The Realist Lens - For Researchers Who Keep It Real

Alejandro Arguelles Bullon
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The Realist Lens is a podcast that makes realist evaluation and synthesis accessible and easy to follow. Through relaxed conversations with expert guests, students, and practitioners, we explore key realist concepts like mechanisms, context, and outcomes. Whether you're new to realist approaches or more experienced, this podcast offers practical insights, real-world examples, and thoughtful reflections to support your learning and curiosity—one conversation at a time.

  1. 1d ago

    Episode 36 –Bringing Behavioural Science and Realist Research Together with Justin Aunger

    What happens when we bring behavioural science and realist research into the same conversation? And could the two approaches help address some of each other’s limitations? Alejandro is joined by Dr Justin Aunger, Research Fellow at the University of Birmingham, whose work spans behavioural science, patient safety, health services research, realist synthesis and realist evaluation. Drawing on his experience across both traditions, Justin explores a challenge familiar to many realist researchers: programme theories can be rich and context-sensitive, butthe language used to describe interventions and mechanisms can vary considerably from one study to another. Behavioural science, meanwhile, has developed increasingly structured ways of describing intervention components and the processes through which behaviour may change. The conversation explores what realist research might learn from concepts such as behaviour change techniques, mechanisms of action, and behavioural settings, and whether these could provide a more shared language for describing what interventions actually do, how people respond and why outcomes occur. Justin also introduces the idea of causal chain configurations, offering one possible way of connecting intervention resources, proximal and distal contexts, changes in reasoning and outcomes. But integration also brings trade-offs. Alejandro and Justin discuss the risks of adding further complexity to an already demanding approach, whether behavioural frameworks adequately capture social and organisational mechanisms and why greater standardisation should not come at the expense of the flexibility that makes realist approaches valuable. Whether you are a realist evaluator, realist reviewer, behavioural scientist, intervention researcher, healthcare researcher, student, supervisor, or PhD researcher, thisepisode offers an accessible exploration of what these traditions might learn from one another and how a more shared language could strengthen the accumulation and practical use of realist knowledge.

  2. Aug 31

    Episode 35 – The Elephant in the Room: Using (or Not Using) AI in Realist Research with Andrew Booth

    What does it mean to use artificial intelligence well in realist research? And where should we draw the red lines? In this timely and balanced conversation, Alejandro is joined by Professor Andrew Booth, Professor in Evidence Synthesis at the University of Sheffield, whose work spans systematic reviews, qualitative evidence synthesis, information retrieval, and realist synthesis. Andrew approaches AI not as a solution to every methodological challenge, nor as something researchers should simply reject, but as a potentially useful assistant. Drawing on his extensive experience in evidence synthesis and realist research, he considers where AI might genuinely enhance existing research practices and where its apparent convenience can become misleading. But the conversation also tackles the risks. Andrew discusses hallucinated references, the persuasive plausibility of AI-generated answers and the danger of producing neat, fully formed CMO configurations when the evidence itself may bepartial, ambiguous, or better represented through incomplete configurations that require human synthesis and discussion. Alejandro and Andrew also explore one of the deeper concerns surrounding AI: what happens to researchers’ intellectual development and academic voice when too much of the process begins with a blank page handed over to a machine? Andrew concludes with three practical principles for responsible AI use in realist research. Whether you are a realist evaluator, realist reviewer, evidence synthesis researcher, information specialist, student, supervisor, or PhD researcher, this episode offers a practical and refreshingly nuanced discussion of how we might engage with AI without allowing it to replace the distinctly human work of thinking, judging, interpreting and explaining.

  3. Aug 17

    Episode 34 – Realist Review of Communication Partner Training after Stroke with Yvonne Fitzmaurice

    What does it really take to conduct a realist review when you are new to realist research, and there is no simple methodological roadmap to follow? How can realist approaches help us understand why communication partner training works in some contexts but is difficult to sustain or embed in others? In this open and highly practical conversation, Alejandro is joined by Yvonne Fitzmaurice, an experienced speech and language therapist, educator and PhD researcher, currently working in clinical speech and language therapy education at the University of Galway. Drawing on more than 20 years of clinical experience, Yvonne explores her work on communication partner training (CPT) for people with communication impairments followingstroke. She explains why realist review felt particularly well suited to an intervention whose success depends not only on the training itself, but on the people delivering it, the settings in which it is introduced, the wider systems surrounding it and whether it can be sustained and embedded into healthcareeducation. Yvonne also reflects candidly on her transition from experienced clinician to novice realist researcher. She shares how developing a protocol, undertaking realist training working closely with supervisors and building acarefully selected advisory group helped provide structure and direction. The discussion explores what Yvonne’s realist review has revealed about the multiple, interacting and layered contexts surrounding CPT. Yvonne also describes the crucial contribution of realist advisors, educators, students, and public and patient contributors with lived experience of communication impairment in developing and refining programme theory. Whether you are a clinician, speech and language therapist, educator, researcher, student, PhD researcher, PPI contributor or someone beginning a realist review of a complex intervention, this episode offers an honest and encouraging account of learning to grow as a realist researcher.

  4. Aug 3

    Episode 33 – Realist Evaluation in Commissioned Settings with Brad Astbury

    What does it mean to conduct realist evaluation well when timelines are tight, budgets are limited, data access is imperfect, and commissioners want findings that areclear, useful, and actionable? How can evaluators remain faithful to realist principles without becoming trapped in theoretical complexity, or reducing context, mechanism, and outcome configurations to formulaic boxes? In this refreshingly practical conversation, Alejandro is joined by Associate Professor Brad Astbury, Associate Professor of Health Systems Evaluation at the University of Melbourne, whose work spans evaluation practice, public health,government-commissioned evaluation, programme theory, teaching, and realist approaches. Brad reflects on his journey from criminology and the corrections system to more than two decades of engagement with realist evaluation. Drawing on his extensive experience conducting evaluations for government, he explores some of the most common ways realist approaches are misunderstood, overcomplicated, underdeveloped, or applied in circumstances where another evaluation approachmight be more appropriate. The discussion explores the pressure commissioners and public servants face to produce straightforward answers to complex questions. Brad explains how evaluators canacknowledge legitimate accountability needs while also generating the more nuanced knowledge required to improve, adapt, target, transfer, and scale programmes. Throughout the episode, Brad emphasises the importance of accessible language, listening before prescribing a methodology, preparing to explain realist ideas todifferent audiences, and approaching evaluation as a form of disciplined curiosity that asks “why?” relentlessly. He concludes with four practical principles for commissioned work. Whether you are an evaluator, commissioner, researcher, public servant, policymaker, consultant, student, or PhD researcher, this episode offers practical wisdom for conducting realist evaluation with integrity under real-world conditions.

  5. Jul 20

    Episode 32 – Co-Design in Realist Evaluation and Exercise Oncology with Deirdre McGrath

    How can realist evaluation help us understand why exercise interventions work, for whom, in what circumstances, and why? And what happens when patients and interest group holders are not just consulted, but actively involved in shaping programme theories, intervention design, and implementation? In this reflective conversation, Alejandro is joined by Dr Deirdre McGrath, lecturer in nursing at Queen’s University Belfast, whose work brings together realist evaluation, co-design, patient and public involvement, oncology, palliative care, and cancer rehabilitation. Deirdre reflects on her journey from clinical practice in oncology and palliative care to realist research, focusing particularly on exercise interventions for women with ovarian cancer. Drawing on her PhD work, she explains why traditionalevaluations of exercise interventions often struggle to explain variation in participation, adherence, and outcomes, and how realist approaches can help us ask deeper questions about what works, for whom, in what circumstances, and why. The conversation explores how co-design can strengthen realist evaluation by bringing patients, carers, clinicians, academics, and other interest group holders into the research process in meaningful ways. Deirdre discusses how women with ovarian cancer helped reshape her assumptions about what an exercise intervention should look like, including the move from an initially imagined in-person intervention to a home-based programme shaped by lived experience, practical constraints, psychological safety, trust, relevance, and flexibility. Deirdre also reflects on the challenges of making realist terminology accessible, avoiding tokenistic involvement, managing different interest group holder perspectives, and creating safe spaces where people feel genuinely able to contribute. She highlights the importance of humility, listening, feedback loops, and recognising patients as experts in their own care. Whether you’re an evaluator, researcher, clinician, public health practitioner, student, PhD researcher, or someone interested in realist evaluation, co-production, cancer rehabilitation, patient involvement, or complex interventions, this episode offers valuable insights into how realist thinkingand co-design can work together to produce more grounded, useful, and meaningful research. Note: Although the terms “co-production” and “co-design” are sometimes used interchangeably in the conversation, this podcast episode specifically focuses on co-design.

  6. Jul 6

    Episode 31 – Realist Research Across Ways of Knowing with Kenneth Yakubu

    What happens when realist approaches meet other research traditions, disciplines and ways of knowing? And how can researchers work across different assumptions about evidence, causation, truth, knowledge and equity without flattening, absorbing or privileging one tradition over another? In this thoughtful conversation, Alejandro is joined by Dr Kenneth Yakubu, whose work sits at the intersection of health systems, global health governance, implementation research, health equity, Indigenous methodologies and realist thinking. Yakubu reflects on his journey from family medicine in Nigeria to global health research, interdisciplinary work, and his current role across health systems implementation research and Indigenous health at the George Institute for Global Health in Sydney, Australia. He discusses how his clinical training helped him see people rather than diseases, and how this shaped his attention to context, complexity, culture, history and lived experience. The conversation explores Yakubu’s experience developing a realist protocol for evaluating the Healthy Homes and Neighbourhoods Project in Sydney, an integrated care initiative designed to support families facing complex healthand social challenges. The protocol brought together realist approaches, Indigenous research methodologies, implementation science, qualitative methods, quantitative analysis and health economics. Reaching shared agreement took nearly two years Yakubu reflects on the tensions that emerged around truth, voice, evidence, analysis and self-determination. He discusses why some team members found realist language or assumptions difficult, how Indigenous research traditions raised important questions about visibility, community voice and historical harms, and how the team worked through disagreement without forcing premature consensus. Whether you’re an evaluator, researcher, public health practitioner, implementation scientist, policymaker, student, or someone interested in realist approaches, Indigenous methodologies, global health, health equity or interdisciplinary research, this episode offers valuable insights into the messy but necessary work of building shared understanding across different ways of knowing.

  7. Jun 22

    Episode 30 – Realist Evaluation and Health Systems with Prashanth Srinivas

    How can realist evaluation help us understand health systems, inequality, and social change in marginalised and ecologically sensitive contexts? And what happens when realist thinking moves beyond academic projects and becomes part of long-term, participatory work with communities? In this insightful conversation, Alejandro is joined by Dr Prashanth N Srinivas, a public health researcher and health systems scholar at the Institute of Public Health Bengaluru. Prashanth reflects on his journey into realist evaluation, from his early work as a clinician in community health settings to using realist approaches in health systems research, government health management, and long-term work with Adivasi communities in Southern India. The conversation explores how realist inquiry can help move beyond surface-level explanations of health inequalities, such as remoteness, literacy, or cultural difference, to examine the deeper structures, mechanisms, relationships, and histories that shape health outcomes. Prashanth discusses the value of realist thinking for making sense of complexity, building explanations with communities, and creating research approaches that are less extractive and more participatory. Prashanth also reflects on middle-range theory, participatory workshops, learning sites, global health, donor dependence, resilience, and the importance of humility in research. He highlights how realist approaches can support more grounded, equity-oriented health systems research by helping researchers, practitioners, and communities ask not only what works, but why things are the way they are, for whom, and under what conditions. Whether you’re an evaluator, researcher, public health practitioner, policymaker, student, or someone interested in realist approaches, global health, Indigenous health, or participatory research, this episode offers valuable insights into using realist thinking as a way of building shared understanding, practical wisdom, and more equitable approaches to health systems research

  8. Jun 8

    Episode 29 – Realist Synthesis, Online Forums and Living Libraries with Paul Marshall

    How can realist synthesis help us understand digital forums, online communities, and living libraries? And what happens when lived experience, story sharing and peer support take place in dynamic online or hybrid spaces where safety, connection and meaning are constantly being negotiated? In this insightful and reflective conversation, Alejandro is joined by Dr Paul Marshall, Research Associate at the Spectrum Centre for Mental Health Research at Lancaster University. Paul shares his experience of working with realist approaches across projects on living libraries and online mental health forums, exploring how people share experiences, build connections and seek support in both face-to-face and digital environments. The conversation explores how realist evaluation and synthesis can help unpack what makes online forums meaningful, helpful or challenging for different people indifferent contexts. Paul reflects on the difficulty of conceptualising online forums as interventions, the difference between context and setting, and the importance of psychological safety that enables people to share experiences and ask questions. Paul also discusses the value of combining realist synthesis with realist interviewing, working with multiple stakeholders, and using mixed methods to understand what is happening beyond individual posts or interactions. He reflects on the roleof forum moderators, service leads, forum hosts and users in shaping the culture and functioning of online spaces. Whether you’re an evaluator, researcher, student, practitioner, digital health professional or someone interested in lived experience, online communities and participatory approaches, this episode offers valuable insights into using realist approaches to understand how digital and hybrid spaces work, for whom, and under what circumstances.

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The Realist Lens is a podcast that makes realist evaluation and synthesis accessible and easy to follow. Through relaxed conversations with expert guests, students, and practitioners, we explore key realist concepts like mechanisms, context, and outcomes. Whether you're new to realist approaches or more experienced, this podcast offers practical insights, real-world examples, and thoughtful reflections to support your learning and curiosity—one conversation at a time.

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