Unpacking economic programme theory for supervision training: Preliminary steps towards realist economic evaluation

Area of Science:

• Health economics
• Programme evaluation
• Supervision training

Background:

• Cost studies are vital due to resource constraints.
• Traditional cost studies often neglect context and theory.
• Realist economic evaluation (REE) emphasizes context and economic programme theory.

Purpose of the Study:

• To test and refine economic programme theory for supervision training programs of varying durations.
• To inform future program design and implementation through a preliminary REE.

Main Methods:

• A preliminary REE was conducted using mixed methods (qualitative realist and quantitative cost methods).
• Short (half-day) and extended (12-week) supervision training programs in Victoria, Australia were analyzed.
• Economically optimized program models were developed based on identified cost-sensitive mechanisms and contexts.

Main Results:

• The extended program (12 weeks) produced more outcomes (11) but at a higher cost (AU$3069/learner) than the short program (7 outcomes; $385/learner).
• Shared cost-sensitive mechanisms included training duration, learner protected time, engagement, and facilitator competence.
• Optimized models suggested shorter programs for experienced supervisors and extended programs for inexperienced ones, with adjusted costs.

Conclusions:

• The initial economic programme theory was refined through the REE.
• Findings extend previous research by detailing cost-sensitive mechanisms and contexts in supervision training.
• Conducting REE presents methodological challenges in integrating economic and realist analyses.
• Balancing training costs and outcomes can be achieved by considering training duration and facilitator-learner experience levels.