Introduction

Cost studies are increasingly popular given resource constraints. While scholars stress the context-dependent nature of cost, and the importance of theory, cost studies remain context-blind and atheoretical. However, realist economic evaluation (REE) privileges context and the testing/refinement of economic program theory. This preliminary REE serves to test and refine economic program theory for supervision training programs of different durations to better inform future program design/implementation.

Methods

Our preliminary REE unpacked how short (half-day) and extended (12-week) supervision training programs in Victoria, Australia produced costs and outcomes. We employed mixed methods: qualitative realist and quantitative cost methods. Economically optimised program models were developed guided by identified cost-sensitive mechanisms and contexts.

Results

As part of identified context-mechanism-outcome configurations (CMOCs) for both training programs, we found a wider diversity of positive outcomes but greater costs for the extended program (11 outcomes; AU$3,069/learner) compared with the short program (7 outcomes; $385/learner). We identified four shared cost-sensitive mechanisms for both programs (training duration, learner protected time, learner engagement, and facilitator competence), and one shared cost-sensitive context (learners’ supervisory experience). We developed two economically optimised program models: (1) short program for experienced supervisors facilitated by senior educators ($406/learner); and (2) extended program for inexperienced supervisors facilitated by junior educators ($2,104/learner).

Discussion

Our initial economic program theory was somewhat supported, refuted, and refined. Results were partly consistent with previous research, but also extended it through unpacking cost-sensitive mechanisms and contexts. While our preliminary REE fills a pressing gap in the methodology literature, conducting REE was challenging given our desire to integrate economic and realist analyses fully, and remain faithful to realist principles. Attention to training duration and experience levels of the facilitator-learner dyad may help to balance the cost and outcomes of training programs.