Educational Evaluation in Nursing and Health Care
What Is Evaluation In Health Education
Evaluation is defined as a systematic process that judges the worth or value of something-in this case, teaching and learning. Evaluation can provide evidence that what nurses do as educators makes a value-added difference in the care they provide.
Health Education Evaluation Present and Past
Early consideration of evaluation has never been more critical than in today's healthcare environment, which demands that “best” practice be based on evidence. Crucial decisions regarding learners rest on the outcomes of learning. Can the patient go home? Is the nurse providing competent care? If education is to be justified as a value added activity, the process of education must be measurably efficient and must be measurably linked to education outcomes.
The outcomes of education, both for the learner and for the organization, must be measurably effective.For example, the importance of evaluating patient education is essential (London, 2009). Patients must be educated about their health needs and how to manage their own care so that patient outcomes are improved and healthcare costs are decreased (Institute for Healthcare Improvement, 2012; Schaefer, Miller, Goldstein, & Simmons, 2009).
Health Education Evaluation In Patient Discharge
Preparing patients for safe discharge from hospitals or from home care must be efficient so that the time patients are under the supervision of nurses is reduced, and it also must be effective in preventing unplanned read- missions (Stevens, 2015). Monitoring the hospital return rates of patients is not a new idea as a method to evaluate effectiveness of patient education efforts.
The Institute for Healthcare Improvement (2012) has been sponsoring and conducting studies since 2009 linking hospital admissions and readmissions to patient education programs that are primarily nurse driven (Bates, O'Connor, Dunn, & Hasenau, 2014).
The importance of evaluating continuing staff development and student nurse education to improve professional practice is equally as important. Nurse educators must ensure that staff nurses and nursing students have the knowledge, attitudes, and skills that demonstrate essential competencies for the delivery of safe, high quality, evidence based patient care.
Evaluation includes identifying and measuring educational activities and learner outcomes that indicate that the learning needs of registered nurses and student nurses have been met (American Nurses Credentialing Center, 2014: Bunyan & Lawson, 2013; Houghton, 2015).
Health Education Evaluation Components and Process
Evaluation is a process within other processes a critical component of the nursing practice decision making process, the education process, and the nursing process. Evaluation is the final component of these three processes. Because these processes are cyclical, evaluation serves as the critical bridge at the end of one cycle that provides evidence to guide direction of the next cycle.
Health Education Evaluation Steps
The sections of the steps in conducting an evaluation. These steps include :
(1) determining the focus of the evaluation, including use of evaluation models
(2) designing the evaluation.
(3) conducting the evaluation
(4) determining methods to analyze and interpret the data collected
(5) reporting results and a summary of the findings from the data collected
(6) using evaluation results
Each of these aspects of the evaluation process is important, but all of them are meaningful if the results of evaluation are not used to guide future action in planning and carrying out educational interventions. In other words, the results of evaluation provide practice-based evidence to either support continuing an educational intervention as it has been designed or support revising that intervention to enhance learning.
Evaluation, Evidence Based Practice, and Practice Based Evidence
Evidence-based practice (EBP) is defined as “the conscientious use of current best evidence in making decisions about patient care” (Melnyk & Fineout Overholt, 2015, p. 3). More broadly, EBP may be described as “a lifelong problem solving approach to clinical practice that integrates the most relevant and best research one's own clinical expertise... and patient preferences and values” ( Melnyk & Fineout Overholt, 2015, p. 3).
The definition of a related term, known as evidence-based medicine, includes these same three primary components but also adds “patient circumstances” to account for both. the patient's clinical state and the clinical setting in which the care has been delivered (Straus, Glasziou, Richardson, & Haynes, 2011, p. 1).
With the advent of evidence based medicine in 1992 and the founding of the Cochrane Collaboration a year later, evidence generated from systematic reviews of clinically relevant randomized controlled trials (RCTs) has been acknowledged as the strongest evidence upon which to base practice decisions . Systematic reviews of RCTs remain important, especially for decisions about treatment.
Not every clinical question can be answered by conducting an RCT, however. More recent literature describes evidence generated from metasyntheses of rigorously conducted qualitative studies as providing strong evidence for informing nurses' care of patients through a more thorough understanding of the patients' experience, the processes of care delivery, and the context within which care is delivered (Eddy, Jordan, & Stephenson, 2016; Goethals, Dierckx de Casterlé, & Gastmans, 2011; Taylor, Shaw, Dale, & French, 2011).
Evidence from research is also called externalevidence, reflecting the fact that it is intended to be generalization or transferable beyond the specific study setting or sample.When evidence generated from research is not available, the conscientious use of internal evidence is appropriate.
Internal evidence might be defined as data generated from a diligently conducted quality improvement project or EBP implementation project within a specific practice setting or with a specific population (Melnyk & Fineout Overholt, 2015).
Internal evidence is not intended to be generalization beyond the original practice setting or population that yielded the data collected. Melnyk and Fineout Overholt (2015) describe results of a systematically conducted evaluation as one example of internal evidence. Evaluations are not intended to be generalizable but rather are carried out to determine the effectiveness of a specific intervention in a specific setting with an identified individual or group.
Although not considered external evidence, results of a systemically conducted evaluation are still important from an EBP perspective.Nurses' understanding and use of EBP have evolved and expanded over the past 2 decades. With the advent of electronic health records and availability of real time clinical data, healthcare professionals have been able to engage in timely evaluation of whether the care they have provided has resulted in improved outcomes for their patients.
The Institute of Medicine's Roundtable of Evidence-Based Medicine published a report titled The Learning Health-care System (Olsen, Aisner, & McGinnis, 2007) in which use of practice-based evidence along with EBP was recommended to narrow the gap between research and practice.
Practice based evidence is defined as “the systematic collection of data about client progress generated during treatment to enhance the quality and outcomes of care” (Girard, 2008, p. 15), which includes internal evidence that can be used both to identify whether a problem exists and to determine whether an intervention based on external evidence effectively resolved that problem.
Put another way, practice based evidence can be equally useful for assessment and for evaluation. Practice based evidence also can be used to generate research questions. Results of practice driven 1 research that is both rigorous and relevant are more likely to reach the point of care (Cogan, Blanche, Diaz, Clark, & Chun, 2014; Kovacs, 2015: Mason & Barton, 2013).
The results of evaluations, the outcomes of expert delivered patient centered care, and the results of quality improvement projects all represent internal evidence. This information should be gathered by nurses and other healthcare providers on an ongoing basis as an integral and important component of professional practice.
Recognizing these findings about current practice as a source of evidence to guide future practice and to identify needs for future research requires that nurses think critically before acting and carry out ongoing critical appraisal during 1 and after each nurse-patient interaction.
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