Whoever believes that the ‘scientific’ method should not be the sole approach to quality assurance and evaluation research may be attracted to fourth‐generation evaluation The first three generations of evaluation have been categorized as ‘measurement‐orientated,’ objective‐orientated’ and ‘judgement‐orientated’, whereas fourth‐generation evaluation is ‘negotiation‐orientated’ In the present paper the author embarks on a description of these generations and makes suggestions for the implementation of fourth‐generation evaluation in the health care setting The appeal of fourth‐generation evaluation is that it argues for all ‘stakeholders’ to have a right to place their claims, concerns and issues on the negotiating table The evaluator acts as a facilitator of the evaluation process ‘Stakeholders’ refers to all people in the setting who are affected by the evaluation, including managers, evaluators, medical and nursing staff Participation of patients/cli
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