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UBC Theses and Dissertations

Realist evaluation of violence prevention education in British Columbia healthcare : how does it make a difference? Provost, Sharon Marie


Psychological and physical violence from patients and visitors towards healthcare workers is an increasing problem internationally that negatively affects the wellbeing of workers and the care they deliver. The predominant intervention has been to educate workers in violence prevention (VP); however, the complexity of both the healthcare environment, the multiple reasons for violence, and a chronic underreporting of violent incidents makes it challenging to evaluate VP program effectiveness. To address these obstacles, this research used a lesser-known realist evaluation approach that asks for whom, how and in what contexts VP education makes a difference. Building upon theories developed from a realist literature review, the synthesis of data from interviews and focus group interviews conducted in British Columbia emergency departments resulted in 15 explanations of contexts that support participants to learn and apply VP education. Findings include how credible trainers and applicable content increases engagement as participants see the content as relevant; how teams with a shared mental model of VP apply knowledge and skills due to confidence in a team approach; and how workplaces that support physical safety increase application of VP knowledge and skills as individuals feel less physically vulnerable.

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