An innovative evaluation tool to reduce recall bias in developing a skill-based spinal cord injury caregiver training program

Providing quality skill-based caregiver services is important for successful community reintegration, which enables individuals with spinal cord injury (ISCI) to effectively manage secondary conditions and live independently in community settings. Only a well-developed training program that has been systematically evaluated would be effective in providing caregivers the appropriate skills and knowledge. Computer-supported collaborative learning (CSCL) is a pedagogical approach that has been widely used in numerous academic disciplines, but not use as an evaluation tool in the development of healthcare training programs. Amongst the commonly used evaluation methods are post-review questionnaires and focus group discussions. The salient weakness of these approaches is the lag time between review and evaluation, which can produce recall bias and threaten content validity. Advantage of CSCL provides a collaborative environment for reviewers to share comments and provide instant feedback, thus avoiding the lag time that can result in recall bias. The goal of this study is to determine if CSCL can be used as an effective evaluation tool to reduce recall bias in the development of a SCI caregiver training program. Six panels of caregivers and ISCI (n=30) were recruited to evaluate a skill-based SCI caregiver training program. There different evaluative methods were used: CSCL, post-review questionnaires, and post-review focus groups. Comparative analysis showed that CSCL significantly reduced recall bias by accounting for 47% of the discrepancies and errors contributed by 60% of the reviewers. This study demonstrated that CSCL is an effective program evaluation tool for reducing recall bias and increase content validity.