Uncovering the wisdom hidden between the lines: the Collaborative Reflexive Deliberative Approach

• Published in: Family practice Vol. 35; no. 3; pp. 266 - 275
• Main Authors: Crabtree, Benjamin F, Miller, William L, Gunn, Jane M, Hogg, William E, Scott, Cathie M, Levesque, Jean-Frederic, Harris, Mark F, Chase, Sabrina M, Advocat, Jenny R, Halma, Lisa M, Russell, Grant M
• Format: Journal Article
• Language: English
• Published: UK Oxford University Press 23-05-2018
• Subjects: Health Care Reform; Health Service Research; Humans; Interprofessional Relations; Meta-Analysis as Topic; Organizational Innovation; Primary Health Care - organization & administration; Program Evaluation; health care reform; Evaluation studies; interprofessional relations; primary health care; qualitative research; research methodology; policy
• ISSN: 0263-2136; 1460-2229
• DOI: 10.1093/fampra/cmx091

Abstract
Background
Meta-analysis and meta-synthesis have been developed to synthesize results across published studies; however, they are still largely grounded in what is already published, missing the tacit ‘between the lines’ knowledge generated during many research projects that are not intrinsic to the main objectives of studies.
Objective
To develop a novel approach to expand and deepen meta-syntheses using researchers’ experience, tacit knowledge and relevant unpublished materials.
Methods
We established new collaborations among primary health care researchers from different contexts based on common interests in reforming primary care service delivery and a diversity of perspectives. Over 2 years, the team met face-to-face and via tele- and video-conferences to employ the Collaborative Reflexive Deliberative Approach (CRDA) to discuss and reflect on published and unpublished results from participants’ studies to identify new patterns and insights.
Results
CRDA focuses on uncovering critical insights, interpretations hidden within multiple research contexts. For the process to work, careful attention must be paid to ensure sufficient diversity among participants while also having people who are able to collaborate effectively. Ensuring there are enough studies for contextual variation also matters. It is necessary to balance rigorous facilitation techniques with the creation of safe space for diverse contributions.
Conclusions
The CRDA requires large commitments of investigator time, the expense of convening facilitated retreats, considerable coordination, and strong leadership. The process creates an environment where interactions among diverse participants can illuminate hidden information within the contexts of studies, effectively enhancing theory development and generating new research questions and strategies.