MUSEO PROVINCIAL DE ZARAGOZA

The word ‘paradigm’ is conceptualised and used in several ways amongst social sciences researchers. In his seminal book “The Structure of Scientific Revolutions”, Kuhn (1970) acknowledged the use of four meanings of this term, which reflects that the paradigm concept is a human construction that is susceptible to differing interpretations. For some researchers the word refers to a holistic and comprehensive view of the world and the

encompassing view that includes the morality and values of the researcher when examining the world (Kuhn, 1970). On the other hand, a narrower definition of paradigm refers to metaphysical philosophies that underpin knowledge claims (Morgan, 2007). This involves identifying the ontology, epistemology and methodology of the research process (Table 5.1). Guba and Lincoln (2004) suggested that each researcher has a fixed worldview that guides the research process. Thus, in such cases of a deeply entrenched worldview, a paradigm shift is unlikely to occur when a researcher moves from one study into another. That is, an individual researcher is not expected to move from a positivist to interpretivist paradigm or vice versa. A summary of the key features of the four main research paradigms is shown in Table 5.1.

This traditional conceptualisation of what ‘paradigm’ means has divided researchers into either objectivists (i.e. knower and known are independent) or subjectivists (i.e. knower and known are inseparable) (Denscombe, 2008). Furthermore, this traditional conceptualisation of the term challenged the idea of mixing qualitative and quantitative data collection methods in a single study (Shaw et al., 2010), leading to the use of the incommensurability concept by researchers who do not accept the possibility of mixing the two types of data (Teddlie and Tashakkori, 2009).

Such dualistic ‘either-or’ research practice referred to in the above text does not recognise the increasing complexity of research projects and the nature of the questions currently being asked by research communities (Greene et al., 1989, Brannen, 2005, Gorard and Makopoulou, 2012). It is argued that the nature of the research questions, not a predetermined philosophical view, should be the sole determinant of how to design and conduct research (Morgan, 2007). Therefore, in a pragmatic research approach, the researcher acknowledges that his or her community has an influential role in determining the type of questions to be asked, and the appropriate methodologies to be used; thus,

either objective, subjective or intersubjective views about social reality can be embraced (Punch, 2014). While this implies a rejection of the metaphysical arguments regarding ontology, it does not imply rejection of positivism or interpretivism as research

approaches (Morgan, 2014). Methods of data collection are chosen if they are likely to

enable one to answer the research questions without any commitment to a philosophical system of reality (Creswell, 2009).

Therefore, instead of debating the nature of reality, a pragmatic research approach shifts the focus to a consideration of the social contexts of the research as a form of social action (Morgan, 2014). Put differently, the pragmatic maxim suggests that construction of reality is a consequence of social interaction with events and that knowledge is the outcome of reflecting on those social interactions (Garrison, 1994, p. 8). In this way, scientific inquiry, as a special form of social interaction, starts with thinking about actions to solve a problem instead of beginning with a preconceived understanding of reality.

Embracing such views in this study in the form of a pragmatic mixed-method research approach was an outcome of both the research culture in the School of Sport, Exercise and Rehabilitation at the University of Birmingham, which encourage the drawing on multiple methods of data collection, and my physiotherapy background, in which practice is characterised by movement between collecting qualitative and quantitative patient data (Edwards and Richardson, 2008, Shaw et al., 2010, van Griensven et al., 2014). In the context of this study, the research objectives necessitated considering a mixed-methods research design framework in which qualitative and quantitative data collections were utilised to measure changes in clinical reasoning skills and to understand how the programme’s learning culture influenced changes.

Table 5.1: Research Paradigms. Adapted from: Doan (1997), Creswell (2009), Teddlie and Tashakkori (2009), Creswell and Plano-Clark (2011), Smith et al. (2012), and Morgan (2014).

Dimensions of comparison

Positivism Post-positivism Pragmatism Interpretivism

Ontology: nature of reality, being and truth.

Naïve realism: objective existence of independent, single, tangible and fragmentable reality.

Critical realism: reality exists independent of social actors and observers. Because our understanding of the world may change this does not mean that the world itself changes.

Transactional realism: Intersubjective view where reality is constructed by the interactions of events. Both Positivism and Interpretivism views are sides of the same coin

No objective reality. It is Multiple, constructed and holistic.

Necessitate fitting each reality within its context

Epistemology: how researchers obtain knowledge

Knower and known are independent

The world exists and is knowable as it really is

Outsider and insider views are co-constructed to create knowledge

Knower and known are inseparable with

simultaneous reliance on both believes and actions.

Knower and known are interactive, inseparable

Claims on Causation There are real causes temporally precedent to or simultaneous with their effects

Possible but transitory and hard to identify

There are stable

relationships in the social world, but causation cannot be fully established.

It is impossible to distinguish causes from effects as all entities in a state of mutual

simultaneous shaping Methodology: the

process for studying

Quantitative Deductive logic Testing hypothesis

Avoiding researcher’s bias

Mixed method that best fits the investigation

Integrating data to create representative model

Mixed method that best fits the investigation with the use of inductive, deductive, and often abductive logic

Qualitative Inductive logic meaning-making and contextualising the lived experience

Possibility of generalisation

Time- and context-free generalisation are possible

Modified time- and

context-free generalisation; external validity important

Time- and context- bounded working

hypothesis are emphasised; both external validity and transferability issues are important

Only time- and context- bounded working hypothesis are possible; consider naturalistic generalisability

5.2.2.1. Characteristics of Pragmatic Research

The three main elements that characterise pragmatic research are transferability, intersubjectivity and abduction (Morgan, 2007). In terms of transferability, knowledge is viewed as anything that can potentially change the individual’s physical or social functioning (Shaw et al., 2010, Creswell and Plano-Clark, 2011). As such, pragmatic research moves away from the argument of whether the outcomes of the research are context-bound or can be generalised to various contexts (Lincoln and Guba, 1985). In terms of this position, one acknowledges that drawing on multiple sources of evidence can more readily produce knowledge that would inform practice and policymaking (Smith and Caddick, 2012). In adopting this approach, it was anticipated that this study would contribute to our existing understanding of how clinical reasoning is advanced and to offer guidance for planning M-level curricula through an analysis of how the participants in M-level musculoskeletal physiotherapy education effectively advanced their skills.

Intersubjectivity draws on the differences in the shared social experiences between various communities or group of individuals (Joas, 1990). It is suggested that whilst there is a single reality in the lived world, individuals hold multiple interpretations of their experiences of this world (Morgan, 2007). As such, being the social actors, the emphasis is to capture the shared meaning amongst the study participants in an attempt to construct knowledge (i.e. an interpretation) that is intersubjectively stable and fixed (Garrison, 1994). Therefore, intersubjectivity entails that researcher’s relationship to what is known is reliant on both belief and actions (Teddlie and Tashakkori, 2009). Thus it is not unusual for a pragmatic researcher to swing between frames of reference to address the research questions (Shannon-Baker, 2015), which is consistent with daily practice, in which subjective and objective actions are taken to inform decisions (Shaw et al., 2010). In the

context of this study, drawing on the concept of intersubjectivity allows capturing the shared meanings of students and educators on how M-level education influenced the advancement of clinical reasoning skills.

Whilst the positivist researcher uses deductive analysis to draw inferences from probably true premises and the interpretivist researcher uses inductive analysis to generalise from the particular, the pragmatic researcher uses an abductive logic of analysis (Fox, 2008, Shank, 2008). Abductive logic is described as a movement between deduction and induction with a particular emphasis is on capturing the meaning of events through proposing a logical best explanation for which there are grounds to believe that such explanation is part of the phenomenon (Morgan, 2007, Bryant, 2009). Although this best explanation is considered plausible, abductive logic produces creative and innovative knowledge whilst analysing data (Reichertz, 2004, Timmermans and Tavory, 2012). In this way, the researcher tries to seek new ideas through an iterative process of deductive, inductive and abductive analysis. This iterative stance constitutes the framework of constructivist grounded theory, which although often being described as an inductive method of analysis, inherently involves abductive processes that facilitate logical explanations and understanding of data (Charmaz, 2014).

5.2.2.2. Nature of Truth in Pragmatism

Pragmatism as a philosophy does not close the debate around the need to combine different methods (Moran et al., 2011). However, it has a unique stance in recognising the nature of truth obtained through pragmatic research. While Greene (2007) suggested that it is evidence that matters, it is not clear what evidence should be recognised as truth, or when the evidence is acceptable and who determines that. According to Dewey (1941/2008), truth is in constant formation as new evidence emerges. In accordance with

the lower case ‘truth’ is used since it is impossible to reach the absolute or universal ‘Truth’ (Hall, 2013, Hesse-Biber, 2015). That is, pragmatic researchers aim to capture the stable and fixed shared meanings of social actors at the time (Garrison, 1994). This produces knowledge that is temporal and embedded in a transactional relationship (Hall, 2013). The nature of truth is revisited and revised with the emergence of renewed understandings (Hesse-Biber, 2015). Thus, the researcher’s role is to capture different understandings and to evaluate which one offers the best explanation of the studied phenomenon. It can be argued that the integration of different methods, as in mixed- methods research, has the potential to approximate the researcher to one version of the truth.

In conclusion, the pragmatic research approach provides an umbrella for combining qualitative and quantitative methods in a single inquiry. It enables capturing best interpretations of the participants’ experience through iterative processes of analysis and abductive reasoning.