How Can We Study Transnational Contexts Comparatively? Quasi-Experimental Research on the Glocalization of Medical Professional Knowledge

Transnational analyses are a challenge for comparative sociologists. How can we organize comparisons without clearly defined and bounded country units? Suppose we engage with the transnational contexts that might be relevant for studying, e.g., professions. How can we consider a variety of potentially relevant contexts, such as professional language, organizational networks, or epistemic communities at the same time? We need to solve both problems if we want to avoid methodological nationalism and the oversimplification of flat globalism, as these pitfalls can hinder our understanding of complex transnational phenomena.

The paper explains and exemplifies a transnationally comparative research design based on an international and interdisciplinary study of medical professional knowledge and practice. Focusing on a prevalent cardiological disease, chronic heart failure, we first followed the insights of neo-institutionalist theory. Here, global scope is achieved by focusing on the formal organization and published knowledge of cardiologists treating heart failure.

In line with cultural sociologist Robertson (1992), we expect local practice to adapt or vernacularize global standards (Levitt et al. 2009). Therefore, in the second part of our study, we video-observed the professional practice of 71 physicians in Ankara (Turkey), Beijing (PRChina), Groningen (Netherlands) and Wuerzburg (Germany) in a quasi-experimental setting where they were asked to treat a patient actor simulating heart failure.

Our design can serve as a blueprint for global-scope comparative research on non-bounded contexts. Thanks to the contrasts in the sample, similarities would lend credence to the claim that the medical profession has transnationalized. Due to the heterogeneity in the sample, differences cannot be causally explained. Still, by combining descriptive statistics and grounded theory, we gained some insights into the relative salience of transnational vs. inter-country vs. inter-individual explanatory factors.