Evolving from Outcome to Impact on Clinical Decisions and Delivery of Care

For decades, continuing education has been seen as a solution to improving clinical decision-making (knowledge, skill, confidence, attitude) of healthcare professionals (HCPs) as well as changing their behaviors (performance). However, education alone does not always impact delivery of care, and thus, does not always lead to improved patient health. This interactive workshop invites participants to explore and reflect on how, when and why we should rethink what we are truly trying to evaluate when it refers to educational interventions.

The terms Outcome and Impact are often used interchangeably, although they refer to quite different concepts. Outcome usually refer to specific and measurable short-term effects, such as an immediate change in knowledge following the education program for example. Impact implies a more comprehensive perspective, looking at broader and longer-term effects, evaluating the overall contribution of the intervention on individuals, teams and systems (Harding, 2014). According to Fedorciow & Bayley (2014), impact in education has been defined as “an effect on, change or benefit to the economy, society, culture, public policy or services, health, the environment or quality of life, beyond academia.” Husseini et al. (2022) differentiate outcome and impact by responding to the question: Does the result of the program derive directly from the program itself (outcome) or from the program’s interactions with outside forces (impact)? In other words, the impact of an intervention is influenced, positively or negatively, by the context in which the learning took place (instructional context), and the context in which the learner will attempt to transfer it (implementation context). A systematic impact evaluation should include investigation of all impacts of an intervention, whether positive or negative, direct or indirect, or reflecting an intended or unintended change, and should include context in its identification of causalities (Clark, Conti et al., 2019).

This facilitated interactive workshop will provide an opportunity for participants to reflect and discuss the differences between outcome and impact among their peers, and what really matters most when evaluating interventions and programs aimed at changing HCPs’ practices and positively impact delivery of care. In the context of constraints in budget and resources, it is important to reflect on when and why it becomes relevant to invest in collecting evidence on long term impact and how to optimally engage in impact assessment.

Real-world case examples of programs and their evaluation plan will be presented to support the discussion. Finally, participants will be invited to share real examples from their practice with each other, to incite reflection and learning.

Participants will leave with key takeaways on the important considerations to keep in mind when assessing impact versus outcome, and where education and other interventions and strategies should be combined to truly impact and generate improvement in the delivery of care in real-world settings