Realist synthesis: illustrating the method for implementation research
By J. Rycroft-Malone, B. McCormack, Alison M. Hutchinson, K. Decorby, T. Bucknall, B. Kent, A. Schultz, E. Snelgrove-Clarke, C. Stetler, M. Titler and 2 more. Implementation Science, 2012
679 citations recorded by the source corpus.
BackgroundRealist synthesis is an increasingly popular approach to the review and synthesis of evidence, which focuses on understanding the mechanisms by which an intervention works (or not). There are few published examples of realist synthesis. This paper therefore fills a gap by describing, in detail, the process used for a realist review and synthesis to answer the question ‘what interventions and strategies are effective in enabling evidence-informed healthcare?’ The strengths and challenges of conducting realist review are also considered.MethodsThe realist approach involves identifying underlying causal mechanisms and exploring how they work under what conditions. The stages of this review included: defining the scope of the review (concept mining and framework formulation); searching for and scrutinising the evidence; extracting and synthesising the evidence; and developing the narrative, including hypotheses.ResultsBased on key terms and concepts related to various interventions to promote evidence-informed healthcare, we developed an outcome-focused theoretical framework. Questions were tailored for each of four theory/intervention areas within the theoretical framework and were used to guide development of a review and data extraction process. The search for literature within our first theory area, change agency, was executed and the screening procedure resulted in inclusion of 52 papers. Using the questions relevant to this theory area, data were extracted by one reviewer and validated by a second reviewer. Synthesis involved organisation of extracted data into evidence tables, theming and formulation of chains of inference, linking between the chains of inference, and hypothesis formulation. The narrative was developed around the hypotheses generated within the change agency theory area.ConclusionsRealist synthesis lends itself to the review of complex interventions because it accounts for context as well as outcomes in the process of systematically and transparently synthesising relevant literature. While realist synthesis demands flexible thinking and the ability to deal with complexity, the rewards include the potential for more pragmatic conclusions than alternative approaches to systematic reviewing. A separate publication will report the findings of the review.
Subfields: General Health Professions, Management Science and Operations Research, Public Health, Environmental and Occupational Health
View Paper: https://www.semanticscholar.org/paper/16a66261d6d1aa153af412b6efd504e24ae9c4c6
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In General Health Professions
In Management Science and Operations Research
In Public Health, Environmental and Occupational Health
Citations in the corpus
- Realist review (2021, methodology): “Focusing the review is arguably the most important (Rycroft-Malone et al., 2012), challenging (Greenhalgh et al.”
- Lessons for Responsible Innovation in the Business Context: A Systematic Literature Review of Responsible, Social and Sustainable Innovation Practices (2017, methodology): “[38], we started by extracting the data and clustering it into evidence tables.”
- RAMESES publication standards: realist syntheses (2013, neutral): “They are not intended to provide detailed guidance on how to conduct such a synthesis; for this, we direct interested readers to summary articles [15,22] or various publications on methods [1,11,14,23].”