Evaluating your Prenatal Program

Also by Andrea Robertson Book: The Midwife Companion Book: Preparing for Birth: Mothers Book: Preparing for Birth: Fathers Book: Your Childbirth Education Classes: Finding Clients Weblog: Andrea's Diary On the same subject Andrea's Papers Childbirth Education

by Andrea Robertson
		Andrea Robertson is a Consultant in Childbirth Education from Sydney, Australia. Her books include Preparing for Birth, Making Birth Easier, Empowering Women, and The Midwife Companion. As the Principal of Associates in Childbirth Education, an independent training organisation, she oversees the world's first Graduate Diploma in Childbirth Education, and presents highly acclaimed training workshops for midwives and educators on teaching and practical midwifery, within Australia, and in many overseas countries.

Evaluation is an essential part of any educational program. It is important to know if your efforts are worthwhile and that your goals are being achieved, not only as a measure of your skills as an educator, but also to prevent burnout. There is nothing more likely to produce frustration and boredom as a feeling that what you are doing is not valued or appreciated.

Checking for results can be done in lots of ways, each offering specific information and opportunities. First, you need to know what you are setting out to achieve because without a defined set of goals it will be impossible to know if they have been attained. Part of your program planning will involve setting down the aims and objectives for your program as a whole, for each session and for each topic. Remember that there are two sets of aims to be considered, your own as the group leader and those of the people in your group. They have come with specific needs and wants and your responsibility as a leader is to ensure that these are met. One direct form of evaluation occurs when the group size shrinks because people don't feel the program is meeting their needs, and this is not the kind of evaluation most educators welcome!

Once you have established your aims and objectives and have determined what your group members want, then it should be relatively easy to check for success at this level. There are a number of ways this can be done:

• At the beginning of the program, ask the group what they are hoping to learn from the program as a whole. Write this down (perhaps on a large sheet of paper) so it can be produced during the final session for evaluation. If there are any topics that have not been covered, decide with the group how these issues might be addressed, perhaps with handouts, referral to another source of information or even an extra session. The group's needs often change during the program, so this must be borne in mind and it may be worthwhile to refer to the original list on several occasions to note any changes in their needs.

• At the end of each session, you can run a quick evaluation to assess how people are feeling at that point about the program, its content and their reactions. This could be done using a simple evaluation line ("rate yourself on a line from 'happy' to 'unhappy' how you are feeling now about ....."); a 'field of words' where participants are invited to circle words on a page that reflect their feelings at that moment; a round of sentence completion 'right now I am feeling .....', 'what I liked most about tonight was....', 'I hope that next week we .....'.

• A formal questionnaire can provide more detailed responses. Use open questions such as "the most useful part of the program for me was....", "I would have like more time spent on....." rather than closed questions such as "did you enjoy the classes?", which offer very little useful feedback. The time when this questionnaire is completed will give different results: if it is done at the end of the last class, then you will have a more accurate view of the educational value of the program just completed. A questionnaire completed after the birth will be heavily influenced by the impact of the birth itself, and may yield different results. Both have value, and you will need to consider the purpose of the questionnaire when you decide how it will be used. You can increase the rate of return of surveys postnatally if you provide a stamped addressed envelope for its return, ask people to bring them to the reunion, or even distribute them at the reunion for completion on the spot.

• Another useful form of evaluation that is not often used, is to record where people learned about the program, and an appropriate question can be asked when booking parents into the classes. Referrals from friends are a powerful affirmation of the worth of the classes and also reflect the standing of the program in the general community.

Apart from these formal ways of evaluating your work, you will also want to know from minute to minute how effectively you are performing as a presenter/leader so you know that your message is getting through. The easiest way to monitor the impact of your communication is to constantly monitor people's reactions as you are speaking. Sweep your eyes over the group (don't forget to take everyone in most of us tend to direct our gaze to certain segments of our visual field, missing some people out altogether) and notice their facial expressions. These are usually far more accurate than asking for a direct response, because if someone is confused about what is said, they are likely to say they understand for fear of appearing "stupid". Noticing their facial reaction is more likely to reveal the true picture people tend to narrow their eyes and appear slightly withdrawn when they are unclear or puzzled. When you see this happening, you can take the initiative, especially if you notice more than one person looks confused or uncertain. A simple feedback such as "I don't think I made that very clear" or "I think I may have made that more confusing than I meant to let me explain it like this..." not only confirms that you are on their wavelength, but helps build rapport with the group.

Evaluation can also be a useful tool when you want to revamp the program or introduce new teaching strategies. Plan a way of checking to see whether the new initiative produced the desired results, either directly or indirectly as part of a broader evaluation process. Be aware that sometimes an unexpected outcome of the introduction of a new teaching activity, such as confusion, boredom or lack of involvement may not be the fault of the activity itself. Many factors influence success, such as matching the teaching strategy to the level of education within the group, the learning styles preferred by group members or even just the timing within the program. Try to take all these factors into account and be willing to try the activity again under different circumstances before you consign it to the dustbin.

Many educators use their evaluations to effectively lobby for more funds/personnel/space/time etc. They can be powerful in persuading management of the value of prenatal education and the community's expectations of having quality programs available. Surveys also form an essential ingredient of any needs analysis prior to setting up new programs and they can be married with feedback already received to strengthen the case for outreach courses etc.

As an effective and professional educator, evaluation will be a tool you use regularly. Look at how you can use it creatively to strengthen your presentation and improve your status within the health care team. In many hospitals there seems to be an attitude that "anyone who is a midwife can teach the classes". This not only undermines the value of your work but seriously hampers professional development. Parents too may suffer from poorly prepared educators who struggle to provide good programs with a minimum of training. I think prenatal education deserves better recognition and evaluation is the very tool to provide the evidence!