DHA 700 Week 1 Doctoral Study and the Scholar-Practitioner Role Example

From Running the Hospital to Studying It: A Chief Operating Officer's Case for Becoming a Scholar-Practitioner in Health Administration

[Student Name]

University of Phoenix

DHA/700: Introduction to Health Administration in Doctoral Study

Week 1 Assignment

[Instructor Name]

[Date]

The health system, the executive's career, the decisions described and the plan of study are composites written for a model paper; research findings come from the sources cited.

Eighteen months ago, the chief operating officer of a composite rural health system in eastern North Carolina stood before the board and recommended closing the labor and delivery unit at the smallest of its three hospitals. Births had fallen, staffing was difficult and losses were mounting. The board approved. Months later, a reporter asked what the evidence showed about the effects of rural obstetric closures on mothers and babies. The executive realized that the recommendation had rested on finances and staffing reports, with little attention to research on outcomes. That moment led to doctoral study. This paper reflects on what it means to become a scholar-practitioner.

Why a Practice Doctorate

A research doctorate prepares scholars to produce original knowledge, usually for academic careers. A practice doctorate in health administration prepares leaders to apply research to the problems of health organizations and systems, to generate practical knowledge and to lead change. The executive chose the practice doctorate because the questions that matter most arise in the work itself.

Defining the Scholar-Practitioner

A scholar-practitioner is a leader who brings rigorous inquiry to practical problems and brings the knowledge of practice back to inquiry. Such a leader asks what the evidence shows before acting, uses organizational data systematically, knows when evidence is thin and contributes what practice teaches to the wider field.

The Evidence Gap in Management

Health care has spent decades asking clinicians to practice evidence-based medicine. Walshe and Rundall argue that managers and policymakers have been quick to urge evidence on clinicians but slower to apply it to their own practice, although the same problems, underuse of effective interventions and overuse of ineffective ones, are just as widespread in health care management. They conclude that evidence-based practice must be translated for management rather than simply transferred, given differences in culture, research base and decision-making (Walshe & Rundall, 2001).

Seeing the Gap in One Decision

The obstetric closure fits that description. The executive's team studied volumes, staffing costs and payer mix. It did not review research on travel distance and birth outcomes, examine how other rural systems had managed closures or consult community members about alternatives such as a regional perinatal network. The decision may still have been right, but it was not evidence-based in the full sense.

What Evidence-Based Management Means

For Rousseau, evidence-based management means taking what the strongest research shows and building it into how organizations actually work, and she argues that management lags medicine in using research partly because managers rarely encounter it and partly because management education seldom teaches its use (Rousseau, 2006). A manager who would never accept an untested drug often accepts an untested reorganization.

Kinds of Evidence

For a health executive, evidence includes published research, the organization's own data, the experience of professionals and the values and concerns of patients and communities. The scholar-practitioner weighs them together rather than relying on any single source.

The Limits of Evidence-Based Management

Evidence-based management has limits. Management research rarely offers randomized trials, contexts differ widely and decisions often cannot wait for studies. Some critics warn that an emphasis on measurable evidence can crowd out judgment and values. The scholar-practitioner's task is not to wait for perfect evidence but to use the best available evidence honestly and to know its limits.

Engaged Scholarship

The gap between research and practice runs both ways: researchers often study questions practitioners do not ask, and practitioners rarely read research. Van de Ven and Johnson describe the gap as a knowledge production problem and propose engaged scholarship, a collaborative form of inquiry in which researchers and practitioners combine their different perspectives to study complex problems (Van de Ven & Johnson, 2006). For the executive, engaged scholarship means partnering with researchers on questions that matter to the health system.

What the Executive Brings

Practitioners bring knowledge that researchers often lack: how decisions are really made, which data can be trusted, what staff and communities will accept and where research questions are hiding in daily operations. The executive's twenty years in hospitals, first as a nurse and then as a manager, are an asset to scholarship, not a distraction from it. Doctoral study should add rigor to that experience rather than replace it.

What the Executive Must Learn

The executive also named gaps: reading statistical results with confidence, judging the quality of qualitative studies, searching databases efficiently and writing in a scholarly voice. These skills are the focus of early coursework, and the executive plans to practice them on real questions from the health system rather than on abstract exercises.

Tensions to Manage

The executive expects tensions. Board and operational decisions move in weeks; rigorous research moves in months or years. Staff may view inquiry as delay. Evidence may point toward options that are politically or financially difficult. And the executive's own experience may be challenged by findings.

A Problem Worth Studying

The executive identified a problem for doctoral work: emergency department boarding at the system's flagship hospital, where admitted patients often wait many hours for inpatient beds. Boarding affects safety, staff and finances, and it is a problem where research, organizational data and community experience can all inform action.

How Doctoral Study Will Change Practice

Already, the executive has asked the planning team to include a brief evidence review in every major proposal to the board, naming what research shows, what the system's data show and where evidence is thin. The first proposal under the new approach, on nurse staffing, included studies of staffing and outcomes and a comparison with peer hospitals.

Scholarly Goals

The executive set scholarly goals for the first year: complete a structured literature review on emergency department boarding, learn to appraise quantitative and qualitative studies, write one paper suitable for presentation at a regional health management conference and build a relationship with a university health services research group.

Professional Goals

Professional goals include establishing an evidence review step for board proposals, creating a small internal group of managers who read and discuss research monthly and involving community members in major service decisions.

How Success Will Be Judged

Twelve months in, the executive will check three things: whether the evidence review step is used in every major board proposal, whether the boarding literature review is complete and has been shared with the emergency department team and whether the reading group has met at least ten times. These checks turn aspirations into commitments.

Personal Reflection

The obstetric closure remains a source of discomfort. The executive does not know whether a different process would have changed the decision, but knows that the process would have been more defensible and more respectful of the community. Doctoral study is a way to make the next hard decision better.

Conclusion

Becoming a scholar-practitioner means bringing rigorous inquiry to the problems of health organizations and bringing practical knowledge back to scholarship. Research shows managers underuse evidence, evidence-based management offers a way to translate principles into practice and engaged scholarship offers a way to connect researchers and practitioners. A specific problem and concrete goals turn that commitment into a plan for doctoral study.

References

Rousseau, D. M. (2006). Is there such a thing as "evidence-based management"? Academy of Management Review, 31(2), 256-269. https://doi.org/10.5465/amr.2006.20208679

Van de Ven, A. H., & Johnson, P. E. (2006). Knowledge for theory and practice. Academy of Management Review, 31(4), 802-821. https://doi.org/10.5465/amr.2006.22527385

Walshe, K., & Rundall, T. G. (2001). Evidence-based management: From theory to practice in health care. The Milbank Quarterly, 79(3), 429-457. https://doi.org/10.1111/1468-0009.00214