Critical Reflection

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Academic Level: Masters

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a critical of the following ch.14 16, 17 of that book I will send you. Thank you

in this book you will find the chapters mentioned in the instructions to do a reflection
Kindly consider that the following has been adressed in the paper. 
In reading chapters 6 through 9 in the Issel text, I found myself relating to my experience in program planning/implementation, intervention selection, and goal/objective setting.  Although I did not know the specific terminology related to Program Theory, I do feel that I have lived through the process of developing a program theory.  The value of reading the textbook, to me, was in having a better understanding of the theories and elements that must be present for an effect program theory.  In my work, I primarily utilize the Institute for Healthcare Improvement (IHI) Model of Improvement.  Although the model does not specify the details found in the textbook about the Process Theory and Effect Theory, the IHI model does include similar principles found in the text including stakeholder engagement in program planning, needs analysis, and objective/goal definition, causal/determinant factors identification, a process for identifying interventions that will affect the causes of the health problem, goal statements, and SMART objectives.  Although the IHI model has some useful tools to identify health problems and develop programs to improve those health problems, the Issel text provides a stronger, more detailed explanation of why it is important to have clear, concise statements and pictorial representations of the Causal Theory Statement and Program Theory.  Being able to ensure all stakeholders and project team members are clear on the problem, interventions, objectives, organizational capacity, and intended health outcomes/impacts is important to keep everyone focused and on track. In developing interventions I have generally referenced most of the 8 Characteristics of Good Interventions in determining if an intervention was the correct one to move forward with in a program.  The text helped to categorize these characteristics and in future projects I will use this as a checklist to ensure all are addressed.  In my position as Director of Population Health at Drexel Medicine, I am responsible for developing quality improvement plans for our practices as part of our Patient Centered Medical Home submission.  The National Committee for Quality Assurance (NCQA) requires similar goal and objective setting standards as were outlined in Chapter 7.  Particularly, setting a target goal and not relying on words like “reduce” or “improve” to quantify the objective.  We use HealthPeople2020, NCQA, PQRS, and CMS benchmarks when developing our objectives to ensure they are reliable targets and align with our patient population.  I appreciated Issel’s list of options for creating objectives when reliable targets are not available.  It can be anticipated that this will be useful to apply to future programs. In Chapter 8, Issel discusses program implementation in terms that I was able to relate to the Project Management Institute’s (PMI) PMBOK Process Groups and Knowledge Areas.  Similar theories were presented in both as it relates to inputs, outputs, throug

I found the summary tables in Chapter 14 describing types of analysis test by level of intervention (14-4), level of measurement for comparison-focused analyses (14-6), and level of measurement for association-focused analyses (14-7) to be especially effective as a refresher for some of the content we learned in biostatistics. It’s very helpful to have a quick reference for the types of analytic tests I should use if, for example, I have interval data. This will definitely be a resource that I use for my work in the future. The qualitative analysis content in Chapter 15 was especially relevant because I will be doing qualitative work (interviews and focus groups) for my independent study. Qualitative methods are an area in which I’m looking to grow my skill set. Although I have assisted in developing discussion guides and leading discussions, I have not had the opportunity to code qualitative data or think critically about sampling strategies, since funding for our projects usually dictates/limits the number of interviews or focus groups we can conduct. I also found the discussion of credibility and transferability to be interesting because qualitative methods are often viewed as less rigorous. Issel mentions that credibility is increased when those who provided the data are asked to review and confirm the accuracy of data interpretations. It seems to be that this is not done often enough! Finally, I think that Chapter 16 is immensely important and very relevant to my current work. Although PHMC has always had an IRB, it recently underwent major changes to make the review process far more rigorous. PHMC and the Research and Evaluation Group within PHMC is currently grappling with the “HIPAA and evaluations” conundrum Issel describes on pg. 388. PHMC operates six FQHCs around the city, which all use a single EMR system. The currently discussion within our IRB is who may have access to data stored within the EMR since PHMC is a large organization with a complicated structure. Finally, I thought that the discussion of dissemination was lacking in one major area – it did not discuss dissemination back to the communities/populations/individuals providing the data. Researchers and evaluators alike should have a commitment to ensuring the information is fed 

example of how to do the reflection I found the summary tables in Chapter 14 describing types of analysis test by level of intervention (14-4), level of measurement for comparison-focused analyses (14-6), and level of measurement for association-focused analyses (14-7) to be especially effective as a refresher for some of the content we learned in biostatistics. It’s very helpful to have a quick reference for the types of analytic tests I should use if, for example, I have interval data. This will definitely be a resource that I use for my work in the future. The qualitative analysis content in Chapter 15 was especially relevant because I will be doing qualitative work (interviews and focus groups) for my independent study. Qualitative methods are an area in which I’m looking to grow my skill set. Although I have assisted in developing discussion guides and leading discussions, I have not had the opportunity to code qualitative data or think critically about sampling strategies, since funding for our projects usually dictates/limits the number of interviews or focus groups we can conduct. I also found the discussion of credibility and transferability to be interesting because qualitative methods are often viewed as less rigorous. Issel mentions that credibility is increased when those who provided the data are asked to review and confirm the accuracy of data interpretations. It seems to be that this is not done often enough! Finally, I think that Chapter 16 is immensely important and very relevant to my current work. Although PHMC has always had an IRB, it recently underwent major changes to make the review process far more rigorous. PHMC and the Research and Evaluation Group within PHMC is currently grappling with the “HIPAA and evaluations” conundrum Issel describes on pg. 388. PHMC operates six FQHCs around the city, which all use a single EMR system. The currently discussion within our IRB is who may have access to data stored within the EMR since PHMC is a large organization with a complicated structure. Finally, I thought that the discussion of dissemination was lacking in one major area – it did not discuss dissemination back to the communities/populations/individuals providing the data. Researchers and evaluators alike should have a commitment to ensuring the information is fed back to research/study subjects as well as the academic literature……

 

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