Performance Measurements There Are Several

Performance Measurements

There are several problems with Marjorie's research design. One major ethical issue is the random assignment of the subjects to groups. The women expressing interest in the programs may have specific programs in mind or alternately they may have specific needs. Some of the pregnancy-related courses may have medical implications. This means that if a woman interested in post-natal care is instead assigned to a budgeting course and subsequently experiences problems that could have been addressed by the post-natal care course, Marjorie would have exposed that woman and her baby to risk for the sake of her research. If this can be done in an ethical fashion at all, it should be done with the informed consent of the woman.

It is also worth considering that Marjorie is proposing to arbitrarily treat some of the courses as placebos. For example, the family budgeting workshop is being treated as a placebo for other courses yet because it has specific value it is not a true placebo. Therefore, Marjorie will not be accurately testing a hypothesis against a placebo, which reduces the validity of the study. The placebo study structure is highly effective, but may not be appropriate for the type of information that Marjorie is attempting to gain. There are ethical issues that arise when a placebo format is used, and Marjorie can avoid these issues altogether with a better study design (Huston, 2001).

In addition, Marjorie's proposed measure of outcome is fraught with ethical issues. She is going to measure negative outcomes in order to test the effectiveness of her programs. In doing this, she is willfully exposing mothers and infants to problems -- some potentially serious. Essentially, she is proposing that mistakes be made so that they can be learned from. While noting negative outcomes is important for making quality improvements, the objective of the evaluation should be positive outcomes or at the least an absence of negative outcomes. Marjorie is correct in claiming that fewer problems are one way to measure the success of the programs, but she has not framed this in an ethically-acceptable manner. Problems for the key stakeholders -- the mothers and their infants -- should be avoided at all costs in her evaluation. She needs to focus on reducing errors and she should also focus on developing positive outcomes, as these demonstrate a greater degree of respect for the stakeholders (Winstanley & Stuart-Smith, 1996).

The study should be observational in nature. The clinic may have, or could gather, data from past participants to begin Marjorie's evaluation process. This would allow her to make improvements immediately to the programs. Even if only partial data could be gathered, it may be sufficient for Marjorie to develop stronger hypotheses to test. She currently has little more than hunches to test, so gathering data from past courses would be a good starting point, since many of the participants will have retained their contact information.

Marjorie could also begin her evaluation based on the experiences of other similar programs elsewhere. Other clinics, governments or NGOs will have run similar programs and some of the data from those programs may be readily obtainable. By doing so, Marjorie would shorten the lead time for gathering information about program effectiveness. Currently, it could take years for Marjorie to truly understand the effectiveness of the various programs available.