Positioning positivism, critical realism and social constructionismin the health sciences: a philosophical orientation

Nursing Inquiry 2012; 19(1): 71–82

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Positioning positivism, critical realism and social constructionism in the health sciences: a philosophical orientation Justin Cruickshank
University of Birmingham – POLSIS, Edgbaston, Birmingham, West Midlands, UK
Accepted for publication 25 March 2011
DOI: 10.1111/j.1440-1800.2011.00558.x

CRUICKSHANK J. Nursing Inquiry 2012; 19: 71–82
Positioning positivism, critical realism and social constructionism in the health sciences: a philosophical orientation
This article starts by considering the differences within the positivist tradition and then it moves on to compare two of the most prominent schools of postpositivism, namely critical realism and social constructionism. Critical realists hold, with positivism, that knowledge should be positively applied, but reject the positivist method for doing this, arguing that causal explanations have to be based not on empirical regularities but on references to unobservable structures. Social constructionists take a different approach to postpositivism and endorse a relativist rejection of truth and hold that the task of research is to foster a scepticism that undermines any positive truth claim made. It is argued that social constructionism is a contradictory position. Key words: critical realism, postpositivism, social constructionism.

INTRODUCTION: FROM POSITIVISM TO
POSTPOSITIVISM
A number of postpositivist positions have been developed in the human and health sciences (Alexander 1985). Two of the most prominent forms of postpositivism are critical realism and social constructionism. Much literature on positivism treats it as a single flawed entity and fails to perceive the differences within the positivist tradition, preferring to knock down a position that is reduced to a caricature (Clark
1998). Although critical realists reject positivism, they do adhere to the notion that knowledge may be positively applied to assist technical and medical

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