Occasionally, I receive inquiries about possible manuscript submissions. Typically, my response includes the statement that our reviewers expect a strong theory to guide the research. I include this statement for two practical reasons: one, the desk reject rate for manuscripts without theory or only a weak theory is very high and, two, reviewers frequently point out the weakness of the theoretical base. Given this situation, I highlight four key reasons why theory is so important to a successful submission to Health Care Management Review (HCMR).
A theory section must do more than name a theory (Whetten, 1989). Authors must explain how the concepts of the theory relate to the topic or problem being addressed. Unfortunately, too often manuscripts are submitted with a theory section, which would more appropriately be called a literature review or a background section. Such manuscripts are rarely sent out for peer review.
One reason for the use of a theory is that the selection of a theory situates the study within a world view. That world view, to the extent that HCMR readers recognize the theory, makes the topic and the study more accessible to the readers. Perhaps more importantly, situating the study in a theoretical frame also situates the study within a lineage of scholarship and thus makes the manuscript's merit (or not) more obvious.
A second reason to use theory is that it guides the study methods. From the theory and corresponding hypotheses flows the selection of the variables. Variable definitions need to be in alignment with the theory. In the same way that a theory guides the selection of variables to include, it guides the selection of variables to exclude. This parsimony and parameter setting needs justification, and the driving theory provides the justification basis.
Third, use of theory facilitates "metalearning," by which I mean the extended accumulation of knowledge through a process of synthesis. Specifically, performing a literature synthesis or meta-analysis becomes easier when the findings can be organized according to the similarity of the theories used. It is much more difficult to make sense of a set of findings (as facts) that have no explicit relationship to a common process. The accumulation of knowledge, not facts, advances a discipline, such as health care management.
Last, theory is a prerequisite to the prediction of outcomes. And, the ability to predict an outcome is a prerequisite for considering an intervention. Points of possible intervention become more evident when knowledge has been systematized into a refined theory, particularly a midrange theory. Thus, theory building and testing precedes intervention building and testing. From the perspective of HCMR, too few intervention studies are conducted. I attribute this dearth of intervention studies, in part, to the lack of utilizing management and administrative theories to drive intervention development.
Overall, solid use of theory leads to stronger and more interesting research. Naturally, HCMR readers are more engaged with such research. The Critical Advancement type of HCMR manuscript was specifically created to accommodate works that seek to explore new theoretical directions and thus advance research through new and important theoretical directions.
L. Michele Issel, PhD, RN
Editor-in-Chief
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