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Impact evaluation of the teaching and
research process of the General Teaching
Hospital of Calderón Quito-Ecuador
Evaluación de impacto del proceso de docencia e
investigación en el Hospital General Docente de
Calderón Quito-Ecuador
Luis Olmedo-Pérez
Hospital General Docente de Calderón, Quito, Ecuador
Gestión de Docencia e Investigación
luis.olmedo@hgdc.gob.ec
https://orcid.org/0000-0002-3098-2725
Patricia Benavides-Vera
Hospital General Docente de Calderón, Quito, Ecuador
Gestión de Docencia e investigación
patricia.benavides@hgdc.gob.ec
https://orcid.org/0000-0003-0282-9229
Fernando Durán-Lucio
Universidad Central del Ecuador, Quito, Ecuador
Facultad de Medicina, Dirección de Docencia UCE para HGDC
fduran@uce.edu.ec
https://orcid.org/0000-0001-7516-311X
(Received on: 26/03/2024; Accepted on: 30/04/2024; Final version received on: 30/06/2024)
Suggested citation: Olmedo-Pérez, L. F., Benavides-Vera, P. y Duran-Lucio, F. (2024). Impact
evaluation of the teaching and research process of the General Teaching Hospital of
Calderón Quito-Ecuador. Revista Cátedra, 7(2), 98-116.
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Abstract
The Impact Evaluation Study of the teaching and research process of the Calderón General
Teaching Hospital-HGDC in the city of Quito-Ecuador in the period 2016-2022, aims to
measure the impact of the Teaching and Research process with respect to: (1) academic
process and resources, (2) evaluation and research, (3) learning, training and knowledge
transfer and (4) clinical-surgical practice and performance; through the design and
application of the impact evaluation methodology with a focus on measurable results,
Balanced Scorecard-BSC. The target group was identified as undergraduate students,
rotating interns, postgraduate students, teachers and health care personnel of the Higher
Education Institutions (HEI) that perform their health care and academic activities at the
HGDC. It was developed in three phases: the first comprises the period 2016-2020, with a
total population of 949 participants and an effective sample of 291 participants, served as a
baseline for the construction of the follow-up and monitoring matrix-BSC. The second phase
of 2021 has 382 participants and an effective sample of 165. The third phase of 2022 has a
total population of 344 and an effective sample of 128 participants. The BSC monitoring
matrix resulted that the average Global Effective Impact Evaluation of the HGDC Teaching
and Research process in the period 2016-2022 reached 87.39% effectiveness, reflecting
that the care and teaching activities are adequately fulfilled. The research provides
conclusions and suggestions aimed at improving the care and teaching processes of the
hospital, and allows it to be a model replicated for other institutions.
Keywords
teaching, education, evaluation, impact, indicators, research.
Resumen
El Estudio de Evaluación de impacto del proceso de docencia e investigación del Hospital
General Docente de Calderón-HGDC de la ciudad de Quito-Ecuador en el periodo 2016-2022,
tiene como finalidad medir el impacto del proceso de Docencia e Investigación respecto a:
(1) proceso académico y recursos, (2) evaluación e investigación, (3) aprendizaje,
capacitación y transferencia de conocimientos y (4) la práctica clínico-quirúrgica y
desempeño; mediante el diseño y aplicación de la metodología de evaluación de impacto
con orientación a resultados medibles, Balanced Scorecard-BSC. Se identificó como grupo
objetivo a estudiantes de pregrado, internado rotativo, posgrado, docentes y personal
asistencial de las Instituciones de Educación Superior-IES que realizan sus actividades
asistenciales y académicas en el HGDC. Se desarrolló en tres fases: la primera comprende el
periodo 2016-2020, con una población total de 949 participantes y una muestra efectiva de
291 participantes, sirvió de línea base para la construcción de la matriz de seguimiento y
monitoreo-BSC. La segunda fase de 2021 cuenta con 382 participantes y una muestra
efectiva de 165. La tercera del periodo 2022, tiene una población total de 344 y una muestra
efectiva de 128 participantes. La matriz de monitoreo BSC dio como resultado que la
Evaluación de Impacto Efectiva Global promedio del proceso de Docencia e Investigación
del HGDC en el periodo 2016-2022 alcanzó 87.39% de efectividad, reflejando que las
actividades asistenciales y docentes se cumplen de manera adecuada. La investigación
aporta conclusiones y sugerencias orientadas a mejorar los procesos asistenciales y
docentes del hospital, y permite ser un modelo replicado para otras instituciones.
Palabras clave
Docencia, educación, evaluación, impacto, indicadores, investigación.
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1. Introduction
In order to improve the quality and effectiveness of management and teaching and
healthcare activities, the Teaching and Research Unit of the HGDC promotes strategies to
maintain an environment of study and activities in which theory and practice are
interrelated in order to guarantee new health professionals with solid knowledge, altruism
and solidarity. As a result, and considering that the quality of management must be
anchored to continuous improvement, the question arises as to what has been the impact
of the Teaching and Research process of the Calderón General Teaching Hospital in these
eight years of management and to have a feedback from the perspective of students,
teachers and assisting personnel who perform their daily work in this health center.
The impact evaluation study of the Teaching and Research process of the Calderón General
Teaching Hospital-HGDC is aimed at evaluating the impact on the training of health
professionals, scientific research, training and knowledge transmission, the improvement
of clinical-surgical practice and the fulfillment of institutional objectives, through the design
and application of a dynamic impact evaluation methodology whose results allow for the
continuous improvement of the teaching-care process.
In this sense, a methodology has been proposed that presents a set of key concepts, practical
orientations and guidelines for the application of evaluation in the different stages of the
teaching-care process. Tools and mechanisms have been developed for the collection,
analysis, monitoring and follow-up of the evaluation through previously defined indicators.
The applicability of the methodology involves several actors, on the one hand, the Higher
Education Institutions (HEI) as training centers for professionals, on the other hand, the
HGDC as the center where the future professional performs his internships and rotations.
Finally, the student who is being trained and acquiring knowledge and new competencies
to become a professional in the near future at the service of society.
The present study is a guide that has been structured on the basis of seven axes that address
the topics that have been considered key in the elaboration process: 1. Generalities of the
study, 2. Design of indicators and data collection instruments, 6. Sample and sample design,
and 7. BSC monitoring matrix, based on the Organic Statute of Organizational Management
by Processes of Hospitals of the Ministry of Public Health 2012, the Internal Regulations for
Teaching and Research of the HGDC 2017, and the ILO Methodological Guide for Impact
Evaluation 2011.
Given that the Organic Statute of Organizational Management by
Processes of the Hospitals of the Ministry of Public Health 2012 and the
Functional Organic of the HGDC contemplates that the Teaching and
Research Units as a mission should promote and coordinate the
integration in health care of the training activities of health professionals
and research, as tools for the transmission of knowledge, improvement
of clinical-surgical practice and the motivation and involvement of health
professionals, through programs, plans and projects aimed at improving
the quality of Teaching and Research (MSP, 2012, p. 12).
Considering the above-mentioned background, the General Teaching Hospital of Calderón,
through the Teaching and Research Unit, proposed to carry out a cross-sectional descriptive
research, of quantitative type, supported by the application of a web-based questionnaire
of its own elaboration addressed to teachers, assisting staff and undergraduate, graduate
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and postgraduate students of the different HEIs, whose main objective was to measure the
degree of impact of the Teaching and Research process in the period 2016-2022 as a first
starting point for taking corrective actions of the teaching-assistance process. The results
are translated into strategies to be implemented by the Teaching and Research Unit in order
to improve the teaching-teaching training process of the students of the different careers
that are trained at HGDC. The information gathering was carried out in three phases, one in
2020, a second in 2021 and a third in 2022.
The article consists of the following parts: an introduction with a brief description of the
problem investigated, the justification on which the research is based, a description of the
methods and materials used, describing the methodology, the scope, the determination of
the sample, the tools for the collection of information and the indicators for the follow-up
matrix Balance Score Card - BSC. The results and discussion reflect relevant interpretations
of the quantitative cross-sectional descriptive study carried out. Finally, conclusions are
presented with a synthesis of the most significant findings of the study.
1.1. Justification
The Calderón General Teaching Hospital is a second level and sixth level of complexity
health center, one of its components is training and research. During its more than eight
years of operation, it has incorporated several promotions of rotating interns in medicine,
nursing, obstetrics and nutrition, prior to the draw for the rural health year. Additionally, it
has added students from several undergraduate careers to perform their internships in the
careers of Statistics, Psychology, Social Work, Pharmaceutical Chemistry, Clinical
Chemistry, Clinical Laboratory, Physical Therapy, Environmental Engineering, Psychiatry,
Nutrition, and Journalism, among others, with a total of 3,800 undergraduate students who
have completed their internships. 800 undergraduate students who have completed their
pre-professional practices or internship prior to obtaining their professional degree, and
1,192 fourth-level postgraduates from various universities in the capital, who have
completed their graduate rotations at Calderón (UDI-HGDC, 2016-2022).
The Teaching and Research Management of the HGDC is in charge of generating research,
studies, projects and the integration of teaching and care activities, which involve a series
of processes that have not been previously measured or monitored. In this sense, it has been
necessary to have an impact evaluation methodology that allows measuring, through
management indicators, how is the process of Teaching and Research Management of the
HGDC in the teaching, assistance, academic, research, learning, clinical-surgical practice and
human talent training activities. This exercise shows the critical processes of the Teaching
and Research Management and those processes that should be strengthened or redesigned
in order to guarantee a high-quality teaching-care process, in constant monitoring and
continuous improvement.
The impact evaluation methodology is intended to serve as a guide for application in other
health units that manage teaching and research processes or are involved in training
activities for health professionals.
2. Methods and materials
The study is descriptive, cross-sectional, quantitative and based on primary data collected
through the application of a web-based questionnaire developed by the authors, which
responds to the methodological criteria of the Training Impact Evaluation Guide issued by
the International Labor Organization-ILO-CINTERFOR. The different questions developed
for each axis are quantitative, and were measured through an ordinal scale and for their
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tabulation they are parameterized through a Likert scale with the following options: 1=Bad,
2=Regular, 3=Good, 4=Very good and 5=Excellent; for their validation and reliability,
Cronbach's Alpha was used, which reached a score of 0.926. The questionnaire was
addressed to teachers, assisting personnel and undergraduate, rotating internship and
postgraduate students of the different HEIs that carried out their academic and assisting
activities at the Calderón General Teaching Hospital in the period 2016-2022. To determine
the population and details of the sample size calculation, it was considered that the total
population of teachers and students for the entire period was 1,675 participants, broken
down as follows: in the period 2016-2020 with 949 participants, year 2021 with 382
participants and year 2022 with 344 participants (UDI-HGDC, 2016-2022). The sample
calculation was based on the simple random probability sampling method and the finite
population sampling formula, with a confidence level of 95% and an error level of 5%
(Malhotra, 2004, p. 344-348), which determined an overall effective sample in the reference
period of 584 participants, with 291 participants for the 2016-2020 period, 165 for the year
2021 and 128 for the year 2022.
For data collection, two anonymized web survey forms were designed under the
methodological criteria of the Training Impact Evaluation Guide issued by the International
Labor Organization-ILO-CINTERFOR (one for teachers and assisting staff and the other for
students), whose links were sent to the e-mails registered in the databases of teachers and
students of the reference period, which is under the custody of the Teaching and Research
Unit of the HGDC.
Due to the scope of the study and the database, it was considered that the methodology that
best fits the analysis requirements is quantitative, which seeks to establish the degree of
causality between the precepts of the management of the Teaching and Research Unit of the
HGDC and its impact on the teaching, assistance and research activities carried out by both
teachers and students; this methodology has allowed for a more rigorous and accurate
statistical analysis. The study inclusion criteria were: teachers, assisting staff and
undergraduate, rotating internship and postgraduate students from the different higher
education institutions that performed their teaching and assisting activities at HGDC in the
reference period 2016-2022. In the exclusion criteria are students who do not have a
registered email and who could not be feasibly located.
The data collected have been anonymized and were treated with strict confidentiality and
only for research purposes. A presentation of the study was made to teachers, health care
personnel and students in order to encourage the participation of all. Similarly, the
introductory part of the questionnaire stipulates informed consent; if the participant
accepts, the contents of the different sections of the questionnaire are displayed; if he/she
does not accept, the questionnaire closes with a thank you. The results made it possible to
determine the degree of impact of the Teaching and Research process of the HGDC on the
teaching, assistance, academic, research and training activities of human talent in health of
the sample mentioned above (584 participants).
In order to guarantee the results, for the validation of the reliability or trustworthiness of
the questionnaire used for the research, it was performed through the "Cronbach's Alpha
coefficient (α), which allows identifying the absence of measurement errors in a test, or as
the precision of its measurement" (Ruiz, 2019, para. 2). Instruments with questions that
have more than two answers can be evaluated with this test. "The Cronbach's α score is a
number between 0 and 1. An acceptable reliability score is one that is equal to or greater
than 0.7" (QuestionPro, 2019, para. 17).
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As mentioned in previous lines, Cronbach's Alpha presents a high or acceptable reliability
score of 0.926, evaluating 25 (quantitative variables) of the 33 items of the applied
questionnaire. This result shows that the method, the instrument and the research sample
selected were reliable and the results obtained are guaranteed.
Data tabulation and analysis was performed using the statistical software SPSS.25 and Excel
2019. Before entering into the analysis of the results, it is necessary to point out the
proposed levels of impact evaluation and some key methodological components. For Baker
(2000)
Impact evaluation is the process of determining in general terms whether
the program produced the desired effects on individuals, households and
institutions and whether these effects are attributable to the program
intervention. Impact evaluations also allow for the examination of
unintended consequences on beneficiaries, whether positive or negative
(p. 75).
Four levels have been identified to evaluate the impact of the actions of the Teaching and
Research Process; these levels have been considered as a system, since there is a causal and
sequential relationship between them.
Academic process and resources. - Seeks to know the impact of the academic process
by analyzing the academic planning, assignments, syllabus, time load and the digital
platform used for teaching activities.
Evaluation and research. - Seeks to know the impact of evaluation and research on
professional training in students who perform their rotation at the HGDC.
Learning, training and knowledge transfer. - Seeks to evaluate to what extent the
education, learning, training and knowledge transfer are being applied by future health
professionals in the units/areas in which they perform their rotation.
Clinical-surgical practice and performance. - Seeks to evaluate how the Teaching and
Research process contributes to improve clinical-surgical practice and performance in
the units/areas in which they perform rotations.
It is also important to mention that an indicator is "a comparison between two or more types
of data that serves to elaborate a quantitative measure or a qualitative observation. This
comparison yields a value, a magnitude or a criterion, which has meaning for the person
analyzing it" (Billorou et al., 2011. p. 38-40). The indicators and instruments are aimed at
measuring the four levels of impact evaluation mentioned above. The methodological
guidelines underpinning the construction of indicators, as cited by Billorou et al.:
Management indicators. - They are used to monitor the processes, inputs and activities
that are executed in order to achieve the specific outputs of a policy or program.
Outcome indicators. - They relate to the goods and services generated by the training
action; they result from the transformation activities of the inputs and generate an
increase in the outputs applicable to training.
Effect indicators. - They refer to the immediate consequences of training and
development of competencies on individuals, companies and society. They represent
the encounter of the training actions with the demand of the participants.
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Impact indicators. - They represent the expected change in the situation of the
participants once the upgrading, knowledge transfer and training are carried out. They
can usually be measured in medium or long term periods due to the fact that a period of
time is required to observe the improvement of clinical-surgical practice, working
conditions and work performance.
The indicators considered for the study were those of management, effect and impact. With
regard to the data collection instruments, two surveys were used, which were designed via
the web with an access link for students and teachers, respectively.
Outcome indicators. - They relate to the goods and services generated by the training
action; they result from the transformation activities of the inputs and generate an
increase in the outputs applicable to training.
Effect indicators. - They refer to the immediate consequences of training and
development of competencies on individuals, companies and society. They represent
the encounter of the training actions with the demand of the participants.
Impact indicators. - They represent the expected change in the situation of the
participants once the upgrading, knowledge transfer and training are carried out. They
can usually be measured in medium- or long-term periods due to the fact that a period
of time is required to observe the improvement of clinical-surgical practice, working
conditions and work performance.
The indicators considered for the study were those of management, effect and impact.
Regarding the data collection instruments, two surveys were used, which were designed via
web with an access link for students and teachers, respectively, for teachers and assisting
personnel who are part of the teaching, research and professional training process and who
are responsible for the accompaniment, control and monitoring of the students who
perform their rotation at HGDC in period.
Form C.1.- Survey Management indicators. - They are used to monitor processes, inputs
and activities that are executed in order to achieve the specific outputs of a policy or
program.
Form C.2.- Survey for students (undergraduate, rotating internship and postgraduate)
who are part of the professional training and who are or were doing their rotation at
the HGDC in the different areas/units assigned. A representative sample is made and
they are randomly selected.
Finally, the use of the Balanced Scorecard-BSC tool (Kaplan & Norton, 1992) has been
considered for monitoring the impact evaluation indicators; through this matrix, the
continuous control of the impact evaluation indicators is carried out to determine whether
or not the proposed objectives have been met and to make strategic decisions in order to
guarantee a highly effective teaching and research process.
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Figure 1. BSC Matrix assessment process
3. Presentation of results
The following are the results of the Impact Evaluation Study of the Teaching and Research
Process of the Calderón General Teaching Hospital-HGDC for the period 2016-2022. It is
important to indicate that the qualification and weighting was measured through an ordinal
scale and for the tabulation it was parameterized through a Likert scale and each weight
responds to the weighted weights method, which is used for the quantification of variables
or alternatives through a numerical value. For the study, 5 measurement groups were
determined as follows:
RATING VALUES
1=Bad (<= 30%)
2=Regular (> 30% y <= 50%)
3=Good (> 50% y <= 70%)
4=Very good (> 70% y <= 90%)
5=Excelent (> 90%)
Table 2. Rating values by variables
3.1 Analysis by levels
Of the sample under study in the reference period, 86. 30% of the participants were
students (504) and 13. 70% were teachers and assistants (80).
3.1.1 Academic process
The level of impact of the academic process from the perspective of teachers and health care
personnel reached an average impact of 76. 03%, equivalent to very good. From the results
by subcomponents, 80. 36% of the participants expressed that the planning of academic
activities was very good, 89. 09% considered that the teaching load was very good, 89. 07%
stated that the tasks and academic material was very good, 69. 84% that the curricular
design was good, 69. 62% considered that the curricular design was very good, 69.62%
considered that the academic material was very good, 70.60% stated that the duration of
the modules and the teaching load were very good, and 63.67% stated that university-
teacher communication was good.
3.1.2 Training resources
The impact of the resources for training from the students' perspective reached an average
impact of 63.32%, equivalent to good. Analyzing the subcomponents of this axis, 65.88%
consider that the material resources have been good for their training, 64.12% that the
Periodic data entry
management
Automatic systematized
calculation
management.
Information
condensation and
report management.
Monitoring, control
and corrective
management.
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digital platform provided by the university for academic activities is good, 65.19% consider
that the duration of the modules is good and 58.10% state that the organization of class
schedules has been good.
It is important to note that the control of this axis is the responsibility of the HEI, however,
the results reflect that the Teaching Management of the HGDC should put more emphasis
on these parameters analyzed.
3.1.3 3.1.3 Evaluation and investigation
The impact of evaluation and research from the perspective of teachers and health care
personnel reached an average impact of 86. 17%, equivalent to very good. Analyzing the
subcomponents of this axis, student participation in the teaching assistance activities
reached an average of 86.32%, equivalent to very good; the teaching assistance evaluation
system applied to the student reached an average of 89. 76%, equivalent to very good; the
scientific activities achieved an excellent average of 91. 28%; in reference to the motivation
of the HGDC and teachers to work in the field of research, a very good level of achievement
of 75. 60% is evidenced. Finally, regarding the capacity for synthesis, reasoning, reflection
and criticism developed by the student, it reached an average of 87. 87%, equivalent to very
good.
Continuing with the analysis of the impact of evaluation and research from the students'
perspective, it reached an average impact of 80. 97%, equivalent to very good. Within this
axis, the following results have been obtained: students consider that the teaching
assistance evaluation system is very good, 85. 39% average; scientific activities achieved an
average of 79. 74% equivalent to very good, in reference to the motivation by the HGDC and
teachers to work in the field of research, a level of achievement of 71. 36% equivalent to
very good is evidenced; at the level of the evaluation made by the teacher or tutor is
considered very good with a level of achievement of 82. 42%. Finally, regarding the
student's qualification on his participation in the teaching assistance activities, an average
of 85. 95% was achieved, equivalent to very good.
3.1.4 Learning, training and transfer of knowledge
The impact of learning, training and knowledge transfer, from the perspective of teachers
and healthcare personnel, reached an average impact of 80. 94%, equivalent to very good.
It is highlighted that, at the level of knowledge of hospital regulations and norms, it is very
good with an average impact of 79. 44%, the functionality of the hospital infrastructure for
care and academic activities reached an average of 76. 17% equivalent to very good, the use
of classrooms, residences and dining room reached an average of 80. 44% equivalent to very
good. When inquiring about the level of knowledge and professionalism of the health care
staff-teaching staff, an average score of 82. 80% was reached, equivalent to very good; the
interpersonal relationships between teachers-health care staff-students reached a level of
achievement of 85. 88%, significant to very good.
The impact analysis of the learning, training and knowledge transfer axis from the students'
perspective reached an average impact of 80.38%, equivalent to very good. Within this axis,
the following results are evident: knowledge of hospital regulations and norms is very good
with an average impact of 73. 52%, the functionality of the hospital infrastructure for
assistance and academic activities reached an average of 81. 23%, equivalent to very good,
the use of classrooms, residences and dining room reached an average of 78. 29%,
equivalent to very good. When asked about the level of knowledge and professionalism of
the health care staff-teaching staff, this reached an average score of 80. 17%, equivalent to
very good; the interpersonal relationships teacher-health care staff-student reached a level
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of achievement of 85. 34%, significant to very good. Finally, in the transfer of knowledge
from the teachers to the students, it reached an average of 83. 72%, equivalent to very good.
3.1.5 Clinical-surgical practice and performance
The results on the impact of the clinical-surgical practice and performance from the
perspective of teachers and assisting personnel achieved an average impact of 80. 85%,
equivalent to very good. When analyzing the subcomponents, the supervision of student
practices reached a result of 85. 64%, equivalent to very good, and the teaching assistance
process aimed at improving clinical-surgical practice reached an average of 75. 85%,
equivalent to very good. When asked if the training process will allow the student to
perform adequately in the functions or activities, it reached an average impact of 80.48%,
equivalent to very good. Finally, when asked about the qualification of their teaching-
assistance performance, this reached an average of 81. 43%, equivalent to very good.
Continuing with the analysis of results on the impact of clinical-surgical practice and
performance from the students' perspective, this reached an average impact of 81. 32%,
equivalent to very good. The following results stand out within this axis: on average, the
supervision of practices performed on students at HGDDC reached an impact of 82. 92%,
equivalent to very good; the process destined to clinical-surgical practice reached an
average of 75. 16%, equivalent to very good. When asked if the training process will allow
the student to perform adequately in the functions or activities, it reached an average
impact of 81. 62%, equivalent to very good. Finally, when asked about the qualification of
their general rotation at the HGDC, it reached an average of 85. 59%, equivalent to very
good.
3.1.6 Overall weighted results
Under the Balanced Scorecard (BSC) philosophy, three weighting levels were identified:
efficient >90%, precaution between 70% and 90%, and danger <70%. These values are
detailed in section 3.2, with the traffic light scale. In Figure 2, the weighted results of the
Impact Evaluation of the Teaching and Research process of the HGDC 2016-2022 under the
BSC approach and from the perspective of teachers and assisting staff reached a weighted
average of 81% which evidences that this axis has a caution alert, where the first evaluation
axis on the academic process obtained a rating equivalent to 76. 03% with a caution alert,
the second axis on evaluation and research reached a score equivalent to 86. 17% with a
caution alert, the third axis on learning, training and knowledge transfer reached a score
equivalent to 80. 94% with a caution alert. Finally, the fourth axis referring to clinical-
surgical practice and performance achieved a score equivalent to 80. 85% with a caution
alert.
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Figure 2. Weighted impact assessment, faculty and staff perspective, period 2016-2022, IDU-HGDC
In Figure 3, the weighted results of the Impact Evaluation from the students' perspective
reached a weighted average of 76. 50% which shows that this axis has a caution alert, where
the first evaluation axis on the resources used for training obtained a score equivalent to
63. 72% with a danger alert, the second axis on evaluation and research reached a score
equivalent to 80. 97% with a caution alert, the third axis on learning, training and
knowledge transfer reached a score equivalent to 80.38% with a caution alert. Finally, the
fourth axis referring to clinical-surgical practice and performance achieved a score
equivalent to 81. 32% with a caution alert.
62,10%
79,43%
78,96%
79,54%
75,01%
62,73%
81,95%
81,33%
81,30%
76,83%
65,13%
81,54%
80,85%
83,13%
77,66%
RECURSOS DE LA FORMACIÓN
EVALUACIÓN E INVESTIGACIÓN
APRENDIZAJE, CAPACITACIÓN Y TRANSFERENCIA DE
CONOCIMIENTOS
PRÁCTICA CLÍNICO-QUIRÚRGICA Y DESEMPEÑO
PROMEDIO PONDERADO
BSC C.2. EVALUACIÓN DE IMPACTO PONDERADA
2022 2021 2016-2020
Figure 3. Weighted impact assessment, student perspective, period 2016-2022, UDI-HGDC
BSCC.1. WEIGHTED IMPACT ASSESSMENT
WEIGHTED AVERAGE
CLINICAL-SUCURSAL PRACTICE AND
PERFORMANCE
LEARNING, TRAINING AND KNOWLEDGE
TRANSFER
EVALUATION AND RESEARCH
ACADEMIC PROCESS
81,43%%
82,19%
79,38%
83,44%
83,67%
75,44%
TRANSFER
81,50%
82,40%
78,93%
86,50%
85,37%
86,13%
74,29%
76,81%
77,00%
2016-2020
2021
2022
BSCC2. EVALUACION DE IMPACTO PONDERADA
WEIGHTED AVERAGE
CLINICAL-SURGICAL PRACTICE AND PERFORMANCE
LEARNING, TRAINING AND KNOWLEDGE TRANSFER
EVALUATION AND RESEARCH
TRAINING RESOURCES
77,66%
76,83%
75,01%
83,13%
81,30%
79,54%
80,85%
81,33%
78,96%
81,54%
81,95%
79,43%
65,13%
62,73%
62,10%
2016-2020
2021
2022
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3.2 Impact Results by indicators, Balanced Scorecard matrix (BSC)
It should be noted that in the follow-up matrix, in the "Measurement" column, the results
processed for each of the questions in Forms C.1 and C.2 are located. This column is marked
with a traffic light and each selection of visual codes makes it possible to obtain differences
between the goals and the effectiveness of the processes. Thus, in summary:
Green color: The weighting is above the target value, depending on the case it can be
good or it can be bad. For the study, efficient green color >90%.
Yellow color: The weighting is within normal measurement parameters. Caution
yellow color value between 90% and 70%.
Red color: The weighting is below the quantitative target value to be reached and
indicates that urgent corrective action is needed. Danger red color value <70%.
MONITORING MATRIX
BASE
LINE
MEASURE
MENT 2
MEASUREM
ENT 3
LEVE
LS
INDICATOR
TYPE OF
INDICATOR
FÓRMULA
VALUE
TARGET
2016-
2020
2021
2022
ACADEMIC PROCESS AND RESOURCES
EFFECTIVEN
ESS OF THE
PLANNING OF
ACADEMIC
ACTIVITIES
MANAGEMENT
Number of teachers who consider the
planning of academic activities to be adequate
activities is adequate
_____________________________________
______ x 100
Total number of participants surveyed
90%
88.39
%
67.69%
85.00%
EFFECTIVEN
ESS OF THE
TEACHING
LOAD
MANAGEMENT
Number of teachers who consider the
teaching load to be adequate
_____________________________________
______ x 100
Total number of participants surveyed
90%
87.74
%
90.77%
88.75%
EFFECTIVEN
ESS OF
ASSIGNMENT
S AND
ACADEMIC
MATERIAL
MANAGEMENT
Number of teachers who consider the tasks
and academic material to be adequate
is adequate
_____________________________________
______ x 100
Total number of participants surveyed
90%
86.45
%
90.77%
90.01%
EFFECTIVEN
ESS OF
SYLLABI AND
GUIDE TEXTS
MANAGEMENT
Number of teachers who consider the syllabus
and guide texts to be optimal
_____________________________________
_____________________ x 100
Total number of participants surveyed
90%
70.97
%
72.31%
66.25%
TECHNOLOGI
CAL
PLATFORM
EFFICIENCY
EFFECT
Number of teachers who consider that the
technological platform
platform used for teaching activities is
adequate.
_____________________________________
______ x 100
Total number of participants surveyed
90%
70.97
%
75.38%
62.50%
EFFECTIVEN
ESS OF
MODULES
AND
SCHEDULES
EFECT
Number of teachers who consider that the
modules and class schedules are
and class schedules are adequate
_____________________________________
____ x 100
Total number of participants surveyed
90%
68.71
%
73.08%
70.00%
EFFECTIVEN
ESS OF
INTER-
INSTITUTION
AL
COMMUNICA
TION
MANAGEMENT
Number of teachers who consider that inter-
institutional communication
inter-institutional communication is efficient or
excellent
_____________________________________
______ x 100
Total number of participants surveyed
90%
65.81
%
67.69%
57.50%
EFFECTIVEN
ESS OF
TRAINING
RESOURCES
EFECT
Number of students who consider that the
syllabus, bibliography, guide texts and
complementary materials are adequate,
guide texts and
complementary material are adequate
_____________________________________
___ x 100
Total number of participants surveyed
90%
63.87
%
66.27%
67.50%
EFECT
Number of students who consider that the
technological platform is
platform is adequate
_____________________________________
______ x 100
Total number of participants surveyed
90%
60.59
%
63.73%
68.04%
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EFECT
Number of students who consider the duration
of the modules to be adequate
is adequate
_____________________________________
____ x 100
Total number of participants surveyed
90%
64.62
%
64.53%
66.43%
EFECT
Number of students who consider the
organization of class schedules to be
of class schedules are adequate
_____________________________________
____ x 100
Total number of participants surveyed
90%
59.33
%
56.40%
58.57%
EVALUACIÓN E INVESTIGACIÓN
EFICIENCIA
DE
PARTICIPACI
ÓN
ACTIVIDADES
ASISTENCIAL
ES
DOCENTES
EFECT
Number of faculty and support staff who
believe that student participation in teaching
support activities is the most effective way to
ensure student participation in teaching
support activities
_____________________________________
____________ x 100
Total number of participants surveyed
90%
84.89
%
85.33%
88.75%
EFECT
Number of students who consider their
participation in teaching assistance activities
to be participatory
teaching assistance activities is participatory
_____________________________________
____________ x 100
Total number of participants surveyed
90%
83.95
%
86.93%
86.6%
EFICIENCIA
DEL SISTEMA
DE
EVALUACIÓN
ASISTENCIAL
DOCENTE
IMPACT
Number of students who consider the
teaching assistance evaluation system to be
efficient
the teaching assistance evaluation system is
efficient
_____________________________________
___ x 100
Total number of respondents
90%
83.03
%
87.60%
85.54%
IMPACT
Number of teachers and assistants who
consider that the system for evaluating
teachers and assistants is efficient
the system of evaluation of teaching
assistants is efficient
_____________________________________
____ x 100
Total number of participants surveyed
90%
89.78
%
92.00%
87.50%
IMPACT
Number of students who consider that the
evaluation by the teacher or tutor is
permanent
_____________________________________
___ x 100
Número total de encuestados
90%
81.51
%
85.20%
80.54%
EFICIENCIA
DE
ACTIVIDADES
CIENTÍFICAS
E
INVESTIGACI
ÓN
EFECT
Number of students who consider that
scientific and research activities are always
carried out
___________________________________
x 100
Número total de participantes encuestados
90%
69.23
%
68.09%
73.12%
EFECT
Number of faculty and staff who believe that
scientific and research activities are always
carried out
scientific and research activities are always
carried out
___________________________________
x 100
Total number of participants surveyed
90%
84.43
%
77.83%
77.26%
EFICIENCIA
DE
REFLEXIÓN,
RAZONAMINE
TO Y
SÍNTESIS
EFECT
Number of teachers and assistants who
consider that always
teaching-assistance activities allow students
to develop their reflection, reasoning and
synthesis skills.
___________________________________
x 100
Total number of participants surveyed
90%
85.78
%
85.33%
92.50%
LEARNING, TRAINING AND
KNOWLEDGE TRANSFER
PERCENTAG
E OF
KNOWLEDGE
OF HOSPITAL
REGULATION
S
EFECT
Number of students who are aware of hospital
regulations
regulating academic-administrative activities
_____________________________________
___ x 100
Total number of participants surveyed
90%
71.34
%
73.87%
75.36%
EFECT
Number of teachers and healthcare personnel
familiar with hospital regulations governing
academic-administrative activities
_____________________________________
90%
78.22
%
81.33%
78.75%
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___ x 100
Total number of participants surveyed
EFFICIENCY
OF
INFRASTRUC
TURE
FUNCTIONALI
TY
EFECT
Number of students who consider that the
hospital infrastructure allows for the optimal
development of academic assistance
activities.
_____________________________________
____ x 100
Total number of participants surveyed
90%
80.84
%
82.13%
80.71%
EFECT
Number of teachers and healthcare personnel
who consider that the hospital infrastructure
allows for the optimal development of
academic healthcare activities.
_____________________________________
____ x 100
Total number of participants surveyed
90%
76.00
%
80.00%
72.50%
EFFICIENCY
OF USE OF
CLASSROOM
S,
RESIDENCE
HALL AND
DINING HALL
EFECT
Number of students who consider that the
classrooms, residence and dining room are
used in an adequate manner and at the
established times.
_____________________________________
____ x 100
Total number of participants surveyed
90%
76.13
%
80.53%
78.21%
EFECT
Number of teachers and care staff who
consider that the classrooms, residence and
dining room are used adequately and at the
pre-established times.
_____________________________________
____ x 100
Total number of participants surveyed
90%
78.67
%
82.67%
80.00%
INTERPERSO
NAL
RELATIONS
EFFICIENCY
INDEX
EFECT
Number of students who consider hospital
interpersonal
interpersonal relationships is collaborative
_____________________________________
____ x 100
Número total de participantes encuestados
90%
84.45
%
86.93%
84.64%
EFECT
Number of faculty and staff who consider
hospital interpersonal relationships to be
collaborative.
hospital interpersonal relations are
collaborative
_____________________________________
____ x 100
Total number of participants surveyed
90%
82.22
%
86.67%
88.75%
LEVEL OF
EXPERTISE
AND
PROFESSION
ALISM
EFECT
Number of students who consider the level of
knowledge and professionalism
knowledge and professionalism of the
teaching and care staff.
_____________________________________
______________ x 100
Total number of participants surveyed
90%
79.71
%
80.00%
80.80%
EFECT
Number of faculty and support staff who rate
the level of knowledge and professionalism of
the support and support staff as excellent
the level of knowledge and professionalism of
the teaching and care personnel
_____________________________________
____ x 100
Total number of participants surveyed
90%
79,56
%
81,33%
87,50%
EFFECTIVEN
ESS OF
KNOWLEDGE
TRANSFER
IMPACT
Number of students who consider that the
transfer of knowledge has allowed them to
knowledge has allowed them to put it into
practice
_____________________________________
____ x 100
Total number of participants surveyed
90%
81.26
%
84.53%
85.36%
CLINICAL-SURGICAL PRACTICE
AND PERFORMANCE
EFFICIENCY
SUPERVISIO
N OF
INTERNSHIPS
IMPACT
Number of students who consider the
supervision of internships to be adequate
of internships are adequate
_____________________________________
_____ x 100
Total number of participants surveyed
90%
78.99
%
84.93%
84.82%
IMPACT
Number of faculty and staff who believe that
supervision of student internships is efficient
and ongoing
supervision of students is efficient and
permanent.
_____________________________________
_____ x 100
Total number of participants surveyed
90%
81.33
%
89.33%
86.25%
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EFFECTIVEN
ESS OF
CLINICAL-
SURGICAL
PRACTICE
IMPACT
Number of students who consider the clinical-
surgical practice to be adequate or excellent
practice is adequate or excellent
_____________________________________
_____ x 100
Total number of participants surveyed
90%
74.87
%
73.47%
77.14%
IMPACT
Number of faculty and staff who consider the
design of the clinical-surgical practice to be
adequate or excellent.
of the clinical-surgical practice is adequate or
excellent.
_____________________________________
______ x 100
Total number of participants surveyed
90%
70.22
%
77.33%
80.00%
STUDENT
PERFORMAN
CE LEVEL
IMPACT
Number of students who consider that the
training they have received and/or received
allows them to perform adequately
and/or given allows them to perform
adequately
_____________________________________
____________ x 100
Total number of participants surveyed
90%
80.08
%
81.73%
83.04%
IMPACT
Number of teachers and assisting personnel
who consider that the training received and/or
given to the students allows them to perform
adequately
_____________________________________
____________ x 100
Total number of participants surveyed
90%
76.44
%
80.00%
85.00%
LEVEL OF
SATISFACTIO
N WITH THE
ROTATION AT
THE HEALTH
CENTER
EFECT
Number of students who are satisfied with
the rotation performed at the assigned health
performed in the assigned medical home
_____________________________________
_____________ x 100
Total number of participants surveyed
90%
84.20
%
85.07%
87.50%
PERCENTAG
E OF
TEACHING
AND
ASSISTANCE
PERFORMAN
CE
IMPACT
Number of teachers and assistants who
evaluate their teaching-attendance
performance l
_____________________________________
______ x 100
Total number of participants surveyed
90%
73.78
%
88.00%
82.50%
Table 2. HGDC Teaching and Research Process Impact Assessment BSC Monitoring and Indicator Matrix,
period 2016-2022
4 Discussion
“Teaching presents a challenge when it comes to finding new dynamics and ways of
transmitting knowledge to others, especially in times when information is almost
immediate and the dynamics of socialization have changed” (CGFGlobal, 2016, para. 1).
However, a large part of university students, have difficulties in their academic preparation
on a regular basis. “Difficulties are expressed in lack of motivation for certain subjects or
study programs; also due to inadequate school-family environments or spaces,
disorganization of autonomous schedules, weakness in the management of study
techniques, among others” (Barreno et al., 2022, p. 75-97).
According to Denegri, impact evaluation in higher education is a systematic process carried
out to measure and evaluate the results of an intervention or educational program. The goal
of impact evaluation is to determine whether educational programs or interventions are
achieving the desired outcomes and whether they are having a positive impact on students,
the university community, and society at large (Denegri, 2023, para. 1). Impact evaluation
should be approached and managed as a management process that determines to what
extent the initially stated purposes or objectives have been achieved. It consists of
identifying, obtaining and providing useful and descriptive information on the value and
merit of the goals, planning, implementation and impact of an intervention on a need or
problem identified and intended to change its condition (Aponte and Pérez, 2021, p. 16-19).
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The educational community, according to Bayona et al., as the main axis around which
higher education institutions-IES revolve, should always be the main beneficiary of the
interventions that are carried out in order to improve the scope of their mission and
objectives. The better the quality of the HEI, the better the conditions it can offer to the
entire educational community; if something benefits the institution, it will directly or
indirectly benefit its members (Bayona et al., 2022, p. 18). Impact evaluations always have
the intention of benefiting the participants; it is possible to say that the more a student is
exposed to the different interventions developed by the HEI, the more benefits he/she can
receive from them. Likewise, the more the impact of the interventions is evaluated, the more
efficient they will be and, therefore, the benefits for the students will also be greater and
greater (Cambridge Assessment International Education, 2019).
Commonly, the interventions proposed by an HEI according to Abdala are focused on
implementing strategies that improve some identified aspect to turn it into a strength. By
virtue of this, the efforts and resources allocated for their implementation and evaluation
are usually focused on addressing the priority needs of students within the institutions
(Abdala, 2004, p. 32). In general, the guiding bodies of HEIs, such as professors, managers,
administrators, etc., propose interventions that, in spite of achieving their objectives, are
not positively valued by their participants. It is important to emphasize that the deeper the
analysis, the better the results and the greater the conclusions of the interventions carried
out.
It is important to mention that the General Teaching Hospital of Calderón, since its creation,
has had a formative and research focus, has incorporated several promotions of rotating
interns in nursing, medicine, nutrition and obstetrics; in addition to this, students from
several undergraduate careers perform pre-professional internships in careers such as:
Statistics, Psychology, Social Work, Pharmaceutical Chemistry, Clinical Chemistry, Clinical
Laboratory, Physical Therapy, Environmental Engineering, Psychiatry, Nutrition,
Communication, Administrative Sciences, among others. Not to mention the fourth level
students from several HEIs that perform the postgraduate rotation at the HGDC (UDI-HGDC,
2016-2022).
Under these considerations, the Global Effective Impact Evaluation of the Teaching and
Research process of the HGDC in the period 2016-2022 reached a rating of 87. 39% of
effectiveness, which indicates that the teaching-teaching activities are adequate and that
certain specific aspects of the academic process need to be reviewed, which is the
responsibility of the Higher Education Institutions-IES that work directly with the Calderón
General Teaching Hospital.
The Global Effective Impact Evaluation from the perspective of teachers and health care
personnel achieved an 89. 12% effectiveness rating, showing that the teaching and health
care process has been very good during the study period. Among the aspects highlighted is
the functionality of the infrastructure and classrooms that the HGDC has set aside for the
training of students, the interpersonal relations between teachers, assistants and students
is very good and the high level of collaboration and participation stands out. One of the areas
for improvement is the academic process in general (planning of activities, timetable,
syllabus, digital platform and university-faculty communication), which is a net competence
of the HEIs.
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The Global Effective Impact Evaluation from the students' perspective reached a rating of
85. 48% equivalent to very good, which reflects that students in the study period support
the management of the Teaching and Research process. There are specific aspects to
improve, such as academic resources for training, which is a competence of the HEIs.
Internally, as HGDC will motivate teachers, assistants and students to develop research and
the promotion of scientific activities to strengthen their knowledge.
The central idea behind the design and application of the impact evaluation methodology is
that it should be an instrument that can be replicated in other health units where future
health professionals rotate and do their internships. It is also important that once several
evaluations have been carried out and a baseline has been established, the impact of the
teaching and research process should continue to be evaluated periodically in order to
compare the variations of the indicators and the actions for continuous improvement to be
implemented. The forms designed for the collection of information can be applied both
virtually and physically, which makes it possible to obtain highly reliable information.
In terms of methodology and applicability of the research, it is important to consider the
limitation for the collection of information, in many cases the web surveys do not have the
due acceptance due to the boom of information received by e-mail and social networks. As
this was internal research of the Calderón General Teaching Hospital, a presentation of the
study was made to teachers, assisting personnel and students to encourage the
participation of all the participants.
5. Conclusions
In the axis on the academic process, it was evidenced that there is a need to improve: the
communication system, the duration of modules and schedules, the digital platform and the
curricular design, as a competence of the higher education institution-IES. Regarding the
resources allocated for training, these are not totally efficient and it is pertinent to carry out
an analysis so that students have academic resources that go hand in hand with their
training.
The evaluation and research axis presented a high incidence in the students' training and
the results reflect that the students have a good acceptance of the current evaluation system
and that research is gaining more space. In the learning, training and knowledge transfer
axis, the results show that this practice is very good and that what was learned in the
internship and/or in the pre-professional practices have allowed the students to improve
their performance in the units or services where they work. The axis of clinical-surgical
practice and performance should be strengthened and the interaction between the
teacher, the assisting staff and the student should be improved; associated to this, supplies,
materials and equipment should be provided to enhance the clinical-surgical practice.
Finally, in order to guarantee accurate decision-making and continuous monitoring of the
proposed impact evaluation indicators, the Teaching and Research Unit of the Calderón
General Teaching Hospital should apply the Impact Evaluation Methodology once a year in
order to compare the results in the indicator follow-up matrix, as well as the design and
updating of the research, including the sample size.
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Authors
LUIS OLMEDO-PÉREZ obtained his degree in Commercial Engineering from Escuela
Politécnica del Ejército-ESPE (Ecuador) in 2011. He obtained his Master's degree in Human
Talent Management from the Escuela Politécnica Nacional-EPN (Ecuador) in 2016. She is an
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applicant to the Doctorate in Higher Education at the Universidad Benito Juárez (Mexico)
2022-2025.
He is currently a Research Analyst at the Teaching and Research Unit of the Calderon
General Teaching Hospital. He is a consultant for Training and Consulting in management
and strategic planning, process management, integrated management of human talent,
prospective studies, relevance and demand studies for the creation of new academic
offerings in higher education and impact assessment. He is Technical Vice President and
founding partner of the Foundation for Sustainable Economic and Productive Development
-FADEPS, Quito-Ecuador.
PATRICIA BENAVIDES-VERA obtained her Doctor of Medicine and Surgery degree from
the Universidad Central del Ecuador in 2002. She obtained her Master's degree in Public
Health from Universidad San Francisco de Quito (Ecuador) in 2012.
She is currently in charge of the Teaching and Research Unit of the Calderon General
Teaching Hospital. She teaches at the Faculty of Medical Sciences at the Central University
of Ecuador, and has participated as a lecturer in several postgraduate programs at several
universities in the country.
FERNANDO DURÁN-LUCIO obtained his degree of Doctor of Medicine and Surgery at the
Universidad Central del Ecuador (Ecuador) in 1975. He obtained the degree of Specialist in
Psychiatry at the Universidad Central del Ecuador (Ecuador) in 1982.
He is currently the Director of Teaching at the Faculty of Medicine of the Central University
of Ecuador for the General Teaching Hospital of Calderon.
Statement of Authorship-CRediT
LUIS OLMEDO-PÉREZ: conceptualization, methodology, validation, formal analysis,
research, data curation and analysis, visualization, state of the art, related concepts, writing
- first draft and final editing.
PATRICIA BENAVIDES-VERA: related concepts, organization and integration of collected
data, conclusions, supervision, writing - revision and editing.
FERNANDO DURÁN-LUCIO: conceptualization, validation, conclusions, writing - review
and editing.