DEVELOPING RESEARCH CAPABILITY TMA 1

DEVELOPING RESEARCH CAPABILITY : 

DEVELOPING RESEARCH CAPABILITY TMA 1 CRITICAL REVIEW ASSIGNMENT Sarah McLeod

JOURNAL PAPER: : 

JOURNAL PAPER: Evaluating the Outcomes of Rural Health Policy: Jane Farmer and Margaret Currie Centre for Rural Health, UHI Millennium Institute, Centre for Rural Health, Inverness, UK Australian Journal for Rural Health (2009) 17, 17 53-57

INTRODUCTION: : 

INTRODUCTION: Paper challenges issues around health policies developed in Scotland specifically looking at the impact on rural health. Authors identify lack of evaluation in this context pointing out the sense of urgency given rural health policy is maturing. They suggest application of policy outcome measurement in order to redress the balance between health policy, research and outcome measurement. Wide range of evidence is used to emphasise points. Paper concludes with significant questions indicating need for further study into a highly relevant area around the impact of health policy in rural Scotland.

HEALTH POLICY: : 

HEALTH POLICY: ‘Big Picture’ – reference to main drivers i.e. Better Health Better Car, 2007 Adjuncts to ‘big policy’ Delivering for Remote & Rural Health Care, 2007 Vital in order to challenge issues around evaluation of policy in the context of rural heath Authors point out the concept of ‘rural proofing’ policy – emerging international term Issue of confusion highlighted around specialisation within health care policy - does not fit with rural health care

CHALLENGES FOR EVALUATION: : 

CHALLENGES FOR EVALUATION: Understanding policy making process vital before consider evaluation Specific issues around rurality – might not be explicit goals of some policies Ambiguity within policy objectives around safety & cost effectiveness – local communities take different views around perceived improvements Quantitative data not always appropriate for outcome measurement - some policy objectives intangible Evidence for rural health evaluation single influence on future policy All the above indicate complexity of policy making in the context of evaluation

EVALUATING POLICY OUTCOMES: : 

EVALUATING POLICY OUTCOMES: Definition of policy outcomes as per expert on policy evaluation Adds credence to the paper Types of evaluation suggested - how they might be measured using combined approaches Important within the context of rural health care – not just looking at the end point, see how it is evolving along the way. Evaluation is intended to ‘inform policy’

EXAMPLES OF POLICY EVALUATION: : 

EXAMPLES OF POLICY EVALUATION: 1st example further challenges complexity of policy evaluation in the context of rural health – ‘not straightforward’ 2nd example provides evidence using robust evaluation around patient safety – topical and valuable approach Vital part of paper – essential to illustrate central theme Two very different examples given - provide rigour to argument

CONCLUSION: : 

CONCLUSION: Acknowledgement of brevity of paper -merely identifying some issues Ends by asking more questions thereby challenging further research on impact specifically around sustainability of rural health policy Important to recognise need for further study in order fully to explore concepts of policy evaluation within rural health

OVER ALL VIEW OF PAPER: : 

OVER ALL VIEW OF PAPER: Important paper examining issues around health policy within rural health Insight into specific needs around importance of evaluation in rural health policy using a wide range of evidence Use of practical examples regarding care provision in this context i.e. sustain health care workers, looking at concepts beyond health care i.e. ‘community resilience’ No fear in identifying uncomfortable issues regarding practicalities of policy – ‘lack of competence’ or ‘not cost effective’ both of which are relevant in the provision of rural health care This paper threw down the gauntlet for further exploration around robust evaluation of policy within rural health using a Positivist approach

REFERENCES: : 

REFERENCES: Cottrell, S (2005) Palgrave Study Skills: Critical Thinking Skills Palgrave MacMillan Crombie, IK (2008) Pocket Guide to Critical Appraisal BMJ Books Crotty, M (2003) The Foundations of Social Research: Meaning and Perspectives in the Research Process Sage Publications Ltd. Greenhalgh, T (2006) How to Read a Paper: The Basics of Evidence-based Medicine BMJ Books