Academic journal article Health Sociology Review

Towards an Integrated Model of Practice Evaluation Balancing Accountability, Critical Knowledge and Developmental Perspectives

Academic journal article Health Sociology Review

Towards an Integrated Model of Practice Evaluation Balancing Accountability, Critical Knowledge and Developmental Perspectives

Article excerpt

Introduction

In her infl uential typology of evaluation research, Chelimsky (1997) identifies three perspectives concerned with the evaluation of welfare practice: an accountability perspective, a knowledge perspective and a developmental perspective. The purpose of evaluation in the accountability perspective is to measure outcomes, cost-effectiveness and the efficiency of services. The knowledge perspective, on the other hand, strives for a better and more critical understanding of social problems and the working of programs and interventions. Finally, the developmental perspective aims at promoting the capacity of organizations to use knowledge wisely and respond appropriately as a learning organization to changing needs and circumstances.

Much of Chelimsky's work is driven by a need to alleviate unnecessary tensions within the field of evaluation. She suggests that the prime reason for confl ict is a failure to recognize that all three perspectives are necessary to correct weaknesses and improve the quality of practice evaluation, and that what is relevant for one perspective may be inappropriate for another. In this article, a contextualized account of Chelimsky's typology of practice evaluation will be used as a basis for unpacking the methodological discourses on evaluation, crystallized in the debate between evidencebased practice (EBP) and critical practice (CP) (Stepney 2010). Further, this will be used to explore the possibility of balancing the three perspectives to develop a more integrated model of practice evaluation in the field of mental health. It will be argued that evaluation not only represents a critical arm in driving practice agendas, but can become the basis for promoting more progressive and emancipatory forms of practice. Such debates provide critical context for the evaluation of professional practice in Australia, the UK, US and many European welfare states.

A number of questions emerge from these debates. For example, does evaluation research produce contextualized, 'robust' and reliable knowledge about the effectiveness of services? At a time when creating the conditions for economic growth has resulted in significant social costs, has the institutional capacity for evaluation within public agencies concentrated upon increasing accountability and reducing costs at the expense of critical knowledge production and development? How can new technologies of evaluation be used to liberate rather than control practitioner identities and practice communities? This article will attempt to answer such questions using evidence primarily from Finland, the UK and the international literature. However, first it may be helpful to situate practice evaluation within its global policy context.

Practice evaluation in a global policy context

The huge societal changes and rise of 'global governmentalities' (systems of regulation across national boundaries, see Larner and Walters 2004), associated with the modernization of the welfare state (Clarke 2000), have stimulated the need to rethink the role of science, including social science, and the challenges facing researchers (Novotny et al. 2001). The modernization of public services has typically involved processes designed to increase competition and improve outcomes, but within parameters of cost containment and effectiveness (Stepney 2010). It is within this context that the evaluation of professional practice and public service performance now takes place.

It should be noted that within this global context, a series of policy-to-practice paradoxes have emerged, and these present a 'slightly different view of evaluation from that offered in official accounts' (Clarke 2008:125). Three paradoxes are worthy of brief description at this juncture and will be revisited later in the analysis of the practice examples.

The first is a paradox of public authority. Governments increasingly claim that the expansion of public service evaluation is central to the modernization process and results in improved services. …

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