Using program evaluation to support knowledge translation in an interprofessional primary care team: a case study.

BACKGROUND: Evaluation is a fundamental component in building quality primary care and is ideally situated to support individual, team and organizational learning by offering an accessible form of participatory inquiry. The evaluation literature has begun to recognize the unique features of KT evaluations and has described attributes to consider when evaluating KT activities. While both disciplines have focused on the evaluation of KT activities neither has explored the role of evaluation in KT. The purpose of the paper is to examine how participation in program evaluation can support KT in a primary care setting. METHODS: A mixed methods case study design was used, where evaluation was conceptualized as a change process and intervention. A Memory Clinic at an interprofessional primary care clinic was the setting in which the study was conducted. An evaluation framework, Pathways of Influence provided the theoretical foundation to understand how program evaluation can facilitate the translation of knowledge at the level of the individual, inter-personal (Memory Clinic team) and the organization. Data collection included questionnaires, interviews, evaluation log and document analysis. Questionnaires and interviews were administered both before and after the evaluation: Pattern matching was used to analyze the data based on predetermined propositions. RESULTS: Individuals gained program knowledge that resulted in changes to both individual and program practices. One of the key themes was the importance clinicians placed on local, program based knowledge. The evaluation had less influence on the broader health organization. CONCLUSIONS: Program evaluation facilitated individual, team and organizational learning. The use of evaluation to support KT is ideally suited to a primary care setting by offering relevant and applicable knowledge to primary care team members while being sensitive to local context.

Learning together for effective collaboration in school-based occupational therapy practice.

BACKGROUND: School-based occupational therapy (SBOT) practice takes place within a complex system that includes service recipients, service providers, and program decision makers across health and education sectors. Despite the promotion of collaborative consultation at a policy level, there is little practical guidance about how to coordinate multi-agency service and interprofessional collaboration among these stakeholders. PURPOSE: This paper reports on a process used to engage program administrators in an examination of SBOT collaborative consultation practice in one region of Ontario to provide an evidence-informed foundation for decision making about implementation of these services. METHODS: Within an appreciative inquiry framework (Cooperrider, Whitney, & Stavros, 2008), Developmental Work Research methods (Engeström, 2000) were used to facilitate shared learning for improved SBOT collaborative consultation. Program administrators participated alongside program providers and service recipients in a series of facilitated workshops to develop principles that will guide future planning and decision making about the delivery of SBOT services. FINDINGS: Facilitated discussion among stakeholders led to the articulation of 12 principles for effective collaborative practice. Program administrators used their shared understanding to propose a new model for delivering SBOT services. IMPLICATIONS: Horizontal and vertical learning across agency and professional boundaries led to the development of powerful solutions for program improvement.

How Do Evaluators Differentiate Successful From Less-Than-Successful Experiences With Collaborative Approaches to Evaluation?

OBJECTIVES: In this exploratory study, we wanted to know how evaluators differentiate collaborative approaches to evaluation (CAE) perceived to be successful from those perceived to be less-than-successful. METHOD: In an online questionnaire survey, we obtained 320 responses from evaluators who practice CAE (i.e., evaluations on which program stakeholders coproduce evaluation knowledge). Respondents identified two specific CAE projects from their own experience-one they believed to be "highly successful" and another they considered "far less successful than [they] had hoped."-and offered their comments and reflections about them. They rated the respective evaluations on 5-point opinion and frequency scales about (i) antecedent stakeholder perspectives, (ii) the purposes and justifications for collaborative inquiry, and (iii) the form such inquiry takes. FINDINGS: The results showed that successful evaluations, relative to their less-than-successful counterparts, tended to reflect higher levels of agreement among stakeholders about the focal program; higher intentionality estimates of evaluation justification and espoused purposes; and wider ranges and deeper levels of stakeholder participation. No differences were found for control of technical decision-making, and evaluators tended to lead evaluation decision making, regardless of success condition. DISCUSSION: The results are discussed in terms of implications for ongoing research on CAE.