title: A formative and process evaluation of a service development group: an analysis of the Waikato Hospital Board’s review of maternity services

authors: Driscoll, Sharon Lucille

abstract: This study is a formative and process evaluation and analysis of what occurred before and during the Waikato Hospital Board’s Review of Maternity Services. An historical perspective of the Service Development Group (SDG) approach to health planning is presented together with information about the establishment of the SDG and review process. Nine objectives were proposed which were to: establish the reasons behind the Board’s decision to review existing maternity services; describe what happened during the review period; describe the reasons for the Board’s decision to use a SDG to review maternity services; assess the effectiveness of evaluation research techniques for this study; describe participants’ attitudes toward the SDG; examine the interaction and co-operation between the various  committees involved in the review; attempt to measure the amount of satisfaction with the SDG exercise as perceived by participants; draw conclusions about the value of the SDG and make recommendations for future Service Development Group exercises.
Three major research techniques were used. Analysis of archival data gave an historical perspective of the Board and its maternity services, while questionnaires were used to gather information from the three groups involved in the study an: 11 member Service Development  Group, the 6 member Board’s Steering Committee, and several committee members of each of the 7 SDG nominating organisations. Interviews with the SDG and the Board’s Steering Committee members provided in-depth qualitative information. One questionnaire was administered to SDG members after pre-testing. It was then adapted for use with the Board’s Steering Committee and committee members of the SDG nominating organisations. The research was sequential with preliminary data analysis being completed before interviews were conducted with SDG and Steering committee members. There were no refusals for interviews or questionnaires. Data analysis consisted of descriptive statistics and qualitative interpretation which highlighted the emergence of global trends and allowed comparison between groups. 
Nine themes emerged from the questionnaire and interview data. The SDG approach was positively supported as was the combination of professional and community representation in health services reviews. Full discussion and agreement on terms of reference for any SDG should involve all participants. Other findings concerned the members’ role as nominated representatives, support for the SDG’s work and its ability to effect change, and concern with the methods of the general administration of the SDG. Issues concerning group size and parochial interests of individuals and groups were elaborated as were the SDG’s feelings toward the power of the Board’s Steering Committee. An awareness of cultural issues surfaced as a result of the SDG’s work. 
Advantages of the participant role of the researcher and benefits of in-depth qualitative analysis are discussed. There is a critical appraisal of the methodology and directions for future research are discussed. Major recommendations arising from the research were that the SDG approach is a worthwhile method for health services reviews, that all potential SDG members should be appointed before commencement of meetings, and that skilled public relations and communications programmes should be used. Terms of reference require careful consideration, SDG membership should be limited to preferably less than 11 people, a key person is required to act as facilitator, and an awareness of cultural issues is necessary. It was concluded that evaluation research techniques were useful and successful when employed to monitor and assess the SDG process. 
A prescriptive model for service development groups is proposed in the final chapter. The model presented would be applicable to any SDG involved in a service planning task. It is a model for planning, implementing, monitoring and evaluating the impact of the service development group. Consideration is given to the way that diverse cultural and social viewpoints can be accommodated in the deliberations of SDG’s. The overall objective of the model presented is participatory democracy attempted through community involvement in planning.

text: A formative and process evaluation of a service development group: an analysis of the Waikato Hospital Board’s review of maternity services This study is a formative and process evaluation and analysis of what occurred before and during the Waikato Hospital Board’s Review of Maternity Services. An historical perspective of the Service Development Group (SDG) approach to health planning is presented together with information about the establishment of the SDG and review process. Nine objectives were proposed which were to: establish the reasons behind the Board’s decision to review existing maternity services; describe what happened during the review period; describe the reasons for the Board’s decision to use a SDG to review maternity services; assess the effectiveness of evaluation research techniques for this study; describe participants’ attitudes toward the SDG; examine the interaction and co-operation between the various  committees involved in the review; attempt to measure the amount of satisfaction with the SDG exercise as perceived by participants; draw conclusions about the value of the SDG and make recommendations for future Service Development Group exercises.
Three major research techniques were used. Analysis of archival data gave an historical perspective of the Board and its maternity services, while questionnaires were used to gather information from the three groups involved in the study an: 11 member Service Development  Group, the 6 member Board’s Steering Committee, and several committee members of each of the 7 SDG nominating organisations. Interviews with the SDG and the Board’s Steering Committee members provided in-depth qualitative information. One questionnaire was administered to SDG members after pre-testing. It was then adapted for use with the Board’s Steering Committee and committee members of the SDG nominating organisations. The research was sequential with preliminary data analysis being completed before interviews were conducted with SDG and Steering committee members. There were no refusals for interviews or questionnaires. Data analysis consisted of descriptive statistics and qualitative interpretation which highlighted the emergence of global trends and allowed comparison between groups. 
Nine themes emerged from the questionnaire and interview data. The SDG approach was positively supported as was the combination of professional and community representation in health services reviews. Full discussion and agreement on terms of reference for any SDG should involve all participants. Other findings concerned the members’ role as nominated representatives, support for the SDG’s work and its ability to effect change, and concern with the methods of the general administration of the SDG. Issues concerning group size and parochial interests of individuals and groups were elaborated as were the SDG’s feelings toward the power of the Board’s Steering Committee. An awareness of cultural issues surfaced as a result of the SDG’s work. 
Advantages of the participant role of the researcher and benefits of in-depth qualitative analysis are discussed. There is a critical appraisal of the methodology and directions for future research are discussed. Major recommendations arising from the research were that the SDG approach is a worthwhile method for health services reviews, that all potential SDG members should be appointed before commencement of meetings, and that skilled public relations and communications programmes should be used. Terms of reference require careful consideration, SDG membership should be limited to preferably less than 11 people, a key person is required to act as facilitator, and an awareness of cultural issues is necessary. It was concluded that evaluation research techniques were useful and successful when employed to monitor and assess the SDG process. 
A prescriptive model for service development groups is proposed in the final chapter. The model presented would be applicable to any SDG involved in a service planning task. It is a model for planning, implementing, monitoring and evaluating the impact of the service development group. Consideration is given to the way that diverse cultural and social viewpoints can be accommodated in the deliberations of SDG’s. The overall objective of the model presented is participatory democracy attempted through community involvement in planning.

year: 1988

title: Book review: From A to <A>: Keywords of Markup

authors: Hight, Craig

subjects: book review

abstract: This article reviews the book: “From A to <A>: Keywords of Markup”, edited by Dilger, Bradley and Rice, Jeff.

text: Book review: From A to <A>: Keywords of Markup This article reviews the book: “From A to <A>: Keywords of Markup”, edited by Dilger, Bradley and Rice, Jeff.

year: 2011

title: Talk More: Student Learning Through Reciprocal Conversations

authors: Grant, Sarah

subjects: oral language

abstract: This research explored ways of improving the oral language development of Year 1 children in four low decile mainstream schools who were making limited progress in literacy. Over 82% of these students were Māori.  Due to the continued impact of past educational policies and the subsequent interruption of the intergenerational transmission of the mother tongue, many Māori children are not exposed to proficient and fluent models either of spoken English or of spoken Māori.  Such children struggle to make the English literacy progress expected of them by schools and communities. The central focus of the research was to evaluate a claim that Year 6 students (tuākana)  could make a substantial improvement in the oral language achievement of  Year 1 students (teina), through engaging with them in regular conversational contexts using the TALES (Talk, Ask, Listen, Encourage, and Say) procedures. This pedagogical approach is understood as one which was culturally responsive for these students. 

Quantitative analysis of data from three quantitative outcome measures (Record of Oral Language, Junior Oral Screening Tool, and Auditory-Vocal Association Assessment of Verbal Attainments) demonstrated that there were substantial oral language gains for the 72 teina students involved in the study. The quantitative analysis also demonstrated that these gains occurred most strongly during the phases in which the TALES procedures were being implemented by the 72 tuākana students, in accord with the multiple baseline design. Detailed qualitative analysis of a random sample of six of the 72 pairs illustrated both the effectiveness of the tuākana language interaction with the teina, and the different ways that the tuākana were able to implement the TALES procedure. Analysis of five minute probes of transcripts over six weeks from these six tuākana - teina pairs indicated that a wide range of literacy activities and conversations took place. The unique learning needs and personal learning intentions of each tuakana and teina were successfully monitored using this five minute probe procedure. Powerful reciprocal learning processes were evident in transcripts of conversations between the tuākana and the teina, and also within feedback and feed-forward meetings between the tuākana and key teachers.  

The substantial oral language gains for the teina students in this study  were achieved within learning contexts that were social and  interactive, and that embodied the principles of ako (learning and teaching roles were shared) and whakawhanaungatanga (building caring and  supportive relationships). These principles are among those that underpin pedagogies that are culturally responsive (Bishop  Glynn, 1999; Glynn, Wearmouth,  Berryman, 2006; Ladson-Billings, 1995, 2006) and transformative. The results of this research study give a clear message to mainstream non-Māori teachers, that they can make a positive and substantial difference to the learning outcomes of their Māori students.

text: Talk More: Student Learning Through Reciprocal Conversations This research explored ways of improving the oral language development of Year 1 children in four low decile mainstream schools who were making limited progress in literacy. Over 82% of these students were Māori.  Due to the continued impact of past educational policies and the subsequent interruption of the intergenerational transmission of the mother tongue, many Māori children are not exposed to proficient and fluent models either of spoken English or of spoken Māori.  Such children struggle to make the English literacy progress expected of them by schools and communities. The central focus of the research was to evaluate a claim that Year 6 students (tuākana)  could make a substantial improvement in the oral language achievement of  Year 1 students (teina), through engaging with them in regular conversational contexts using the TALES (Talk, Ask, Listen, Encourage, and Say) procedures. This pedagogical approach is understood as one which was culturally responsive for these students. 

Quantitative analysis of data from three quantitative outcome measures (Record of Oral Language, Junior Oral Screening Tool, and Auditory-Vocal Association Assessment of Verbal Attainments) demonstrated that there were substantial oral language gains for the 72 teina students involved in the study. The quantitative analysis also demonstrated that these gains occurred most strongly during the phases in which the TALES procedures were being implemented by the 72 tuākana students, in accord with the multiple baseline design. Detailed qualitative analysis of a random sample of six of the 72 pairs illustrated both the effectiveness of the tuākana language interaction with the teina, and the different ways that the tuākana were able to implement the TALES procedure. Analysis of five minute probes of transcripts over six weeks from these six tuākana - teina pairs indicated that a wide range of literacy activities and conversations took place. The unique learning needs and personal learning intentions of each tuakana and teina were successfully monitored using this five minute probe procedure. Powerful reciprocal learning processes were evident in transcripts of conversations between the tuākana and the teina, and also within feedback and feed-forward meetings between the tuākana and key teachers.  

The substantial oral language gains for the teina students in this study  were achieved within learning contexts that were social and  interactive, and that embodied the principles of ako (learning and teaching roles were shared) and whakawhanaungatanga (building caring and  supportive relationships). These principles are among those that underpin pedagogies that are culturally responsive (Bishop  Glynn, 1999; Glynn, Wearmouth,  Berryman, 2006; Ladson-Billings, 1995, 2006) and transformative. The results of this research study give a clear message to mainstream non-Māori teachers, that they can make a positive and substantial difference to the learning outcomes of their Māori students.

year: 2009