Thursday, July 15, 2010

Empowerment Evaluation in Stanford University's School of Medicine

Empowerment Evaluation in Stanford University’s School of Medicine (Article in Academic Medicine)

An empowerment evaluation was conducted in Stanford University’s School of Medicine, focusing on the curriculum during an accreditation self-study.  This study was notable because:

  •         It was conducted in a premier tier 1 research institution
  •         It was conducted in a medical school context
  •         The findings were statistically significant 

 The findings were presented in Academic Medicine, a medical education journal, earlier this year.  A graph of some of the findings is presented below:

The graph is a comparison of course ratings of “excellent” or “very good” at Stanford University School of Medicine before and after the empowerment evaluation intervention, and the percentage difference between the ratings from 2006-2007 and those from 2004-2005.  Overall, the average student ratings for the required courses improved significantly (P=.04, Student’s t test).  The courses are represented by letters to preserve anonymity.

This article also highlights tools of empowerment evaluation. The example provides additional insight into the application of this approach, including: 

1.  developing a culture of evidence
2.  using a critical friend
3.  encouraging a cycle of reflection and action
4.  cultivating a community of learners
5.  developing reflective practitioners

Overall, empowerment evaluation was found to provide an approach that is more in keeping with the evolving culture of medical education nationwide and offers valuable tools for building a better teaching experience for faculty and an enhanced learning environment for students.

Senior Author:  Dr. Fetterman at the time of the curriculum change and the accreditation self-study, was the Director of Evaluation, Office of Medical Education in the School of Medicine at Stanford University. He is currently President and CEO of Fetterman and Associates, an international evaluation firm.  He is also professor of education at the University of Arkansas at Pine Bluff (UAPB), Arkansas.  UAPB is recognized as an Historically Black College and University (HBCU).  Dr. Fetterman is also the Director of the Arkansas Evaluation Center (passed by the House and Senate and signed by the Governor in 2008).

This is the link to the Academic Medicine web page.  The abstract is presented below:  


Medical schools continually evolve their curricula to keep students abreast of advances in basic, translational, and clinical sciences. To provide feedback to educators, critical evaluation of the effectiveness of these curricular changes is necessary. This article describes a method of curriculum evaluation, called “empowerment evaluation,” that is new to medical education. It mirrors the increasingly collaborative culture of medical education and offers tools to enhance the faculty's teaching experience and students' learning environments. Empowerment evaluation provides a method for gathering, analyzing, and sharing data about a program and its outcomes and encourages faculty, students, and support personnel to actively participate in system changes. It assumes that the more closely stakeholders are involved in reflecting on evaluation findings, the more likely they are to take ownership of the results and to guide curricular decision making and reform. The steps of empowerment evaluation include collecting evaluation data, designating a “critical friend” to communicate areas of potential improvement, establishing a culture of evidence, encouraging a cycle of reflection and action, cultivating a community of learners, and developing reflective educational practitioners. This article illustrates how stakeholders used the principles of empowerment evaluation to facilitate yearly cycles of improvement at the Stanford University School of Medicine, which implemented a major curriculum reform in 2003–2004. The use of empowerment evaluation concepts and tools fostered greater institutional self-reflection, led to an evidence-based model of decision making, and expanded opportunities for students, faculty, and support staff to work collaboratively to improve and refine the medical school's curriculum.

Contact Dr. Fetterman for additional information.