upon the NHS
Chapter 2 Literature Review
2.3 Approaches and methods of evaluation
2.3.2 Decision making evaluation models
Also in th e 1970s, some researchers developed decision-m aking evaluation m odels which
process th a t provided decision makers w ith m eaningful and useful in form ation regarding
decision alternatives. His "context, input, process, and product" (CIPP) m odel described
fo u r types o f evaluation activities. These evaluation activities are shown in Table 2.1. The
CIPP m odel thus system atically assesses w h a t needs to be done, how it should be done,
w h e th e r it is being done and w h e th e r th e program is successful. Stufflebeam (2 0 0 7 ) also
stated th a t Scriven's fo rm a tiv e evaluation related prim arily to decision making, w hile
sum m ative evaluation was m ore focused on accountability.
Evaluation type Evaluation activities
Context evaluation Assessment o f the problems, needs and opportunities available in the program’s setting
Input evaluation Assessment o f competing strategies and the work plans and budgets Process evaluation Monitors, documents and assesses a program’s activities
Product evaluation Examines the program’s impact on the target audience, the quality and importance of outcomes and the program’s sustainability and
transferability Table 2.1 Stufflebeam's CIPP model
Patton's (1 9 7 8 ) utilisation focused evaluation model addressed th e concern th a t decision
makers o ften ignored evaluation findings by developing a general approach to evaluation
based on tw o essential requirem ents. First, Patton argued th a t decision m akers and
audiences o f evaluation reports should clearly be identified. Second, he recom m ended th a t
evaluators should w o rk w ith decision makers to decide about all aspects o f evaluation, such
as th e evaluation questions, research design, data analysis, in te rp re ta tio n and
dissem ination o f results. Cronbach (1980) also contributed to th e discourse o f decision
m aking evaluation. He stressed th a t decision-m aking was political and m ostly involved
various actors rath er than lone decision-m akers. Cronbach suggested th a t th e evaluator
should ta k e th e role o f a te a c h e r w ho educates and advises th e client th ro u g h o u t th e
evaluation process. During this process, th e evaluator should constantly give feedback to
th e client rath er than just w a it fo r th e final report. Unlike S tufflebeam and Patton,
Cronbach did not think it was th e evaluator's role to d e te rm in e th e program 's w orthiness
nor recom m end ap p ropriate courses o f action. How ever, in practice th e d iffe re n t roles of
evaluators and decision m akers may not be clearly distinguishable.
A n o th e r w id ely used education-based evaluation approach is th e fo u r level m odel
developed by Kirkpatrick (1 9 9 4 ). Although it prim arily focuses on th e c o rp o rate hum an
resource d evelopm ent, it has been adapted to evaluate te ach er professional d e v e lo p m e n t
program s (Guskey, 2000) and th e assessment o f health inform ation m a n a g e m e n t courses
and program m es (Rouse, 2 0 1 1 ). This m odel is comprised o f reaction, learning, behaviour,
and results. Reaction refers to th e m easu rem en t o f participants' satisfaction w ith th e
program , usually through a survey. Learning relates to th e m easu rem en t o f th e e x te n t to
w hich participants' attitudes change, th e ir know ledge or skills im prove thro u g h a tte n d a n c e
o f th e e x te n t to which participants' behaviour changes as a consequence o f attending th e
course. This evaluation looks at th e exten t to which lasting change has occurred as a result
o f atten d in g th e course. The exten t can be m easured through im provem ents in
productivity, m anagem ent or quality. Kirkpatrick recom m ended th e use o f control group
comparisons to assess a program 's effectiveness a t th e behaviour and results levels. This
m odel was influenced by scientific approaches such as random ised controlled trials, which
m aintain th a t effectiveness is reliably m easured by elim inating bias in th e evaluation
process by controlling th e enviro n m en t (Cochrane, 1 9 7 2 ). Decision m aking evaluation
models shifted th e emphasis o f evaluation fro m outcom es and objectives o f program s to
o th e r contributory factors in th e lifecycle o f a program or in terven tio n . Such factors provide
essential inform ation regarding how a program or in tervention works and ho w it results in
th e observed outcom es.