Critical Realism: An Emerging Approach in Nursing


1 PhD Student of Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad, Iran.

2 Professor of nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad, Iran.



Background: Critical realism has remarkable consequences in healthcare organizations and especially in nursing. We aimed to explain the role and effects of the philosophical school of critical realism in the nursing profession.
Materials and Methods: In this review, online databases, including PubMed, Scopus, Web of Science, and CINAHL were searched with no language limitation up to March 2021. The keywords "Realism, Critical realism, Nursing, Education, Knowledge, Care, Research, and Clinical" were searched separately and also using combined operators (AND, OR, NOT).
Results: Nursing teachers should provide a rich learning environment based on critical realism, use their selected content in the curriculum, and pay attention to individual and social factors affecting learning. In the field of nursing research, managers and policy makers can use critical realism to evaluate the available evidence on an issue or topic and achieve a more comprehensive explanation of the results and the effectiveness of interventions and programs. Also, in the clinical field, critical realism emphasizes the involvement of various individual, social, and structural factors in the behavior of nurses and patients and advises nurses to pay attention to the role of these factors in assessing the condition of their clients and notes the effectiveness of nursing interventions. Also, the application of philosophical perspectives in nursing can reduce the gap between theory and clinical knowledge.
Conclusion: The realistic approach that emerges from critical realism fits the complexities of health care organizations and helps understand the nature of nursing work and decision making better. However, it seems that not enough attention has been paid to the philosophical roots of this framework in nursing and the result is insufficient application in nursing.