The Race to the Top of the Mountain

Remember the old joke about the two men who were racing to the top of the mountain and when they got there, a third man asked them what took them so long? The guy at the top has been a rabbi, a priest, a woman, and a host of other things, depending on the point the comedian was trying to make.

I feel like that joke just became real after reading this article. Nurses, doctors, and health care researchers clamoring to the top of the mountain as they discuss how to interpret data from interventions in health care settings, and realizing that the organizational scientists have been there for some time.

I couldn’t agree more with the conclusions drawn in the article. Randomization is a great tool, but it loses power in quasi-experimental settings. Field studies trade realism for control, and while the ecological validity of a field study is very valuable, extraneous variance due to internal validity violations is always problematic.

Organizational scientists are in a unique position to help those involved in RCTs with the identification and modeling of these variance sources, both in terms of measurement AND with respect to the meaning that they provide. For example, the article states that “changes in the skill and confidence of practitioners” was observed (Results section, first paragraph). Of course, this is not surprising from a human performance perspective, but it also constitutes a history effect, which is an internal validity concern. How are these concerns being addressed? Psychologists have many ways to do so, but how well have we applied these ideas to health care practice?

I encourage health care practitioners to seek out partnerships with organizational science. We can help each other make patient experiences in care of even higher quality.