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Unpacking economic programme theory for supervision training: Preliminary steps towards realist economic evaluation.

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Title: Unpacking economic programme theory for supervision training: Preliminary steps towards realist economic evaluation.
Authors: Rees, Charlotte E., Foo, Jonathan, Nguyen, Van N. B., Edouard, Vicki, Maloney, Stephen, Ottrey, Ella, Palermo, Claire
Source: Medical Education. Apr2022, Vol. 56 Issue 4, p407-417. 11p. 1 Diagram, 1 Chart, 1 Graph.
Subjects: Research methodology, Clinical supervision, Human services programs, Supervision of employees
Geographic Terms: Australia
Abstract: Introduction: Cost studies are increasingly popular given resource constraints. While scholars stress the context‐dependent nature of cost, and the importance of theory, cost studies remain context‐blind and atheoretical. However, realist economic evaluation (REE) privileges context and the testing/refinement of economic programme theory. This preliminary REE serves to test and refine economic programme theory for supervision training programmes of different durations to better inform future programme design/implementation. Methods: Our preliminary REE unpacked how short (half‐day) and extended (12 week) supervision training programmes in Victoria, Australia, produced costs and outcomes. We employed mixed methods: qualitative realist and quantitative cost methods. Economically optimised programme models were developed guided by identified cost‐sensitive mechanisms and contexts. Results: As part of identified context‐mechanism‐outcome configurations (CMOCs) for both training programmes, we found a wider diversity of positive outcomes but greater costs for the extended programme (11 outcomes; AU$3069/learner) compared with the short programme (7 outcomes; $385/learner). We identified four shared cost‐sensitive mechanisms for both programmes (training duration, learner protected time, learner engagement, and facilitator competence) and one shared cost‐sensitive context (learners' supervisory experience). We developed two economically optimised programme models: (1) short programme for experienced supervisors facilitated by senior educators ($406/learner); and (2) extended programme for inexperienced supervisors facilitated by junior educators ($2104/learner). Discussion Our initial economic programme theory was somewhat supported, refuted and refined. Results were partly consistent with previous research, but also extended it through unpacking cost‐sensitive mechanisms and contexts. Although our preliminary REE fills a pressing gap in the methodology literature, conducting REE was challenging given our desire to integrate economic and realist analyses fully, and remain faithful to realist principles. Attention to training duration and experience levels of the facilitator–learner dyad may help to balance the cost and outcomes of training programmes. The authors test and refine economic program theory for supervision training programs of different durations to better inform program design and implementation. [ABSTRACT FROM AUTHOR]
Copyright of Medical Education is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Unpacking economic programme theory for supervision training: Preliminary steps towards realist economic evaluation.
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  Data: <searchLink fieldCode="JN" term="%22Medical+Education%22">Medical Education</searchLink>. Apr2022, Vol. 56 Issue 4, p407-417. 11p. 1 Diagram, 1 Chart, 1 Graph.
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  Data: <searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+supervision%22">Clinical supervision</searchLink><br /><searchLink fieldCode="DE" term="%22Human+services+programs%22">Human services programs</searchLink><br /><searchLink fieldCode="DE" term="%22Supervision+of+employees%22">Supervision of employees</searchLink>
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  Data: Introduction: Cost studies are increasingly popular given resource constraints. While scholars stress the context‐dependent nature of cost, and the importance of theory, cost studies remain context‐blind and atheoretical. However, realist economic evaluation (REE) privileges context and the testing/refinement of economic programme theory. This preliminary REE serves to test and refine economic programme theory for supervision training programmes of different durations to better inform future programme design/implementation. Methods: Our preliminary REE unpacked how short (half‐day) and extended (12 week) supervision training programmes in Victoria, Australia, produced costs and outcomes. We employed mixed methods: qualitative realist and quantitative cost methods. Economically optimised programme models were developed guided by identified cost‐sensitive mechanisms and contexts. Results: As part of identified context‐mechanism‐outcome configurations (CMOCs) for both training programmes, we found a wider diversity of positive outcomes but greater costs for the extended programme (11 outcomes; AU$3069/learner) compared with the short programme (7 outcomes; $385/learner). We identified four shared cost‐sensitive mechanisms for both programmes (training duration, learner protected time, learner engagement, and facilitator competence) and one shared cost‐sensitive context (learners' supervisory experience). We developed two economically optimised programme models: (1) short programme for experienced supervisors facilitated by senior educators ($406/learner); and (2) extended programme for inexperienced supervisors facilitated by junior educators ($2104/learner). Discussion Our initial economic programme theory was somewhat supported, refuted and refined. Results were partly consistent with previous research, but also extended it through unpacking cost‐sensitive mechanisms and contexts. Although our preliminary REE fills a pressing gap in the methodology literature, conducting REE was challenging given our desire to integrate economic and realist analyses fully, and remain faithful to realist principles. Attention to training duration and experience levels of the facilitator–learner dyad may help to balance the cost and outcomes of training programmes. The authors test and refine economic program theory for supervision training programs of different durations to better inform program design and implementation. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Medical Education is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – SubjectFull: Australia
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      – TitleFull: Unpacking economic programme theory for supervision training: Preliminary steps towards realist economic evaluation.
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              Text: Apr2022
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