EVALUATE WITH THE CLIENT OUTCOMES OF HEALTH EDUCATION COMPETENCE BASED ON

LEARNING NEEDS.

Topic Outcomes:

A. Identify the purposes of evaluation

B. Differentiate the types of evaluation
C. Create an Infographics based on a given case scenario

Topic outline:

1. Definition and Purposes of Evaluation

2. Types of Evaluation
3. Steps in Evaluation

EVALUATION

Evaluation - is the process of examining a program or process to determine

what's working, what's not, and why.

▪ It determines the value of learning and training programs and acts as

blueprints for judgment and improvement. (Rossett, Sheldon, 2001)

▪ is defined as a systematic process that judges the worth or value of

something for teaching and learning. It can provide evidence that what
nurses do as educators makes a value – added difference in the care they
provide. (Bastable, 2017)

▪ will help you to determine how effective you are in achieving your
objectives.

◦ Education outcomes – must be measurably effective both for the learner and the
organization
 ◦ Effectiveness refers to the extent to which you have achieved your goals and objectives.
While planning your health education work, you should have set down certain learning
and behavioral objectives – and by using the process of evaluation you will be able to
assess whether you have achieved these objectives.

◦ Efficiency means the extent to which you have achieved your objectives with the
available number of resources. In other words, it refers to the proper utilization of
resources when achieving your health education objectives

• Although assessment and evaluation are highly interrelated and the terms are often used
interchangeably, they are not synonymous. The process of assessment focuses on
initially gathering, summarizing, interpreting, and using data to decide a direction
for action. In contrast, the process of evaluation involves gathering, summarizing,
interpreting, and using data after the activity has been completed to determine the
extent to which an action was successful. Thus, the primary differences between
these two terms are in timing and purpose of each process.

Activity 1
Genet and Dora are Community health nurses. They are working at the Lourdes Sur health post.
Both visit 15 households each week. During her visits, Dora always advises the family members on
several health issues, like family planning, personal hygiene, housing conditions, use of the toilet,
and how to keep utensils clean. However, Genet always teaches the families about only one
health issue on each visit, and she needs 3 more visits than Dora to achieve the behavioral
changes in health promoting practice.

Who is more effective in achieving health promoting practice among family members, and why?
Who is more efficient in achieving health promoting practice among family members? Why?

Five Basic Components of Evaluation (Ruzicki, 1987):

1. Audience – “For which audience is the evaluation being conducted?”

• Person or groups
2. Purpose – “For what purpose is the evaluation being conducted?”
3. Questions – “Which questions will be asked in the evaluation?”
• Must be directly related to the purpose
• Must be clear, concise and appropriate
 4. Scope – “What is the scope of the evaluation?”
• Extent of what is being examined
5. Resources - “Which resources are available to conduct the evaluation?”
• Time, expertise, personnel, materials, equipment, and facilities

TYPES OF EVALUATION:

1. Process (Formative) Evaluation – Its purpose is to make necessary adjustments to an

educational activity as soon as they are identified, such as changes in personnel,
materials, facilities, teaching methods, learning objectives or even the educator’s
own attitude.
- Is a component of the ongoing education cycle of assessment, planning and
implementation.
- Helps the nurse anticipate and prevent problems before they occur or identify
problems as they arise.
- It can be carried out throughout your activities and can guide you to make
changes to maximize your effectiveness and efficiency.
- It is conducted while health education activities are going on.

Specific questions to ask:

1. What health education methods were used during learning activities? How
acceptable were the methods?

2. What health learning materials were used during learning activities? How
effective were the materials?

3. What health issues were taught? How were they selected? Were they
appropriate topics for health education?

4. What resources were used in health education sessions? Think about

Personnel, resources, material and financial and so on.

Aspects of the learning experience:

- Learner behavior
- Teacher behavior
- Learner – teacher interaction
- Learner response to teaching methods
- Materials
- Characteristics of the environment

Examples of Formative activities: quizzes, games, projects, presentations, group activities

Clinical Practice Guidelines (CPGs) – Clinical or Critical Pathways

- Is intended as a guide in caring for all patients who have similar characteristics and
learning needs
 USES:
1. Orientation of new healthcare employee
2. Quality Improvement
3. Evaluating Clinical learning and student precepted situations

2. Content Evaluation – to determine whether learners have acquired the knowledge and
skills taught during the learning experience.
- Abruzzese (1992) described content evaluation as taking place immediately after
the learning experience to answer the guiding question, “To what degree did
the learners learn what they were taught?” or “To what degree did the learners
achieve preset behavioral objectives?

Examples: a. Return demonstration of a teaching session on psychomotor skills

b. Complete a cognition test at the completion of a 1 day seminar
c. Pretests used at the beginning of a continuing education can be
readministered as a posttest at seminar completion to measure change
resulting from program delivery
d. Completed quizzes after each Module to determine short term knowledge
retention

3. Outcome (Summative) Evaluation – to determine the effects of teaching efforts.

- Focus on long-term program objectives. Appropriate measures demonstrate
changes in health conditions, quality of life, and behaviors.
- Summarizes what happened based on the education intervention; occurs after
teaching has been completed or after an educational program has been carried
out.
- Long - term changes may include decreases in mortality, morbidity, the
prevalence of disease, or the incidence of the health conditions.

- Resources needed for evaluation are costly and complex

- Some examples of instruments used are questionnaires, surveys, interview,
observations and tests, use of rubrics and checklists

Examples of Guide questions:

a. “Was teaching appropriate?”
b. “Did the individual(s) learn?”
c. “Were behavioral objectives met?”
d. “Did the patient who learned a skill before discharge use that skill correctly once at
home?
e. “Did the student nurse who acquired a new skill in a laboratory setting or a staff
nurse who learned a new skill in a continuing education session
 demonstrate the ability to independently perform the skill accurately in practice?

4. Impact Evaluation – to determine the relative effects of education on the institution or

the community.
-To obtain information that will help decide whether continuing an educational
activity is worth its cost (Adams, 2010)
- The short-term or immediate effect of health education on people is assessed.
These short-term changes include changes in knowledge, attitudes, beliefs, skills
and practice.
-If no improvement has taken place, then something is probably wrong, either
with your message or your methods.

Examples of Guide questions:

a. “What is the effect of the orientation program on subsequent nursing turnover?”
b. “What is the effect of a discharge program on long term frequency of
rehospitalization among patients who have completed a program?”

Resources needed to design and conduct an Impact Evaluation:

1. Reliable and valid instruments

2. Trained data collectors
3. Personnel with research and statistical expertise
4. Equipment and materials necessary for data collection and analysis
5. Access to populations who may be culturally or geographically diverse.

5. Total Program Evaluation – to determine the extent to which all activities for an entire
department or program over a specified time meet or exceed the goals originally
established. The scope is broad, generally focusing on overall goals rather than on specific
learning objectives.

Example of guide questions:

a. “To what extent did programs undertaken by members of the nursing staff
development department during the year accomplish annual goals established in the
department?”
b. “How well did patient education activities implemented throughout the year meet
annual goals established for the institution’s patient education program?”

Activity 2:

Mrs Abebech is a community health nurse in Angeles City. She has conducted health education
sessions for ten mothers in a nearby village about family planning. She had a series of
discussions with them. During these discussions she showed them different family planning
methods. At the end of the sessions, she evaluated her activities.
Identify which of the following are process, impact or outcome types of evaluation and say
why.

a. Asking about the mother’s knowledge and understanding about family planning
methods at the end of each session.

b. Asking the mothers their beliefs about contraceptives after the final session.
c. Assessing for herself how the discussions had been conducted.

d. Asking the mothers whether the messages about contraception had been
acceptable to them.

e. Assessing whether the mothers were more interested in the discussion method than
the demonstration method.

Steps in the evaluation of health education activities:

Step 1: Involve people to participate in the activities

- If you fail to involve them, your evaluation might not address certain important aspects.

Step 2: Describe the activities to be evaluated

- It needs to describe the activities being evaluated in detail. This enables you to determine
the objectives, activities, methods, and materials—as well as the content of the messages
used in the activities being evaluated.

Step 3: Select methods

- You could select observation, or interviews, or use other methods, depending on what you
want to evaluate, who you want to interview, and when to interview them.
Step 4: Collect credible data
- The data that is collected to conduct an evaluation is the most important step. You can use
multiple data collection methods, such as observation, interviewing and discussion, at the
same time.

Step 5: Analyse the data

- Analysis involves presenting the information you have collected in such a way that it gives
meaning.

Step 6: Learn from evaluation

- Deals with judging your achievements. In this step, you look at the extent to which you have
achieved your objectives, particularly behavioral and learning objectives. This could mean
that you have achieved only a portion of your behavioral and learning objectives.

EVALUATING PATIENT LEARNING

1. Ask the patient to read pamphlets or brochures and fact sheets summarizing what the
nurse have taught. Repeat important information.
2. Interview patient with thorough observation, discussion and gesturing who can elicit
adequate response and understanding of the information taught.
3. Determine change of patient behavior related to health care practices.
4. Do a return demonstration to determine skills learned and collect evidence of teaching
effectiveness.
5. Evaluate performance and provide reinforcements.
6. Document the teaching information and evidence of what the patient has learned.