Title: Education Outcomes Framework: Developing Indicators and the Evidence Base
Funder: Department of Health (England)

Abstract: Background The delivery of excellent healthcare and health improvement is complex. Interventions (such as educational or training) cannot be directly attributed due to the indirect impact that education has on patients. The challenge will be to deconstruct this relationship and identify under what contexts positive outcomes are produced following education/training interventions. Aims in relation to the issue to be addressed The study aims to identify and develop key indicators that demonstrate a measurable link between education and training and the quality of patient care for the implementation of the Educational Outcomes Framework in the evaluation of training and education interventions. The objectives are: To identify and synthesise the evidence on key indicators for each of the five following domains: excellent education; competent and capable staff; flexible workforce receptive to research and innovation; NHS values and behaviours; widening participation. To identify the contexts and mechanisms that improve the quality of patient experience, effectiveness, and patient safety across the healthcare system. To use data to develop and test models that link education, training, and staff development interventions to healthcare outcomes. Research plan and methods of investigation Our research will be delivered in two main phases. Phase 1a We will conduct a realist synthesis of the evidence to support each EOF domain. The literature reviews will be conducted systematically, searching for relevant key words and concepts reflecting both the identified indicators as well as searching for relevant others. The approach will be to conduct a realist synthesis in which the synthesis will involve the identification of context, mechanism, and outcome. This is a robust approach which the team has used previously for other research, most recently for NIHR. Phase 1b is to refine indicators in consultation with key stakeholders e.g., HEE, DH, PALS, GMC, HCPC, and NMC. Phase 1c will identify and describe case studies which aim to make the link between education/training and patient benefit. Phase 2a will develop, populate and test models identified from Phase 1 with available data (e.g. GMC survey, NHS Staff survey). Phase 2b will test the models with established partners using newly linked data at the organisation, service and patient level. If possible models will need to be implemented in a multilevel framework which will allow predictors at variable levels to be evaluated, as well as any cross-level interactions, if appropriate data are available. Ethics The literature review and NHS consultation with experts will not require ethical review. Routinely collected (anonymised) clinical data will need University and NHS caldicott permissions but not external NHS ethics review. Patient involvement in Phase 2b will require both Durham University and NHS ethical review. Research team The team comprises the necessary experience and methodological expertise to successfully complete this research. Members of the team have national and international standing in the areas of medical education, health professional training, and training evaluations. The team have expertise in realist syntheses (Illing et al. 2012; De Wet et al, forthcoming) and experience in systematic review research (Illing et al. 2009; McLachlan and Turnbull 2010; Crampton, McLachlan and Illing 2013; McLachlan et al. 2012). Additional members of the team chosen for this project represent a diverse set of skills and knowledge, ranging from clinical and educational research, and extensive team leadership. Potential impact/influence on policy, users and wider stakeholders The study output from this project will be the identification of evidenced based indicators for each of the five EOF domains linking educational/training interventions to healthcare improvements. The measures will be applicable to a range of users, including educators, evaluators, and commissioners. Phase 2 will model and test the links between education and patient outcomes.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: GENERIC HEALTH RELEVANCE