How to … deconstruct the research paradigm: Supporting the non-social scientist researching in medical education

Explicitly acknowledging one's paradigm can be a discombobulating element of medical education research for health professionals who are new to social science methods. The constituent parts of the research paradigm and how to use it to construct a good research project involve immersion in the language of social science and philosophy. These concepts may be very familiar to some academics; however, for non-academics coming newly to research technique and philosophy, this may be an alien topic, or ‘alien knowledge’.^{4, 5} This means there can be a lack of awareness that there may be more than one way of approaching research.

Healthcare professionals have typically been trained in research methods underpinned by positivism to consider ‘best practice’ through guidelines and ‘gold standards’, to look for confounding factors and controls and to judge quality by validity, reliability and generalisability in outcomes. However, although education research can use the positivist paradigm, it also embraces a much broader range of paradigmatic practice such as interpretivism and critical theory. For these researchers, being guided by assumptions, beliefs and values of a particular paradigm can be a new and challenging concept. Indeed, the original idea for our ‘paradigm games’ session was created through our own experiences of finding this type of theoretical thinking challenging.

Our role as teachers were therefore as facilitators of learning rather than information providers.⁷ We also recognised the utility of Socratic questioning as an andragogical practice in health professions education.⁸ Socrates' objective was to engage others in an exercise of critical thinking, placing an individual's existing beliefs under scrutiny with the intention of leading to the individual refuting these beliefs.^{9, 10} This would lead to confusion, followed by curiosity, which would then lead to the search for truth through further consideration and discussion. Socratic methods of enquiry can further promote self-directed learning and critical thinking,^{11, 12} both of which are skills needed to formulate an education research proposal.

In our context, we designed a game to deconstruct and simplify the complexity of the research paradigm. We took a social constructivist approach encouraging participants to draw upon what they already knew, to ask themselves questions about their assumptions and approaches to their research ideas. We planted seeds of uncertainty where participants had to find their own answers and come to their own conclusions, most importantly, their own positions in the paradigm continuum. We then drew upon Socratic teaching methods using an interactive task that encouraged participants to scrutinise their research project ideas by answering a series of questions. These were presented as a ‘colour matching game’. Unbeknownst to the participants, each question was designed around the elements of the research paradigm (aim, ontology, epistemology, axiology, rhetoric, methodology, methods and sources) and a question around quality measures, for example, measures of validity, transferability, etc. The seven questions are provided in Figure 1.

With their current research project in mind, for each question, participants were asked to consider four statements and choose which best reflected their work or point of view. They then selected the relevant colour to note down. For example, the four options for question one are shown in Figure 2.

The relation of the four statements to four key paradigms (red-positivism, blue-post-positivism, green-constructionism/interpretivism and yellow-critical theory) was consistent but kept hidden from the participants at the time of questioning. As the participants were unaware of which paradigms the answer options related to, they were less likely to be swayed by their existing schemas.

Another challenge we came across was that some individuals considered this exercise through their own personal philosophies. They perceived themselves as falling under a paradigm, rather than a philosophical approach for a particular project. This often led to a mixed picture, or confusion that their viewpoint and that of their project were misaligned. Reassurance could then be given that we can all undertake all types of research, even if we have a philosophical preference for a particular paradigm or method, and that part of the process of ensuring robust research practice is to consider paradigmatic alignment for each project and perhaps even for each research question.

Learning new skills relating to philosophy and the ‘-ologies’ of the research paradigm can be challenging for healthcare professionals as they venture into education research. Our approach allowed us to tackle this challenging topic so often either overlooked by novice researchers or feared due to being outside of the individual's comfort zone. It allowed us as healthcare educators to reflect on how we support others to embrace thinking about their paradigmatic approach to better align their research and ground it in practice but also to aid them in their thinking about positionality and the influences on their practice. We believe the tool and its approach can be transferrable to novice researchers across other disciplines, as well as providing a framework for other healthcare educators teaching philosophy of research practice.

We confirm that this manuscript is original, has not been published before and is not currently being considered for publication elsewhere. Sarah Allsop was responsible for the development of the paradigm deconstruction tool discussed in this paper through work for her doctoral studies. In discussion, Sarah Mclaughlin then crafted the first draft of the manuscript with the theoretical framing, and both worked collaboratively to substantially edit and critically revise the paper. Both authors have approved the final submitted version and agree to be accountable for all aspects of the work.

The authors have no conflicts of interest to declare.

Ethical approval was not required, as it is based upon the literature and no human subjects were involved.