Essent Of Evidence-Based Pract
1.Quantitative Research Designs
In order to find the best information on a topic, not only should you develop a question and search for resources, but you should also know how to analyze the value of the resources that you identify. There are different ways to evaluate resources, such as using the hierarchy of evidence, which you explored in Week 4 of this course. Another way to evaluate resources is to consider the appropriateness of the research design. Understanding how research designs contribute to the quality of a study is essential for being able to analyze resources when conducting a literature review or locating evidence for practice.
In this Discussion, you consider the different research designs and evaluate how these designs have been used to research a specific topic. You also consider strategies for selecting an appropriate research design.
To prepare:
· Review the information in the course text on quantitative research designs. Focus on the information on, “Guidelines for Critiquing Research Designs in Quantitative Studies”.
· Select a topic from the list below and search the Walden Library to find two different quantitative research studies addressing that issue:
- Caregiver stress
- Anxiety in children
- Sleep apnea
- Depression in college freshmen
- Rural health care issues
- Post-traumatic stress syndrome
- Traumatic brain injury in veterans
- Health effects of environmental contaminants
- Bipolar disorder
End-of-life ethical issues
Alternative medicine
· For each of the sources that you select, identify the type of quantitative research design used, and evaluate whether it is the most appropriate approach to the research.
· Consider the ramifications of choosing an inappropriate design for a research study.
RESOURCES
Required Readings
Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.
Chapter 8, “Planning a Nursing Study”
This chapter focuses on the necessary steps for planning a research study. It describes different research designs and their key features and discusses how to plan for data collection.
Chapter 9, “Quantitative Research Design”
This chapter explores quantitative research in greater depth including the importance of experimental design and the role of randomization in conducting research. The chapter also describes quasi-experimental design and observational research.
Media
Laureate Education (Producer). (2012m). Quantitative research for evidence-based practice. Baltimore, MD: Author.
In this video, Dr. Kristen Mauk explains specific quantitative research designs, methods, and considerations related to her Doctorate of Nursing Practice (DNP) project. She discusses how she developed her research design and how she used sound quantitative research methods throughout her project.
2.Validity in Quantitative Research Designs
Validity in research refers to the extent researchers can be confident that the cause and effect they identify in their research are in fact causal relationships. If there is low validity in a study, it usually means that the research design is flawed and the results will be of little or no value. Four different aspects of validity should be considered when reviewing a research design: statistical conclusion validity, internal validity, construct validity, and external validity. In this Discussion, you consider the importance of each of these aspects in judging the validity of quantitative research.
To prepare:
· Review the information in Chapter 10 of the course text on rigor and validity.
· Read the method section of one of the following quasi-experimental studies. Identify at least one potential concern that could be raised about the study’s internal validity.
o Metheny, N. A., Davis-Jackson, J., & Stewart, B. J. (2010). Effectiveness of an aspiration risk-reduction protocol. Nursing Research, 59(1), 18–25.
o Padula, C. A., Hughes, C., & Baumhover, L. (2009). Impact of a nurse-driven mobility protocol on functional decline in hospitalized older adults. Journal of Nursing Care Quality, 24(4), 325–331.
o Yuan, S., Chou, M., Hwu, L., Chang, Y., Hsu, W., & Kuo, H. (2009). An intervention program to promote health-related physical fitness in nurses. Journal of Clinical Nursing, 18(10), 1,404–1,411.
· Consider strategies that could be used to strengthen the study’s internal validity and how this would impact the three other types of validity.
· Think about the consequences of an advanced practice nurse neglecting to consider the validity of a research study when reviewing the research for potential use in developing an evidence-based practice.
RESOURCES
Required Readings
Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.
- Chapter 10, “Rigor and Validity in Quantitative Research”
This chapter introduces the concept of validity in research and describes the different types of validity that must be addressed. Key threats to validity are also explored.
- Chapter 11, “Specific Types of Quantitative Research”
This chapter focuses on the specific types of quantitative research that can be selected. The focus is on the purpose of the research rather than the research design. These include such approaches as clinical trials, evaluation research, health services and outcomes research, needs assessments, or replication studies.
Cantrell, M. A. (2011). Demystifying the research process: Understanding a descriptive comparative research design. Pediatric Nursing, 37(4), 188–189.
The author of this article discusses the primary aspects of a prominent quantitative research design. The article examines the advantages and disadvantages of the design.
Schultz, L. E., Rivers, K. O., & Ratusnik, D. L. (2008). The role of external validity in evidence-based practice for rehabilitation. Rehabilitation Psychology, 53(3), 294–302.
This article details the results of a study that sought to balance concern for rigor with concern for relevance. The authors of the article derive and determine a rating format for relevance and apply it to cognitive rehabilitation.
Note: For the Discussion this week, you will need to read the method section of one of the following quasi-experimental studies. Refer to the details provided in the Week 6 Discussion area.
Metheny, N. A., Davis-Jackson, J., & Stewart, B. J. (2010). Effectiveness of an aspiration risk-reduction protocol. Nursing Research, 59(1), 18–25.
Padula, C. A., Hughes, C., & Baumhover, L. (2009). Impact of a nurse-driven mobility protocol on functional decline in hospitalized older adults. Journal of Nursing Care Quality, 24(4), 325–331.
3. Qualitative Research Designs
For the past 2 weeks, you have focused on the features and considerations of quantitative research designs. However, quantitative designs are not appropriate for all research questions. Perhaps you are concerned with how patients react when confronted with negative test results, or you wish to study how views on a certain health topic change over time. In each of these cases, the emphasis is more on understanding the thinking and experiences of an individual or group than on numerical measurements. For these types of questions, a qualitative or mixed methods research design is the most appropriate.
For this Discussion, you focus on the different types of qualitative research designs, when they are used, and why they are important.
To prepare:
· Reflect on the comments made by Dr. Mauk in this week’s media presentation on the value of qualitative research in nursing.
· Locate the journal Qualitative Health Research in the Sage Premier database in the Walden Library.
· From this journal, select an article of interest to you that was published within the last 3 years.
· Review the information on different qualitative research designs in Chapter 21 of your course text.
· Determine what qualitative research design was used in your selected article and evaluate whether it was the best choice.
· Consider ethical issues involved in the study and how the researchers addressed them.
· Think about how using a quantitative design would have affected the type of data gathered.
RESOURCES
Required Readings
Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.
- Chapter 21, “Qualitative Research Design and Approaches”
This chapter introduces qualitative research designs. It provides an overview of the different types of qualitative research and then describes each one in greater detail, outlining how and when they should be used.
Houghton, C. E., Casey, D., Shaw, D., & Murphy, K. (2010). Ethical challenges in qualitative research: Examples from practice. Nurse Researcher, 18(1), 15–25.
This article explores ethical challenges associated with qualitative research. Specifically, the authors examine the challenges of informed consent procedures, the researcher-participant relationship, risk-benefit ratio, confidentiality, and the dual role of the nurse-researcher.
Pringle, J., Hendry, C., & McLafferty, E. (2011). Phenomenological approaches: Challenges and choices. Nurse Researcher, 18(2), 7–18.
This article examines the dilemmas faced by a researcher looking for appropriate methods and approaches for investigating the experiences of stroke survivors. In addition, this article reviews the challenges of using phenomenology as a research method.
Ryan-Nicholls, K. D., & Will, C. I. (2009). Rigour in qualitative research: Mechanisms for control. Nurse Researcher, 16(3), 70–85.
The authors of this article provide recommendations for improving the control mechanisms of methodological rigor in qualitative research methods. The text establishes the basis of criticism on the rigor of qualitative work, ways of demonstrating methodological rigor, and the definition of rigor.
Smith, J., Bekker, H., & Cheater, F. (2011). Theoretical versus pragmatic design in qualitative research. Nurse Researcher, 18(2), 39–51.
This article assesses the benefits of using a generic qualitative approach to design studies for understanding user and caregiver perspectives. The authors assess these benefits in the context of a qualitative study that focused on parents’ experience of living with children with hydrocephalus.
Walker, W. (2011). Hermeneutic inquiry: Insights into the process of interviewing. Nurse Researcher, 18(2), 19–27.
This article examines the process of interviewing from a research perspective. The authors supply personal and theoretical insights into using the research interview, along with a guide to the practicalities of interviewing.
Williamson, K. M. (2009). Evidence-based practice: Critical appraisal of qualitative evidence. Journal of the American Psychiatric Nurses Association, 15(3), 202–207.
This article highlights the importance of qualitative evidence to mental health clinicians. The author stresses that critically appraising evidence is crucial to the EBP process and provides guidelines for appraisal.
Wuest, J. (2011). Are we there yet? Positioning qualitative research differently. Qualitative Health Research, 21(7), 875–883.
This article focuses on the shifting role of qualitative research in the past two decades. The author discusses the merits and detriments of concrete distinctions, the hurdles of flexibility and convergence, and the need to develop a complete research toolbox for improving health.
Media
Laureate Education (Producer). (2012l). Qualitative and mixed methods research designs. Baltimore, MD: Author.
This video features Dr. Kristen Mauk’s overview of how she applied qualitative research designs and methods to her doctoral dissertation work. Dr. Mauk explains the advantages of qualitative research as well as strategies for increasing credibility when conducting qualitative or mixed methods research.
4. Planning for Data Collection
Data collection is an important part of both quantitative and qualitative research. Although the actual approach to gathering information may vary, for either research design, researchers need to plan in advance how the data will be gathered, reported, and stored, and they need to ensure that their methods are both reliable and valid. As nurses’ review research when considering a new evidence-based practice, it is important to be familiar with sound collection practices in order to ascertain the credibility of the data presented.
Consider the following scenario:
Nurses and other health care professionals are often interested in assessing patient satisfaction with health care services. Imagine that you are a nurse working in a suburban primary care setting that serves 10,000 patients annually. Your organization is very interested in understanding the patient’s point of view to help determine areas of care that can be improved. With this focus in mind, consider how you would create a survey to assess patient satisfaction with the services your organization provides. You may wish to consider variables such as the ease of accessing care, patient wait time, friendliness of the staff, or the likelihood that a patient would recommend your organization to others.
For this Discussion, you generate questions and an overall plan for data collection that would be appropriate for a patient satisfaction survey in relation to the above scenario.
To prepare:
· Consider the guidelines for generating questions presented in this week’s Learning Resources.
· Review the scenario and formulate at least five questions that you could use to evaluate patient satisfaction.
· Reflect on the different methods or instruments that can be used for gathering data described in Chapter 13 and Chapter 23 of the course text.
· Which methods or instruments would work well for the scenario? Determine an appropriate sample size for the scenario.
RESOURCES
Required Readings
Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.
- Chapter 12, “Sampling in Quantitative Research”
This chapter introduces key concepts concerning sampling in quantitative research. This includes such concepts as a description of populations, different types of sampling and their uses, and how to determine a manageable, yet sufficient number to be included in a sample. The chapter also includes suggestions for implementing a sampling plan.
- Chapter 13, “Data Collection in Quantitative Research”
Once a sampling design is complete, the next step is to collect the data, and this is the focus of Chapter 13. The chapter describes how to develop a data collection plan, and provides information about the different types of instruments that can be used, such as structured observation and biophysiologic measures.
- Chapter 22, “Sampling in Qualitative Research”
The focus of this chapter is on the sampling process in qualitative research. The chapter describes the different types of sampling and when they are commonly used. Sampling techniques in the three main qualitative traditions (ethnography, phenomenological studies and grounded theory studies) are highlighted.
- Chapter 23, “Data Collection in Qualitative Research”
This chapter examines the process of data collection in qualitative research as well as key issues surrounding data collection. This includes such methods as self-reporting, surveys, interviews, and personal journal keeping. The chapter also highlights important considerations when utilizing unstructured observations to gather data and how to record field notes.
Media
Laureate Education (Producer). (2012b). Data collection. Baltimore, MD: Author.
Note: The approximate length of this media piece is 4 minutes.
Dr. Kristen Mauk discusses how she collected data for her DNP project in this video. She describes the details of her pre- and post-tests used to track nurses’ knowledge in a rehabilitation unit.
Optional Resources
Krainovich-Miller, B., Haber, J., Yost, J., & Jacobs, S. (2009). Evidence-based practice challenge: teaching critical appraisal of systematic reviews and clinical practice guidelines to graduate students. Journal of Nursing Education, 48(4), 186–195.
This text emphasizes the advantages of survey research. The authors describe the nuances of survey research projects, including their design, methods, analysis, and limitations.
Horsley, T., Hyde, C., Santesso, N., Parkes, J., Milne, R., & Stewart, R. (2011). Teaching critical appraisal skills in healthcare settings. Cochrane Database of Systematic Reviews (Online), 11, Art. No.: CD001270.
Melnyk, B., Fineout-Overholt, E., & Mays, M. (2009). The evidence-based practice beliefs and implementation scales: Psychometric properties of two new instruments. Worldviews on Evidence-Based Nursing, 6(1), 49.
Fawcett, J., & Garity, J. (2009). Evaluating research for evidence-based nursing. Philadelphia, PA: F.A. David Company.
- Chapter 9, “Evaluation of Research Instruments and Experimental Conditions”
5.Weighing the Evidence
When conducting original research, the final step researchers must complete is weighing the evidence and interpreting the meanings of their data, statistics, and analyses. This is the culmination of the research process in which all of the research methods and designs can be synthesized into a meaningful conclusion. In this stage, researchers should formulate explanations for what their data indicates, determine whether the data answers their initial research question, identify areas of uncertainty, and consider directions for further research.
In this Discussion, you focus on one of the research articles that you identified for Part 2 of the Course Project (Literature Review). You then explore the process of how the researchers generated conclusions based on their data, consider other possible interpretations of their data, and formulate ideas for further research.
To prepare:
· Review this week’s Learning Resources, focusing on how researchers find meaning in their data and generate sound conclusions. Pay particular attention to Table 2 in the article, “Study Design in Medical Research.”
· Revisit the 5 articles that you identified in Part 2 of the Course Project. Select one to consider for the purpose of this Discussion.
· Read sections of the chosen article where the data is presented, analyzed, and interpreted for meaning. What reasoning process did the researchers use to formulate their conclusions? What explanation did they give to support their conclusions? Were there any weaknesses in their analysis or conclusions?
· Consider possible alternate conclusions that the researchers could have drawn based on their data.
· Examine the findings that the article presents and consider how well they addressed the researcher’s initial question(s). What additional research could be done to build on these findings and gain a fuller understanding of the question?
RESOURCES
Required Readings
Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.
Review Chapter 2, Fig. 2.1
Chapter 29, “Systematic Reviews of Research Evidence: Meta-analysis, Metasynthesis, and Mixed Studies Review”
This chapter focuses on the different types of systematic reviews. The chapter discusses the advantages of this type of analysis and the steps for conducting a meta-analysis or metasynthesis.
Dingle, P. (2011). Statin statistics: Lies and deception. Positive Health, 180, 1.
In this article, the author outlines how misleading statistics are used to make false claims about the positive use of statin drugs in order to retain a market share of sales for pharmaceutical firms.
Katapodi, M. C., & Northouse, L. L. (2011). Comparative effectiveness research: Using systematic reviews and meta-analyses to synthesize empirical evidence. Research & Theory for Nursing Practice, 25(3), 191–209.
The authors of this article assert that more comparative effectiveness research (CER) is necessary to accommodate the elevated demand for evidence-based health care practices. The article supplies a summary of methodological issues relevant to systematic reviews and meta-analyses used in the process of CER.
Stichler, J. F. (2010). Evaluating the evidence in evidence-based design. Journal of Nursing Administration, 40(9), 348–351.
The quality of evidence used in EBP can vary considerably. This article highlights the necessity of critically appraising facility design research articles and using a hierarchical model to rate the strength of evidence.
Bernd, R., du Prel, J.-B., & Blettner, M. (2009). Study design in medical research: Part 2 of a series on the evaluation of scientific publications. Deutsches Aerzteblatt International, 106(11), 184–189. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695375/pdf/Dtsch_Arztebl_Int-106-0184.pdf
This article provides guidance in evaluating the study design of scientific publications for reliability and credibility. The authors suggest that the most important elements to consider are the question to be answered, the study population, the unit of analysis, the type of study, the measuring technique, and the calculation of sample size.
Walden University. (n.d.a). Paper templates. Retrieved July 23, 2012, from http://writingcenter.waldenu.edu/57.htm
This website provides you access to the School of Nursing Sample Paper, which will serve as a template for formatting your papers.
Media
Laureate Education (Producer). (2012g). Hierarchy of evidence pyramid. Baltimore, MD: Author.
This multimedia piece explains the hierarchy of evidence pyramid. The piece offers definitions and key information for each level of the pyramid.
Laureate Education (Producer). (2012n). Weighing the evidence. Baltimore, MD: Author.
In this video, Dr. Kristen Mauk provides insight about how she analyzed her data and interpreted meanings of what the data showed. She describes how she drew conclusions based on the results and how she explained unexpected findings that were contrary to her initial hypotheses.
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