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The authors would like to express our sincere gratitude to participants for their contributions in this research. We would also like to thank the experts who provided their helpful suggestions in the validation process of the data collection tools. "At first, I believed that if there was a factor that could influence learning, it would probably be a simulated patient. I was impressed by how this simulated patient could perform very well. It made the conversation flow smoothly and gradually." In this research, the initial codes had been pre-defined from previous literature and subsequently adjusted following the analysis of each transcript to develop an analytical framework (themes and subthemes), requiring several iterations until no additional codes emerged. Subsequently, the established categories and codes were applied consistently across all transcripts (indexing). The data from each transcript were then charted to develop a matrix, facilitating the management and summarization of qualitative findings.
Section 1. A Framework for Program Evaluation: A Gateway to Tools
This type of evaluation views the outcomes of the project through the lens of the target audience and it often measures changes such as knowledge-improvement, skill acquisition, and increased job efficiency. EvaluACTION, from the CDC, is designed for people interested in learning about program evaluation and how to apply it to their work. Evaluation is a process, one dependent on what you’re currently doing and on the direction in which you’d like go. In addition to providing helpful information, the site also features an interactive Evaluation Plan & Logic Model Builder, so you can create customized tools for your organization to use. The framework for program evaluation helps answer these questions by guiding users to select evaluation strategies that are useful, feasible, proper, and accurate. Facilitating the use of evaluation findings also carries with it the responsibility to prevent misuse.
Theme 2: Learning settings of the gamified online role-play
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Besides determining the evaluation focus and specific evaluation questions, at this point you also need to determine the appropriate evaluation design. Of chief interest in choosing the evaluation design is whether you are being asked to monitor progress on outcomes or whether you are also asked to show attribution—that progress on outcomes is related to your program efforts. Attribution questions may more appropriately be viewed as research as opposed to program evaluation, depending on the level of scrutiny with which they are being asked. The users will likely have been identified during Step 1 in the process of engaging stakeholders. In this step, you need to secure their input into the design of the evaluation and the selection of evaluation questions.
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Concerns research designs should address
Building program theories on the basis of stakeholder knowledge and social scientific theory supports more relevant and practice-grounded program theories, improves the conceptual clarity and precision of the theories, and ultimately increases the credibility of the evaluation. It explains in simple terms the requirements for good evaluation, and some straightforward steps that policy makers can take to make a good evaluation of their intervention more feasible. It discusses in more detail the key steps to follow when planning and undertaking an evaluation and how to answer evaluation research questions using different evaluation research designs. It also discusses approaches to the interpretation and assimilation of evaluation evidence. One challenge with that approach is that if you don’t see evidence of impact on program outcomes, you won’t be able to know why that’s the case. Was there a problem with feasibility, and the people implementing the program weren’t able to deliver the program as it was intended?
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Each of these components might be included in a process evaluation of a childhood lead poisoning prevention program. The important role of program theory (or variants thereof) is well established in evaluation. By describing the inner workings of how programs operate (or at least are intended to operate), the use of program theory is a fundamental step in evaluation planning and design. Regardless of the evaluation question or purpose, a central step will always be to develop a thorough understanding of the intervention that is evaluated. To this end, the development of program theories should always be grounded in stakeholder knowledge and informed to the extent possible by social scientific theories from psychology, sociology, economics, and other disciplines.
The program evaluation standards make it practical to conduct sound and fair evaluations. They offer well-supported principles to follow when faced with having to make tradeoffs or compromises. Attending to the standards can guard against an imbalanced evaluation, such as one that is accurate and feasible, but isn't very useful or sensitive to the context. Another example of an imbalanced evaluation is one that would be genuinely useful, but is impossible to carry out. For example, saying, "15 % of the people in our area witnessed a violent act last year," may be interpreted differently depending on the situation.
Often this logic is displayed in a flow-chart, map, or table to portray the sequence of steps leading to program results. Resources include the time, talent, equipment, information, money, and other assets available to conduct program activities. Reviewing the resources a program has tells a lot about the amount and intensity of its services. It may also point out situations where there is a mismatch between what the group wants to do and the resources available to carry out these activities. Understanding program costs is a necessity to assess the cost-benefit ratio as part of the evaluation. Evaluations done without agreement on the program definition aren't likely to be very useful.
It is not uncommon for organizations to build the expectations of target markets as they embark on specific projects. Service quality evaluation allows these organizations to track the extent to which the actual product or service delivery fulfils the expectations. Service quality is the evaluation research method that accounts for any differences between the expectations of the target markets and their impression of the undertaken project.
In the planning stage, a truly formative evaluation—who is your target, how do you reach them, how much will it cost—may be the most appropriate focus. Conversely, an evaluation of a program in maintenance stage would need to include some measurement of progress on outcomes, even if it also included measurement of implementation. Several guidelines inspired by the “utility” and “feasibility” evaluation standards can help determine the best focus. Consistency here refers to the extent to which the different analytical steps of an evaluation are logically connected. The quality of inference is enhanced if there are logical connections among the initial problem statement, rationale and purpose of the evaluation, questions and scope, use of methods, data collection and analysis, and conclusions of an evaluation. The difficulty for governmental and community-based organizations is to find or create a randomized control group.
Moreover, online communication skills and technology literacy, including competency in using technological tools and applications, have been frequently reported as challenges in teledentistry15,16. Concerns regarding limitations stemming from the lack of physical examination are also significant17. These challenges and complexities may impact the accuracy of diagnosis and the security and confidentiality of patient information.
For some complex intervention research problems, an efficacy or effectiveness perspective will be the optimal approach, and a randomised controlled trial will provide the best design to achieve an unbiased estimate. For others, alternative perspectives and designs might work better, or might be the only way to generate new knowledge to reduce decision maker uncertainty. In the ASSIST study,20 a school based, peer led intervention for smoking prevention, researchers considered implementation at each phase. Refinements should be guided by the programme theory, with acceptable boundaries agreed and specified at the beginning of each research phase, and with transparent reporting of the rationale for change.
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