Unpacking economic programme theory for supervision training: Preliminary steps towards realist economic evaluation

Rees, Charlotte E.; Foo, Jonathan; Nguyen, Van N.B.; Edouard, Vicki; Maloney, Stephen; Ottrey, Ella; Palermo, Claire

doi:10.1111/medu.14701

Cited by 9 publications

(5 citation statements)

References 37 publications

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Section: Discussionmentioning

confidence: 99%

“…This can be achieved by grounding HPE cost research in a theoretical economic framework; however, existing theories fail to adequately capture the unique and complex phenomena that is HPE 34 . Therefore, investigations that integrate economic and educational theories 35 are needed to develop a theoretical framework suitable for HPE economic research. Finally, as cost is ultimately a representation of value, it is essential that the development of a theoretical framework begins by eliciting the values and preferences of all HPE stakeholders 36 so that our evidence is not only unified and valid but also relevant and beneficial.…”

Section: Discussionmentioning

confidence: 99%

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Cost identification in health professions education: A scoping review

Yaros,

de Mortier,

oude Egbrink

et al. 2024

Medical Education

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BackgroundResource scarcity in health professions education (HPE) demands rigorous consideration of costs. Yet, thus far, we have been unable to completely and consistently identify the costs of HPE. To address this knowledge gap and enable use of economic evidence in decision making, a detailed overview of all existing costs and approaches to cost identification in HPE is needed.ObjectivesThis review summarises the diversity of costs, cost perspectives and cost identification methods used in economic research of HPE to answer the following questions: which educational topics, costs, cost perspectives and cost identification methods are being investigated in HPE literature?MethodsThis investigation followed the Joanna Briggs Institute guidelines for scoping reviews. PubMed, ERIC, CINAHL and PsycINFO were iteratively searched for English language publications between 2012 and 2022 that reported costs of HPE. Data was extracted for study characteristics, educational context and economic methodology.ResultsA total of 136 articles of original research on the costs of educating all major licence healthcare professionals were included. A diffuse interest in costs is reflected in publications from 93 distinct journals and by the diversity of educational topics and cost types explored. However, the majority of investigations failed to define the cost perspective (86, 63%) and cost identification methods (117, 86%) and did not demonstrate common reporting structure or cost terminology, all of which contribute to persistent inconsistencies in cost identification.ConclusionThe source of disharmonious cost identification in HPE is fuelled by diverse interests and divergent concepts of costs and costing methodology. Left in its current state, disharmonious cost identification will continue to limit transparency, comparison and synthesis of evidence, hamper objectivity in implementation and policy decisions and impede the efficient and sustainable allocation of resources. A research agenda must be developed, prioritised, and validated by the broader community to develop a theoretical framework for HPE cost research, define stakeholders, elicit values and preferences and chart a path toward harmonised costing.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cost identification in health professions education: A scoping review

Yaros,

de Mortier,

oude Egbrink

et al. 2024

Medical Education

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“…A variable practice duration model increases the time commitment of the faculty facilitators needed to provide feedback, thus increasing the cost. 12,13 At our institution the cost of independent training with automated performance feedback is estimated to cases-anesthesia-analgesia.org a & a PRacticE be an initial $5000 for the manikin plus $75/h for facility and equipment charges versus $375/h with faculty time as a cost. By replacing faculty supervision with simulator feedback, simulation training for mastery learning of procedural skills becomes more cost-effective, less resource intensive, and as a result more likely for widespread acceptance in medical education curricula.…”

Section: Discussionmentioning

confidence: 99%

Enhancing Laryngoscopy Mastery: The Impact of Autonomous Practice with Feedback-Providing Simulators

Patel,

Rudolf,

Schwartz

et al. 2024

A&A Practice

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Mastery learning with fixed end points and variable training time leads to more consistent expertise but is difficult to implement. Here we piloted mastery learning of laryngoscopy with independent practice. 35 learners participated in independent mastery learning on a manikin that provides automated performance feedback. A pre- and postpractice assessment of intubation skills was completed. After an average of 21 minutes of open practice, the percentage of subjects that met mastery criteria improved from 24% to 89% (P < .05). Independent intubation practice with manikin feedback facilitated mastery learning, enhanced procedural education, and may impact clinical care.

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“…Therefore, further realist evaluation is needed to explore extended-duration supervision training and to compare training of different durations. 41 , 50 …”

Section: Discussionmentioning

confidence: 99%

What Really Matters for Supervision Training Workshops? A Realist Evaluation

et al. 2022

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Purpose Supervision training supports health care supervisors to perform their essential functions. Realist evaluations are increasingly popular for evaluating complex educational interventions, but no such evaluations exist appraising supervision workshops. Building on an earlier realist synthesis of supervision training, the authors evaluated whether supervision workshops work, for whom and under what circumstances, and why. Method The authors conducted a 2-stage realist evaluation during 2018–2019 to refine and develop program theory. The intervention involved half-day, face-to-face supervision workshops as part of an Australian state-wide government-funded program for health care and human services supervisors. Data collection involved realist interviews with 10 workshop developers (stage 1) and 43 supervisors (stage 2). The authors employed team-based data analysis using realist logic to refine and develop program theory by identifying contexts, mechanisms, outcomes, and context-mechanism-outcome configurations. Results Despite their brevity, the supervision workshops had many reported benefits for supervisors (e.g., improved satisfaction) through various perceived mechanisms pertaining to pedagogy (e.g., mixed pedagogies), workshops (e.g., optimal duration), and individuals (e.g., supervisor engagement). However, they also yielded negative reported outcomes (e.g., suboptimal knowledge gains) brought about by assorted perceived mechanisms related to pedagogy (e.g., suboptimal peer learning), workshops (e.g., content irrelevance), and individuals (e.g., suboptimal facilitator competence). Such mechanisms were thought to be triggered by diverse contexts including supervisors’ levels of experience, sector, and workplace supervision cultures. Conclusions While the findings partly support the realist synthesis of supervision training and previous realist evaluations of faculty development, this realist evaluation extends this literature considerably. Health care educators should employ mixed pedagogies (e.g., didactic teaching, peer learning), relevant content, optimal workshop duration, and competent/engaging facilitators. Educators also need to tailor workshops according to supervisors’ contexts including the sectors and supervision cultures in which supervision is practiced, and supervisors’ levels of experience (e.g., experienced supervisors appreciated workshop brevity).

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Unpacking economic programme theory for supervision training: Preliminary steps towards realist economic evaluation

Cited by 9 publications

References 37 publications

Cost identification in health professions education: A scoping review

Cost identification in health professions education: A scoping review

Enhancing Laryngoscopy Mastery: The Impact of Autonomous Practice with Feedback-Providing Simulators

What Really Matters for Supervision Training Workshops? A Realist Evaluation

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