Eco-Normalization: Evaluating the Longevity of an Innovation in Context.

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Abstrakt

Tytuł:: Eco-Normalization: Evaluating the Longevity of an Innovation in Context.
Autorzy:: Hamza DM; D.M. Hamza is an implementation scientist and the research and evaluation lead for postgraduate medical education, University of Alberta, Edmonton, Canada; ORCID: https://orcid.org/0000-0001-8943-2165 .
Regehr G; G. Regehr is professor, Department of Surgery, and scientist, Centre for Health Education Scholarship, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; ORCID: https://orcid.org/0000-0002-3144-331X .
Źródło:: Academic medicine : journal of the Association of American Medical Colleges [Acad Med] 2021 Nov 01; Vol. 96 (11S), pp. S48-S53.
Typ publikacji:: Journal Article; Review
Język:: English
Imprint Name(s):: Publication: Philadelphia, PA : Published for the Association of American Medical Colleges by Lippincott Williams & Wilkins
Original Publication: [Philadelphia, Pa. : Hanley & Belfus, c1989-
MeSH Terms:: Diffusion of Innovation*
Models, Educational*
Education, Medical/*trends
Humans ; Implementation Science ; Program Evaluation
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Entry Date(s):: Date Created: 20210804 Date Completed: 20211108 Latest Revision: 20230717
Update Code:: 20240105
DOI:: 10.1097/ACM.0000000000004318
PMID:: 34348375
: Czasopismo naukowe

Purpose: When initiating an educational innovation, successful implementation and meaningful, lasting change can be elusive. This elusiveness stems from the difficulty of introducing changes into complex ecosystems. Program evaluation models that focus on implementation fidelity examine the inner workings of an innovation in the real-world context. However, the methods by which fidelity is typically examined may inadvertently limit thinking about the trajectory of an innovation over time. Thus, a new approach is needed, one that focuses on whether the conditions observed during the implementation phase of an educational innovation represent a foundation for meaningful, long-lasting change.
Method: Through a critical review, authors examined relevant models from implementation science and developed a comprehensive framework that shifts the focus of program evaluation from exploring snapshots in time to assessing the trajectory of an innovation beyond the implementation phase.
Results: Durable and meaningful "normalization" of an innovation is rooted in how the local aspirations and practices of the institutional system and the people doing the work interact with the grand aspirations and features of the innovation. Borrowing from Normalization Process Theory, the Consolidated Framework for Implementation Research, and Reflexive Monitoring in Action, the authors developed a framework, called Eco-Normalization, that highlights 6 critical questions to be considered when evaluating the potential longevity of an innovation.
Conclusions: When evaluating an educational innovation, the Eco-Normalization model focuses our attention on the ecosystem of change and the features of the ecosystem that may contribute to (or hinder) the longevity of innovations in context.
(Copyright © 2021 by the Association of American Medical Colleges.)

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