O' theory where art thou? The role of theory in Health Care Management Review articles.

One of major underpinnings of Health Care Management Review (HCMR) is its connection to the field of health care practice. This commitment is summarized in the journal’s editorial mission that emphasizes “articles that are theory-driven and translate findings into implications and recommendations for health care administrators, researchers, and faculty.” Some may wonder (and some have asked), “Why theory-driven? What does theory have to do with informing the world of practice?” Well, to quote Kurt Lewin, “there is nothing as practical as a good theory” (Lewin, 1943). In this editorial, we would like to reaffirm our commitment to theory and the role that theory can and should play in articles submitted to HCMR, as well as things to avoid in your submissions. A theory can be defined as “a statement of relations among concepts within a set of boundary assumptions and constraints. It is no more than a linguistic device used to organize a complex empirical world” (Bacharach, 1989). By simplifying and organizing a complex world, theory provides a number of benefits for researchers and practitioners. First, as the previous definition makes clear, a good theory helps us specify the expected relationships and, in doing so, supports study rigor by avoiding or mitigating spurious relationships. More rigorous research increases the likelihood that health care management practices are rooted in a solid evidence base. Second, a good theory helps us generalize study findings across settings, populations, and time and translates these findings into implications for the field of practice. Indeed, one of the required elements of all articles published in HCMR is that they explicitly speak of the practical implications of the research. But then again, if you are reading this editorial, chances are you already know these things. Knowing, however, does not necessarily equate to doing. In our time as editors at HCMR, we have noted several things related to theory that differentiate successful submissions from those that are not. Successful submissions explicitly and substantively invoke theories that have implications for management practice. Submissions that stop short at generic reviews of the literature and are not grounded in a specific management theory, on the other hand, tend to be reviewed unfavorably. This is true for original research articles and literature reviews. Similarly, successful submissions go beyond superficial treatments of a theory. For example, merely listing references to existing theories and mentioning their names does not constitute a substantive or beneficial use of theory (Sutton & Staw, 1995). Likewise, lists of variables, constructs, and definitions do not constitute substantive use of theory, nor do standalone diagrams or figures. These things are a starting point, not the finish line. Authors must meaningfully apply the theory and its core concepts to motivate the relationships between study variables and the underlying causal logic of why the variables are expected to be related. Meaningful engagement with and application of a theory will help authors avoid two common problems we often see in submitted manuscripts—orphaned hypotheses that are disconnected from the theory (“Wait, how did the authors arrive at this conclusion about the hypothesized relationship?”) and misalignment between theoretical concepts and operationalized variables (“The authors say they are interested in X but are actually measuring Y”). This is clearly not an exhaustive list of things to consider but highlights those that are most frequently and critically noted in editorial and peer reviews. Meaningful application of theory for the benefit of practice can be hard, slow, and intimidating. It requires moving back and forth between fuzzy abstractions and concrete applications. But through this struggle comes simplification, clarity, and practical value. This is why we remain committed to the use of theory in all submissions to HCMR, which we look forward to seeing soon. Larry R. HearldCheryl RathertCo-Editors-in-Chief