As a university teacher I have taught on an number of campuses during my career. A few students remain in mind through the years for either having made a lasting positive impression or a lasting negative impression. I remember one student in a previous university employment who told me that as a public official her preparation for the prospect of a deadly epidemic would be to buy lots of coffins. I was at the time trying to teach her and other graduate students to use computer modeling to gain insights into dynamic complex systems so as to be able to take informed preemptive actions. In retrospect I realize that I should have been better prepared to demonstrate use of the software to my graduate students. But neither my colleagues nor my students seemed to appreciate the pedagogical use of computer simulations to help students better understand complex systems. I think now that if I had only shown students a computer simulation rather than asking them to think through the modeling of one the assignment would have been deemed acceptable. I have for years advocated that the academic field of public administration become more of a design science with ties not only to political science, management and business administration, but also to operations research. I take some comfort in the thought that Herbert Simon, if he were still with us and if he knew, would approve of my efforts, even if my efforts have on occasion contributed to the mobility of my career.
These memories were sparked this evening upon viewing the following TEDMED 2010 presentation. Jay Walker spoke of the origins of public health statistics using a Bills of Mortality book prepared during London's great plague of 1665. To me, his point is that data is the necessary basis of information that can support the knowledge needed to recognize patterns and design interventions.
If you would like to view the video directly from the YouTube site the URL is as follows.
http://www.youtube.com/watch?v=5IRsqDnPzSE
Showing posts with label public administration. Show all posts
Showing posts with label public administration. Show all posts
Friday, June 17, 2011
Sunday, January 16, 2011
Reflecting on Evidence-based Management
This is an initial reflection upon an assigned reading by Kovner and Rundall in our textbook Health Services Management, Cases, Readings and Commentary (9th) by Kovner, McAlearney and Neuhauser. The essence of the reading is that healthcare managers should make decisions based upon evidence just as physicians should practice evidence-based medicine. Basically this means there should be close ties between scholarly research and managerial practices. My approach to this is shaped by my experiences as a academic person who teaches public administration.
If there is a disjoin between scholarly research and managerial practice the easy explanation is to fault practitioners for not reading academic journals. It is not that simple. Even in public administration (PA), which is an applied field of study and practice, there is a substantial divide between scholarship and practice. The best practitioners were often not outstanding students. Successful PA scholars are not necessarily able to make a transition to successful practice. Success in scholarship requires a deep, narrow focus. Success as a practitioner requires a wide variety of interests and abilities. Scholarly journals are much more geared toward the needs of academic persons than practitioners. Even in PA, an article seldom includes an "executive summary," to clearly identify the relevance of findings to practice. Getting a paper published in a scholarly journal often requires the use of advance mathematics in the data analysis. Few practitioners have either the need or the interest to work through the mathematics. The bottom line is that practitioners are more likely to learn through informal communities of practice than by reading articles written by academics as required to advance their academic careers. Peer-review does not usually include practitioners as reviewers and what is required by peer-review to get work accepted for publication is sometimes not as rational and scientific as the public may assume. Assuming that what I have observed in PA applies to healthcare management the status quo does not favor greater use of evidence based management practices. As indicated by Kovner and Rundall, healthcare managers claim to practice evidenced-based decision making but do not cite scholarly research as the evidence they draw upon.
If a disjoin exists between research and managerial practices I believe the scholars must accept at least part of the responsibility for closing the divide. Academic cultures are probably among the most durable of all organizational cultures. It is unlikely that in the near future tenured or tenure-track faculty members will be rewarded for their abilities to span related areas of knowledge or to contribute to successful practice. If this is correct, this is sad. There is a degree of distain for academic "ivory towers" among some practitioners. And there is a degree to which some scholars look down upon successful practitioners. It is cause for concern when former students who did not display advanced cognitive skills as students sometimes move quickly into high-paying positions with major responsibilities. While evidenced-based management practices are surely important they are probably not highly correlated with successful careers as practitioners. "Success" of course can be defined in different ways, but that is probably more evident to scholars than practitioners. If the major institutions of society were ever managed by persons with the most advanced cognitive abilities it appears that those entering the systems now may be less well prepared to practice evidence-based management. If there is a gap between research and practice it is the responsibility of all concerned to try to address that divide.
If there is a disjoin between scholarly research and managerial practice the easy explanation is to fault practitioners for not reading academic journals. It is not that simple. Even in public administration (PA), which is an applied field of study and practice, there is a substantial divide between scholarship and practice. The best practitioners were often not outstanding students. Successful PA scholars are not necessarily able to make a transition to successful practice. Success in scholarship requires a deep, narrow focus. Success as a practitioner requires a wide variety of interests and abilities. Scholarly journals are much more geared toward the needs of academic persons than practitioners. Even in PA, an article seldom includes an "executive summary," to clearly identify the relevance of findings to practice. Getting a paper published in a scholarly journal often requires the use of advance mathematics in the data analysis. Few practitioners have either the need or the interest to work through the mathematics. The bottom line is that practitioners are more likely to learn through informal communities of practice than by reading articles written by academics as required to advance their academic careers. Peer-review does not usually include practitioners as reviewers and what is required by peer-review to get work accepted for publication is sometimes not as rational and scientific as the public may assume. Assuming that what I have observed in PA applies to healthcare management the status quo does not favor greater use of evidence based management practices. As indicated by Kovner and Rundall, healthcare managers claim to practice evidenced-based decision making but do not cite scholarly research as the evidence they draw upon.
If a disjoin exists between research and managerial practices I believe the scholars must accept at least part of the responsibility for closing the divide. Academic cultures are probably among the most durable of all organizational cultures. It is unlikely that in the near future tenured or tenure-track faculty members will be rewarded for their abilities to span related areas of knowledge or to contribute to successful practice. If this is correct, this is sad. There is a degree of distain for academic "ivory towers" among some practitioners. And there is a degree to which some scholars look down upon successful practitioners. It is cause for concern when former students who did not display advanced cognitive skills as students sometimes move quickly into high-paying positions with major responsibilities. While evidenced-based management practices are surely important they are probably not highly correlated with successful careers as practitioners. "Success" of course can be defined in different ways, but that is probably more evident to scholars than practitioners. If the major institutions of society were ever managed by persons with the most advanced cognitive abilities it appears that those entering the systems now may be less well prepared to practice evidence-based management. If there is a gap between research and practice it is the responsibility of all concerned to try to address that divide.
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