Evaluating evaluation: implications for assessing quality.

Aims to review the literature on evaluation and to examine research, theory and practice in relation to two key questions: What is evaluation and What is its contribution? Evaluation is increasingly a contemporary concern owing to growing demand for verification of programme results and the current political and economic climate. With the growth in evaluation activity in diverse fields, especially within new domains, those involved in health-care delivery can benefit from an overview of the universal fundamentals of research and theory that translate into improved practice. To evaluate effectively, there is a need for a full understanding of evaluation's nature, purposes and concepts. Identifies and reviews the key subdomains of evaluation, namely: definitions; theoretical underpinning; formulation of goals and objectives; specification of the programme; and cost-benefit analysis.

Gender, religion, and adolescent patterns of self-disclosure in the divided society of Northern Ireland.

Adolescence is a period when levels of self-disclosure are often lowest. While studies have revealed a clear preference for female targets of disclosure, little research has been carried out on the effects of religion upon disclosure. The impact of religion was of importance in this investigation, given that it was conducted in Northern Ireland, where religion affects almost every aspect of social life. The aim was to ascertain the effects of gender and religious affiliation on adolescent disclosure to friends and strangers. Results revealed that while females were significantly higher disclosers than were males, religion per se did not play a key role. This suggests that even in a highly polarized society, gender is the central determinant of disclosure and is even more important than political identity. The implications of these findings are discussed, particularly with regard to the difficulty young males have in terms of revealing personal information.

Pharmacists' evaluation of key communication skills in practice.

This paper reports the results of a major research initiative into the identification of key communication skills in community pharmacist-patient consultations. It is now widely accepted that the quality of practitioner-patient communication is fundamental to effective health care. However, an analysis of the literature pertaining to the communication issues facing health professionals in general and pharmacists in particular emphasised the need for more empirical research, to chart what pharmacists themselves deemed to be the nature and range of skills which contribute to effective communication performance in community pharmacy practice. The main aim of this research investigation was, therefore, to identify what constituted effective communicative performance by community pharmacists. This paper provides full details of the repertoire of skills and sub-skills identified as being the core communicative elements of practice. The results of this research will have relevance for health professionals and behavioural scientists, and will also contribute to the assurance of quality within the field of community pharmacy practice.

Auditing senior management communication practices in the NHS: a regional study.

Increasingly, organizations are being confronted with significant strategic change. This process can only be managed effectively if human resource implications, including how effectively managers and staff communicate with each other, are taken into account. This paper outlines how communication audits provide managers with insights into patterns of communication within their organizations. The nature of communication audits are briefly delineated and explained. An investigation from within the National Health Service (NHS) is offered, which illustrates how a communication audit focusing on relationships between regional, district and local levels of management illuminated patterns of communication between senior managers at these levels. This resulted in the development of an action plan for the improvement of communication practices. The generalizability of these findings to the NHS is discussed.

Assessing the effectiveness of communication in organisations: the communication audit approach.

Within the past decade there has been an enormous growth of interest in the field of organisational communication. Numerous books, book chapters and journal articles have been devoted to this topic. However, much of this output has been at the level of common sense exhortation, has tended to be anecdotal, or at best has been based upon the personal experience of the authors. Certainly within the UK there has been little hard empirical research into the nature, flow and functions of communication within organisations. This paper proposes the introduction of a much more systematic methodology for the study of such communication, based upon what is known as the 'communication audit' approach. This approach is fully explained and the main methods employed in communication audits outlined, together with their relative advantages and disadvantages. It is also pointed out that audits are now widely employed to measure performance in other spheres of the organisation, such as finance, and it is argued that the implementation of this system to measure communication performance is therefore long overdue. The benefits for organisations of carrying out audits are highlighted and suggestions are made about possible future directions for research in this area.

Assessing assertive behaviour in student nurses: a comparison of assertion measures.

This study compared four different assertive measurements used to assess student-nurse behaviour. The measurements employed included a semantic differential 'subjective self-report', the Rathus Assertiveness Schedule, a behavioural test, and observer ratings. The study was divided into three different phases. In phase one, subjects (n = 19) were requested to complete the two self-report measures. Several days later, they were asked to partake in a behavioural test which took the form of a response to an unreasonable request. The final phase entailed observers (n = 9) viewing a video-recording of the behavioural test (without sound) and rating subjects on levels of assertiveness. Analyses of the results revealed only one significant finding, namely that there was a positive relationship between the scores on the Semantic Differential Measurement and the Rathus Assertiveness Schedule (P less than 0.05). No other significant results emerged. The findings of this investigation are discussed in the context of the role of assertive behaviour in nursing.

An evaluation of a communication skills course for health visitor students.

This paper presents part of the findings of an extensive empirical evaluation of a communication skills training programme for health visitor students. The programme was designed to develop the health visitors' ability to communicate with clients. A wide range of interpersonal skills were addressed and the training format involved skill analysis, roleplay practice and video-recorded feedback. The method of evaluation included an appraisal of the health visitors' social behaviour in a roleplay of a home-visit to a pregnant client. Data were collected, both before and following training, in an attempt to assess changes in trainee behaviour. The analysis took the form of a detailed frequency measurement of behavioural elements of health visitor performance, and a global rating of social competence by independent judges. Results of the analyses indicated that 14 out of the 20 behavioural variables changed in the desired direction. Thus, for example, following training the health visitors used significantly more open questions and verbal encouragers, and significantly fewer multiple questions and interruptions when communicating with the client. They were also rated significantly higher on the rating scale for social competence following training. These findings would seem to suggest that the training programme had a considerable degree of success. The findings are discussed in terms of the implications for development of health visitors' social skills, the need for more sophisticated measures of social behaviour and for the formulation of a model of competent professional practice in this area.

The effectiveness of microtraining in developing pharmacists' communication skills: a study of personality and attitudes.

This paper examines the effectiveness of a microtraining programme in developing the communication skills of pharmacists. In particular, it investigates the influence of this programme upon self-reported communication activities in the actual work environment. Inter-relationships are also obtained between the personality of participants, their attitude to the microtraining technique and the degree of self-reported influence on work performance. Overall, participants demonstrated a strongly positive attitude to, and indicated that they had been highly influenced by, the microtraining programme. It was also found that there was a significant and positive correlation between extroversion and attitude to microtraining (p less than 0.005). Furthermore, a positive correlation was also obtained between attitude and influence although this did not reach the 0.5 level of significance. It is concluded that microtraining is a promising technique for developing the communicative competence of pharmacists, but may need to be modified to cater for personality differences within trainees.