Ethics and evaluating educational programmes

Sir,

I read with interest the recently published AMEE education guide on evaluating educational programmes (Goldie, 2006). It is disappointing that the author made no reference to whether educational evaluations should have any form of external ethical review prior to their commencement. There are clearly many ethical issues associated with an evaluation, not least those of consent, privacy, confidentiality and risk of coercion. It could also be argued that inappropriate methodology leading to invalid or misleading results suggests that a study is unethical (this is similar to the situation in clinical research). In the United Kingdom there is no standard process available for evaluations to be ethically reviewed. The COREC route (used for clinical research in the UK) is unwieldy and not ‘fit for purpose’ for educational evaluations (or educational research for that matter) (Bedward et al. 2005). The resulting danger of this situation is that the scientific and ethical standards of evaluations (if not reviewed) may be poor. Furthermore research projects may be labelled as an ‘evaluation’ or ‘audit’ in order to avoid the COREC system. There is an urgent need for processes to be developed to enable external ethical review of educational evaluations and educational research. The processes must facilitate both these types of study by providing positive constructive feedback and avoiding excessive bureaucracy whilst at the same time ensuring the highest ethical (and scientific) standards.

Dr NJ Shaw

Associate Postgraduate Dean

1st Floor, Regatta Place, Brunswick Business Park,

Summers Road,

Liverpool, L3 4BL

Author's response

 I feel that the points made are valid and welcome. However, a system of peer review may not be practical in every context. In the guide I avoided being prescriptive as the ethics of evaluation is in its infancy. I suggested that medical educators could use similar approaches to those taken in medical ethics regarding, for example issues of consent and confidentiality. I advocated making the evaluation as robust as possible, which ideally would include external peer review although this was not prescribed. In terms of evaluation research, my experience in recent years is that it would be standard practice to submit to external peer review, particularly as it would be unlikely to be published in mainstream journals without such review. In my case I submitted it to the Medical Faculty Ethics committee. In small internal evaluations, where there is no intention to disseminate the findings, it would, however, not always be feasible to submit the proposals to external peer review.

Dr John Goldie

Department of General Practice and Primary Care

Community Based Sciences

University of Glasgow

1 Horselethill Road

Glasgow G12 9LX