School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland.
Nurs Inq. 2012 Mar;19(1):18-28. doi: 10.1111/j.1440-1800.2011.00551.x. Epub 2011 Jul 10.
The use and limitation of realistic evaluation as a tool for evidence-based practice: a critical realist perspective In this paper, we assess realistic evaluation's articulation with evidence-based practice (EBP) from the perspective of critical realism. We argue that the adoption by realistic evaluation of a realist causal ontology means that it is better placed to explain complex healthcare interventions than the traditional method used by EBP, the randomized controlled trial (RCT). However, we do not conclude from this that the use of RCTs is without merit, arguing that it is possible to use both methods in combination under the rubric of realist theory. More negatively, we contend that the rejection of critical theory and utopianism by realistic evaluation in favour of the pragmatism of piecemeal social engineering means that it is vulnerable to accusations that it promotes technocratic interpretations of human problems. We conclude that, insofar as realistic evaluation adheres to the ontology of critical realism, it provides a sound contribution to EBP, but insofar as it rejects the critical turn of Bhaskar's realism, it replicates the technocratic tendencies inherent in EBP.
从批判实在论的角度评估现实评估作为循证实践工具的使用和局限性 在本文中，我们从批判实在论的角度评估现实评估与循证实践（EBP）的一致性。我们认为，现实评估采用实在论的因果本体论意味着它比 EBP 传统方法——随机对照试验（RCT）更能解释复杂的医疗干预措施。然而，我们并不是要得出这样的结论：使用 RCT 没有价值，而是认为在现实主义理论的框架下，可以结合使用这两种方法。更消极地说，我们认为，现实评估拒绝批判理论和乌托邦主义，转而支持零碎的社会工程实用主义，这意味着它容易被指责为促进对人类问题的技术统治主义解释。我们的结论是，只要现实评估坚持批判实在论的本体论，它就为循证实践提供了合理的贡献，但只要它拒绝接受巴卡的现实主义的批判转向，它就会复制循证实践固有的技术统治主义倾向。
