Journal of Advanced Nursing, 1998, 27, 12421249

The qualitative-quantitative debate: moving from

positivism and confrontation to post-positivism
and reconciliation
Alexander M. Clark BA(Hons) RN
Doctoral Research Student, Department of Nursing and Community Health, Glasgow
Caledonian University, City Campus, Cowcaddens Road, Glasgow G4 0BA, Scotland

Accepted for publication 8 June 1997

CLARK A.M. (1998) Journal of Advanced Nursing 27, 12421249

The qualitative-quantitative debate: moving from positivism and confrontation
to post-positivism and reconciliation
Critiques of logical positivism form the foundation for a significant number of
nursing research papers, with the philosophy being inappropriately deemed
synonymous with empirical method. Frequently, proposing an alternative
method to those identified with the quantitative paradigm, these critiques are
based on a poor foundation. This paper highlights an alternative philosophy to
positivism which can also underpin empirical inquiry, that of post-positivism.
Post-positivism is contrasted with positivism, which is presented as an
outmoded and rejected philosophy which should cease to significantly shape
inquiry. Though some acknowledgement of post-positivism has occurred in the
nursing literature, this has yet to permeate into mainstream nursing research.
Many still base their arguments on a positivistic view of science. Through
achievement of a better understanding of post-positivism and greater focus on
explicating the philosophical assumptions underpinning all research methods,
the distinctions that have long been perceived to exist between qualitative and
quantitative methodologies can be confined to the past. Rather methods will be
selected solely on the nature of research questions.

Keywords: research, paradigms, philosophy, methodology, science

deemed here to be the philosophical. In line with defi-

TRENDS IN NURSING RESEARCH:
PHILOSOPHIES, PARADIGMS AND
METHODS
To argue any proposed position effectively, it is imperative
that accuracy, clarity and congruence are present regarding
terms used. Though some concepts are discussed and used
extensively to frame arguments (the concept of paradigms
being a prime example) this need not warrant that the
author whole heartedly condones their use.
Philosophical level of research methods
Research methods can be described, examined and catego-
rized at different levels. The most fundamental level is
nitions of the discipline of philosophy, the philosophical
level of a research method focuses on its assumptions relat-
ing to the most general features of the world, encompassing
aspects such as the mind, matter, reason and proofs for
knowledge (Blackburn 1994). As will be outlined, different
research methods may share or greatly differ in their
philosophical conceptualizations of truth.
Consequently, when using a specific research method,
consciously or otherwise, assumptions about philosophi-
cal aspects are made. For example, if undertaking a
Heideggerian phenomenological study, the philosophy
which underpins this research method dictates that certain
perspectives are adopted regarding what it is to be a
person. Reality is deemed to be interpretive with inquiry

1242 1998 Blackwell Science Ltd


centred around Being. Using the concept of Being-in-the-
world, Heidegger emphasizes that all human existence is
shaped by and cannot be disassociated from past experi-
ences, culture, history and even future intentions (Walters
1994, Koch 1995).
Such a stance has extensive implications regarding truth
alone. Because it is acknowledged that humans cannot be
separated from their own Being, the possibility of
researcher objectively in inquiry is not supported. This
stance acknowledges the researchers influence in shaping
all stages of their inquiry, with no party, such as an expert
analyst or even a participant, being able to verify research-
ers interpretive findings as being objectively true to the
original experience (Sandelowski 1993). Participants
narratives are so prone to revision and reinterpretation
over time by the participant themselves, that no bench-
mark can exist from which to evaluate the truthfulness
of interpretations (Boykin & Schoenhofer 1991).
The concept of objective truth is not appropriate to this
research method, because it goes against the revisionist
nature of experience. This absolute rejection of objec-
tivity of truth in relation to inquiry is in contrast to that
ascribed to by other methods, such as experimentalists.
Paradigm level of research methods
The philosophical aspects underpinning methods facili-
tate the categorization of research methods into paradigms.
The concept of paradigm was proposed initially by
Thomas Kuhn in 1962 (Kuhn 1970). The concept is appro-
priately applied when a high level of professional consen-
sus is recognized to exist within particular communities
of scientists, regarding aspects of philosophical beliefs,
theories, standards for research and exemplary findings
(Kuhn 1970, Poythress 1988). That the formation of para-
digms is related to philosophical assumptions is emphas-
ized by Kuhn (1970 pp. 45) in his comment that:
Effective research scarcely begins before a scientific community
thinks it has acquired firm answers to questions like the following:
What are the fundamental entities of which the universe is com-
posed? How do these interact with each other and with the senses?
What questions may be legitimately asked about such entities and
what techniques employed in seeking solutions?
Here Kuhn highlights that in the carrying out of research
endeavour, philosophical positions are adopted about the
nature of matter, what can be known, and how can this
knowledge be attained. Within paradigms, in addition to
philosophical aspects, it is likely that consensus will also
exist (where applicable to methods) regarding funda-
mental equations, their associated theories and the basic
concepts forming these theories (Kegley 1995).
The concept of paradigm is more frequently presented
by nursing authors in isolation from other aspects of
Kuhns cyclical theory of scientific development (Allen
1998 Blackwell Science Ltd, Journal of Advanced Nursing, 27, 12421249
The qualitative-quantitative debate
et al. 1986, Cull Wilby & Pepin 1987, Cushing 1994, Carr
1994). Historically, nursing authors tend instead to use the
concept to categorise research methods into one of two
paradigms, the qualitative or the quantitative (Ford-Gilboe
et al. 1995, Carr 1994, Cushing 1994, Rolfe 1994, Dzurec
& Abraham 1993, Gortner & Schultz 1988, Moccia 1988,
Leininger 1985).
Questioning the qualitative-quantitative distinction
Though some distinction between methods is well placed,
as will be shown, it is being acknowledged that philo-
sophically the qualitative and quantitative paradigms are
not as diverse or mutually incompatible as is often con-
veyed. Staunch identification of methods with particular
paradigms may not be as accurate, or even as useful, an
endeavour as past trends would indicate. This tendency
may lead to over-simplification of methods in relation to
paradigms, or worse, confusion over the philosophies and
assumptions that underpin particular methods.
Though empiricism has been recognized as a philosophy
in itself (Blackburn 1994), it is supported here that it is best
understood as a quantitative paradigm that can be shaped
by more than one philosophy. The remainder of this paper
highlights disagreement which exists regarding the philos-
ophy deemed to underpin empiricism. These disputes
appear to originate from regarding all empirical methods as
being shaped by a single philosophy, that of positivism.
After positivism is outlined, and its presence and influ-
ence in nursing literature examined, it is proposed that
post-positivistic philosophy has replaced positivism as
that which underpins most researchers empirical method.
Examination of post-positivistic philosophy and its influ-
ence in nursing literature is undertaken, with reasons for
its lack of acknowledgement speculated on. These reasons
are then formulated into guidance for researchers using
any method(s). Overall, it is noted that the strict categoriz-
ing of methods into paradigms, can cause simplification
and inaccuracy, as such this is a practice which should be
questioned.
THE NATURE OF POSITIVISM:
DETACHMENT AND CERTAINTY
The historical evolution and nature of the philosophy of
logical positivism are comprehensively documented by
Guba & Lincoln (1994), Holton (1993) and Feigl (1969) who
highlight how the philosophy was expressed in research
method. Truth in positivist inquiry is achieved through
the verification and replication of observable findings con-
cerning directly perceivable entities or processes (Wolfer
1993, Poole & Jones 1996). The perspective assumes the
existence of an objective reality, i.e. one that is indepen-
dent of the knower (Holton 1993) which can be accurately
perceived through the human senses.
1243
A.M. Clark
Correspondence theory of truth
Relatedly, positivism adopts a correspondence view of
truth, with true statements taken to correspond with the
knowable facts of reality. Truth is therefore dependent not
on belief but the correspondence of belief to facts present
in external reality. Fundamental to the stance is a rejection
of metaphysical speculations such as those concerning
apriori and transcendental knowledge (Feigl 1969).
Phenomena such as meanings and experiences are there-
fore outwith the scope of positivism (Greene 1979,
Dzurec 1989).
Progress in scientific development, as outlined by Kuhn
(1970), pointed to the inevitability of accepting the influ-
ence of unobservable entities such as molecules, atoms
and electrons. This caused the positivists to revise their
original denial of unobservables to a modified form of
instrumentalism. This stance deemed unobservable con-
cepts to be useful for calculation and understanding
related to the control and prediction of observable phen-
omena. However, irrespective of their pragmatic use, unob-
servables were still denied any form of real existence.
This antirealist stance regarding theoretical entities,
drew a fundamental distinction between observable and
theoretical aspects. Though useful for control and predic-
tion, that which could not be seen could not make claims
to existence. Consequently, though theories involving
unobservable phenomena could be used to generate pre-
dictions relating to reality, they could not explain occur-
rences because they were not held to exist (Gortner &
Schultz 1988, Blackburn 1994, Poole & Jones 1996). Under
this view, theories had limited explanatory power.
An additional facet of positivist inquiry which has gen-
erated much criticism is its adherence to an atheoretical,
abiased view of the researchers involvement in the
research process. Positivist philosophers acknowledged
and valued rationality and intellectualism but these were
tempered with great focus on objectivity, globalism,
anti-individualism, un-self-conscious and non-self-
reflectiveness in inquiry (Holton 1993). Dualism (or
Cartesianism) and the associated capability of separating
biases of the mind from the world (and thus the researcher
from all stages of the research process) were therefore sup-
ported (Guba 1990, Holton 1993). Only if individuals
could achieve this total detachment could inquiry be bias
free and truly objective. Consequently, researchers were
deemed to be neutral observers who indubitably report-
ed their observations free from any cultural, social or
experiential based biases (Phillips 1990).
Laws
In creating and building knowledge, positivist inquiry
focused on discovering infallible and universal laws
through the cumulative piecing together of bits of knowl-
edge (Bronowski 1956, Dzurec 1989, Holton 1993, Poole &
1244 1998 Blackwell Science Ltd, Journal of Advanced Nursing, 27, 12421249
Jones 1996). This cumulative, universal, and law-centred
view of science has been challenged by scientific theorists
(Popper 1959, Kuhn 1970, Ziman 1991, Dolby 1996) and
philosophers, notably David Hume (Hume 1975), known
collectively as inductive skeptics (Landesman 1997).
These challenges focused on the limitations which had to
be attached to universally generalizing from a limited
number of cases, highlighting particularly the situational
and perceptual factors influencing scientists work.
Kuhn (1970), taking a more historical perspective, high-
lights previous scientific explanations taken to be indubit-
ably true. Analysing some subsequently shown to be false
(Aristotelian dynamics, phlogistic chemistry and caloric
thermodynamics), Kuhn proposes that those who study
these views of nature will conclude that the methods used
were no less scientific or idiosyncratic than those used in
current times. If these discredited theories are to be
called myths:
... then myths can be produced by the same sorts of methods and
held for the same sorts of reasons that now lead to scientific
knowledge. If on the other hand they are called science, then
science has included bodies of belief quite incompatible with the
ones we hold today.
Kuhn (1970 p. 2)
Kuhn thus illustrates the historical transitoriness that
supposedly universally true findings can possess. We are
never in a position to prove the universality of findings,
as Kuhn highlights, history would warn against making
such a claim.
Positivism and nursing inquiry
It is well recognized that in its endeavours to become estab-
lished in the first half of the 20th century, nursing research
was dominated by the medical model and its associated
positivist philosophy (Cull-Wilby & Pepin 1987, Nagle &
Mitchell 1991, Doering 1992, Cushing 1994). A consider-
able amount of agreement is apparent amongst the many
different descriptions of the positivist view. This research
was quantitative and operated with what was known as
the positivistic received view (Carter 1985, Guba 1990,
Doering 1992, Guba & Lincoln 1994).
When made explicit, as demonstrated by Poole & Jones
(1996), the philosophical assumptions of positivism can
be readily questioned by historical counterexample (Kuhn
1970, Guba 1990) and through the application of reason.
Though positivism has been noted to influence a number
of early nursing theorists work, notably Orem and Roy
(Nagle & Mitchell 1991), as will be outlined, positivistic
conceptions of truth and inquiry have philosophically
been widely dismissed as incompatible with nursing
research.
Barnum (1994) and Rolfe (1994) report the tendency in
nursing literature of dichotomizing research endeavours

into either quantitative or qualitative paradigms, as mutu-
ally exclusive polar opposites, encompassing a differing
view of reality and truth. With significant consistency,
nursing literature states that empirical inquiry is aligned
solely with a positivist philosophy (Ray 1985, Leininger
1985, Allen et al. 1986, Cull-Wilby & Pepin 1987, Moccia
1988, Dzurec 1989, Nagle & Mitchell 1991, Doering 1992,
Carr 1994, Darbyshire 1994, Streubert 1995, Playle 1995,
Hicks & Hennessy 1997).
Such labelling is frequently used to provide contrast to
an authors subsequent proposal of an alternative philos-
ophy or method (Schumacher & Gortner 1992) as demon-
strated by Bailey (1997), Horsfall (1995), Darbyshire
(1994), Rolfe (1994), Mason (1993), Dzurec & Abraham
(1993), Moccia (1988), Allen et al. (1986) and Tinkle &
Beaton (1983) bar many. These authors critiques of positiv-
ism highlight the plain inadequacies to nursing of an
approach which denies the importance of subjective,
social, spiritual and interpretative aspects of the person,
their relationships and psychosomatics. Positivism
employs an overly reductionist view of the person in its
quest for universal mechanistic rules which are culturally
independent. This view of human existence is incongruent
with that focused on by nursing.
Crucially, though these criticisms are in themselves
valid, they need not apply to all empiricist work because
such work need not evolve only around a positivist philos-
ophy. As Norbeck (1987) and Barnum (1994) allude to,
there exists no intrinsic link between logical positivism
and empiricism. To make such a connection is to assume
that empiricism can only operate with the philosophical
assumptions of positivism. Rather, empiricism can also
operate under a post-positivistic philosophy, which his-
torically superseded positivism, evolving in response to
its increasingly obvious limitations.
BEYOND THE LIMITATIONS OF
POSITIVISM TO POST-POSITIVISM
The philosophy of post-positivism is increasingly being
noted as that which underpins contemporary empirical
research activity (Phillips 1990, Schumacher & Gortner
1992, Dzurec & Abraham 1993, Ford-Gilboe et al. 1995).
This has severe implications for those mentioned who
equate all empirical methods with a positivistic philos-
ophy. Given that empirical methods may not be under-
pinned with positivistic views, the fundamental
justifications authors so frequently provide for their
alternative perspectives can be noted to be weak. As dem-
onstrated by Poole & Jones (1996), even those practising
and advocating empirical methods, are heavily critical of
positivistic philosophy.
The main influences in promoting post-positivist philo-
sophies were the works of Karl Popper (Popper 1959),
Jacob Bronowski (Bronowski 1950, 1956), Thomas Kuhn
1998 Blackwell Science Ltd, Journal of Advanced Nursing, 27, 12421249
The qualitative-quantitative debate
(Kuhn 1970) and Charles Hanson (Hanson 1958).
Fundamentally, a different conceptualization of truth was
proposed by the post-positivists. Like positivism, meta-
physical considerations were still deemed to be outwith
the sphere of science (Bronowski 1956). However, in con-
trast, a realist perspective of science was advocated, with
unobservables deemed to have existence and the capability
of explaining the functioning of observable phenomena
(Bronowski 1956, Schumacher & Gortner 1992).
Theoretical explanations therefore had greater predictive
value. Like the positivists, science was still deemed to
require precision, logical reasoning and attention to evi-
dence but was not confined to that which could be directly
perceived. Evidence could be in inferable forms such as
the self-reports inherent in interviews or questionnaires
(Bronowski 1956). As such, distinction drawn between
empirical methods and the qualitative paradigm, as under-
taken by Tesch (1990), cannot be based on the nature of
data (i.e. non-numerical or numerical).
Post-positive research need not exclude either qualitat-
ive (i.e. non-numerical) data or truths found outside
quantitative method; acceptance of this is crucial to
rejecting the strict dichotomy often drawn between the
qualitative and quantitative paradigms. This notion was
central to the work of scientist Jacob Bronowski
(Bronowski 1956, p. 31) who spoke of art and science as
having the same overall aim of highlighting unity in
diversity:
The scientist or the artist takes two facts or experiences which
are separate; he finds in them a likeness which had not been seen
before; and he creates a unity by showing the likeness.
Though Bronowski further argues that scientific and
artistic exploration must remain distinctive, nevertheless
it remains that the truths inherent within each, though
essentially different in nature, are valid. Taking a modified
position to Bronowski (1956), Sandelowski (1993) and
Gadamer (1989) note that many parallels exist between
truths based in artistic experience and those discovered in
many traditionally qualitative based hermeneutic enquir-
ies. Post-positivism does not reject the truths present in
methodologies focusing on the experiences or meanings of
individuals, as encompassed by the phenomenological,
grounded theory and other interpretive methodologies.
Role of the researcher
Importantly, under post-positivistic philosophy, the
researcher and his or her perceptions were not seen as
being wholly detached from inquiry. Science was certainly
not seen as personal opinion or private experience, but
personal processes and involvement were acknowledged
as being characteristic of human inquiry. A distinction was
therefore drawn between retinal images and similar raw
data of sensory experience and the cognitive processes of
1245
A.M. Clark
perception and their experiential, cultural and knowledge
related biases (Hanson 1958, Norbeck 1987, Schumacher
& Gortner 1992, Dzurec & Abraham 1993, Poole & Jones
1996). The strict adherence to dualism inherent in the pos-
itivist approach cannot apply in post-positivist philos-
ophy. It is acknowledged that the researching human, with
or without instruments, must shape the research process.
Necessity existed not only in recognizing the inter-
pretive element of all human undertaken research inquiry,
but also the theory ladeness of scientific instruments. Use
of scientific instruments, such as electron microscopes and
telescopes, involve not only the idiosyncrasies of human
perception but have also beneath their own workings many
sets of previously developed theories pertaining to physics
and chemistry. All of these theories are also prone to
uncertainty and the possibility of further change
(Schumacher & Gortner 1992).
The contextually bound nature of research findings, con-
sequential in the acknowledgement of researcher and
theoretical biases, warrants that knowledge deemed to be
truthful under post-positivistic inquiry is not universally
generalizable to all cases and all situations. Rather, find-
ings are viewed as contextually related and could be
inductively applied with reference to probability of the
similar case holding elsewhere. This stance is in contrast
to the positivists who advocated immutable law. As
Schumacher & Gortner (1992 p. 6) advocate, even in the
physics, true laws are most infrequent with relationships
being proposed on an all things being equal basis. As
with all research, this seldom occurs in the natural
environment.
Relatedly, post-positivistic inquiry had a less ambitious
aim attached to inquiry than the positivists, that of gaining
a greater approximation of truth. This stance also encom-
passed an acknowledgement of the inevitability of
researcher biases and the complications of claims to uni-
versal knowledge (Bronowski 1956, Schumacher & Gortner
1992, Poole & Jones 1996).
Coherence view of truth
Unlike the positivists who claimed to be able to accurately
know reality and discover universal truths under the corre-
spondence model, recognizing the futility of gaining
definitive knowledge of reality (i.e. that which is certain)
leads post-positivists away from a positivist conception of
truth. That some guide to what could be trusted as true
was required amongst this uncertainty, can explain the
adoption of a coherence view of truth in which claims to
knowledge were judged in the context of rational,
informed communal judgements (Bronowski 1956,
Norbeck 1987, Gortner & Schultz 1988, Ziman 1991,
Schumacher & Gortner 1992, Dolby 1996).
Little indication could exist that was more trustworthy
than the informed, albeit subjective, evaluations of those
1246 1998 Blackwell Science Ltd, Journal of Advanced Nursing, 27, 12421249
most likely to know the probability of a finding gaining
closer approximation to truth. As is demonstrated by
prominent scientific theorists (Kuhn 1970, Ziman 1991,
Dolby 1996) entire movements of science could, in time,
be shown to be far less close to truth than their proponents
originally believed.
Implications of post-positivistic philosophy for
nursing research
As highlighted, criticisms of empiricism are still based on
a positivistic view of empirical method with little
acknowledgement of even the possibility of post-
positivistic philosophies shaping nursing research.
Explanation regarding many authors lack of acknowledge-
ment of the post-positivism may point to either a resistance
to its tenets or an unawareness of its existence in relation
to positivism.
The former explanation, given the extreme and readily
refutable nature of positivism, as demonstrated by Poole
& Jones (1996) and Guba (1990), may be a tempting one
for researchers to indulge in, especially those proposing a
radically alternative view. But to argue against a perspec-
tive which ... few, if any philosophers these days sub-
scribe to... (Phillips 1990 p. 39) is unlikely to add great
weight to the strength of the proposed alternative, given
positivism is so vulnerable to straightforward criticism. As
Silverman (1993 p. 21) adds:
In the 1970s, it was common to criticise what was called positiv-
ism... it became increasingly clear that positivists were made of
straw since very few researchers could be found who equated the
social and natural worlds or believed that research was properly
theory-free.
The latter explanation related to awareness, however,
would seem more plausible given that in the main, nursing
research studies in both traditional qualitative and quanti-
tative camps have been consistently noted to seldom
articulate or debate their philosophical underpinnings
(Bowers 1992, Wolfer 1993, Walters 1994, Ray 1994, Playle
1995, Horsfall 1995, Kikuchi et al. 1996). This tendency
has also been noted in wider scientific research (Dolby
1996, Harman 1996). Superficially, it may therefore appear
that those utilizing empirical methods ascribe to a positiv-
istic philosophy. Alternatively, post-positivistic assump-
tions underpinning methods and their significance and
implications for findings may remain implicit. Either way,
identifying empirical studies with positivist or post-
positivist philosophies could then not be readily
undertaken.
Regarding the level of understanding reflected in the
nursing literature about science, Paley comments that con-
temporary views of science are absent in current nursing
theory, describing this as stunning, he adds that:

With few exceptions, the debate seems to be stuck in a mid-
century time-warp.
(Paley 1996 p. 670)
Given the wealth of connections drawn between the out-
dated philosophy of positivism and empiricism, and the
lack of acknowledgement of post-positivism, Paleys pos-
ition is hard to deny. That this accusation holds may be
due to the general lack of attention described above,
regarding philosophical aspects of research methods.
Increasing the philosophical focus
This general lack of attention toward the explication of
philosophical foundations has significant implications for
all research methods. With philosophical assumptions
remaining implicit, qualitative and quantitative research
endeavours are prone to be presented in an overly simpli-
fied and demarcated form. Consequently being treated as
homogenous groups, free from diversity and in opposition
to each other. This trend was also noted by Atkinson
(1995).
When examined in detail, the qualitative paradigm alone
encompasses a diversity of methods that can vary in philo-
sophical assumptions about reality, aims and valid data
collection methods and sources (Sandelowski 1986,
Thorne 1991, Atkinson 1995). That the philosophical
issues beneath these aspects are often ignored,
accompanied by the tendency for listing methods under
paradigms, contributes to the distinction perceived to be
between qualitative and quantitative paradigms.
Whereas the failings of positivism may form justification
for alternative methods, these need not be those tradition-
ally equated with the qualitative paradigm. Post-
positivism was itself a reaction to the limitations of posi-
tivism. Those solely associating positivism with empiri-
cism, negating the existence of post-positivism, would
have empiricists reject the value of these methodologies.
The triangulation of qualitative and quantitative methods
in the same research studies indicates a tacit acceptance
of post-positivistic philosophy, with such researchers
recognizing the diversity of truths reachable through dif-
ferent forms of inquiry, but valuing each for the contri-
bution they can make to knowledge development and
nursing practice.
ACKNOWLEDGING POST-POSITIVISM IN
NURSING RESEARCH
Acknowledgement of post-positivism has formed the
rationale for a number of papers (Watson 1981, Norbeck
1987, Schumacher & Gortner 1992, Dzurec & Abraham
1993, Weiss 1995, Poole & Jones 1996). These have articu-
lated both the need to retain and value all methods and
warned against dismissing the empirical approach based
1998 Blackwell Science Ltd, Journal of Advanced Nursing, 27, 12421249
The qualitative-quantitative debate
solely on the weaknesses of positivist philosophy. Though
published over a significant time, the view of empiricism
(and research methods as a whole) expressed by these
authors remains to be explicitly acknowledged, encom-
passed, or even implicitly indicated in significant amounts
of nursing research. This is the case for those contributing
to both the recognized qualitative or quantitative
literature.
Despite the openness of post-positivism to other means
of inquiry, it may be argued that post-positivism retains
some of the weaknesses of positivism that made it inappro-
priate for nursing inquiry. The approach still focuses on
rendering complex aspects of human beings researchable,
seeking causation, prediction and explanation in the pat-
terns and regularities of life (Bronowski 1956, Guba 1990).
However, as is frequently agreed upon (Moody 1990,
Wolfer 1993, Dreher 1994, Powers & Knapp 1995, Morse &
Field 1996, Polit & Hungler 1997), research questions
should be answered with appropriate research methods.
Particular methods cannot answer every type of problem
pertaining to physical, spiritual, psychological and experi-
ential realms (Wolfer 1993, Rolfe 1994, Ford-Gilboe et al.
1995).
Methods belonging to the traditional qualitative para-
digm therefore retain great use in answering many vital
questions which quantitative methods cannot. It remains
vital that method selection is based not on a limited view
of science, but on an accurate understanding of all forms
of inquiry, with justifications being based on contemporary
understandings about how best to answer research
questions.
CONCLUSION
Authors frequently use the inadequacies of positivism as
a foundation for their alternative views. It is vital that
authors have an accurate understanding of the positivist
perspective. To equate positivism with all empirical
method is erroneous, confusing a general philosophy with
a particular method. Though empirical methods can be
shaped by positivistic philosophy, it is increasingly being
recognized that empirical work can alternatively be based
on a post-positivistic philosophy which avoids many of
the inadequacies correctly associated with the positivist
school.
Authors proposing alternatives to empirical inquiry
must acknowledge the advances post-positivism has
brought to empirical method and base their counter argu-
ments on an appropriate and contemporary understanding
of inquiry. Health researchers should become familiar with
the assumptions underpinning post-positivism, basing
their justifications for both quantitative and qualitative
research methods around this knowledge.
Admittedly, many authors on both sides of the qualitat-
ive-quantitative debate have compounded inappropriate
1247
A.M. Clark
conceptualizations by failing to effectively highlight the
philosophical assumptions beneath their methods.
Quantitative researchers must recognize that the reassur-
ance of common sense and scientific convention does not
warrant that their methods are atheoretical and without
philosophical assumptions or implications. Should philo-
sophical assumptions and their associated implications be
highlighted in the reporting of findings, it may be more
clear to what degree current research in nursing and medi-
cine continues to operate with positivist views. Where
research is noted or strongly inferred to operate with a
positivist philosophy, this should be identified as a weak-
ness. Rather, empirical researchers should encompass con-
temporary understanding of science in their methods,
shaping their design, findings and generalizing
accordingly.
Operating under a post-positivist philosophy, the
empirical methods of quantitative research and those of
the qualitative approaches are not as diametrically
opposed as is frequently conveyed. Truths in these per-
spectives must be reciprocally recognized; to fail to do so
would be to deny both that progress has been made
through empirical endeavour since the 17th century or that
art, human experiences, and human meanings are devoid
from any forms of truth.
Acknowledgements
My thanks go to Dr Valerie Fleming, Dr Debbie Tolson,
Susan Kerr and Anna ONeill, all at the Department of
Nursing and Community Health, Glasgow Caledonian
University, for their comments regarding this paper.
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