Transdisciplinary Collaboration, Systems Thinking, and Questioning "Normal" Science:
Applying Qualitative and Mixed Case Study Methods in a Doctoral Public Health Leadership Program
Keywords:public health, leadership, qualitative methods, mixed methods, case study, action research
Systems thinking, theory, and practice has, throughout its evolution in the past century, had a difficult time fitting into the organizational boundaries of the disciplines institutionalized within universities, since it questions the boundaries of those disciplines as well as aspiring to bridge the boundary between academia and practice. Although there has been recent lip service to the ideal of “transdisciplinary” scholarship in university circles, it’s sometimes difficult to see how this is different from previous assertions of “multidisciplinary” or “interdisciplinary” programs, which over time often developed boundaries as rigid as those of the disciplines they supposedly made more permeable. However, methodologies for linking theory to application to real-world problems, through procedures for building evidence for shared, generalizable or transferable findings as well as for diagnosing and solving practical problems, do cross disciplines. We were engaged in one such endeavor – developing case study as an action research method utilizing systems thinking and both qualitative and quantitative analysis that can serve to build evidence relevant to both studying and leading systemic change in public health.
The University of Illinois at Chicago Doctorate in Public Health Leadership program is a professional terminal degree program for mid-career public health practitioners with at least seven years managerial experience (Lenihan et al 2015). The program focuses on systemic change addressing “wicked problems.” Systems thinking is one of the core principles structuring the curriculum. UIC DrPH faculty and students are collaborating to build understandings of leading systems change in public health (cf. Risley et al 2022, Welter al. 2020). The scope of ‘public health’ covers not only governmental public health but non-profit and public-private partnerships supporting healthy communities. A push towards more focus on health disparities in the last several decades has included more attention to the social determinants of health and the relationship of public health to a social justice agenda. To this end, social science has become more obviously relevant. Furthermore, beyond positivistic social science, calls have gone out to foreground community voices and participation. This opens the door for the need to integrate more open-ended, grounded qualitative methods with the more common statistical approaches to identifying the influence of quantifiable variables in public health outcomes. The co-authors of this paper include the two of us who initially developed and co-taught a case study course integrating qualitative methods, to serve as a key element in developing a methodological toolkit for the DrPH students. One of us is trained in economics and urban planning and policy, with practice experience in public health; the other in cultural anthropology with practice experience in qualitative evaluation. The third author, an alumna, developed a rigorous mixed-methods approach to case study for her dissertation research on evaluability. We present a joint, auto-ethnographic account (Adams et al 2017) of how our sometimes divergent assumptions about how to build evidence, and our differing experiences about how it is received, shaped our integration of case study into action research and evaluation, informed by our complementary understandings of systems thinking. We agreed on an approach to case study as research tool (as opposed to the use of case studies in teaching, e.g. in business school curricula) based on the approach of Robert Yin (1984) supplemented with tools from Miles and Huberman (1994, updated with Saldana in 2018) which allows for a rich consideration of variation and nuances in context while developing an explicit structure for data collection. However, our descriptions of what we were doing sometimes differed, with one of us labeling positivistic approaches as “normal” science and another saying that “normal” depends on what discipline you are rooted in (Kuhn 2012 ).