The assessment seeks to outline the principles of research reflected in research articles, the type of study applied in the research articles, the appropriate tools of evaluation applied and the issues relating to ethics in the research articles. This study also seeks to find out the strengths and limitations of the kind of study applied to the research articles in question as well as the repercussions of the research to public health. The major segments of the appraisal are, type of study, assessment tools applied and the ethical issues revolving around the research articles.
In the quantitative article a 360o subjective appraisal tool and a case-study objective assessment tool were used. The tools sort to find out the competence of mid-level managers in applying the competency of Evidence-Informed Decision-Making and the behaviors within the competency that necessitate improvement for mid-level health service managers at the individual and managerial levels (Bhattacherjee, 2012). In the 360o subjective assessment, a self-assessment of senior health service managers, supervisor assessment, peer evaluation and report study were done to find out the competency level of mid-level managers in making substantial decisions (Liang, et al., 2017).
In the qualitative article a case-control study tool was used to find out the effect of separation from kindred on the psychological condition and welfare of Sudanese migrants in Australia and the schemes used to cope with the situation (Guest & Namey, 2015). Systematic interviews were conducted with the Sudanese communal reps and health workers, primary and psychological medical providers, health service executives and legislatures (Savic, et al., 2013).
The capability of managers to apply EIDM in their roles was assessed by a 360o subjective valuation and a case study objective valuation. A 360o appraisal tool constituting a self-assessment completed by the key mid-level managers participating in the evaluation, supervisor assessment, peer evaluation done by the managers from the same management level within the same institution and report study completed by staff who directly report to key managers participating in the research (Liang, et al., 2016). The objective assessment was conducted via a series of questions pertaining clinical governance across a range of services through a platform based in the web. The web-based platform developed for accommodating and analyzing the evaluations was managed by a research team. The analysis of the data downloaded from the website provided different results of the several types of subjective study and the objective valuation.
A combined colleague results was calculated to protect the confidentiality of primary participants (Petrova, et al., 2014). The results were calculated using mean scores in order to get the combined result for the EIDM competency and the behavioral questions. Majority of the people participated as assessors. Majority of the managers completed the subjective appraisal thereby giving a 100% completion rate of the behavioral questions and the competency level research of Evidence-Informed Decision-Making. In some hospitals the managers proved to be very competent while in others the competency level was quite low. Some behavioral aspects indicated that managers required support while making decisions judging by the scores (Ellen, et al., 2014). On the other hand, some aspects indicate that managers do not require support in making decisions.
The improvement of Health managers’ decision making practices is necessary for the career of managers. The research is relevant since EIDM is associated with good health care results (Naude, et al., 2015). The competence level increases with increase in the management level. The education level of managers and gender also has an impact on the competency level of senior and mid-level health managers (Huber, et al., 2015). The competency level of managers with a doctorate in medicine is higher compared those with a masters’ degree, bachelors’ degree, a diploma or a certificate. This varies due to the knowledge accrued along the way by the managers. Male doctors are believed to stay in the mid-level sector longer compared to female doctors (Liang, et al., 2016). Making Evidence-Informed Decisions depends on experience gained throughout their medical professions. Male doctors will have acquired more experience in the mid-level sector compared to female doctors thereby being at a better position of making Evidence-Informed decisions.
The competency context of health service managers, however, varies between different sectors and organizations (Naude, et al., 2015). The overall competency result of the management group does not reveal the individual competence of health managers and organizations. The number of managers perceived as requiring guidance in demonstrating competency in Health managers’ decision making and managers perceived as highly competent with vast experience in the subjective assessment varies from one organization to another (Langlois, et al., 2016). The requirements for enhancing the competence of managers such as EIDM vary among individual managers. Therefore, the important needs for improving the competence in the decisions made between individual managers should be identified and the training & development opportunities should also be provided for competency enhancement.
The appraisal of the article only focused on health service managers at two local hospitals and those who participated were volunteers and not selected randomly. Even though the size of the sampling was small, a difference between the competencies levels of organizations was assessed (Fukada, 2018). According to the research study, mid-level health service managers from Victorian hospitals are quite competent. However, the question of why managers do not incorporate EIDM in their daily jobs arose. The key barriers to making substantial decisions between mid-level managers and senior health service managers are the availability of time, the relevance of research management, insufficient financial resources to aid the best practice and lack of vital assessment skills (Stewart, et al., 2017).
The competence of the mid-level managers from the two Victorian hospitals was assessed and found to be competent enough. The areas with gaps require improvements to enhance their competence. The areas necessitating improvements also vary between organizations and individuals. Some individuals and organizations have more short comings in behavioral items compared to others. The improvement of an individual manager’s competence is vital to the enhancement of the EIDM exercise among health service managers. Additional improvements to the organizations are also necessary to the individual and organizational competency levels. The challenging health care environment can be solved by the enhancement of Health managers’ decision making (Walston & Khaliq, 2010).
The changes in healthcare experiences have altered the functioning and management of healthcare system. Improvements in EIDM practices improve the efficiency and effectiveness of provision of services by health organizations and health service managers. The behavioral items of health service managers was portrayed in seven different ways, not competent, basic, advanced beginner, competent, but need guidance, competent but no guidance is required, proficient and superior expertise (Liang, et al., 2017). The 360o subjective assessment and case-study assessment have portrayed more strengths than weaknesses according to the research article.
The assessment of the effect of separation from kindred on health of Sudanese migrants in Australia took a qualitative approach and a case-control study. The qualitative approach involves seeking people’s opinions and personal experiences (Rahman, 2016). The case-control study starts with the outcome and involves interrogation of a group of people, for instance the Sudanese refugees in Australia. Since 1996, a number of Sudanese migrants have settled in Australia.
The Sudanese population in Australia has been increasing over time. Skirmishes, negative experiences in the refugee camps and persecution are some of the things the Sudanese community endures (Munro, 2017). The aftermath effects of these problems are mental distress and illness. Mental health involves the person being in a position to cope with the normal stress in life and be productive to the society. The value of culture and children makes the community’s cohesion important and Sudanese families are also likely to be very large.
However, the Sudanese families’ organization has been altered by wars and consistent migration as many people are separated from their families. Many migrants arrived in Australia as lone people though they are likely to have belonged to a larger family. The consistent separation from family has impacted differently to the welfare of the Sudanese community in Australia. The post-migration stress caused by worrying about their families not living in Australia is one of the psychological distresses experienced by the Sudanese people (Li, et al., 2016). Worrying about their original homelands affects the psychological condition of the Sudanese migrants in Australia. Detailed interviews were done involving the Sudanese community agents and health personnel, psychological health care practitioners, health service managers and legislatures.
A number of primary informants above 18 years of age were designated as they were more familiar with the refugee issues among the Sudanese community. Some informants were not of the Sudanese background but were still familiar with the Sudanese Community’s experiences. All the informants gave their resettlement experiences over the last few years. The interviews were carried out over time with a consistent comparison. No new changes were recorded over time. The interview program consisted of migration experiences and mental health needs, service contact and delivery, barriers and gaps and potential improvements to the health system. The interviews were later analyzed using a teaching and learning (thematic) approach (Savic, et al., 2013). The primary data was extensively interpreted by the research to come up with a conclusive outcome. The primary participants in the interview outlined the continuous effect of people and worldwide actions on mental health and migration of the Sudanese immigrants in Australia.
Major issues outlined in the analysis are separation and its impacts, bridging the separation gap and sending money back home. Sudanese refugees reflected more on these matters. Non-Sudanese health service provider primary informants did not engage in the topic of separation and its impacts and the coping strategies. The few that did are those that specifically worked at refugees’ community health service camps where they dealt with social issues and the needs of the refugees.
The Sudanese refugees particularly talked about the conflicts that necessitated the migration and separation of families. Separation greatly impacted on the settlement of refugees in Australia. The guilty feeling of being able to escape from the suffering that some members of their families were still enduring constantly disturbed those settled in Australia. Several Sudanese cultures such as women rearing children were interfered with. This therefore insinuates that men had to take up the responsibility formerly bestowed to women traditionally. The resettling Sudanese refugees try to bridge the separation gap by sending money back home (Wickramaarachchi & Burns, 2016). This helps to maintain the link with family members. However, this has become a perpetual source of agony to the settled refugees. Communication technology exerts the pressure to send money back home. A feeling of disappointment brought by the inability to send money back home is exerted.
The Information Communication Technology has assisted the Sudanese community to keep in touch with their families back at home (Mikal & Woodfield, 2015). Mobile phones and the internet have greatly assisted in bridging the gap even though they are not adequate enough to some people. The assessment reveals that the wellbeing of refugees in Australia is endangered by the feeling of relatives’ insecurity. However, an extensive research needs to be conducted on recent refugees who consume the services at refugee camps and not the service providers. This will help in getting accurate details about the effects of separation on psychological health and how the Sudanese refugees cope with the impacts. In-depth interviews should also be conducted with the families of the refugees back at their homes in order to find out their mental health status.
Respecting the independence of research subjects (National Advisory Board on Research Ethics, 2009)
In the quantitative article the participants volunteered to participate in the research. The confidentiality of the participants’ details has also been upheld. There’s no mentioning of names within the research and no illegal research was conducted. The health service managers engaged in the research out of consent and not coercion.
In the qualitative article a selection of the informants was done, however, it was out of will. The primary informants volunteered to give information of behalf fellow refugees. No personal details were revealed in the research articles thereby respecting the informants’ confidentiality.
Avoiding mental harm (National Advisory Board on Research Ethics, 2009)
In the quantitative article, the health service managers were asked general questions that did not cause any financial or social harm to the participants. Moreover, the details of the interview were kept confidential thereby averting the risk of a possible social harm.
In the qualitative article the researchers seemed to have asked very personal and emotional questions. Questions of how the refugees got separated from their families bring back sad memories to the participants. However, in the research article, the emotional events are not outlined thereby a risk of mental harm is avoided.
Right to privacy and data protection (National Advisory Board on Research Ethics, 2009)
Right to privacy is accorded to people in the constitution therefore for people to reveal personal details to a researcher, they must entrust them with that information. The researcher should not at any point be careless with that data collected. In case such kind of information is not needed for research then it should be destroyed. If the information is necessary, then the researcher should protect the data at all costs.
In the quantitative article, the researcher uses a subjective assessment tool to find out the effectiveness of Evidence-Informed Decision-Making. A collective result is calculated in order to protect the identity of the participants.
In the qualitative article, the researcher gives an account of how the Sudanese refugees’ mental health is affected by the separation from their families. Neither identities nor personal details of the refugees are mentioned. Therefore, the privacy of the refugees has been upheld.
The competence of mid-level manager is measured in two Victorian hospitals using a 360o Online Subjective Assessment tool and a case-study objective assessment. The strengths of the study are, the competence of the health service managers is measured and is able to be improved and their behaviors within the competency can also be improved. However, the competency of health service managers in making decisions varies between individuals and organizations therefore an accurate average of the competency level cannot be measured (Nehrir, et al., 2016). Competency also depends on the resources available at the hospitals. Health service managers in hospitals with better resources are more likely to make Evidence-Informed decisions compared to their counterparts at hospitals with inadequate resources. The behavioral items used in EIDM also vary between individuals therefore an accurate average result is rare to find.
A qualitative research approach and a case-control study were used in this article. Comprehensive interviews with the Sudanese community representative and health workers, key mental health care providers and health managers were conducted. The research team analyzed the data by learning from the refugees and teaching them as well (Sutton & Austin, 2015). Extensive interviews with refugees helped the researchers get accurate and first-hand information about the effects of migration to the mental health of the Sudanese evacuees. The researchers found out that the separation of the Sudanese refugees in Australia from their families affected their psychological condition. However, further research is necessary. The researchers did not interview recent refugees at the camp. The research team also gave priority to the service providers the refugee camp instead of the refugees who were receiving the services.
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