What makes physiotherapy such a complex, context-dependent practice, and how can realist approaches help us better understand what works, for whom, and why?

In this insightful and grounded conversation, Alejandro isjoined by Dr Leah Morris, a physiotherapist, senior lecturer, and realist researcher working at the University of the West of England. Leah’s work spans academia, teaching and supporting realist research across healthcare settings.

Leah shares her journey into realist evaluation, reflectingon how it helped her make sense of complex roles such as first contact physiotherapy and why realist thinking aligns so naturally with physiotherapy’s core principles of individualised care and clinical reasoning. Drawing on projects like FREEHAB and her work in supporting colleagues, she highlights how realist approaches can uncover the mechanisms behind tailored interventions and explain variation in outcomes across contexts.

From applying realist thinking in non-realist projects to navigating methodological challenges, limited guidance, and misconceptions about “realist light,” Leah offers practical insights grounded in both clinical and research experience.

Whether you’re a clinician, researcher, or educator, thisepisode provides valuable lessons on embracing complexity and applying realist approaches to physiotherapy and beyond.