A nivel internacional

The decision-making process which unfolded while the IETP module was being

delivered clearly adhered to the PAR validity criteria discussed in Chapter four (section 4.10):

 the students generated new knowledge about which teaching/ learning

approaches supported them in the specific context of the IETP module (catalytic validity)

 the NGT decisions were made by consensus (democratic validity)

 there were action-oriented outcomes as at the end of each class the students modified subsequent module content and teaching/ learning approaches (outcome validity)

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 the inquiry process was systematic and open to scrutiny through detailed RFN and NPO notes (process validity)

 the expert panel, when it monitored the RFN and my reflexive diary entries from the first two classes, deemed that they exhibited a good level of critical subjectivity (dialogic validity).

6.9 Chapter summary

In this chapter I have described the findings from the second stage of the research; namely the iterative PAR reflective cycles in which the students engaged as the IETP module was being conducted. The pre-determined learning processes and content (detailed in the module descriptor and IETP module handbook) were reviewed and modified by the students, thereby validating their role as co-researchers. This second stage fulfilled the first research aim: to develop, in collaboration with clinical therapists, learning opportunities for acquiring the skills necessary for locating, critiquing and translating research findings into practice within the framework of a multi-disciplinary post-qualification MSc module on EBP.

Chapter seven addresses the second research aim: evaluating the module‟s influence on the students‟ subsequent engagement in EBP.

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CHAPTER SEVEN - THE RESEARCH PROCESS STAGE THREE:

FINDINGS FROM EVALUATING THE IETP MODULE

7.1 Overview of the chapter

This chapter presents findings from the final stage of the main study (Figure 16). During stage three the participants evaluated the IETP module which they had monitored and adapted throughout stage two through iterative PAR reflective cycles. The purpose of the evaluation process was to explore the influence of the module on the participants‟ acquisition of EBP knowledge and skills and subsequent engagement in EBP activities. The participants‟ reflections on the module were gathered at two points in time:

immediately following completion of the classes in December 2009; and 4 to 5 months later in May - June 2010.

Figure 16 Recapitulation of the three stages of main study

Stage One: Designing the IETP

module

•Researcher developed IETP module framework in accordance with study university guidelines.

•Framework was based on conclusions drawn from pilot Sunnyview project and scoping reviews of the literature on healthcare continuing education, adult learning theory and the threshold concepts teaching & learning construct.

Stage Two: Conducting the

IETP module

•Through engaging in iterative PAR reflection cycles, study participants collaborated with the researcher in monitoring and adapting the IETP module. •Findings from these cycles were based on the non-participant observer (NPO)

notes, researcher field notes (RFN) and participants' nominal group technique (NGT) decisions. In accordance with the study's PAR methodology, these findings resulted in immediate and demonstrable changes being made to the content and learning approaches of each class.

Stage Three: Evaluating the

IETP module

•December 2009 (immediately post module) the participants: 1) completed EBP knowledge, skills, attitudes & behaviours (KSAB) questionnaire they had also filled out on the first day of class; 2) responded to a study university module evaluation form; 3) engaged in a group discussion evaluating the module. •May - June 2010 (4-5 months post module) during an individual interview each

participant reflected on what the module had been like for them and what they perceived as its influence on their subsequent clinical practice.

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Continuing education outcomes are frequently evaluated using Kirkpatrick‟s (2007) four-level framework (Figure 17): reaction, learning, behaviour and results. The scope of this study incorporates the lower three levels only.

This chapter first focuses on findings from data collected in December 2009 from three sources: 1) EBP knowledge, skills, attitudes and behaviours (KSAB) questionnaires which participants completed individually pre and post module; 2) individual written responses to the study university module evaluation form; and 3) a group discussion evaluating the module. The main objective of these three data sources was to ascertain whether, by the last day of class, the participants felt that their participation in the module had permitted them to acquire the EBP knowledge and skills stated in the learning objectives of the IETP module descriptor (Appendix 5). Differences in pre and post module responses on the EBP KSAB questionnaires are described. Participant comments about what they felt had impacted on their learning, drawn from the module evaluation forms and group discussion, are reviewed. Finally, this chapter presents findings from one individual semi-structured interview in which each participant took part in either May or June 2010. The themes that emerged are defined and compared with reflections that the participants made in December 2009. The rationale for these multiple data sources was to achieve completeness of data in order to provide a holistic and contextual representation of how the IETP module influenced the participants EBP

Evaluation of results (impact on society)

Evaluation of behaviour (transfer of learning into

the workplace)

Evaluation of learning (knowledge and skills)

Evaluation of reaction (satisfaction)

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learning and their subsequent engagement in EBP activities. While the purpose was not to attain convergence in the findings, there are broad linkages between the different data sources (Appendix 17).

7.2 EBP Knowledge, Skills, Attitudes and Behaviours (KSAB)