FOURTH GENERATION EVALUTION BY STANFORD MUHOMBA (2020)

1. Background to The Writeup

The purpose of this write up is to present an understanding of the Fourth Generation Evaluation
(FGE) as an evaluation theory. This write up begins by critically analysing the fundamental
nature of FGE evaluator model and some analytical issues related to its multidimensional
character. Pioneered by Guba and Lincoln in 1989, the FGE responds to the inherent
inadequacies faced by previous generations of evaluators of the modernist positivist base of
conventional evaluation approaches. A significant subtheme weaving its way in this narrative
is the level of application and practicability of this model in real interventions. Fundamental
issues and concerns surrounding this theory are highlighted and further unpacked in this write
up.

The second chapter of this write up describes the fourth-generation theory, its purpose,
established facts, issues and debates around it. After expounding on definitional matters, the
paper will further propound on the processes and the components of this theory. In chapter
three, the writer describes the role of the evaluator in the application of this theory. In chapter
four the writer, then carefully analyses the theory and unpacks how the theory was developed,
what events led to development of the theory as well as the advantages and disadvantages
associated with the theory. These theoretical tools are valuable in understanding several
political, economic, and social issues in the global economy of the past as well as the present
(Dillman, 2011).

With reliable empirical data, cogent and sophisticated theorizations, it is the aim of this paper
to attempt to trace the genesis of FGE and its usefulness at this juncture in the society and
enhance the argument through analysis of the different authors and in the end conclude with
a position that should be supported. The concluding section conclude by illustrating the theory
and how it was applied in real time evaluations and ascertain if the listed process was actually
pragmatic and followed as expected.

The findings of this write-up are therefore submitted to add to the body of knowledge in order
to have an acute comprehension of this theory. It is not the intention of this write up to cover
all arguments presented in favour of the fourth-generation evaluation or against such concept,
but it is more of providing an overview regarding how the concept is shaping different
evaluations approaches.

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 2. Fourth Generation Evaluation described
Fourth generation evaluation is another approach to evaluation where the claims, issues and
concerns of stakeholders serve as organizational foci 1 that is implemented within the
methodological precepts of the constructivists paradigm. Guba & Lincoln (1989) characterised
the initial three primary evaluation generations as ‘measurement‐orientated’, objective‐
orientated’ and ‘judgement‐orientated’, while the fourth‐generation evaluation as ‘negotiation‐
orientated.

Based upon relativism, a unity between the knower and the known, and a subjective
epistemology, Guba & Lincoln (1989) comprehensively described FGE as a constructivist
evaluation theory that regard all stakeholders as having a right to place a panoply of their
claims, concerns and issues on the negotiating table. Stakeholders in this context are defined
as those who are exposed to some risk by the evaluation and to all people in the setting who
are affected by the evaluation. Stakeholders are recognised in three main types namely agents
(such as those who developed the evaluand and who fund it); beneficiaries (both direct and
indirect); and victims (who can be negatively affected by the use of the evaluand (Appleton &
Jane , 1997). Guba & Lincoln (1986) contents that it is imperative to ensure the inclusion of
stakeholders concerns because there are often placed at risk by an evaluation, therefore in
the interests of fairness, the evaluation should include the voices and inputs of the stakeholder
groups.

Guba and Lincoln (1989:227) further describes FGE as being centred on a divergent paradigm
variously known as the ‘constructivist, naturalistic, hermeneutic or interpretative paradigm’. In
agreement, Patton (2002) further acknowledged the sentiments of Guba & Lincoln by relating
constructionism as being relativistic instance, meaning knowledge is viewed as relative to time
and place thus the reluctance to generalise and the suspicion of generalisation asserted by
others. These sentiments allude to the fact that constructions are inextricably linked to a
particular physical, psychological, society and cultural contexts within which they are formed
and to which they refer.

Fourth generation evaluation is generally considered as a more sophisticated method that

moves beyond science to include several human, political, social, cultural and contextual
elements (Guba & Lincoln, 1989). The fundamental ontological postulation of constructivism is
relativism meaning that human (semiotic) sense-making systematises experience so as to
translate it into understandable, and explicable form. Beneath relativism there can be no

1 The basis for determining what information is needed.

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“objective” truth. Furthermore, the elementary epistemological supposition of constructivism is
transactional subjectivism meaning that claims regarding “reality” and “truth” depend
exclusively on the meaning sets (information) and the level of complexity existing to the
individuals and audiences involved in forming those proclamations. Moreover, fundamental
methodological assumption of constructivism is hermeneutic dialecticism meaning a process
by which constructions are welcomed by the involved stakeholders are primarily revealed,
comprehended and then confronted, compared, and contrasted in different situations.

2.1 The Genesis of FGE

Founded by Guba and Lincoln in 1989, to address and respond to the inherent challenges
faced by preceding generations of evaluators-politics, ethical dilemmas, inadequacies,
inconclusive deductions which were the causes of failure and non-utilization of evidence in
decision making caused by reliance on the positivist paradigm of research (Laughlin and
Broadbent, 1996).

The pioneers of the fourth-generation evaluation are Egon Guba and Yvonne Lincoln. Egon
Guba is a former Professor of Education in Indiana University, Bloomington. What stimulated
him was his continual questioning of the applicability of conventional methods to evaluation
methods. His questioning became more formalized in 1977 when he developed a monograph
on the applicability of naturalistic methods to evaluations. On the other hand, Yvonne S.
Lincoln is Associate Professor at the University of Kansans. After disagreeing with traditional
methods of evaluation, she felt a strong need to search out for approaches in which reality of
field research could be made to match the assumptions of the guiding enquiry paradigm.

Hall (1996), embraces that the emergent of FGE brought about the unification between the
evaluator and the stakeholders in an interaction that creates the product of the evaluation.
Cuba and Lincoln questioned the methodologies employed in generations one to three and
gave the reasons as to why they should be superseded by the FGE. Critically, they contend
that ‘there is no “right” way to define evaluation’ (1989: 21), somewhat they refer to it as a
construction, meaning distinct matters in different varying settings. They identified four
generations of evaluation; the first three being based on the positivist scientific methodology
which suggests the existence of objective truth or reality that can be actually measured. Guba
and Lincoln (1989) further contend that evaluations based on this traditional science can
disenfranchise and disempower stakeholders as the evaluation may be utilized by those
holding power to maintain their status quo. Guba & Lincoln (1989) have charted the
developments of the generations in evaluation theories and provided critiques as indicated in
the table below:

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Table 1: Evaluation Models Generation 1-3

Element First Second Third

Focus Measurement Description Judgement
Role of the Evaluator Technical Expert: Describer: Objectives; Judge Standards:
Tests to measure Formative Evaluation Objective Evaluator
achievement
Examples IQ and achievement Tyler; Eight Year Study Stake: Scriven Eisner
tests
Weakness Narrow Focus Objectives not Evaluator maybe
necessarily valid reluctant to judge

Guba and Lincoln (1989) embraced to have addressed the above gaps by introducing the
Fourth-Generation evaluation which is believed to have the below characteristics:

Table 2: FGE Characteristics

Focus Empowerment; Equality of stakeholders

Roles of the evaluator
Key Features
1. Human instrument and data analyst
2. Illustrator and historian
3. Mediator of judgemental process
4. Collaborator, learner, teacher, reality shaper, change agent
Primarily qualitative methods
No causally inferential statistics

Guba & Lincoln (1989) discarded the positivist approach whose focus is on measurement,
description and judgement. They, however, contend that the evaluator should discern the
meaningful constructions that individuals employ to make sense of their situations and these
constructions should not be separated from the physical, psychological, social and cultural
contexts within which they are designed, and in which the programme is situated. The
stakeholders themselves are also part of the context, for each other of which this was missing
in other generations. Fourth Generation Evaluation is thus a participatory pluralistic practice
that provides a framework through which the interests of often disempowered stakeholder
groups and individuals can be put onto the agenda and renegotiated. Clearly, this approach is
in better position to react to the claims, concerns and issues of stakeholders who are from
socially excluded, disadvantaged or politically repressed groups.

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2.2 Properties of Fourth Generation
Guba & Lincoln (1989) wrote the below as the properties of FGE:

1. Firstly, FEG posits that evaluation outcomes are not descriptions of the way things
really are or really work or some true state of affairs but instead represent meaningful
constructions that individual actors or groups of actor's forms to make sense of the
situations in which they find themselves,
2. Secondly, FEG recognises that constructions through which people make sense of
their situations are in a very major way shaped by the values of the constructors,
3. Thirdly, FEG suggests that these constructors are inextricably linked to the, physical
psychological, social and cultural contexts within which they are formed and to which
they refer,
4. Fourth, FEG suggest that evaluations must have an orientation that defines a course
to follow it and generates and as well preserves their commitment to do so,
5. Fifth, FEG embraces that evaluations can be shaped to enfranchise or disenfranchise
stakeholder groups in variety of ways and
6. It is important to know that in as much as an evaluation involves humans (as clients,
stakeholders as information sources), it is incumbent on the evaluator to interact with
those humans in a manner respecting their dignity , their integrity and privacy.

3. The Process of Constructivist Evaluation: Responsibilities of the

Constructivist Evaluator
The steps of the fourth-generation evaluation are discussed in this chapter in general terms,
reflecting on the implementation of every single stage as suggested by Guba and Lincoln
(1989:188-226). The chapter ends with a critical review of the fourth-generation evaluation
model using practical examples. As alluded to above, a constructivist evaluation is a practice
for doing evaluation that meets two requirements:

An evaluator in this context refers to the one who orchestrates a negotiation process that
attempts to initiate a consensus on well-defined and more sosphisticaated constructions. FGE
is systematized by the claims, concerns, and issues of the stakeholders, and it employs the
methodology of the constructivist paradigm (Swenson, 1991). Swenson further postulate that
the role of an evaluator in FGE is unique and content specific. Moreover, the evaluator is
tasked with the responsibility of providing the evaluation context and methodology
( hermeneutic/dialectic) through which distinct constructions of the evaluand, the sundry claims
and issues of the stakeholders can be understood. Additional responsibilities of the evaluator
include:

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 1. Key negotiator between all the stakeholder groups.
2. As Alderman (1996;56) points out that, in typical relativist evaluation approaches the
evaluator “makes interpretations of particular instances and relates these to emergent
cases, making , to be honest some judgements about the success or failure of the
endeavour .
3. In FGE, as time progresses, the evaluator moves from “the judge” to that of a mediator
as he/she facilitates the rendering of judgements, conclusions and recommendations
4. Finally, in this process the evaluator becomes a collaborator rather than a controller of
the process (Guba & Lincoln, 1989).

FGE demands a shared evaluation agenda and a solid comprehension of the complexities of
the intervention and the stakeholders they serve. This advocates for the evaluator to facilitate
communication among diverse stakeholders. Among others, below are the major
responsibilities that the constructivist evaluator must accomplish. He or she must:

1. The initial step to be undertaken by an evaluator is to identify the full range of participants
who are at stake by the virtue they hold in the entity being assessed. The risks that the
stakeholders are exposed to may comprise of several elements but not be limited to money,
status, power, face, opportunity, or other coin; those stakes are determined by and defined by
the stakeholders (in their own terms) and not only by the evaluator or the client seeking the
evaluation (although they too are stakeholders and may identify their own stakes and
definitions). When participating groups have been recognised, the process of preparing group
constructions of the evaluand may commence. Moreover, it is the evaluator’s obligation to
engage with all the identified stakeholders, including even those who may need to maintain
low reflectivity or to absent themselves entirely.

2. The second step is for the evaluator to engage with the participants in their respective
groups regarding their constructions around the form and process of the evaluand. This also
include the claims, concerns, and issues the stakeholders would like to discuss in relation to
it. The preliminary list may be reordered, deleted, or have additions made as the evaluation
proceeds. This step includes the initiation of the singular aspects of the fourth-generation
evaluation approach which is the view of the hermeneutic dialectic circle (Guba and Lincoln
1989:152, 204). The term hermeneutic is well-defined as an interpretive process (Concise
Oxford Dictionary 1982:467), and as a common viewpoint of human insight and understanding
(Rowan and Reason 1981:134).

3. In Fourth Generation Evaluation, the evaluator needs a clear comprehension of the

evaluation context in order to be able to construe the responses. The evaluator is then
expected to provide the context and a methodology through which diverse constructions of the

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evaluand, and various claims, concerns, and issues, can be realized and subjected to criticism.
The process is first carried out within specific stakeholder groups; then the products of these
intragroup negotiations (defined constructions, claims, concerns, and issues) are further
negotiated in hermeneutic circles that cut across stakeholder groups, if necessary, in dialogic,
adversarial, or confrontational settings.

4. After providing the methodology and context, the evaluator is then expected to generate
consensus with several constructions, and their correlated claims, concerns, and issues. The
agreements should first be sought on an intragroup base and then on an intergroup basis. If
mutual agreement can be reached with respect to an item, it can be excluded from further
discussion, but preserved for further engagement, if there is agreement on that action.

5. The evaluator should then prepare an agenda for discussion on the items which there is
no, or incomplete, consensus. This is so because failure to reach a full agreement indicates
the perpetuation of competing constructions, which disjunction(s) can be ameliorated only
through the introduction of new information or an increase in the level of analytic sophistication.
The evaluator’s responsibility is to gather the required information. In the process of gathering
information, the evaluator must create some means for prioritizing the unresolved items. At
this juncture, stakeholder participation is important, lest this need be taken as an opportunity
to disempower selected stakeholders.

6. The following step will be the collection and provision of the information called for in the
agenda for discussion. However, it is not guaranteed that the required information will be
provided. Nonetheless, the evaluator is still expected to ensure the availability of this
information.

7. The evaluator should then provide and facilitate a forum of stakeholder representatives in
which discussions and negotiations will be taking place. Unresolved differences in
constructions, as well as unresolved claims, concerns, and issues, are reviewed in light of the
new information and/or level of sophistication, in the hope that their number can be reduced.
It is likely that some items will remain unresolved, thereby setting the stage for another, later
round of evaluation activity. Outcomes of this forum must include action steps if the negotiation
is to be regarded as successful.

8. After ensuring the availability of the required information, the evaluator is then expected to
compile a report, possibly numerous targeted reports, that relates to each stakeholder group
regarding any resolutions pertaining to the claims, concerns, and issues. The most resourceful
form for such report(s) is the case study, which may provide the explicit understanding,
necessary to influence stakeholder constructions.

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9. Lastly, the evaluator should then recycle the evaluation paying attention to the unresolved
constructions and their claims, concerns, and issues. This also entails exploring new aspects
that would have emerged on the basis of the initial evaluation conducted. Weade and Evertson
(1991) claims that fourth generation evaluations are never finalised; they pause until a further
need or opportunity for review emerges.

3.1 Discourse Around Fourth Generation Evaluation

Several academics including Fisherman (1992) criticised FGE concept of mixing technology
and politics where he mentioned that the critical skills of an evaluator must not be deployed to
support the political view of FGE. Fisherman further condemns the fact that FGE is the only
evaluation model that utilises the constructivist approach. However, he contends that FGE was
going to be practical if the approach would have used a mixed method approach that includes
the quantitative method within a naturalistic setting. Lau (1992) supports Fisherman searing
condemnation of FGE when he mentioned that he remains convinced that solutions can never
be generalised from one context to another. On the other hand, Senchrest (1991), dismissed
the FGE as a bothersome metaphor which has a limited contribution to the development and
evolvement of evaluation. His main argument was anchored on the illogical action behind
replacing proven quantitative approaches of evaluation with subjective qualitative approaches.

It should further be noted that the phases of development in this theory are quite vast with
some authors condemning the notion of fourth generation evaluation as politically naïve and
operationally endless. House (1992) further contends that extreme idealism led Guba & Lincoln
to unjustified inferences because statements such as evaluation creates reality are untenable.
House (1992) further argues that while evaluation may help participants to redefine their own
reality, people do not create their language, culture or society. However, Guba & Lincoln (1992)
aver that the divisive witticisms of FGE by Senchrest were a result of his failure to understand
their original work and the qualitative approach which houses the FGE. In response to Guba
& Lincolns’ defence, Hammersley (1992), contends that the way constructive paradigm has
been defined have a potential to engender conflict rather than advocating peaceful
transference from an identified paradigm to another. On a more temperate tone, Patton (1990)
embraces that the FGE comply and meets the principles of humanistic evaluation through its
commitment of ensuring equality and empowerment of stakeholders.

3.2 Advantages and Disadvantages of Fourth Generation Evaluation

Guba & Lincoln (1989), wrote that FGE must be applauded of its ability to ensure equal
participation of the disempowered stakeholders and at the same time ensuring that they are
protected from exploitation from elite structures. These authors wrote that the FGE have the
capacity to adopt several courses of action based on the formulation of constructions and

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further enables stakeholder groups to see the adequacy, the relevance and the continued
profitability of such actions. These arguments were further supported by Huebner & Berts
(1999) who concurred that despite several cited weaknesses of the FGE, its main strength is
derived from its ability to involve several stakeholder groups who bring in varied constructive
perspectives. This ultimately avail support to be utilised in latter programme development.
However, despite its strengths, McCoy and Hargie (2001) argue that FGE is not commonly
accepted nor widely known which make it remain outside the mainstream of recommended
methodologies employed when conducting evaluations. Surprisingly, Guba & Lincoln (1989)
seem to admit to some of the shortcomings of their theory when they attested to the fact that
it is not always easy to find skilled evaluators who are able to effectively undertake FGE. This
means that training is always mandatory before someone undertakes such an evaluation.
Further weaknesses of FGE includes its complexity in defining stakeholders and the inability
to prove its empowerment and educational capability which was initially named “educational
and tactical aunthenticity (Guba & Lincoln, 1989:236).

3.3 Summary and conclusion

In summation and drawing from different debates around the FGE, it is evident that FGE
approach is a more sophisticated and informed approach that avails several benefits to many
stakeholder groups more than conventional positivist evaluation approaches. However, based
upon their analysis, Guba & Lincoln (1992) propose a fundamental redefinition and
restructuring of the whole evaluation field.

4. SECTION B: CASE STUDIES

4.1 Introduction
This Chapter critically analyses an intervention that was launched in 1999 in England called
Sure Start. The mission of this initiative was geared towards addressing social issues affecting
children mainly poverty eradication and social exclusion. This initiative was tasked to
recommend the most effective ways that guarantees financial well-being of children.
Furthermore, Sure Start Local Programmes (SSLPs) were then set up in the areas where many
disadvantaged families were located in England. Additionally, these SSLPs worked together
with several stakeholder groups in order to fully support the underprivileged families.

4.2 Background to the evaluation

Sure Start was launched as a pilot project, designed to formulate recommendations that were
supposed to aid the government to attain their envisaged objectives towards children in
England. During the project implementation, SSLPs were superseded by Sure Start Children
Centres which were mandated to ensure poverty alleviation and children social inclusion.
Because of the aforementioned background, in order to ascertain the most effective SSLPs

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an evaluation was commissioned to evaluate the Play and Information Project in 2004. This
was of the selected local programmes initiated by Sure Start.

4.3 The Evaluation Design

The framework governing the evaluation of this project under study, was initially crafted by
Sure Start Unit and was further improved by SSLT. Subsequently, a service level agreement
was then signed between the commissioners and the external evaluators. The commissioners
adhered to their working principles as well affording flexibility culminating in an emergent
design which response to FGE evaluation proposed processes as stated by Guba & Lincoln
(1989).

4.4 Analysis
Guba & Lincoln (1989) developed a guideline and a check list that one can use for a
constructivist evaluation. One of the things advocated by this guideline is the entering of a
working arrangements between the contractor and the evaluator. In this case a service level
agreement (SLA) was signed between the evaluator and the Sure Start company just after
the evaluation was commissioned. Guba & Lincoln further states that the sponsor of the
evaluation must be clearly identified as the stakeholders are entitled to know the sponsor of
the evaluation. This evaluation clearly demonstrates that the study was conducted by a team
of researchers from a university and were assisted by a people theatre company who
participated in the data collection process.

This evaluation utilised several precepts of FGE as advocated by Guba & Lincoln. Guba &
Lincoln (1989) described FGE as a participatory pluralistic practice that provides a framework
through which the interests of often disempowered stakeholder groups and individuals can be
put onto the agenda and renegotiated. Clearly, the FGE approach is characterised to react to
the claims, concerns and issues of stakeholders who are from socially excluded,
disadvantaged or politically repressed groups. The application of this condition is evidenced
when Sure Start encouraged the external evaluators to ensure that parents, community
members should be actively involved in the entire evaluation process. The involvement they
requested was more than their physical participation, but also ensuring that stakeholder groups
are trained and given adequate support. It is imperative to comprehend that the principle of
stakeholder involvement is pivotal to fourth generation evaluation. Furthermore, Sure Start unit
ensured that negotiations were focused on ‘matters known to be relevant’ as advocated by
Guba and Lincoln (989: 247).

One of the main responsibilities of an evaluator in FGE is to identify the full array of
stakeholders who are exposed to risk by the virtue of the role they hold within the evaluation.
In order to meet this criterion, the evaluators ensured the inclusion of representatives from all

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stakeholder groups. This move assisted to ensure that the stakeholders are not disempowered
or disenfranchised as advocated by FGE. The different stakeholders were allowed to
participate in joint negotiations which meant that their views, issues and concerns were
considered resulting in them being empowered and their confidence boosted. Empowering and
boosting the morale of stakeholders means that the evaluation met the ontological authenticity.
The stakeholders also managed to learn about values and concerns about other stakeholder
groups. This provided the stakeholders with learning experience meaning that values of
educative aunthenticity were attained.

Guba & Lincoln (1989) states that after eliciting from the stakeholder group constructions, the
evaluator should provide context and methodology to be used. The provision of the
methodology and context is believed to enhance the understanding of various issues and
claims of the stakeholders. This evaluation employed an observational method to evaluate the
children’s responses. Additionally, the evaluation methods that were utilised demonstrates the
application of FGE principles , such as the working relationship that existed between the
evaluator and the stakeholders. This assisted in making sure that issues of equality and equity
in negotiations are addressed. The evaluation team embraced that this assisted in increasing
stakeholders’ preparedness to own and accept the outcomes of the evaluation. The criteria of
ensuring fairness employed by FGE is formulated to make sure that there is equal participation
of disenfranchised and vulnerable groups and ensuring that they are free from exploitation.
This condition is satisfied when all the stakeholders involved in the negotiation are equally
given an opportunity in regard to the bargaining techniques and access to the right and useful
information. This condition was satisfied in the Play and Information Project. This is evidenced
when women and children were equally represented in the negotiations by the SSPL manager
and their staff.

The methodology also included preparation of a data collection instrument by the evaluators.
This instrument was then reviewed by Play and Information Project coordinator and the SSLP
manager. This data collection tool was qualitative in nature which is a characteristic of FGE
evaluation and was suitable to capture the respondents’ constructions. In this instance , this
enabled the evaluators to effectively capture the children’s emotional reaction to the toys, the
play workers, their parent/s and to other activities during the session, such as being weighed.

Guideline number seven (7) states that the evaluator should develop a report that relay the
results to each stakeholder groups. After the completion of all observation sessions and when
different stakeholder participants were contended that their concerns and issues had been
sufficiently addressed, the evaluation team submitted a draft evaluation report. This also
means that the issue of generating a consensus with respect to numerous constructions and

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their associated claims, issues and concerns was addressed. One of the processes to follow
when conducting an evaluation using the FGE approach is to submit a report. The report was
submitted and was critically reviewed by the Play steering committee which provided some
comments and suggestions aimed at improving the report. To further strengthen the report a
close out meeting was convened by a multitude of stakeholders to iron out methodological
issues as well as the evaluation report and recommendations for action.

5. Case Study Two: Operation of a hospital palliative care service:

a fourth-generation evaluation
5.1 An Overview of the evaluation
Enferm (2019) wrote that palliative care purposes to improve the quality of life of patients who
are facing challenges related life-threatening diseases. The severity of these disease can be
reduced through proper assessment, early detection and correct treatment of pain, spiritual
and other physical problems.

There have been inherent challenges in the health sector as the World Health Organization
(WHO) estimated that 20 million people globally are in urgent need of palliative care, 80% of
them live in low and middle-income countries , 67% are elderly and 6% are children. The major
concern cited by WHO was that scarcity of palliative care in several health institutions world-
wide. This notion has been strongly recommended by several healthy bodies advocating for
the insertion of palliative care in health policies. Furthermore, the Public Health Secretariat in
Germany (2018) also voiced concerns for the need to expand palliative care in public health
institutions. He further advocated for policies that promotes studies to evaluate palliative care
needs and identification of PCS models specially for areas with constrained resources. In
order to fill this knowledge gap, an evaluation was commissioned and conducted to identify the
structure and the operations of PCS. The evaluation was based on FGE. The reason why
FGE was chosen was because of its ability to involve stakeholders through an interactive
process of formative character that highly regard negotiation.

5.2 Methodology
This evaluation followed qualitative methods in assessing the operation of a palliative care
service in oncology. This study was carried out at an Oncology PCS in the Southern region of
Brazil using a fourth-generation evaluation approach. The study successfully conducted 45
semi-structured interviews, five “negotiation” meetings , observed 460 hours of operation and
also qualitatively analysed the data using the constant comparative method. This evaluation
utilised used semi-structured interviews that were guided by the Hermeneutic -Dialectic Circle

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(HDC). Furthermore, the evaluation comprehensively followed seven steps were adapted from
Guba & Lincoln to systematize the HDC namely:

Table 3; Analysis to ascertain application of FGE processes

Step Fulfilment
Field Contact The evaluation went through ethical clearance and got authorized. The
evaluation further contacted the identified stakeholders in order to get
consent for their participation in the evaluation.
Organization of The evaluation team explained the evaluation process to the different
evaluation stakeholders. This was meant to strengthen the link between the evaluators
and the stakeholders and to comprehend how the targeted respondents
construct meanings that are significant to them.
Identification of The evaluation team undertook about 480 hours conducting a non-participant
Stakeholders observation. This allowed the evaluators to understand the different
dynamics of PC, its link with the work relations and processes. This process
also allowed the evaluators to understand the political, social and cultural
factors recognizing stakeholders that are affected by the evaluation e.g.
family members, patients and different professionals. The evaluation then
proposed the creation of two stakeholders to include the HDC which are
patient-family stakeholder and service professional stakeholder.
Development of 45 interviews were conducted with 29 patient-family stakeholders and 16
joint constructions service professional stakeholders) and five negotiation meetings
Expansion of Joint This constituted deepening joint construction through introducing interview
Constructions guides from practice, observation and literature.
Development of an The conducted interviewed were recorded . This was followed by them being
agenda for transcribed, orthographically corrected and then presented for analysis
negotiation utilising the constant comparative method.
Negotiation This was done through conducting five meetings (2 patient-family
Meetings stakeholders and 3 professional stakeholder). The meetings were conducted
in order to submit the data derived in each stakeholder group, seeking
consensus and validation for only validated information was transcribed in
the final report.

Basing on the above steps, it is evident that even though the evaluation utilised the FGE
approach, the report is silent regarding following other steps such as the commissioning of the
evaluator and the generation of the report after a consensus have been reached. However,
FGE was the right approach to be utilised since it is quiet evident in the report that the
empowering of the stakeholders through negotiation and consideration of their concerns and
values enabled the attainment of the objectives of the study undertaken.

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5.3 CONCLUSION
One of the key merits derived from using the FGE was that it availed a platform to the patients
who have been experiencing challenges and having been doubting the possibility of cancer
treatment to voice their concerns. Furthermore, the application of FGE principles and following
up of the processes aided the different stakeholders to identify the potential, limitations and
needs they require in their daily endeavours of an oncology PSC in its local reality. The
qualitative approach employed in this study earmarked a great difference in the community be
supporting the decision-making process and as well filling the overdue due gap in the health
sector as whole in German.

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