critiquing research literature...critiquing research literature dr. marla kniewel associate...

Critiquing Research Literature

Dr. Marla Kniewel Associate Professor

IRB Chair

Nebraska Methodist College

Objectives

1.Explain the purpose of critiquing research methodology, rigor, study validity and study reliability.

2.Discuss different approaches in the critical appraisal of research literature

Why Critique Research Literature?

• Assumption that printed words are absolutely true– Not all published research is scientifically sound

– Studies with more ‘interesting’ results are more likely to be:• Submitted & accepted for publication

• Published in a major journal

• Published in the English language

• Research literature provides evidence to guide nursing practice– Essential part of research, EBP, or QI projects

– EBP is about incorporating the BEST evidence • Failure to critique may adversely affect patient outcomes

What is a Critical Appraisal?

The first step in transferring research knowledge into practice

• Weighing evidence to see how useful it is in decision making

• Balanced assessment of benefits and strengths of research against its flaws and weaknesses

• Assess research process and results

• Skill that needs to be practiced

How do I appraise Research?

• Mostly common sense.

• You don’t have to be a statistical expert!

• Checklists help you focus on the most important aspects of the article.

• Different checklists for different types of research.

• Will help you decide if research is valid and relevant.

IMRaD

• Introduction

o Background / Review of Literature

• Methodology

• Results

• Discussion

Structure of a Research Article

.

Introduction

• Background

– Review of literature

– Overarching Problem

• Purpose

• Good fit between Problem and Purpose

Structure of a Research Article

• Methodology

– Should describe exactly how the research was carried out:

• Sample: – characteristics, selection, number, non-response

• Measures: – description of tests / questionnaires (validated?), data,

outcome measures

• Procedure: – study design (qualitative, quantitative, controlled?)

Structure of a Research Article

• Results

– Should tell the reader what the findings were.

– All outcome measures must be reported

– Confidence intervals for effect sizes should be

presented.

Structure of a Research Article

• Discussion

– Interpretation of the results / relation to theory

– Comparison with the results of other studies

– Weaknesses / limitations of the study

– Implications

– Recommendations

Critical Appraisal Process

1. Determine appropriateness for project

2. Read entire article first– Organization & presentation

3. Identify unknown terminology

4. Thorough 2nd reading–Highlight each step of research process–Write notes/questions in margins–Circle key points

5. Evaluate rigor of study

6. Make a decision

Critical Appraisal Process: Appropriateness

• Title

• Abstract

• Level of Evidence

• Origin of study

Systematic Review

Single RCT

Controlled Cohort Studies

(Quasi-Experimental)

Uncontrolled Cohort Studies

Case Studies & Case Series

Qualitative & Descriptive Studies

EBP Implementation & QI Projects

Expert Opinion

(Melnyk & Fineout-Overholt, 2015)

Critical Appraisal Process: 2nd Reading

• Methodology

– Sample & Sample size

– Ethical considerations

– Research design

– Data collection

– Instrument design

• Analysis

• Results

Rigor

• Quantitative Study

– Reliability

– Validity

• Qualitative Study

– Trustworthiness

• Credibility

• Transferability

• Dependability

• Confirmability

Critical Appraisal Process

• Identify Strengths & Weaknesses– Does study meet all of the appraisal criteria?

– Does researcher identify weaknesses in limitations section?

• Will the results help me care for my patients?– Were all clinical outcomes being measured?

– What are the risks & benefits?

– Is it feasible in your clinical setting?

Rapid Critical Appraisal

• Is the study design appropriate to the stated aims?

• Are the measurements likely to be valid and reliable?

• Was there a relevant effect size?– Clinical significance

• Is the outcome generalizable to your situation?

Research Appraisal Checklists

• Facilitates the appraisal process– Novice & expert appraisers

• Individualized for type of study– Quantitative study designs– Qualitative Studies– Mixed methods– Systematic reviews (meta-analysis)

• Examples– Joanna Briggs Institute– Critical Appraisals Skills Programme (CASP)– Melnyk’ s Rapid Critical Appraisal Tool

References

• Boswell, C. & Cannon, S. (2020). Introduction to nursing research: Incorporating evidence-based practice (5th ed.). Burlington MA: Jones & Bartlett Learning.

• Buccheri, R. & Sharifi, C. (2017). Critical Appraisal Tools and Reporting Guidelines for evidence-based practice. World Views on Evidence-based Nursing, 14(6), 463-472.

• Melnyk, B. & Fineout-Overholt, E. (2015). Evidenced-based practice in nursing and health care: A guide to best practice (3rd ed.). Philadelphia: Wolters Kluwer Health.

• Melnyk, B., Gallagher-Ford, L., & & Fineout-Overholt, E. (2017). Implementing the evidenced-based practice competencies in Healthcare. Indianapolis, IN: Sigma Theta Tau International.

• Polit, D. & Beck, C.T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia: Wolters Kluwer.