Reviews of theoretical frameworks: challenges and judging the quality of theory application.

Abstract

Background Rigorous reviews of available information, from a range of resources, is required to support medical and health educators in their decision making related to their educational practice. Aim The aim of the paper is to highlight the importance of a review of theoretical frameworks specifically to supplement reviews that focus on a synthesis of the empirical evidence alone. Establishing a shared understanding of theory as a concept is highlighted as a challenge to these types of review and some practical strategies to achieving this are presented. The paper also introduces the concept of theoretical quality to the methodology of literature reviews, arguing that a critique of how theory is applied should complement the methodological appraisal of the literature in a review. Method We illustrate the challenge of establishing a shared meaning of theory through reference to experiences of an on-going review of this kind conducted in the field of interprofessional education (IPE) and use a high scoring paper selected in this review to illustrate how theoretical quality can be assessed. We focus on theories that apply to IPE curriculum design but the findings are transferable to all reviews of theoretical frameworks. Findings In reaching a shared understanding of theory as a concept, practical strategies that promote experiential and practical ways of knowing (e.g. small group work and piloting of all phases of the review protocol) are required in addition to more propositional ways of sharing knowledge. Concepts of parsimony, testability, operational adequacy and empirical adequacy are explored as concepts that establish theoretical quality. Conclusions Reviews of theoretical frameworks used in medical education are required to inform educational practice. Review teams should make time and effort to reach a shared understanding of the term theory. Theory reviews, and reviews more widely, should add an assessment of theory application to the protocol of their review method. .