QUERI Implementation Guide
Section I Part 4: Formative Evaluation
Research or Evaluation?
The Role of Evaluation in QUERI
In general, there is a lack of agreement about the differentiation or association between research and evaluation. While some define this relationship as evaluation research, others see the two terms as separate concepts with different purposes and techniques. The argument arises from the fundamentally different paradigms that guide these seemingly disparate activities: The research paradigm is one of hypothesis testing, while evaluation is geared toward improving rather than proving.1
Paradigmatic differences notwithstanding, a combination of the terms is an accurate reflection of an important type of investigation that is conducted in the Quality Enhancement Research Initiative (QUERI). Within this context, classic research methods provide the means to obtain credible summative information, while standard evaluation modes are used to elicit a better understanding of why interventions succeed or fail. The importance of this understanding becomes more self-evident the closer the research objective is to enabling system-wide change, especially in regard to evidence-based health care delivery.
More specifically, within QUERI, formative evaluation, at times also referred to as process evaluation, is beginning to appear as an important segment of quality improvement research. This type of evaluation is oriented toward understanding the process rather than the outcomes of implementation, as is more typical in research-related efforts. However, formative evaluation is seldom an end in itself; its greatest value lies in the information provided to understand the outcomes of the full study or summative evaluation. Since the concept of formative evaluation may not be familiar to traditional health services researchers, it is the primary focus of this evaluation section – rather than the impact (summative) evaluation.