), especially since these have been shown to be very different. A critical realist would argue that objectivity is not exclusive to an individual but rather belongs to a social group. Objectivity is what we strive for when we criticise each other’s work. In this sense, we may never achieve true objectivity, but as a community of truth seekers we can approach objectivity through scrutiny. Those theories that survive scrutiny are theories we can be most confident in. For example, if we listen to our patients, who consistently tell us they fear going into hospital because of the risk of infection, we can develop a theory ch_01.indd 9 13/09/2013 16:24 Research skills for nurses and midwives 10 that patients are concerned about the risk of hospital-acquired infection. The actual risk may be low in terms of total number of patients admitted to hospital. However, anxiety and stress are known to lower resistance to disease, making it more likely that anxious patients will be less resistant to infection. Using multiple sources of evidence, some of which may be fallible, allows for theory to be generated. For example, patients whose fears and anxieties around hospital-acquired infection are recognised and addressed are less likely to succumb to infection in the hospital setting. Mixed methods You may recall that we mentioned a third philosophical position, which has gained in popularity since the 1980s because it bridges the divide between the positivist and interpretivist philosophical positions. Mixed methods research, also known as mixed methodology or multi-methodology, focuses on research questions that call for real-life contextual understandings, multi-level perspectives and cultural influences, whereby rigorous quantitative and qualitative research methods are integrated to draw on the strengths of each, thereby framing the investigation within the philosophical and theoretical positions of both approaches in the pursuit of pragmatism (linking theory and practice). Mixed methods research has been seen as transformative in being able to use pragmatism to employ what works, using diverse approaches, giving primacy to the importance of the research problem
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