Chapter 4 — Evaluation & Outcomes
4.1 Policy Statement
ARmed for Medical Training and Consultancy – LLC – OP.C shall implement a comprehensive evaluation framework for all CME/CPD activities to measure effectiveness, ensure accountability, and demonstrate impact in alignment with DOH standards.
Evaluation is mandatory for every accredited activity and shall measure:
- Learner satisfaction (Level 1).
- Knowledge/competence acquisition (Level 2).
- Performance-in-practice change (Level 3).
- Patient or system outcomes (Level 4) were feasible.
Reference: DOH requires CME/CPD providers to assess activities for changes in competence, performance, and/or patient outcomes, and to retain evaluation data for 6 years.
4.2 Rationale
- DOH Activity Development Guide mandates that outcomes are linked to identified gaps and must demonstrate measurable improvement.
- Quality Assurance Manual requires providers to systematically evaluate activities for effectiveness and improvement.
- International benchmarks (ACCME) emphasize evaluation as part of a Continuous Quality Improvement (CQI) cycle.
4.3 Evaluation Framework (Kirkpatrick Model)
4.3.1 Level 1 — Reaction (Satisfaction)
- Learners’ perceptions of relevance, quality, and faculty performance.
- Tool: Standard post-activity survey.
- Timing: Immediately after activity.
4.3.2 Level 2 — Learning (Knowledge/Competence)
- Measurement of knowledge gained, or competence acquired.
- Tools:
- Pre- and post-tests.
- MCQs mapped to objectives.
- OSATS for skills-based training.
- Timing: At activity conclusion.
4.3.3 Level 3 — Behavior (Performance-in-Practice)
- Measurement of practice change at the workplace.
- Tools:
- Follow-up survey (2–3 months post-activity).
- Supervisor/peer attestations.
- Clinical audits or case reviews.
- Timing: 2–6 months post-activity.
4.3.4 Level 4 — Results (Patient/System Outcomes)
- Assessment of impact on patient care, safety indicators, or system performance.
- Tools:
- QI/QA data before and after intervention.
- Incident reports, infection rates, error reduction metrics.
- Patient satisfaction data.
- Timing: 6–12 months post-activity.
4.4 Tools and Instruments
4.4.1 Standard Evaluation Survey (Level 1)
- Relevance of topic to practice.
- Achievement of learning objectives.
- Faculty expertise and delivery quality.
- Perceived bias or commercial influence (mandatory DOH item).
- Overall satisfaction rating.
4.4.2 Knowledge Assessments (Level 2)
- Minimum 5–10 MCQs per activity.
- Questions mapped to Bloom’s taxonomy (apply, analyze, evaluate).
- Pre/post score comparison required to demonstrate knowledge gain.
4.4.3 Performance Assessments (Level 3)
- Structured follow-up survey:
- “Have you implemented [X] guideline since attending?”
- “Did this activity change your decision-making in [Y] scenarios?”
- Optional clinical audit forms.
4.4.4 Outcome Assessments (Level 4)
- QI metrics (error rates, compliance with protocols).
- Patient outcomes (readmission rates, complication rates).
- Public health indicators (vaccination coverage, screening uptake).
4.5 Reporting and Documentation
- Evaluation reports must be compiled within 14 days of activity completion.
- Reports include:
- Number of learners.
- Survey response rate.
- Satisfaction scores.
- Knowledge gain (pre/post test results).
- Follow-up performance data (if available).
- CQI actions identified.
- Reports presented to the Scientific Committee for review and approval.
- DOH requires reporting of learner completions (attendance + credits) within 30 days.
4.6 Escalation & Corrective Actions
- Minor gaps (e.g., low response rate <60%) → remedial action (additional surveys).
- Moderate issues (e.g., low knowledge gain) → activity redesign or faculty remediation.
- Serious issues (e.g., evidence of bias, failure to meet objectives) → activity suspension, CAPA log entry, and reporting to DOH within 10 working days.
4.7 Continuous Quality Improvement (CQI)
- Evaluation data is aggregated annually into the CME/CPD Annual Report.
- Oversight Committee reviews trends in:
- Learner satisfaction.
- Knowledge improvement.
- Practice change.
- Patient outcomes (if applicable).
- Findings feed into next year’s activity planning (link between Chapter 4 and Chapter 2).
- CQI actions are logged in the CAPA Register with timelines, owners, and effectiveness checks.
4.8 Documentation and Retention
- All evaluation data (surveys, test results, reports, CAPA logs) must be retained for 6 years.
- Data stored securely in both hard copy and electronic repositories.
- Learner anonymity protected in reporting (compliance with UAE PDPL).
4.9 Templates and Appendices
- Learner Evaluation Survey.
- Activity Evaluation Report format.
- CAPA Log.
- Internal Audit Checklist (evaluation section).