Preformative and Developmental Evaluation Theories Used to Reveal Dimensions of Merit When Implementing an Ethics Committee into a Hospice Organization

Date of Award


Degree Name

Doctor of Philosophy



First Advisor

Dr. Chris L. S. Coryn

Second Advisor

Dr. Janet Hahn

Third Advisor

Dr. Mary Ann Stark


Hospice, goals and objectives of care, dying care, evaluation, predictive valuing, probative inquiry


In this dissertation, the process of developing evidence-based guidelines to add a bioethics function in an established hospice organization was explored. The research examined if the components of preformative evaluation (Scriven), and developmental evaluation (Patton) create a structure of inquiry adequate to serve as scaffolding to demystify the dimensions of merit for the merging of an ethics committee into an established hospice organization. The research sought to respond to two questions: what should be known about an established hospice organization in order to create its bioethics function; and what are the needs of the process owners that should be known in order to create a bioethics function in an established hospice organization? To this end, the research used a bounded single case study approach, and consisted of non-probability emergent purposive sampling methods and utilized direct interviews with the leadership team of the hospice, and a network of respondents, comprised of other affiliated workers in the healthcare field. Data was gathered from the respondents in response to open-ended semi-structured questions, prompted but unstructured narrative listening, body language, unstructured responses to presentation material, and written questions. Relevance of response was established at the single-utterance level.

An inductive approach to analysis of the findings revealed that the use of preformative and developmental evaluation were valuable tools of obtaining information that situates the hospice in the place and context of its role in providing care to its subscribers. In addition, evaluation was useful in predictive-valuing the manner in which any future ethics committee would come to synergy with the mission, values, and vision of the leadership team as they manage a patient-centric organization.

The value of the research into evaluation theory has not only revealed the leaders’ requirements for the creation of the ethics committee; but also has identified many pitfalls that if not addressed prior to project design and implementation could challenge the success of the formation of the ethics committee within their organization. In the presence of the findings from this study, the likelihood of program success is assured, and a possible false-start prevented. Successful implementation of the program makes future formative evaluation possible.

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