Boundary critique: an approach for framing methodological design

Reynolds, Martin and Wilding, Helen (2017) Boundary critique: an approach for framing methodological design. In: Applied systems thinking for health systems research : A methodological handbook. McGraw-Hill / Open University Press, London, UK, pp. 38-56. ISBN 9780335261321

Abstract

The popularity of contemporary evidence-based practice (EBP) approaches in health care research have a long and well-documented history which tends to prioritise the factual world over the world of values. It comprises a conventional linear mechanistic understanding of ‘research’ informing ‘practice’; an understanding described elsewhere in the arena of public administration as the Received View. In the arena of health care, the importance of values is paramount; particularly in setting priorities of health systems research in low-income countries. An alternative approach to the Received View is what we might call a praxis-oriented approach. Here, the continual integral dynamic between research and practice is acknowledged, recognising also that research is essentially value-driven. Praxis can be described as practice-informed-theory and/or theory-informed-practice; or alternatively, ideas-in-action or thinking-in-practice. In praxis, the activities of research and practice are not seen as an either/or dualism, but regarded rather as a continual both/and duality. One significant expression of a praxis-oriented approach in the systems thinking tradition is Werner Ulrich’s notion of boundary critique; an ‘eternal triangle’ of interdependence between judgements of fact and value judgements, mediated through boundary judgements. In this chapter, Section 1 describes boundary critique and a particular manifestation of it - the systems thinking in practice (STiP) heuristic - developed amongst systems practitioners at the UK-based Open University. STiP provides a framework for using multiple methods or techniques – systems-based or otherwise – through a sequence of activities involving (i) understanding inter-relationships, (ii) engaging with multiple perspectives, and (iii) reflecting on boundary judgements. Two sets of systems tools have been found particularly helpful in these activities, as experienced by the authors – tools associated with soft systems methodology (SSM) and critical systems heuristics (CSH). These are briefly outlined. Section 2 describes an application of the STiP heuristic in developing systems for health partnerships. Whilst the case study is situated in a UK context – specifically Newcastle upon Tyne, in North East of England, the wider context of enabling partnerships through the application of boundary critique is one that has universal relevance.