Masterclass Ready for a paradigm shift? Part 1: Introducing the philosophy of qualitative research Nicola J. Petty a, * , Oliver P. Thomson b , Graham Stew a a Clinical Research Centre for Health Professions, School of Health Professions, University of Brighton, Aldro Building, 49 Darley Road, Eastbourne BN20 7UR, United Kingdom b The Department of Sport and Health Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Jack Straws Lane, Oxford OX3 0FL, United Kingdom article info Article history: Received 23 November 2011 Received in revised form 23 February 2012 Accepted 3 March 2012 Keywords: Qualitative research Philosophy of knowledge Manual therapy abstract The manual therapy professions have almost exclusively focused on the use of quantitative research to help inform their practices. This paper argues that a greater use of qualitative research will help develop a more robust and comprehensive knowledge base in manual therapy. The types of knowledge used in practice and generated from the two research paradigms are explored. It is hoped that an understanding of the philosophical and theoretical underpinnings of qualitative research may encourage more manual therapists to value and use this approach to help further inform their practice; for some, this may involve a paradigm shift in thinking. Ó 2012 Elsevier Ltd. All rights reserved. 1. Introduction Manual therapy researchers have, for a number of years, fav- oured quantitative research, which has generated a great deal of useful knowledge for our practice and professional standing. We have identified mechanisms that help explain the therapeutic effects of our treatment modalities as well as determined the effectiveness of a range of therapies and management strategies. While this knowledge has made a significant contribution to our understanding of manual therapy, the exclusive use of quantitative approaches has resulted in a narrow understanding of our practice. Very little use has been made of qualitative research approaches that generate a different sort of knowledge and is complimentary to quantitative approaches. We carried out an audit of published research in this journal, since its inception in 1995; the results are summarized in Fig. 1 . In the last 16 years to December 2011, Manual Therapy has published 475 original articles and only ten of these (2.1%) used a qualitative research approach. An editorial exploring the value of qualitative research for manual therapists was pub- lished in 2005 (Grant, 2005) and the first research paper was published in February 2007. Across other manual therapy journals, qualitative research is also under-represented (Gibson and Martin, 2003; Johnson and Waterfield, 2004) and a number of researchers have highlighted the importance of including qualitative research findings into their professions’ body of knowledge (Jensen, 1989; Greenfield et al., 2007; Adams et al., 2008; Thomson et al., 2011). We believe qualitative research will help develop a more robust and comprehensive knowledge base in manual therapy. This paper sets out our argument by first exploring the types of knowledge used in clinical practice and that derived from quantitative and qualitative research. It then examines the philosophical underpinnings of these two different research approaches. The second paper in this series will continue this exploration by outlining the various methodologies and methods used in qualitative research. The two papers provide an introduction to qualitative research; the reader is directed to further literature for more in depth understanding. Our intention is not to belittle or criticise quantitative research in any way, we firmly believe in the value and necessity of this approach. Rather, we want to provide the rationale for qualitative research and counter the common criticism levelled at this approach of being ‘soft’ and ‘unscientific’. Understanding its philosophical and theoretical underpinnings may help to alleviate this attitude and encourage more manual therapists to value and use this approach to help inform their practice; for some, this may require a paradigm shift in thinking. Since all research seeks to generate new knowledge, it is fundamental to explore what we mean by knowledge. For the purposes of this paper we will focus on knowledge that is used in clinical practice, however the issues could equally be referred to others areas of practice such as education or management. 2. Knowledge used in clinical practice There are a wide variety of types of knowledge (Table 1) that may be of relevance to our practice. We may recognise some as being more important than others. For instance our knowledge of * Corresponding author. Tel.: þ44 01273 641806; fax: þ44 01273 643944. E-mail addresses: N.J.Petty@brighton.ac.uk, n.j.petty@me.com (N.J. Petty). Contents lists available at SciVerse ScienceDirect Manual Therapy journal homepage: www.elsevier.com/math 1356-689X/$ e see front matter Ó 2012 Elsevier Ltd. All rights reserved. doi:10.1016/j.math.2012.03.006 Manual Therapy 17 (2012) 267e274