Are we on the cusp of a fourth research paradigm? Predicting the future for a new approach to methods-use in medical and health services research

Frances Rapport*, Jeffrey Braithwaite

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)
19 Downloads (Pure)


Background: The dominant medical and health research paradigm continues to be quantitative. While the authors sense a sea-change in opinion about mixed-method research, underpinned by two decades of highly-cited publications in medical journals, much of the medical literature still widely favours the Randomised Control Trial. Main body: This debate article examines whether it is the beginning of the end of the dominant quantitative paradigm and the interest this holds for researchers and clinicians at the forefront of care delivery. It examines the Third Research Paradigm, signifying the importance of mixed-methods, and discusses the power of the patient voice and person-focused research activity. The authors discern the coming of age of a Fourth Research Paradigm integrating mixed-methods with data collected 'on the hoof'. Within this new paradigm, the article explores the power of available, real time, and emergent data - from smart phones, wearable devices, and social media, as well as more creative approaches to data collection. The Fourth Research Paradigm will require the support of multi-disciplinary teams, moving through the world alongside their research subjects. The impact of a Fourth Research Paradigm on the health researcher is assessed, as the researcher's gaze moves away from considerations of methodological superiority to re-considerations of their role in the brave new world of research multiplicity. Conclusion: The Fourth Research Paradigm offers extensive opportunities to tell more complete research stories in real-time settings. It concentrates on contextual notions of everyday happenings within the ever-changing world of healthcare delivery. There will be challenges ahead, not least the management of large, complex datasets and adaptive study designs. But rigorous planning will enable unique insights into the relationships played out in the world of the patient and healthcare provider. Better care and new delivery models are likely to result, but how this will manifest is not yet clear.

Original languageEnglish
Article number131
Pages (from-to)1-7
Number of pages7
JournalBMC Medical Research Methodology
Issue number1
Publication statusPublished - 14 Nov 2018

Bibliographical note

Copyright the Author(s) 2018. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • Complexity
  • Fourth research paradigm
  • Methodological development
  • Mobile methods
  • Qualitative research
  • The future of healthcare
  • Third research paradigm


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