formative evaluation

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a critical appraisal or assessment; a judgment of the value, worth, character, or effectiveness of something; measurement of progress. A broad view of evaluation in health care includes three approaches, directed toward structure, process, and outcome, depending on the focus of evaluation and the criteria or standards being used.

Structure evaluations are concerned with physical facilities, equipment, staffing, and other characteristics of the facility or agency that have an effect on the quality of care being provided. Process evaluations center on the activities of the provider and what the provider has done to assess, plan, and implement nursing care. The criteria used in process evaluations in nursing are the Standards of Nursing Practice developed by the American Nurses' Association. Structure and process evaluations are primarily concerned with quality assurance and nursing audits. Outcome evaluations focus on the patient and goals set forth in the care plan and therefore are patient- and goal-oriented. Thus, outcome evaluation is the measurement of a patient's progress or lack of progress toward achievement of specified goals.

The purpose of the evaluation is to determine whether outcome criteria have been met and how care for the patient might be improved. Evaluation is not done to find fault or lay blame for inefficiency, incompetence, or carelessness. It is done for the purpose of improvement, by identifying specific areas that need change for the better. Some weaknesses that could be found during evaluation are vague or inaccurate statement of the problem because of poor assessment or faulty analysis and interpretation of data, unrealistic goal-setting due to overestimating capabilities of the patient or available resources, and well-intentioned but inappropriate nursing interventions that do not effectively meet the hoped-for outcome criteria.

Evaluation of direct care and the effectiveness of care plans and interventions is an ongoing activity. It serves to direct reassessment of patient status, the reordering of priorities, new goal-setting, and revision of nursing care as indicated.

The basic components of evaluation are (1) identifying the parameters of the subject of appraisal, (2) developing criteria specific to the topic within the parameters, (3) data gathering, (4) measuring the data against the criteria, and (5) employing the results of assessment for improvement of the process, status, behavior, or activity evaluated.

Parameters are the exact dimensions or fixed limits that clearly define the area of evaluation. They establish the frame of reference within which the process will take place and are essential to accurate interpretation and meaningful use of the results of the evaluation. Parameters to be considered might include the framework of time within which the data gathering will take place, description of the kinds of data to be obtained, and specification of the patient population selected for evaluation of patient care. In a nursing audit, for example, the medical records chosen for audit might be those of patients whose admission and discharge dates were within a specific period of time, and whose age range and diagnoses were similar. Since it is a nursing audit, the kind of data collected should be limited to information related to the area of nursing activities and the resulting patient care outcomes recorded on the patient's chart.

In the assessment of a patient's status on the health/illness continuum, the parameters might limit the appraisal to respiratory function, neuromuscular function, emotional status, or any of a number of areas that are important to accomplishing the overall goals and objectives of health care for that specific patient.

Data gathering involves the collection of information that gives factual and objective evidence about the subject being evaluated. The evidence may be obtained through observation, interview, the review of patient records, and, as in the case of assessment of a patient's health/illness status, through such procedures as laboratory analysis and testing, radiologic studies, and other diagnostic techniques, as well as a physical assessment or examination and history taking.

The data collected become documented evidence, which is then measured against the established criteria. If the evidence indicates that all of the criteria are being met, there is no indication of a problem in the area of evaluation. If the evidence shows that certain criteria are not met, these deficiencies are identified as the ones needing attention so that there can be progress toward the stated goals.
The evaluation process using occupational therapy as an exemplar. From Pedretti and Early, 2001.
criterion-referenced evaluation evaluation of performance by judging an individual's behavior, performance, or knowledge against specific criteria or standards. See also criterion-referenced testing.
formative evaluation evaluation that involves feedback regarding progress being made; it involves the continuous gathering of evaluative data throughout a learning experience.
normative-referenced evaluation evaluation in which the scores of an individual are interpreted in light of the norm or distribution of scores of others taking the same test; progress is determined by how well the individual compares with peers.
outcome evaluation see evaluation.
process evaluation see evaluation.
product evaluation in the nursing interventions classification, a nursing intervention defined as determining the effectiveness of new products or equipment.
structure evaluation see evaluation.
summative evaluation evaluation that involves one statement of the extent of achievement of objectives or goals; it involves the gathering of evaluative data at the end of a learning experience.

formative evaluation

1 judgments made about effectiveness of nursing interventions as they are implemented.
2 (in nursing education) periodic evaluation of a student during a course, usually a clinical practicum.
References in periodicals archive ?
The research question was how could formative evaluation be used in this case to improve the CSCLIP lesson and the team's interactions.
The results indicate that, while students' initial expectations were consistent with their end of course ratings, their attitudes did change at examination points throughout the course, providing specific content-related information for formative evaluation.
A comprehensive formative evaluation process involves research both before and during a campaign to engage and analyze community resources and stakeholders, explore meanings and contexts of relevant goal behaviors, identify audience characteristics and media preferences, develop and test candidate messages, and help anticipate potential barriers to campaign effectiveness.
Indeed the need is to give priority to conduct formative evaluation in agricultural extension programs to pinpoint the weaknesses and to take necessary measures before all the resources and public money consumed.
A formative evaluation of ELMART conducted by Weber and Specht (1997) found that novice learners benefited more from the direct guidance provided than more knowledgeable students.
The level of rigor for each type of evaluation is indicated by the letters A-C for summative evaluation, with column C representing the most rigorous; the numbers 1-3 indicate the level of rigor for each type of formative evaluation, with row 3 representing the most rigorous.
Diaz Barriga and Pacheco (2000) note the relevance of adopting an evaluation paradigm tied to the formative evaluation, in which importance is given to focusing on what has been the historical function of the school: "instill culture, instill knowledge of national matters, and to enable discovery and human development" (Diaz Barriga & Pacheco, 2000, p.
The purpose of this formative evaluation research was to determine how the simulation experience for a high-acuity nursing course might be adapted midterm to address the feelings of high apprehension among students and, in turn, encourage an atmosphere conducive to shared learning.
The questionnaire also elicited questions, comments, and suggestions from students, contributing to a formative evaluation for the further development of the edublog.
2) In addition, research shows that extensive, theory-driven formative evaluation can lead to more effective interventions.
Formative Evaluation is the assessment of the success or failure of the teaching overall.