A behavioural guide for evaluating patient educators.
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OBJECTIVE: To determine how graduating medical students perceive instructional settings, materials, and teachers as to importance or influence upon their education and how they would change curriculum and allocate educational resources based on their experience. MATERIALS AND METHODS: One hundred thirty-nine graduating medical students at the University of Wisconsin, Madison were offered five dollars to complete and return the survey. Students were asked to rate the importance or influence (1 = most important or influential, 5 = least important or influential) of more than forty educational settings, materials, teachers, and which aspects of the curriculum should be emphasized or preserved when educational resources become more limited. Open-ended responses were also allowed. Ratings were analyzed determining a mean and standard deviation. One way analysis of variance was used to determine whether there were differences among groups. When statistically significant differences existed, the Tukey HSD test was used to compare subsets of the group. In the only group with a dissimilar number of responders, T tests were used for comparison. RESULTS: Sixty-four of 139 (46%) surveys were correctly completed and returned. Students rated the most important and influential parts of their education as experiences in years 3 and 4 of medical school. The most highly rated group of teachers were resident physicians (mean rating = 1.64, F (df = 343) = 12.55, p < .0001) during years 3 and 4 of medical school, followed by full time clinical faculty in years 3 and 4 (mean = 1.78), full time basic science faculty in years 1 and 2 (mean = 1.98), community physicians in years 3 and 4 (mean = 2.15), and teaching assistants in years 1 and 2 (mean = 2.75). Students rated the preservation of teaching efforts in years 1 and 2 (mean = 3.06), developing objective structured clinical examinations (mean = 3.21), and administering "board type" end of course examinations (mean = 3.42), as the lowest priority items for receiving educational resources. Coordination of the basic science and clinical years of medical school (mean = 2.03), problem based learning (mean = 2.08) and preserving teaching effort of years 3 and 4 clinical faculty (mean = 2.09) were the highest priorities for receiving resources. Open-ended comments indicated years 1 and 2 should be condensed and coordinated with years 3 and 4, making learning more clinically oriented. CONCLUSIONS: Students at the end of their medical school education at the University of Wisconsin rate the clinical portions of their training as most important to their medical education and residents as their most important teachers. When asked how best to change medical education, their most common responses were to 1) make years 1 and 2 more clinically oriented, both by including patient care earlier and more often during those years, 2) take the repetitiveness out of the years 1 and 2 curriculum and 3) prepare students for years 3 and 4 with transitional classes.
In view of the numerous and diverse health-education interventions within the NRP 1A, a comparably diverse set of evaluation instruments had to be developed. The continuing evaluation of health-education technics is a complex and resource-consuming process. However, it has the advantage to deliver continuously the data base for the optimization of the different activities. The two main aspects of the continuing health-education evaluation system within the NRP 1A are the statistical documentation of all participating individuals and the measurement of the effects of mass-media campaigns.
The challenge of how best to evaluate educational scholars (and specifically, clinician-educators) and teachers for promotion continues to confront academia. While the work of educational scholars and teachers often overlaps, the terms for justifying their promotion differ substantially. In each case, the author maintains that evaluation should be oriented to evidence of the impact of their work. Educational scholars can be assessed mainly by objective impact, whereas the evidence for the impact of teachers should include profound, subjective effects on individual learners. For example, for clinician-educators engaged in scholarly work, the impact of that work can be identified in terms of changes in educational methods, career commitments, and practices (all intermediate outcomes), and even health outcomes. For teachers, in addition to customary criteria such as critical thinking, depth of knowledge, communication ability, and personal engagement, learners can be asked about the deep influence of these teachers. The author states his case for these principles, and also presents an innovative tool, the "impact map," as a way of graphically portraying the track record of an individual clinician-educator. Such maps are more vivid than narrative testimonials in organizing and displaying evidence of impact over time. This tool, combined with the author's other suggestions to assist the promotion process for educators and teachers, is aimed at fostering a greater emphasis on outcomes in assessing both clinician-educators and teachers to achieve greater rigor and fairness.
Educational programmes were evaluated by 84 students. The students reported increased gain from the course parallel with more teaching outside the university hospital and teaching in small groups. When the original hospital-based programme was resumed, there was a marked reduction in profit. Of 21 students who followed the modified programme, all except one recommended that it should be continued. Of the 25 students who followed a programme based on lectures and teaching exclusively in hospital, all except one recommended a change of programme.
In the face of health educators' reluctance to evaluate their programs and the absence of suitable rewards or punishments to encourage such evaluations, a materials-based strategy to reduce the aversiveness of program evaluation is proposed.
The purpose of continuing education is to build upon nurses' educational and experiential basis for the enhancement of their practice, administration, education or research, to the end of maintaining and improving the public's health. Continuing education evaluations traditionally have been formative and summative, determining the participants' perceptions and opinions about continuing education offerings or immediate assessment of changes in knowledge and attitudes. The purpose of this study was to determine whether nurses who attended a management development continuing education program had greater cognitive knowledge and were able to implement management models and theories into their practice following the program. The program was three to four days, depending on the size of the facility. Ten different Veterans Administration medical centers participated in the programs. The investigator sent questionnaires to 191 nurse managers who had attended a Southwestern Regional Medical Education Center continuing education program. Responses from 111 managers were received. The data analysis indicates a high correlation between theories presented and theories/models implemented in management practice. In addition, data indicate that nurse managers who were able to apply theory in a practical manner felt this was due primarily to the continuing education program. A model for the development of the new nurse manager (Sheridan, Bronstein, & Walker, 1984) was used in planning the program, and the Stake countenance model (Stake, 1973) was used in evaluating the program.
Postsecondary accrediting agencies recognized by the U.S. Secretary of Education and the Council on Postsecondary Accreditation, including the Liaison Committee on Medical Education (LCME), are required to evaluate educational program effectiveness by determining that institutions and programs document the achievement of their students and graduates in verifiable and consistent ways, indicating that institutional and program purposes are met. For the assessment of medical education programs this represents a departure from the traditional method of inferring quality from institutional compliance with standards for program organization and function. In the new assessment calculus, success is measured as the integrated product of the outcomes, the indicators of achievement that medical schools already are collecting from many sources, for instance, data on premedical achievement and attributes, medical school performance, graduate education ratings and test results, specialty certification, licensure, and practice. Although a recent LCME enquiry showed that 80% of U.S. medical schools were collecting outcome data on students and graduates, there was a lack of coherence and system, little integrated analysis, rare longitudinal study, and limited use of the information to evaluate and revise the curriculum or to validate admissions, promotion, and graduation criteria. The longitudinal study of the quantified results of educational programs need not resurrect old controversies about the linkage between learning in medical school and the quality of doctors' later practice. The purpose of examining outcomes is to gain sharper focus on the achievement of distinctive institutional goals, to facilitate program improvement and renewal, and to better assure the competence of graduates within the boundaries of achievement that schools have drawn as their educational objectives.
A short multiple-choice knowledge test on maternal phenylketonuria was developed and validated. It was administered to 49 young female patients participating in a longitudinal study. The test was analyzed for its psychometric qualities and was found to be reliable: Cronbach alpha 0.62. Its validity was indicated by a moderate correlation with IQ scores (r = 0.40) and by its significantly differentiating between subjects who participated in patient education group meetings and those who did not. Items varied in difficulty, indicating which areas of knowledge need special educational efforts. The test was recommended for use to assess patients' knowledge, to identify misconceptions that appear to be remedied by patient education, to stimulate group discussions and to help evaluate educational programs.
Previous research has reported that the number of evaluated children placed in special education is as high as three out of four. The purpose of the present study is to reassess, extend, and update referral-to-placement research. Subjects consisted of 236 predominantly white children referred for special education evaluation from 12 suburban and rural school districts. Of the 236 pupils referred, 128 were diagnosed as learning disabled (LD) by a multidisciplinary team (MDT). The 128 students identified as eligible for services for students with LD had a mean IQ of 96.43 and a mean age of 10.2. The majority of the subjects were male (70%). The results suggest that the number of students referred who are actually placed is lower (approximately one out of two) than previously reported. It is concluded that further research is needed to verify the current referral-to-placement ratio and to explore the factors influencing this ratio.
We evaluated a patient education program on understanding rheumatoid arthritis; 94% of those responding to our questionnaire considered the program helpful in increasing their understanding of their condition, and 93% said it enhanced their communication with their family. A total of 85% reported one or more behavioral changes, such as not abusing joints (63%), getting more rest (56%), and using medications more meticulously (48%) after participating in the program. We recommend patient education as an effective means of helping patients understand and hence comply with physicians' instructions as well as helping patients to assume greater responsibility for their own health care.
This study evaluated an innovative program designed to assist registered nurses to achieve professional competency in a role that was introduced in the career structure and was new to Western Australian nurses. Quantitative and qualitative methods were used to determine formative and summative aspects of the program. The framework for data processing was Stake's Countenance Model. Data were collected from participants and preceptors over one year. A variety of instruments were used including interviews, questionnaires, document reviews and observations. Findings indicate that the program facilitated development of professional behaviours and that the participants found it worthwhile. The method of evaluation was able to demonstrate that the program outcomes were logically and empirically contingent upon transactions and antecedents and were congruent with the program's intentions.
Sampling is often used in evaluation as an economical and efficient means of estimating population parameters. Among the approaches to sampling traditionally used, few provide the apparent flexibility of multi-matrix sampling. The current paper proposes multi-matrix sampling as an alternative to traditional sampling approaches for evaluation of health education programs. A comparison is made between examinee sampling and multi-matrix sampling. No significant differences were found between the estimates of mean test performance provided by the two sampling plans following completion of the fifth grade unit of the School Health Curriculum Project. The advantages and disadvantages of multi-matrix sampling are examined, and potential applications of this technique are illustrated.
BACKGROUND: Providing patients with disease- and treatment-related information is an important role of medical staff and is now reimbursed in Japan by the national health insurance system under the rubric 'patient education'. Evaluation of the effectiveness of patient education programs is necessary to ensure that limited health care resources are used efficiently. OBJECTIVE: The objective is to determine whether educating patients with Parkinson's disease (PD) is related to better health-related quality of life (HRQOL). DESIGN: A cross-sectional study was conducted. SETTING: Members of the Japan Association of Patients with Parkinson's disease were randomly selected. PARTICIPANTS: A total of 1200 patients with PD were asked to fill in written questionnaires and replies from 762 (63.5%) were analyzed. MEASUREMENTS: The questionnaire inquired about clinical characteristics, comorbidity, symptoms of PD, complications of therapy, HRQOL, and patient education. SF-36 was used to assess HRQOL. The section on patient education comprised one question each on patient-perceived satisfaction with information provided on (1) disease condition and pathophysiology, (2) effectiveness of drug therapy, (3) adverse drug reactions, (4) publicly available financial and social resources, and (5) rehabilitation and daily activities. Patient education score was defined as the sum of the individual scores for these five questions. The relationships between scores on the SF-36 subscales and the patient education score were examined. RESULTS: More satisfaction with patient education was associated with higher scores in all SF-36 subscales except physical functioning and bodily pain. The difference in score between the most satisfied and the least satisfied patients ranged from 8.4 points on the subscales of general health and 16.7 points on the subscale of role limitation due to emotional problems. CONCLUSION: The conclusion that patient education is associated with better HRQOL in patients with PD is drawn.
A manual-based program of nutrition education for pregnancy and lactation was developed. This program was evaluated in a classroom setting using two measures of effectiveness. A pretest and posttest format was used to assess cognitive outcomes and predietary and postdietary records were used to assess behavioral changes. The difference between cognitive test scores was significant. However, actual dietary improvements were slight and were within the range of normal intake variation. This study emphasizes the need to assess behavior in order to more fully evaluate educational effectiveness. Observations of the study also suggest the desirability of environmental support for the successful translation of classroom knowledge into appropriate behaviors.