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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.