Research Paradigms in Health

Upon completion, students should be able to:
- Describe the role of research in generating knowledge in the healthcare professions.
- Classify the two dominant research paradigms in health.
- Explain key differences between postpositivist and constructivist research paradigms.
- Explain how research paradigms shape quantitative and qualitative research approaches.

Paradigm: Also referred to as a worldview, a set of beliefs guiding practices.
Constructivism: May also be known as constructivist or interpretivism research paradigm.
Positivism: Alternatively referred to as positivist, postpositivism, or post-positivism.
Ontology: Asks, "What is the nature of reality?"
Epistemology: Asks, "What is knowledge and what can we know?"
Axiology: Asks, "What is the right and wrong way to do this research?"

Different research approaches reflect philosophical assumptions about how to study the world.
Assumption: Something taken for granted.
Philosophy: The study of wisdom.
Example: Designing a project (like a backyard swing) involves certain assumptions similar to research project designs.

Definition: Research paradigms reflect researcher assumptions about:
- What is real
- How knowledge is obtained
- What is right and wrong in research methodology
- What approaches are workable.
These assumptions shape decisions throughout the research process.

A paradigm is defined as a “basic set of beliefs that guide action” (Guba, 1990).
- A way of seeing the world, an overarching stance.
- Functions as a lens to view the world, structured coherently through beliefs and assumptions.

A researcher’s beliefs about knowledge (epistemology) and reality (ontology) guide their position in health research.
Variations in standpoints influence research questions, objectives, methods, analysis, and outputs.

Knowledge is out there to be discovered and can be measured.
People's knowledge is based on perceptions and experiences; therefore, there is no universal truth.

Postpositivism:
- Developed from natural sciences.
- Assumptions include:
- Phenomena are concrete and constant.
- Facts can be established and measured, knowledge is cumulative.
- Social phenomena can be measured to produce facts.
- Often termed as positivist or postpositivist, with a focus on objective measurement.
Constructivism:
- Developed within social sciences challenging positivism.
- Assumptions include:
- Facts are consequences of human perception and social meaning.
- Also known as interpretivist or constructivist, focused on subjective meanings.

Strengths:
- Applies scientific methods for solving medical or technical problems.
- Can establish cause-and-effect relationships.
- Generalization from smaller samples to larger populations.
- Studies are replicable.
Criticisms:
- Social world is not value-free; interpretations are subjective.
- Quantitative measures can be artificial; surveys can misinterpret responses.
- Ethical concerns with experimentation.

Begins with a theory, collects data to test it, analyzes data for confirmation, revises theory, and conducts additional tests.
This is termed deductive reasoning.

Axiology: Researcher’s subjective values and biases play a role.
Ontology: Multiple realities exist, socially constructed.
Epistemology: Knowledge is gained through empathetic understanding of lived experiences.
Methodology: Utilizes qualitative methods; encourages dialogue between researcher and participants.
Leads to inductive reasoning and a generation of new theory based on analysis of patterns in participant data.

Constructivist:
- Multiple realities.
- Subjective experience through qualitative methods.
- Emphasizes inductive reasoning.
Positivist:
- Fixed, observable reality.
- Objective knowledge through quantitative methods.
- Emphasizes deductive reasoning.

Pragmatic:
- Ontology: Truth is what works at the time; no fixed laws.
- Epistemology: Researchers can choose methods providing the best understanding.
- Axiology: Research in social, historical, and political contexts.
- Methodology: Multiple methods for data collection and analysis.
Transformative:
- Ontology: Acknowledges diverse and marginalized groups.
- Epistemology: Incorporates political agendas to address oppression.
- Axiology: Collaborative approaches to prevent marginalization in research.
- Methodology: Qualitative methods capturing narratives of marginalization.

Qualitative Research: Aims to explore meanings attributed to social problems.
Quantitative Research: Tests theories by examining relationships between variables.
Mixed Methods Research: Combines qualitative and quantitative data collection for richer insights.

Postpositivism:
- Objective, measurement-focused, seeks to test theory through experiments.
Constructivism:
- Subjective, explorative, emphasizes lived experiences, generates theory.

Qualitative:
- Unstructured interviews, observations; subjective.
- Emphasis on inductive reasoning; low structure; more time.
- Focuses on real-world contexts.
Quantitative:
- Structured experiments, surveys; objective.
- Deductive reasoning; high structure; efficient time use.
- More controlled research settings.

Example:
- Positivism: Research Approach: Quantitative, Methods: Surveys.
- Topics such as association between financial position and academic performance.
- Constructivism: Research Approach: Qualitative, Methods: Ethnography.