Most Significant Change Technique

Dart, Jessica

doi:10.4135/9781412950596.n354

Cited by 4 publications

(5 citation statements)

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“…The MSC technique is a form of participatory monitoring and evaluation approach that involves project stakeholders in deciding the sorts of change to be recorded and in analyzing the data (27). The legacy evaluation exercise adopted the MSC method for qualitative data collection which was a slightly different method from the traditional qualitative interview method used during the end-line evaluation conducted in March 2019.…”

Section: Most Significant Change Methodologymentioning

confidence: 99%

Sustainability of the Effects and Impacts of Using Digital Technology to Extend Maternal Health Services to Rural and Hard-to-Reach Populations: Experience From Southwest Nigeria

Akeju

Okusanya

Okunade

et al. 2022

Front. Glob. Womens Health

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BackgroundNigeria has one of the worst health and development profiles globally. A weak health system, poor infrastructure, and varied socio-cultural factors are cited as inhibitors to optimal health system performance and improved maternal and child health status. eHealth has become a major solution to closing these gaps in health care delivery in low- and middle-income countries (LMICs). This research reports the use of satellite communication (SatCom) technology and the existing 3G mobile network for providing video training (VTR) for health workers and improving the digitization of healthcare data.ObjectiveTo evaluate whether the expected project outcomes that were achieved at the end-line evaluation of 2019 were sustained 12 months after the project ended.MethodsFrom March 2017 to March 2019, digital innovations including VTR and data digitization interventions were delivered in 62 healthcare facilities in Ondo State, southwest Nigeria, most of which lacked access to a 3G mobile network. Data collection for the evaluation combined documents' review with quantitative data extracted from health facility registers, and 24 of the most significant change stories to assess the longevity of the outcomes and impacts of digital innovation in the four domains of healthcare: use of eHealth technology for data management, utilization of health facilities by patients, the standard of care, and staff attitude. Stories of the most significant changes were audio-recorded, transcribed for analysis, and categorized by the above domains to identify the most significant changes 12 months after the project closedown.ResultsFindings showed that four project outcomes which were achieved at end-line evaluation were sustained 12 months after project closedown namely: staff motivation and satisfaction; increased staff confidence to perform healthcare roles; improved standard of healthcare delivery; and increased adoption of eHealth innovations beyond the health sector. Conversely, an outcome that was reversed following the discontinuation of SatCom from health facilities is the availability of accurate and reliable data for decision-making.ConclusionDigital technology can have lasting impacts on health workers, patients, and the health system, through improving data management for decision-making, the standard of maternity service delivery, boosting attendance at health facilities, and utilization of services. Locally driven investment is essential for ensuring the long-term survival of eHealth projects to achieve sustainable development goals (SDGs) in LMICs.

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Section: Most Significant Change Methodologymentioning

confidence: 99%

Sustainability of the Effects and Impacts of Using Digital Technology to Extend Maternal Health Services to Rural and Hard-to-Reach Populations: Experience From Southwest Nigeria

Akeju

Okusanya

Okunade

et al. 2022

Front. Glob. Womens Health

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“…To explore students’ stories of change after cultural safety training, we will use the most significant change approach, which is a narrative technique that allows participants to communicate changes that are most meaningful to them [ 40 ]. Using a predefined format in Google Forms, we will ask participants to write down and enter their stories based on the following instruction: “Please, tell me a story describing what you think is the most significant change in your clinical practice as a result of your participation in the activity [game jam or standard lesson] 6 months ago.”…”

Section: Methodsmentioning

confidence: 99%

Impact of Co-Designed Game Learning on Cultural Safety in Colombian Medical Education: Protocol for a Randomized Controlled Trial

Pimentel¹,

Cockcroft²,

Andersson³

2020

JMIR Res Protoc

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Background Cultural safety encourages practitioners to examine how their own culture shapes their clinical practice and to respect their patients’ worldviews. Lack of cultural safety in health care is linked to stigma and discrimination toward culturally diverse patients. Training in cultural safety poses considerable challenges. It is an unappealing subject for medical students and requires behavioral changes in their clinical practice. Game jams—collaborative workshops to create and play games—have recently shown effectiveness and engaging potential in university-level education. Objective The trial aims to determine if medical students’ participation in a game jam to design an educational game on cultural safety is more effective than a standard lesson on cultural safety in terms of change in the students’ self-reported intended patient-oriented behavior. Methods A parallel-group, 2-arm randomized controlled trial with a 1:1 allocation ratio will randomize 340 medical students and 60 medical interns (n=400) at the Faculty of Medicine at La Sabana University, Colombia (170 students and 30 medical interns to each arm). The intervention group will participate in an 8-hour game jam comprising (1) a preliminary lecture on cultural safety and game design, (2) a game building session where groups of students will create educational games about cultural safety, and (3) a play-test session in which students will play and learn from each other’s games. The control group will receive a standard lesson, including a 2-hour lecture on cultural safety, followed by a 6-hour workshop to create posters about cultural safety. Web-based self-administered 30-item Likert-type questionnaires will assess cultural safety self-reported intended behavior before, immediately after, and 6 months after the intervention. An intention-to-treat approach will use a t-test with 95% CIs to determine the significance of the effect of the intervention, including within- and between-group comparisons. The qualitative most significant change technique will explore the impact of the intervention on the clinical experience of the students. Results Study enrollment began in July 2019. A total of 531 students completed the baseline survey and were randomized. Data collection is expected to be complete by July 2020, and results are expected in October 2020. The study was approved by the institutional review board of the Faculty of Medicine at McGill University (May 31, 2017) and by the Subcommittee for Research of the Faculty of Medicine at La Sabana University (approval number 445). Conclusions The research will develop participatory methods in game-based learning co-design that might be relevant to other subjects. Ultimately, it should foster improved cultural safety skills for medical students, improve the quality of health services for diverse cultural groups, and contribute to enhanced population health. Game learning may provide an innovative solution to a long-standing and neglected problem in medical education, helping to meet the educational expectations and needs of millennial medical students. Trial Registration ISRCTN Registry ISRCTN14261595; http://www.controlled-trials.com/ISRCTN14261595

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“…To this end, in addition to the usual end-of-program feedback forms that participants were asked to complete, each Green Steps @ Wannon Water participant was interviewed using a dialogic, story-based technique called Most Significant Change (MSC; Dart & Davies, 2003, 2005). MSC was initially developed to evaluate complex rural development programs.…”

Section: Identifing Program Impacts — Methodsmentioning

confidence: 99%

Transformations? Skilled Change Agents Influencing Organisational Sustainability Culture

Davis

Boulet

2016

Aust. J. environ. educ.

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Training employees in sustainability knowledge and skills is considered a vital element in creating a sustainability culture within an organisation. Yet, the particular types of training programs that are effective for this task are still relatively unknown. This case study describes an innovative workplace training program using a ‘head, hands, heart and feet’ learning framework to create skilled change agents among employees, in order to influence organisational sustainability culture. Utilising a dialogic inquiry methodology (Most Significant Change), as well as Mezirow's phases of transformative learning and Schein's organisational culture framework, this study considers the training program's impact on both participants and organisational sustainability culture. While transformative learning impacts for participants were identified, questions remain as to the overall impact of the program on the organisation's sustainability culture. Considering training participants as ‘seeds of influence’ as opposed to wholly responsible for organisational culture might provide new perspectives to these questions.

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Most Significant Change Technique

Cited by 4 publications

References 0 publications

Sustainability of the Effects and Impacts of Using Digital Technology to Extend Maternal Health Services to Rural and Hard-to-Reach Populations: Experience From Southwest Nigeria

Sustainability of the Effects and Impacts of Using Digital Technology to Extend Maternal Health Services to Rural and Hard-to-Reach Populations: Experience From Southwest Nigeria

Impact of Co-Designed Game Learning on Cultural Safety in Colombian Medical Education: Protocol for a Randomized Controlled Trial

Transformations? Skilled Change Agents Influencing Organisational Sustainability Culture

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