ii from Learning Health Systems journal - to case studies

Returning to this journal, reference #47 -

MacQuarrie C. Holistic designs. Encyclopedia of Case Study Research.Thousand Oaks, CA: SAGE; 2010:442-443.

In -

From “Invented here” to “Use it everywhere!”: A Learning health system from bottom and/or top?

Christian Colldén, Andreas Hellström

- led me to (with my emphasis) 

Encyclopedia of case study research/edited by Albert J. Mills, Gabrielle Durepos, and Elden Wiebe. London: SAGE Publications Ltd. 2010.

"Case study methodology can be a rich source for understanding the multiple structures that support and sustain organizational life and business units. Its strengths are in its ability to gain an insider’s viewpoint during the research process, the more in-depth and nuanced findings based on that, and in its flexibility in using different methods. Its challenges are in the theoretical framework and in the development of concepts based on empirical findings. When these are taken into account, fruitful and nuanced research results are possible, and through the study it is possible to gain an overall and holistic picture of the research object." p.76.

"To reach the intended effect for the learners, these teaching cases must fulfill certain conditions and prerequisites. For this, Bernd Weitz proposes three essential criteria: exemplarity, clearness, and practical orientation.

Exemplarity means that the study must exemplify not just an arbitrary and subjective case, but also one that is objective, unique, or representative. Clearness requires that cases are not trivial; on the contrary, they have to make use of all possible and appropriate alternatives of illustration for a comprehensive understanding. This demands holism, traceability, visualization, and supplementation with additional information. The last point, practical orientation, aims for the highest integration of theory and practice for an integrated learning process." p.77.

    (And many other sources.)

Hodges' model provides a portal. As a frame, not just one type of portal but several including information (portal). A portal that can function as a learning health system. Could this in combination with health literacy* even be extended to represent a definition of self-care? Long identified as a research approach for Hodges' model, case studies are the logical fit. If they were not, then the whole clinical, nursing, healthcare rationale for the model would be lost. A clinical, medical, health care episode begins as a result of case-ness being achieved. In the case that follows in practice, we are looking to assure person-centered care in the midst of criteria, processes, (gate-keeping) thresholds that are inherently service-centred and possibly also influenced by targets and a series of constraints.

"Case studies of the elderly tend to embrace normativism. If health, as in naturalism, amounts to preserving the organic functional ability to make species-typical contributions to survival and reproduction, then health can be objectively and statistically determined—that is, subjects’ perceptions or awareness are not relevant. But if a normative evaluation of the person’s body and mind is a necessary element in the care of the elderly, then case studies are necessary." p.127.

Demographics, and intergenerational factors, plus the (probable) rise of appeals to transdisciplinarity^ means that for policy, governance and assurance case studies and mixed-methods will increase in research.

The orientation of Hodges' model is also inevitably practical and hence pragmatic.

I have only scratched the surface here, and probably not in the most itchy of spots (Encyclopedia and not the only one).

More to follow ... and if you have observations, advice I'd be pleased to hear from you.

*All the literacies and schools of informatics.
^Such are the problems we face.

See also: Contents: Learning Health Systems,6,3, July 2022