Evaluation Designs

The evaluation models described in previous issues of the Quarterly represent some of the major paradigms of educational program evaluation; they have been used to guide many evaluations and they have influenced the thinking of many practicing evaluators. Models provide a broad base for designing evaluation activities by offering a framework and conceptualization that guides both the focus of the evaluator and the orientation of the evaluation. But models do not provide strategies for implementation. Guidelines are provided by the design, which establishes the conditions and procedures for collecting the data required to answer the questions of concern. The design must be related to the type of program or service being evaluated; that is, the selection of a particular design is guided by the decisions that will have to be made as a consequence of the data. In turn, the adequacy of a particular design can be determined by the extent to which the results may be interpreted and the questions answered. In most cases, evaluation designs have been borrowed from research

Evaluation Designs

The evaluation models described in previous issues of the Quarterly represent some of the major paradigms of educational program evaluation; they have been used to guide many evaluations and they have influenced the thinking of many practicing evaluators. Models provide a broad base for designing evaluation activities by offering a framework and conceptualization that guides both the focus of the evaluator and the orientation of the evaluation. But models do not provide strategies for implementation. Guidelines are provided by the design, which establishes the conditions and procedures for collecting the data required to answer the questions of concern. The design must be related to the type of program or service being evaluated; that is, the selection of a particular design is guided by the decisions that will have to be made as a consequence of the data. In turn, the adequacy of a particular design can be determined by the extent to which the results may be interpreted and the questions answered. In most cases, evaluation designs have been borrowed from research

Drama in the high school.

Thesis (M.A.)--Boston University This item was digitized by the Internet Archive

Conflicting priorities: evaluation of an intervention to improve nurse-parent relationships on a Tanzanian paediatric ward.

BACKGROUND: Patient, or parent/guardian, satisfaction with health care provision is important to health outcomes. Poor relationships with health workers, particularly with nursing staff, have been reported to reduce satisfaction with care in Africa. Participatory research approaches such as the Health Workers for Change initiative have been successful in improving provider-client relationships in various developing country settings, but have not yet been reported in the complex environment of hospital wards. We evaluated the HWC approach for improving the relationship between nurses and parents on a paediatric ward in a busy regional hospital in Tanzania. METHODS: The intervention consisted of six workshops, attended by 29 of 31 trained nurses and nurse attendants working on the paediatric ward. Parental satisfaction with nursing care was measured with 288 parents before and six weeks after the workshops, by means of an adapted Picker questionnaire. Two focus-group discussions were held with the workshop participants six months after the intervention. RESULTS: During the workshops, nurses demonstrated awareness of poor relationships between themselves and mothers. To tackle this, they proposed measures including weekly meetings to solve problems, maintain respect and increase cooperation, and representation to administrative forces to request better working conditions such as equipment, salaries and staff numbers. The results of the parent satisfaction questionnaire showed some improvement in responsiveness of nurses to client needs, but overall the mean percentage of parents reporting each of 20 problems was not statistically significantly different after the intervention, compared to before it (38.9% versus 41.2%). Post-workshop focus-group discussions with nursing staff suggested that nurses felt more empathic towards mothers and perceived an improvement in the relationship, but that this was hindered by persisting problems in their working environment, including poor relationships with other staff and a lack of response from hospital administration to their needs. CONCLUSION: The intended outcome of the intervention was not met. The priorities of the intervention--to improve nurse-parent relationships--did not match the priorities of the nursing staff. Development of awareness and empathy was not enough to provide care that was satisfactory to clients in the context of working conditions that were unsatisfactory to nurses

The application of antimicrobial stewardship knowledge to nursing practice: a national survey of United Kingdom pre‐registration nursing students.

To assess student nurses understanding and skills in the application of antimicrobial stewardship knowledge to practice. Five hundred and twenty three student nurses responded across 23 UK universities. Although students felt prepared in competencies in infection prevention and control, patient-centred care and interprofessional collaborative practice, they felt less prepared in competencies in which microbiological knowledge, prescribing and its effect on antimicrobial stewardship is required. Problem-based learning, activities in the clinical setting and face-to-face teaching were identified as the preferred modes of education delivery. Those who had shared antimicrobial stewardship teaching with students from other professions reported the benefits to include a broader understanding of antimicrobial stewardship, an understanding of the roles of others in antimicrobial stewardship and improved interprofessional working. There are gaps in student nurses' knowledge of the basic sciences associated with the antimicrobial stewardship activities in which nurses are involved, and a need to strengthen knowledge in pre-registration nurse education programmes pertaining to antimicrobial management, specifically microbiology and antimicrobial regimes and effects on antimicrobial stewardship. Infection prevention and control, patient-centred care and interprofessional collaborative practice are areas of antimicrobial stewardship in which student nurses feel prepared. Interprofessional education would help nurses and other members of the antimicrobial stewardship team clarify the role nurses can play in antimicrobial stewardship and therefore maximize their contribution to antimicrobial stewardship and antimicrobial management. There is a need to strengthen knowledge from the basic sciences, specifically pertaining to antimicrobial management, in pre-registration nurse education programmes. What Problem Did the Study Address?: Nurses must protect health through understanding and applying antimicrobial stewardship knowledge and skills (Nursing and Midwifery Council 2018); however, there is no research available that has investigated nurses understanding and skills of the basic sciences associated with the antimicrobial stewardship activities in which they are involved. What Were the Main Findings?: There are gaps in student nurses' knowledge of the basic sciences (specifically microbiology and prescribing) associated with the antimicrobial stewardship activities in which nurses are involved. Problem-based learning, and activities in the clinical setting, were reported as useful teaching methods, whereas online learning, was seen as less useful. Where and on Whom Will the Research Have an Impact?: Pre-registration nurse education programmes

Assessing the Diversity of Antarctic and New Zealand Arthropods through DNA Barcoding

Diversity is the foundation of all biological and ecological studies. Globally however, biodiversity is under threat from the varied and cumulative impacts of humans on the environment. It is thus necessary to continually develop tools that are able to assess diversity at the scales now required. DNA barcoding has become an increasingly common approach for species identification as it is efficient and can facilitate high throughput analyses without the routine need of taxonomic experts. This thesis examines the genetic diversity of invertebrate groups from Antarctica and New Zealand to gain an understanding of current baseline levels of variability and to facilitate their use as indicators of environmental change. The juvenile stages of Ephemeroptera (mayflies), Plecoptera (stoneflies) and Trichoptera (caddisflies) (EPT taxa) are key components of aquatic food webs and are frequently used as bioindicators of water quality. However, challenges in identifying juveniles to species levels are one factor limiting their more routine use. New Zealand has over 244 caddisfly species 106 species of stonefly and 50 mayfly species all of which are endemic. Here, my primary aim was to obtain COI sequence coverage for the New Zealand EPT taxa using expertly identified collections of adult specimens. A second aim was to examine levels of sequence diversity within taxa and to test the endemicity of the New Zealand fauna through comparison with international records. Thus far, 225 caddisfly BINs, 48 stonefly and 37 mayfly BINs have been generated. Average intraspecific divergences were between 1.2-1.4% for all three orders while average interspecific distances ranged from 24-32%. The designation of all New Zealand EPT species as endemic was supported with interspecific divergences generally above 13%. These data can facilitate the rapid and accurate assessment of larval specimens and can furthermore be used to facilitate research into the phylogenetic and phylogeographic patterns that have shaped the EPT fauna worldwide. I also examined mitochondrial DNA (COI) sequences for three Antarctic springtail (Collembola) species collected from sites in the vicinity, and to the north of, the Mackay Glacier (77oS) within the Ross Sea region. This area represents a transitional zone between two biogeographic regions (North and South Victoria Land). Here, I assessed levels of genetic variability within and among populations of the three putative springtail species. Each of the three recognised species had multiple highly divergent intraspecific populations (5-11.3% sequence divergence). Based on molecular clock estimates, these divergent lineages were likely to have been isolated for 3-5 million years, a time when the Western Antarctic Ice Sheet (WAIS) was thought to have completely collapsed. Given the current isolation of these genetically distinct populations, any future changes in species’ distributions can be easily tracked through the DNA barcoding of individual springtails across the Mackay Glacier ecotone. Collectively these two studies have established baseline levels of COI diversity for New Zealand and Antarctic invertebrates. Furthermore, they have revealed hidden (cryptic) diversity in both regions and presented opportunities to incorporate DNA barcoding into future studies of New Zealand aquatic and terrestrial Antarctic ecosystems

Understanding aseptic technique: an RCN investigation into clinician views to guide the practice of aseptic technique

Aseptic technique is recognised as an essential component of all infection prevention programmes but terminology used to define it varies. This publication is an RCN investigation into clinical views to guide the practice of aseptic technique. BD have funded this report. BD has had no influence on, or involvement in its content

Sociology of low expectations: Recalibration as innovation work in biomedicine

"This article is distributed under the terms of the Creative Commons Attribution 3.0 License (http://www.creativecommons.org/licenses/by/3.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (http://www.uk.sagepub.com/aboutus/openaccess.htm). "Social scientists have drawn attention to the role of hype and optimistic visions of the future in providing momentum to biomedical innovation projects by encouraging innovation alliances. In this article, we show how less optimistic, uncertain, and modest visions of the future can also provide innovation projects with momentum. Scholars have highlighted the need for clinicians to carefully manage the expectations of their prospective patients. Using the example of a pioneering clinical team providing deep brain stimulation to children and young people with movement disorders, we show how clinicians confront this requirement by drawing on their professional knowledge and clinical expertise to construct visions of the future with their prospective patients; visions which are personalized, modest, and tainted with uncertainty. We refer to this vision-constructing work as recalibration, and we argue that recalibration enables clinicians to manage the tension between the highly optimistic and hyped visions of the future that surround novel biomedical interventions, and the exigencies of delivering those interventions in a clinical setting. Drawing on work from science and technology studies, we suggest that recalibration enrolls patients in an innovation alliance by creating a shared understanding of how the “effectiveness” of an innovation shall be judged.This project was funded by the Wellcome Trust (Wellcome Trust Biomedical Strategic Award 086034)