The Realist Lens - For Researchers Who Keep It Real

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.

Episode 28 – Realist Evaluation in Government and Policy with Finlay Green

How can realist evaluation help make sense of government policy, complexity, and decision-making? And what happens when realist ideas move beyond academic journals and into fast-moving, politically shaped, resource-stretched environments where people need answers quickly? In this insightful and practical conversation, Alejandro is joined by Finlay Green, an evaluation and policy practitioner with experience across consultancy, government evaluation and policy advice. Finlay reflects on his journey into realist evaluation, from discovering Realistic Evaluation during recovery from an ACL injury to applying realist thinking in government settings. The conversation explores where realist evaluation fits within government, where it can clash with existing evidence expectations, and how realist ideas can be adapted without losing their integrity. Finlay discusses the importance ofdropping unnecessary jargon, making evaluation tangible and accessible, using quantitative and administrative data and focusing on explanations that are useful to policymakers. Finlay also reflects on the value of realist approaches for wicked problems, regulation, policy design, and ex ante evaluation. He highlights the need for realist evaluators to engage more directly with policy questions, collaborate across disciplines and understand the pressures and constraints faced by government teams. Whether you’re an evaluator, researcher, policymaker, student, or practitioner interested in applying realist approaches in policy contexts, this episode offers valuable insights into making realist evaluation feasible, credible, and genuinely useful where decisions happen and stakes are high.

Episode 27 – Remote Aboriginal Health and Realist Approaches with Katherine Zippel

How can realist approaches help us understand culturally safe, community-led healthcare? And how can storytelling, lived experience, and clinical practice come together to make research more responsive and relational? In this rich and reflective conversation, Alejandro is joined by Dr Katherine Zippel, a General Practitioner, DPhil student at the University of Oxford, and researcher working at the intersection of clinical care, cultural safety, social prescribing, Aboriginal health, and realist research. Katherine shares how realist approaches helped her move beyond asking “does it work?” to exploring what works, for whom, in what circumstances, and why. Drawing on herexperiences in remote Aboriginal communities in the Northern Territory, she reflects on how care is shaped by trust, cultural legitimacy, relational continuity, and community control. Katherine discusses powerful examples from her work, including HIV testing in Ghana, COVID-19 vaccine rollout in remote Aboriginal communities, and cancer survivorship. She highlights how realist thinking can reveal why interventions succeed in some settings but not others, especially when programmes are implemented in complex cultural and structural contexts. Drawing on narrative medicine, Katherine also explores how stories can surface mechanisms that might otherwise remain hidden. She reflects on the importance of listening deeply, honouring lived experience, and resisting one-size-fits-all models ofcare. Whether you’re a researcher, clinician, or interested in culturally safe and community-led approaches to healthcare, this episode offers rich insights into embracing complexity, valuing stories, and using realist thinking to supportmeaningful change.

Episode 26 – Realist Approaches in Arts and Mental Health Recovery with Louisa Peters

What role can the arts play in recovery? And how can realist approaches help us understand the deeper processes behind healing, identity, and lived experience? In this creative and thought-provoking conversation, Alejandro is joined by Dr Louisa Peters, a researcher who brings together psychology, community arts, and realist thinking. Louisa’s work draws on her background in musicology, community arts practice, and her PhD research exploring recovery in serious mental illness. Louisa shares how realist approaches allowed her to movebeyond asking “does it work?” to exploring how and why arts-based interventions support recovery. She highlights how community arts create safe, trusting spaces that promote coping, acceptance, and positive emotional engagement, while also acknowledging the complexity and non-linear nature of recovery. Drawing on her research, Louisa discusses innovative methods such as arts elicitation interviews, poetry, and visual approaches, showing how creative expression can uncover mechanisms that are difficult to articulate. She also reflects on navigating complexity in realist research through mapping,causal loop diagrams, and embracing a flexible, adaptive approach. Whether you’re a researcher, clinician, or interested in theintersection of arts and health, this episode offers rich insights into embracing complexity, valuing lived experience, and using realist thinking to explore meaningful change.

Episode 25 – Realist Approaches in Physiotherapy with Leah Morris

What makes physiotherapy such a complex, context-dependent practice, and how can realist approaches help us better understand what works, for whom, and why? In this insightful and grounded conversation, Alejandro isjoined by Dr Leah Morris, a physiotherapist, senior lecturer, and realist researcher working at the University of the West of England. Leah’s work spans academia, teaching and supporting realist research across healthcare settings. Leah shares her journey into realist evaluation, reflectingon how it helped her make sense of complex roles such as first contact physiotherapy and why realist thinking aligns so naturally with physiotherapy’s core principles of individualised care and clinical reasoning. Drawing on projects like FREEHAB and her work in supporting colleagues, she highlights how realist approaches can uncover the mechanisms behind tailored interventions and explain variation in outcomes across contexts. From applying realist thinking in non-realist projects to navigating methodological challenges, limited guidance, and misconceptions about “realist light,” Leah offers practical insights grounded in both clinical and research experience. Whether you’re a clinician, researcher, or educator, thisepisode provides valuable lessons on embracing complexity and applying realist approaches to physiotherapy and beyond.