Impact assessment: from theory to practice

Foreign aid is intended to be a major contributor to poverty reduction. However, significant questions arise as to the capacity for development funding to contribute to human development, through service provision, through advocacy, through actions and interventions that change power relations, change the social and institutional arrangements that reinforce inequality, threaten or reproduce well-being, and prevent the fulfillment of human rights. In conjunction with questions about what aid “does,” there is equal focus on how it does it. Questions of efficiency, effectiveness, transparency, accountability, social license to operate, relevance, and many others are all embedded in contemporary aid discourse and practice. The aim of this volume was to contribute to a critical understanding of Impact Assessment (IA) clearly informed by contemporary development theory and practice. There is a significantly increasing push for impact assessment, across the whole aid architecture. This is exacerbated by a much stronger focus on value for money, and accountability – to taxpayers specifically in the context of public funds, and donors in an increasingly competitive NGO environment. As was noted by many authors, since the GFC, a significant number of donor governments have reduced or are considering funding reduction for bilateral aid agencies and their contributions to multilateral aid agencies. At the same time they imposed a more stringent and rigorous requirement focusing on “aid-for-trade” and “value-for-money” strategies. There is a drive to ensure the positive impacts of the grant or loan in a sustainable manner.

It ain't just what you do and the way that you do it: why discourse matters in higher education communities of practice

A number of Australian universities have established and sponsored interdisciplinary communities of practice (CoPs) to develop teaching and learning. CoPs are popularly defined as groups of people who share a passion for something and, together, learn how to do it better. Without further specification, this definition is of limited use in understanding intentionally established CoPs in higher education settings. The term CoP is used and applied in a range of ways in higher education and has been accompanied by some scholarly debate about the meaning and relevance of CoPs to academe. The prevalent response to such debate has been to propose typologies. While typology can be useful, epistemology and discourse are also significant in understanding and developing higher education CoPs. In this paper I focus on discourse surrounding CoPs as a conceptual and developmental factor which has been insufficiently considered in the literature on higher education CoPs. I draw on findings from interviews with 33 CoP members and facilitators in three Australian universities. My findings indicate that discourse surrounding CoPs is significant in shaping notions of participatory value. Connecting with the literature, my findings also reveal a ‘big D’ Discourse of collegiality whereby CoPs offer social support and knowledge sharing to build capacity, as well as spaces in which a collegial academic identity can thrive. This coincides in complex and unpredictable ways with a Discourse of managerialism. I conclude that discourse should supplement typology and epistemology in adaptively shaping understandings of contemporary higher education CoPs and their future development.

Using meta-synthesis to support application of qualitative methods findings in practice: a discussion of meta-ethnography, narrative synthesis, and critical interpretive synthesis

Meta-synthesis refers to a range of approaches by which existing qualitative studies in healthcare can bereviewed and compared. There is increasing use of meta-synthesis to ensure the clinical applicability offindings from qualitative studies, in healthcare generally, and in the creative arts therapies specifically.Qualitative method research can sometimes lack immediate clinical relevance, as such studies usuallyfocus on the experiences of a small number of participants. Additionally, the results are often presented ingreat detail; finely elaborated, and described conceptually. Findings reported in this way can be engaging,and even emotionally compelling, however the utility of these outcomes for clinical practice can belimited. Meta-synthesis of multiple studies aims to ensure that findings from qualitative methods studiescan be more easily, and effectively, applied in health and social care programs. Three approaches to metasynthesisare briefly presented here; meta-ethnography, narrative synthesis, and critical interpretivesynthesis. A procedure for presentation of meta-synthesis reviews is provided.

Identifying and integrating patient and caregiver perspectives for clinical practice guidelines on the screening and management of infectious microorganisms in hemodialysis units

Introduction: The integration of patient and caregiver input into guideline development can help to ensure that clinical care addresses patient expectations, priorities, and needs. We aimed to identify topics and outcomes salient to patients and caregivers for inclusion in the Kidney Health Australia Caring for Australasians with Renal Impairment (KHA-CARI) clinical practice guideline on the screening and management of infectious microorganisms in hemodialysis units.

Methods: A facilitated workshop was conducted with 11 participants (patients [n = 8], caregivers [n = 3]). Participants identified and discussed potential topics for inclusion in the guidelines, which were compared to those developed by the guideline working group. The workshop transcript was thematically analyzed to identify and describe the reasons underpinning their priorities.

Findings: Patients and caregivers identified a range of topics already covered by the scope of the proposed guidelines and also suggested additional topics: privacy and confidentiality, psychosocial care during/after disease notification, quality of transportation, psychosocial treatment of patients in isolation, patient/caregiver education and engagement, and patient advocacy. Five themes characterized discussion and underpinned their choices: shock and vulnerability, burden of isolation, fear of infection, respect for privacy and confidentiality, and confusion over procedural inconsistencies.

Discussion: Patients and caregivers emphasized the need for guidelines to address patient education and engagement, and the psychosocial implications of communication and provision of care in the context of infectious microorganisms in hemodialysis units. Integrating patient and caregiver perspectives can help to improve the relevance of guidelines to enhance quality of care, patient experiences, and health and psychosocial outcomes.