Types Levels and Scope In Nursing Education Evaluating educational programs in nursing is essential for assessing the effectiveness of teaching strategies, ensuring that learning objectives are met, and improving healthcare outcomes. Various models and types of evaluations exist, each serving different purposes within nursing education. This article explores the types and models of evaluation, the role of process evaluation, and the scope of conducting evaluations in nursing education.

Types of Evaluation and Their Components

Evaluation in nursing education can be classified into several types based on their purpose and scope. The most common types of evaluation include:

1. Process (Formative) Evaluation: Focuses on improving teaching methods during the learning process.
2. Content Evaluation: Assesses whether the content taught was understood and retained.
3. Outcome (Summative) Evaluation: Measures the long-term effects of teaching, such as changes in behavior or knowledge.
4. Impact Evaluation: Determines the broader effects of education on the institution or community.
5. Total Program Evaluation: A comprehensive assessment that considers all aspects of a program, including process, content, outcome, and impact.

These types of evaluation are typically used in combination to provide a holistic view of educational effectiveness.

Models of Evaluation Based on Types

Numerous models have been developed to define the different types of evaluation and their interrelationships. Some of the key models include:

• Roberta Straessle Abruzzese (RSA) Model: Developed in 1978, the RSA model remains relevant today for evaluating staff development and patient education. It organizes the five types of evaluation—process, content, outcome, impact, and total program—based on their focus, purpose, and scope. The model offers a visual representation of how these types relate to one another, moving from simple process evaluations to complex impact evaluations.
• CIPP Model (Context, Input, Process, Product): This model is widely used to evaluate educational programs and focuses on continuous feedback at each stage of the educational process.
• ACME Framework (Audience, Channel, Message, Evaluation): Emphasizes the importance of aligning educational activities with the target audience, delivery channels, and content while incorporating ongoing evaluation to improve learning outcomes.

The choice of evaluation model depends on the specific goals of the program, available resources, and the desired level of detail.

Process (Formative) Evaluation in Nursing Education

Process evaluation, also known as formative evaluation, is used to monitor the teaching-learning process and make necessary adjustments as they arise. The goal is to identify and address any issues during the educational activity, allowing for real-time improvements in teaching methods, materials, or even learner attitudes. This evaluation ensures that the learning process is effective and that any challenges are addressed before they negatively impact the learner’s experience.

For example, in teaching a newly diagnosed adolescent with type 1 diabetes how to administer insulin, a nurse educator might modify the original teaching plan based on the learner’s responses. If the adolescent seems more comfortable than the parent, the nurse might allow the adolescent to perform the first self-injection. Process evaluation enables educators to adapt their teaching methods to meet learners’ needs as the learning unfolds.

Process evaluation is part of the ongoing educational cycle of assessment, planning, and implementation. It allows nurse educators to anticipate and prevent problems during the teaching process and make adjustments as necessary. This type of evaluation is particularly important in identifying gaps or issues that arise during the educational activity, helping to ensure the success of the learning process.

Example: SCOPPE and ACME Frameworks

• SCOPPE (Structure, Content, Outcomes, Procedures, Processes, Efficiencies): Focuses on various aspects of the educational process, including teaching methods and instructional materials.
• ACME (Audience, Channel, Message, Evaluation): Stresses the importance of aligning education with learner characteristics and continuously evaluating the process for improvement.

Process evaluation is essential for ensuring that teaching methods are appropriate, materials are useful, and learners are engaged.

Scope of Process Evaluation in Nursing Education

The scope of process evaluation is generally limited in content and time frame, focusing on specific learning experiences such as classes or workshops. However, it is detailed enough to encompass various aspects of the learning experience, including:

• Learner behavior
• Teacher behavior
• Learner-teacher interaction
• Response to teaching methods and materials
• Environmental characteristics

All learners and educators participating in a learning experience should be included in the process evaluation. When resources are limited, a representative sample of individuals from each group can be evaluated instead of every participant.

Compared to other types of evaluations (e.g., impact or total program evaluation), process evaluation is less resource-intensive. It occurs concurrently with teaching, meaning that additional time, facilities, and financial resources are not required.

Example: Clinical Practice Guidelines (CPGs)

Process evaluations are often used in conjunction with Clinical Practice Guidelines (CPGs). These guidelines provide a structured approach to patient care and teaching, including specific interventions and methods for evaluating their effectiveness. Nurses can adjust CPGs based on process evaluations to better fit individual patient needs, ensuring that care remains patient-centered.

Example: Cancer Symptom Management

Chan, Richardson, and Richardson (2012) conducted a process evaluation of an intervention aimed at improving symptom management for patients undergoing palliative radiation therapy for lung cancer. While both nurses used the same procedure, the process evaluation revealed that patients were more satisfied with a nurse who had prior oncology experience. Adjustments were made to the intervention protocol based on these findings.

Process Evaluation in Patient and Staff Education

Process evaluations are not limited to patient education but are also crucial in evaluating staff education. For example, Rani and Byrne (2012) conducted a multi-method evaluation of a training course for providers treating patients with dual diagnoses of mental illness and substance use disorders. Data collected daily through Likert scales provided insights into the effectiveness of the teaching methods, allowing educators to make immediate adjustments to improve learning outcomes.

Example: Parkinson’s Disease Education

Jones et al. (2016) used the CIPP model to involve stakeholders in evaluating self-management education for patients with Parkinson’s disease. Both patients and healthcare professionals provided feedback during each session to improve the next.

Conclusion

In nursing education, evaluation plays a crucial role in ensuring that teaching methods, educational content, and learning experiences meet the needs of both learners and educators. Different types of evaluation—process, content, outcome, impact, and total program—are used to assess specific aspects of education, each with its own scope and purpose. Process evaluation, in particular, is vital for making real-time adjustments to improve teaching effectiveness and learner engagement.

By using established models such as the RSA, CIPP, and ACME frameworks, nurse educators can conduct structured evaluations that address both immediate and long-term goals. Process evaluations focus on the here and now, allowing for continuous improvement in educational practices, while outcome and impact evaluations measure the lasting effects of education on learners and institutions. Together, these evaluations provide a comprehensive approach to improving nursing education and ensuring better patient outcomes.