PLEASE FOLLOW THE INSTRUCTIONS AS INDICATED BELOW:
1). ZERO (0) PLAGIARISM
2). ATLEAST 5 REFERENCES, NO MORE THAN 5 YEARS
3). PLEASE SEE THE FOLLOWING ATTACHMENTS: RUBRIC DETAILS, CRITICAL APPRAISAL TOOLTEMPLATE, ONE ARTICLE
Please carefully review the grading rubric, especially the first column that says, “Excellent”, and please include each component in the assignment requirements.
4). Please Include Introduction, purpose statement, conclusion, and reference page, (APA formatting)
5). PLEASE STICK TO THE NUMBER OF PAGES REQUIRED FOR THE ASSIGNMENT.
Thank you.
ASSIGNMENT:
Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.
Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.
In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.
To Prepare:
The Assignment (Evidence-Based Project)
Part 3A: Critical Appraisal of Research
Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer-reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.
Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.
Part 3B: Critical Appraisal of Research
Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.
Select Grid View or List View to change the rubric’s layout.
NURS_6052_Module04_Week07_Assignment_Rubric
| Excellent | Good | Fair | Poor |
|---|---|---|---|
|
Points: Points Range: The critical appraisal accurately and clearly provides a detailed evaluation table. The responses provide a detailed, specific, and accurate evaluation of each of the peer-reviewed articles selected. Feedback: |
Points: Points Range: The critical appraisal accurately provides an evaluation table. The responses provide an accurate evaluation of each of the peer-reviewed articles selected with some specificity. Feedback: |
Points: Points Range: The critical appraisal provides an evaluation table that is inaccurate or vague. The responses provide an inaccurate or vague evaluation of each of the peer-reviewed articles selected. Feedback: |
Points: Points Range: The critical appraisal provides an evaluation table that is inaccurate and vague or is missing. Feedback: |
|
Points: Points Range: The responses accurately and clearly suggest a detailed best practice that is fully aligned to the research reviewed. The responses accurately and clearly explain in detail the best practice, with sufficient justification of why this represents a best practice in the field. The responses provide a complete, detailed, and specific synthesis of two outside resources reviewed on the best practice explained. The response fully integrates at least two outside resources and two or three course-specific resources that fully support the responses provided. Accurate, complete, and full APA citations are provided for the research reviewed. Feedback: |
Points: Points Range: The responses accurately suggest a best practice that is adequately aligned to the research reviewed. The responses accurately explain the best practice, with adequately justification of why this represents a best practice in the field. The responses provide an accurate synthesis of at least one outside resource reviewed on the best practice explained. The response integrates at least one outside resource and two or three course-specific resources that may support the responses provided. Accurate and complete APA citations are provided for the research reviewed. Feedback: |
Points: Points Range: The responses inaccurately or vaguely suggest a best practice that may be aligned to the research reviewed. The responses inaccurately or vaguely explain the best practice, with inaccurate or vague justification for why this represents a best practice in the field. The responses provide a vague or inaccurate synthesis of outside resources reviewed on the best practice explained. The response minimally integrates resources that may support the responses provided. Inaccurate and incomplete APA citations are provided for the research reviewed. Feedback: |
Points: Points Range: The responses inaccurately and vaguely suggest a best practice that may be aligned to the research reviewed or are missing. The responses inaccurately and vaguely explain the best practice, with inaccurate and vague justification for why this represents a best practice in the field, or are missing. A vague and inaccurate synthesis of no outside resources reviewed on the best practice explained is provided or is missing. The response fails to integrate any resources to support the responses provided. Inaccurate and incomplete APA citations are provided for the research reviewed or is missing. Feedback: |
|
Points: Points Range: Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria. Feedback: |
Points: Points Range: Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment is stated yet is brief and not descriptive. Feedback: |
Points: Points Range: Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic. Feedback: |
Points: Points Range: Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. No purpose statement, introduction, or conclusion was provided. Feedback: |
|
Points: Points Range: Uses correct grammar, spelling, and punctuation with no errors. Feedback: |
Points: Points Range: Contains a few (one or two) grammar, spelling, and punctuation errors. Feedback: |
Points: Points Range: Contains several (three or four) grammar, spelling, and punctuation errors. Feedback: |
Points: Points Range: Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Feedback: |
|
Points: Points Range: Uses correct APA format with no errors. Feedback: |
Points: Points Range: Contains a few (one or two) APA format errors. Feedback: |
Points: Points Range: Contains several (three or four) APA format errors. Feedback: |
Points: Points Range: Contains many (five or more) APA format errors. Feedback: |
Show Descriptions
Show Feedback
Conduct a critical appraisal of the four peer-reviewed articles you selected and analyzed by completing the Critical Appraisal Tool Worksheet Template. Be sure to include:
· An Evaluation Table–
Levels of Achievement:
Excellent
45 (45%) – 50 (50%)
The critical appraisal accurately and clearly provides a detailed evaluation table. The responses provide a detailed, specific, and accurate evaluation of each of the peer-reviewed articles selected.
Good
40 (40%) – 44 (44%)
The critical appraisal accurately provides an evaluation table. The responses provide an accurate evaluation of each of the peer-reviewed articles selected with some specificity.
Fair
35 (35%) – 39 (39%)
The critical appraisal provides an evaluation table that is inaccurate or vague. The responses provide an inaccurate or vague evaluation of each of the peer-reviewed articles selected.
Poor
0 (0%) – 34 (34%)
The critical appraisal provides an evaluation table that is inaccurate and vague or is missing.
Feedback:
Based on your appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.–
Levels of Achievement:
Excellent
32 (32%) – 35 (35%)
The responses accurately and clearly suggest a detailed best practice that is fully aligned to the research reviewed.
The responses accurately and clearly explain in detail the best practice, with sufficient justification of why this represents a best practice in the field. The responses provide a complete, detailed, and specific synthesis of two outside resources reviewed on the best practice explained. The response fully integrates at least two outside resources and two or three course-specific resources that fully support the responses provided.
Accurate, complete, and full APA citations are provided for the research reviewed.
Good
28 (28%) – 31 (31%)
The responses accurately suggest a best practice that is adequately aligned to the research reviewed.
The responses accurately explain the best practice, with adequately justification of why this represents a best practice in the field. The responses provide an accurate synthesis of at least one outside resource reviewed on the best practice explained. The response integrates at least one outside resource and two or three course-specific resources that may support the responses provided.
Accurate and complete APA citations are provided for the research reviewed.
Fair
25 (25%) – 27 (27%)
The responses inaccurately or vaguely suggest a best practice that may be aligned to the research reviewed.
The responses inaccurately or vaguely explain the best practice, with inaccurate or vague justification for why this represents a best practice in the field. The responses provide a vague or inaccurate synthesis of outside resources reviewed on the best practice explained. The response minimally integrates resources that may support the responses provided.
Inaccurate and incomplete APA citations are provided for the research reviewed.
Poor
0 (0%) – 24 (24%)
The responses inaccurately and vaguely suggest a best practice that may be aligned to the research reviewed or are missing.
The responses inaccurately and vaguely explain the best practice, with inaccurate and vague justification for why this represents a best practice in the field, or are missing. A vague and inaccurate synthesis of no outside resources reviewed on the best practice explained is provided or is missing. The response fails to integrate any resources to support the responses provided.
Inaccurate and incomplete APA citations are provided for the research reviewed or is missing.
Feedback:
Levels of Achievement:
Excellent
5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.
Good
4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
Purpose, introduction, and conclusion of the assignment is stated yet is brief and not descriptive.
Fair
3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time.
Purpose, introduction, and conclusion of the assignment is vague or off topic.
Poor
0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
No purpose statement, introduction, or conclusion was provided.
Feedback:
Levels of Achievement:
Excellent
5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
Good
4 (4%) – 4 (4%)
Contains a few (one or two) grammar, spelling, and punctuation errors.
Fair
3.5 (3.5%) – 3.5 (3.5%)
Contains several (three or four) grammar, spelling, and punctuation errors.
Poor
0 (0%) – 3 (3%)
Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Feedback:
Levels of Achievement:
Excellent
5 (5%) – 5 (5%)
Uses correct APA format with no errors.
Good
4 (4%) – 4 (4%)
Contains a few (one or two) APA format errors.
Fair
3.5 (3.5%) – 3.5 (3.5%)
Contains several (three or four) APA format errors.
Poor
0 (0%) – 3 (3%)
Contains many (five or more) APA format errors.
Feedback:
Name: NURS_6052_Module04_Week07_Assignment_Rubric
202 Copyright © 2009 The Author(s)
Evidence-Based Practice: Critical
Appraisal of Qualitative Evidence
Kathleen M.
Williamson
One of the key steps of evidence-based practice is to critically appraise evidence to best answer a clinical question. Mental
health clinicians need to understand the importance of qualitative evidence to their practice, including levels of qualitative
evidence, qualitative inquiry methods, and criteria used to appraise qualitative evidence to determine how implementing
the best qualitative evidence into their practice will influence mental health outcomes. The goal of qualitative research is
to develop a complete understanding of reality as it is perceived by the individual and to uncover the truths that exist.
These important aspects of mental health require clinicians to engage this evidence. J Am Psychiatr Nurses Assoc, 2009;
15(3), 202-207. DOI: 10.1177/1078390309338733
Keywords: evidence-based practice; qualitative inquiry; qualitative designs; critical appraisal of qualitative
evidence; mental health
Evidence-based practice (EBP) is an approach that
enables psychiatric mental health care practitioners
as well as all clinicians to provide the highest quality
of care using the best evidence available (Melnyk &
Fineout-Overholt, 2005). One of the key steps of EBP
is to critically appraise evidence to best answer a
clinical question. For many mental health questions,
understanding levels of evidence, qualitative inquiry
methods, and questions used to appraise the evidence
are necessary to implement the best qualitative evi-
dence into practice. Drawing conclusions and making
judgments about the evidence are imperative to the
EBP process and clinical decision making (Melnyk &
Fineout-Overholt, 2005; Polit & Beck, 2008). The over-
all purpose of this article is to familiarize clinicians
with qualitative research as an important source of
evidence to guide practice decisions. In this article, an
overview of the goals, methods and types of qualita-
tive research, and the criteria used to appraise the
quality of this type of evidence will be presented.
QUALITATIVE BELIEFS
Qualitative research aims to generate insight,
describe, and understand the nature of reality in
human experiences (Ayers, 2007; Milne & Oberle,
2005; Polit & Beck, 2008; Saddler, 2006; Sandelowski,
2004; Speziale & Carpenter, 2003; Thorne, 2000).
Qualitative researchers are inquisitive and seek to
understand knowledge about how people think and
feel, about the circumstances in which they find
themselves, and use methods to uncover and decon-
struct the meaning of a phenomenon (Saddler, 2006;
Thorne, 2000). Qualitative data are collected in a
natural setting. These data are not numerical; rather,
they are full and rich descriptions from participants
who are experiencing the phenomenon under study.
The goal of qualitative research is to uncover the
truths that exist and develop a complete understand-
ing of reality and the individual’s perception of what
is real. This method of inquiry is deeply rooted in
descriptive modes of research. “The idea that multiple
realties exist and create meaning for the individuals
studied is a fundamental belief of qualitative research-
ers” (Speziale & Carpenter, 2003, p. 17). Qualitative
research is the studying, collecting, and understand-
ing the meaning of individuals’ lives using a variety
of materials and methods (Denzin & Lincoln, 2005).
WHAT IS A QUALITATIVE
RESEARCHER?
Qualitative researchers commonly believe that indi-
viduals come to know and understand their reality in
Kathleen M. Williamson, PhD, RN, associate director, Center for
the Advancement of Evidence-Based Practice, Arizona State
University, College of Nursing & Healthcare Innovation, Phoenix,
Arizona; Kathleen.Williamson@asu.edu.
Journal of the American Psychiatric Nurses Association,Vol. 15, No. 3 203
Critical Appraisal of Qualitative Evidence
different ways. It is through the lived experience
and the interactions that take place in the natural
setting that the researcher is able to discover and
understand the phenomenon under study (Miles &
Huberman, 1994; Patton, 2002; Speziale & Carpenter,
2003). To ensure the least disruption to the environ-
ment/natural setting, qualitative researchers care-
fully consider the best research method to answer
the research question (Speziale & Carpenter, 2003).
These researchers are intensely involved in all
aspects of the research process and are considered
participants and observers in setting or field (Patton,
2002; Polit & Beck, 2008; Speziale & Carpenter,
2003). Flexibility is required to obtain data from the
richest possible sources of information. Using a
holistic approach, the researcher attempts to cap-
ture the perceptions of the participants from an
“emic” approach (i.e., from an insider’s viewpoint;
Miles & Huberman, 1994; Speziale & Carpenter,
2003). Often, this is accomplished through the use of
a variety of data collection methods, such as inter-
views, observations, and written documents (Patton,
2002). As the data are collected, the researcher
simultaneously analyzes it, which includes identi-
fying emerging themes, patterns, and insights
within the data. According to Patton (2002), quali-
tative analysis engages exploration, discovery, and
inductive logic. The researcher uses a rich literary
account of the setting, actions, feelings, and mean-
ing of the phenomenon to report the findings
(Patton, 2002).
COMMONLY USED
QUALITATIVE DESIGNS
According to Patton (2002), “Qualitative methods
are first and foremost research methods. They are
ways of finding out what people do, know, think, and
feel by observing, interviewing, and analyzing docu-
ments” (p. 145). Qualitative research designs vary by
type and purpose: data collection strategies used and
the type of question or phenomenon under study. To
critically appraise qualitative evidence for its valid-
ity and use in practice, an understanding of the
types of qualitative methods as well as how they are
employed and reported is necessary.
Many of the methods are routed in the anthropol-
ogy, psychological, and sociology disciplines. Many
commonly used methods in the health sciences
research are ethnography, phenomenology, and
grounded theory (see Table 1).
Ethnography
Ethnography has its traditions in cultural
anthropology, which describe the values, beliefs,
and practice of cultural groups (Ploeg, 1999; Polit
& Beck, 2008). According to Speziale and Carpenter
(2003), the characteristics that are central to eth-
nography are that (a) the research is focused on
culture, (b) the researcher is totally immersed in
the culture, and (c) the researcher is aware of her/
his own perspective as well as those in the study.
Ethnographic researchers strive to study cultures
from an emic approach. The researcher as a par-
ticipant observer becomes involved in the culture
to collect data, learn from participants, and report
on the way participants see their world (Patton,
2002). Data are primarily collected through obser-
vations and interviews. Analysis of ethnographic
results involves identifying the meanings attrib-
uted to objects and events by members of the cul-
ture. These meanings are often validated by
members of the culture before finalizing the results
(called member checks). This is a labor-intensive
method that requires extensive fieldwork.
TABLE 1. Most Commonly Used Qualitative Research Methods
Method
Purpose
Research question(s)
Sample size (on average)
Data sources/collection
Ethnography
Describe culture of people
What is it like to live . . .
What is it . . .
30-50
Interviews, observations, field
notes, records, chart data,
life histories
Phenomenology
Describe phenomena, the
appearance of things, as lived
experience of humans in a natural
setting
What is it like to have this
experience? What does it feel like?
6-8
Interviews, videotapes, observations,
in-depth conversations
Grounded theory
To develop a theory rather than
describe a phenomenon
Questions emerge from the data
25-50
Taped interview, observation,
diaries, and memos from
researcher
Source. Adapted from Polit and Beck (2008) and Speziale and Carpenter(2003).
204 Journal of the American Psychiatric Nurses Association,Vol. 15, No. 3
Williamson
Phenomenology
Phenomenology has its roots in both philosophy
and psychology. Polit and Beck (2008) reported,
“Phenomenological researchers believe that lived
experience gives meaning to each person’s percep-
tion of a particular phenomenon” (p. 227). According
to Polit and Beck, there are four aspects of the
human experience that are of interest to the phe-
nomenological researcher: (a) lived space (spatial-
ity), (b) lived body (corporeality), (c) lived human
relationships (relationality), and (d) lived time (tem-
porality). Phenomenological inquiry is focused on
exploring how participants in the experience make
sense of the experience, transform the experience
into consciousness, and the nature or meaning of
the experience (Patton, 2002). Interpretive phenom-
enology (hermeneutics) focuses on the meaning and
interpretation of the lived experience to better
understand social, cultural, political, and historical
context. Descriptive phenomenology shares vivid
reports and describes the phenomenon.
In a phenomenological study, the researcher is an
active participant/observer who is totally immersed
in the investigation. It involves gaining access to
participants who could provide rich descriptions
from in-depth interviews to gather all the informa-
tion needed to describe the phenomenon under study
(Speziale & Carpenter, 2003). Ongoing analyses of
direct quotes and statements by participants occur
until common themes emerge. The outcome is a vivid
description of the experience that captures the
meaning of the experience and communicates clearly
and logically the phenomenon under study (Speziale
& Carpenter, 2003).
Grounded Theory
Grounded theory has its roots in sociology and
explores the social processes that are present within
human interactions (Speziale & Carpenter, 2003).
The purpose is to develop or build a theory rather
than test a theory or describe a phenomenon (Patton,
2002). Grounded theory takes an inductive approach
in which the researcher seeks to generate emergent
categories and integrate them into a theory grounded
in the data (Polit & Beck, 2008). The research does
not start with a focused problem; it evolves and is
discovered as the study progresses. A feature of
grounded theory is that the data collection, data
analysis, and sampling of participants occur simulta-
neously (Polit & Beck, 2008; Powers, 2005). The
researchers using ground theory methodology are
able to critically analyze situations, not remove
themselves from the study but realize that they
are part of it, recognize bias, obtain valid and reliable
data, and think abstractly (Strauss & Corbin, 1990).
Data collection is through in-depth interview and
observations. A constant comparative process is used
for two reasons: (a) to compare every piece of data
with every other piece to more accurately refine the
relevant categories and (b) to assure the researcher
that saturation has occurred. Once saturation is
reached the researcher connects the categories, pat-
terns, or themes that describe the overall picture
that emerged that will lead to theory development.
ASPECTS OF QUALITATIVE RESEARCH
The most important aspects of qualitative inquiry
is that participants are actively involved in the
research process rather than receiving an interven-
tion or being observed for some risk or event to be
quantified. Another aspect is that the sample is pur-
posefully selected and is based on experience with a
culture, social process, or phenomena to collect infor-
mation that is rich and thick in descriptions. The final
essential aspect of qualitative research is that one or
more of the following strategies are used to collect
data: interviews, focus groups, narratives, chat rooms,
and observation and/or field notes. These methods
may be used in combination with each other. The
researcher may choose to use triangulation strategies
on data collection, investigator, method, or theory and
use multiple sources to draw conclusions about the
phenomenon (Patton, 2002; Polit & Beck, 2009).
SUMMARY
This is not an inclusive list of qualitative methods
that researchers could choose to use to answer a
research question, other methods include historical
research, feminist research, case study method, and
action research. All qualitative research methods are
used to describe and discover meaning, understand-
ing, or develop a theory and transport the reader to
the time and place of the observation and/or inter-
view (Patton, 2002).
THE HIERARCHY OF
QUALITATIVE EVIDENCE
Clinical questions that require qualitative evi-
dence to answer them focus on human response and
Journal of the American Psychiatric Nurses Association,Vol. 15, No. 3 205
Critical Appraisal of Qualitative Evidence
meaning. An important step in the process of apprais-
ing qualitative research as a guide for clinical prac-
tice is the identification of the level of evidence or the
“best” evidence. The level of evidence is a guide that
helps identify the most appropriate, rigorous, and
clinically relevant evidence to answer the clinical
question (Polit & Beck, 2008). Evidence hierarchy for
qualitative research ranges from opinion of authori-
ties and/or reports of expert committees to a single
qualitative research study to metasynthesis (Melnyk
& Fineout-Overholt, 2005; Polit & Beck, 2008). A
metasynthesis is comparable to meta-analysis (i.e.,
systematic reviews) of quantitative studies. A meta-
synthesis is a technique that integrates findings of
multiple qualitative studies on a specific topic, pro-
viding an interpretative synthesis of the research
findings in narrative form (Polit & Beck, 2008). This
is the strongest level of evidence in which to answer
a clinical question. The higher the level of evidence
the stronger the evidence is to change practice.
However, all evidence needs be critically appraised
based on (a) the best available evidence (i.e., level of
evidence), (b) the quality and reliability of the study,
and (c) the applicability of the findings to practice.
CRITICAL APPRAISAL OF
QUALITATIVE EVIDENCE
Once the clinical issue has been identified, the
PICOT question constructed, and the best evidence
located through an exhaustive search, the next step
is to critically appraise each study for its validity
(i.e., the quality), reliability, and applicability to use
in practice (Melnyk & Fineout-Overholt, 2005).
Although there is no consensus among qualitative
researchers on the quality criteria (Cutcliffe &
McKenna, 1999; Polit & Beck, 2008; Powers, 2005;
Russell & Gregory, 2003; Sandelowski, 2004), many
have published excellent tools that guide the process
for critically appraising qualitative evidence (Duffy,
2005; Melnyk & Fineout-Overholt, 2005; Polit &
Beck, 2008; Powers, 2005; Russell & Gregory, 2003;
Speziale & Carpenter, 2003). They all base their cri-
teria on three primary questions: (a) Are the study
findings valid? (b) What were the results of the
study? (c) Will the results help me in caring for my
patients? According to Melnyk and Fineout-Overholt
(2005), “The answers to these questions ensure rele-
vance and transferability of the evidence from the
search to the specific population for whom the practi-
tioner provides care” (p. 120). In using the questions
in Tables 2, 3, and 4, one can evaluate the evidence
and determine if the study findings are valid, the
method and instruments used to acquire the knowl-
edge credible, and if the findings are transferable.
The qualitative process contributes to the rigor or
trustworthiness of the data (i.e., the quality). “The
goal of rigor in qualitative research is to accurately
represent study participants’ experiences” (Speziale
& Carpenter, 2003, p. 38). The qualitative attributes
of validity include credibility, dependability, confirm-
ability, transferability, and authenticity (Guba &
Lincoln, 1994; Miles & Huberman, 1994; Speziale &
Carpenter, 2003).
Credibility is having confidence and truth about
the data and interpretations (Polit & Beck, 2008).
The credibility of the findings hinges on the skill,
competence, and rigor of the researcher to describe
the content shared by the participants and the abil-
ity of the participants to accurately describe the
phenomenon (Patton, 2002; Speziale & Carpenter,
2003). Cutcliffe and McKenna (1999) reported that
the most important indicator of the credibility of
findings is when a practitioner reads the study find-
ings and regards them meaningful and applicable
and incorporates them into his or her practice.
Confirmability refers to the way the researcher
documents and confirms the study findings (Speziale
TABLE 2. Subquestions to Further Answer, Are the Study Findings Valid?
Participants
Sample
Data collection
How were they
selected?
Was it adequate?
How were the
data collected?
Did they provide
rich and thick
descriptions?
Was the setting
appropriate to
acquire an
adequate sample?
Were the tools
adequate?
Were the
participants’
rights protected?
Was the sampling
method
appropriate?
How were the data
coded? If so
how?
Did the researcher
eliminate bias?
Do the data accurately
represent the study
participants?
How accurate and
complete were the
data?
Was the group or
population adequately
described?
Was saturation achieved?
Does gathering the data
adequately portray the
phenomenon?
Source. Adapted from Powers (2005), Polit and Beck (2008), Russell and Gregory (2003), and Speziale and Carpenter (2003).
206 Journal of the American Psychiatric Nurses Association,Vol. 15, No. 3
Williamson
& Carpenter, 2003). Confirmability is the process of
confirming the accuracy, relevance, and meaning of
the data collected. Confirmability exists if (a) the
researcher identifies if saturation was reached and
(b) records of the methods and procedures are
detailed enough that they can be followed by an
audit trail (Miles & Huberman, 1994).
Dependability is a standard that demonstrates
whether (a) the process of the study was consistent, (b)
data remained consistent over time and conditions,
and (c) the results are reliable (Miles & Huberman,
1994; Polit & Beck, 2008; Speziale & Carpenter, 2003).
For example, if study methods and results are depend-
able, the researcher consistently approaches each
occurrence in the same way with each encounter and
results were coded with accuracy across the study.
Transferability refers to the probability that the
study findings have meaning and are usable by oth-
ers in similar situations (i.e., generalizable to others
in that situation; Miles & Huberman, 1994; Polit &
Beck, 2008; Speziale & Carpenter, 2003). To deter-
mine if the findings of a study are transferable and
can be used by others, the clinician must consider
the potential client to whom the findings may be
applied (Speziale & Carpenter, 2003).
Authenticity is when the researcher fairly and
faithfully shows a range of different realities and
develops an accurate and authentic portrait for
the phenomenon under study (Polit & Beck, 2008).
For example, if a clinician were to be in the same
environment as the researcher describes, they would
experience the phenomenon similarly. All mental
health providers need to become familiar with these
aspects of qualitative evidence and hone their criti-
cal appraisal skills to enable them to improve the
outcomes of their clients.
CONCLUSION
Qualitative research aims to impart meaning of
the human experience and understand how people
think and feel about their circumstances. Qualitative
researchers use a holistic approach in an attempt to
uncover truths and understand a person’s reality.
The researcher is intensely involved in all aspects
of the research design, collection, and analysis pro-
cesses. Ethnography, phenomenology, and grounded
theory are some of the designs that a researcher may
use to study a culture, phenomenon, or theory. Data
collection strategies vary based on the research
question, method, and informants. Methods such as
interviews, observations, and journals allow for
information-rich participants to provide detailed lit-
erary accounts of the phenomenon. Data analysis
occurs simultaneously as data collection and is the
process by which the researcher identifies themes,
concepts, and patterns that provide insight into the
phenomenon under study.
One of the crucial steps in the EBP process is to
critically appraise the evidence for its use in practice
TABLE 3. Subquestions to Further Answer, What Were the Results of the Study?
Is the research
design
appropriate
for the
research
question?
Is the
description
of findings
thorough?
Do findings
fit the data
from which
they were
generated?
Are the results
logical,
consistent,
and easy to
follow?
Was the
purpose of the
study clear?
Were all themes
identified,
useful,
creative, and
convincing of
the
phenomena?
Source. Adapted from Powers (2005), Russell and Gregory (2003), and Speziale and Carpenter (2003).
TABLE 4. Subquestions to Further Answer, Will the Results Help Me in Caring for My Patients?
What meaning and
relevance does
this study have
for my patients?
How would I use
these findings
in my practice?
How does the study
help provide
perspective on my
practice?
Are the conclusions
appropriate to my
patient
population?
Are the results
applicable to
my patients?
How would patient
and family values
be considered in
applying these
results?
Source. Adapted from Powers (2005), Russell and Gregory (2003), and Speziale and Carpenter (2003).
Journal of the American Psychiatric Nurses Association,Vol. 15, No. 3 207
Critical Appraisal of Qualitative Evidence
and determine the value of findings. Critical appraisal
is the review of the evidence for its validity (i.e.,
strengths and weaknesses), reliability, and usefulness
for clients in daily practice. “Psychiatric mental
health clinicians are practicing in an era emphasizing
the use of the most current evidence to direct their
treatment and interventions” (Rice, 2008, p. 186).
Appraising the evidence is essential for assurance
that the best knowledge in the field is being applied
in a cost-effective, holistic, and effective way. To do
this, one must incorporate the critically appraised
findings with their abilities as clinicians and their
clients’ preferences. As professionals, clinicians are
expected to use the EBP process, which includes
appraising the evidence to determine if the best
results are believable, useable, and dependable.
Clinicians in psychiatric mental health must use
qualitative evidence to inform their practice deci-
sions. For example, how do clients newly diagnosed
with bipolar and their families perceive the life
impact of this diagnosis? Having a well done meta-
synthesis that provides an accurate representation of
the participants’ experiences, and is trustworthy (i.e.,
credible, dependable, confirmable, transferable, and
authentic), will provide insight into the situational
context, human response, and meaning for these cli-
ents and will assist clinicians in delivering the best
care to achieve the best outcomes.
REFERENCES
Ayers, L. (2007). Qualitative research proposals—Part I. Journal
Wound Ostomy Continence Nursing, 34, 30-32.
Cutcliffe, J. R., & McKenna, H. P. (1999). Establishing the credibil-
ity of qualitative research findings: The plot thickens. Journal
of Advanced Nursing, 30, 374-380.
Denzin, N. K., & Lincoln, Y. S. (2005). The Sage handbook of
qualitative research (3rd ed.). Thousand Oaks, CA: Sage.
Duffy, M. E. (2005). Resources for critically appraising qualitative
research evidence of nursing practice clinical question. Clinical
Nursing Specialist, 19, 288-290.
Guba, E. G., & Lincoln, Y. S. (1994). Competing paradigms in
qualitative research. In N. K. Denzin & Y. S. Lincoln (Eds.),
Handbook of qualitative research (pp. 105-117). Thousand
Oaks, CA: Sage.
Melnyk, B. M., & Fineout-Overholt, E. (Eds.). (2005). Evidence-based
practice in nursing and healthcare. Philadelphia: Lippincott
Williams & Wilkins.
Miles, M. B., & Huberman, A. M. (1994). An expend sourcebook
qualitative data analysis (4th ed.). Thousand Oaks, CA: Sage.
Milne, J., & Oberle, K. (2005). Enhancing rigor in qualitative
description: A case study. Journal Wound Ostomy Continence
Nursing, 32, 413-420.
Patton, M. Q. (2002). Qualitative research & evaluation methods
(3rd ed.). Thousand Oaks: Sage.
Ploeg, J. (1999). Identifying the best research design to fit the
question. Part 2: Qualitative designs. Evidence-Based Nursing,
2, 36-37.
Polit, D. F., & Beck, C. T. (2008). Nursing research: Generating and
assessing evidence fro nursing practice. Philadelphia: Lippincott
Williams & Wilkins.
Powers, B. A. (2005). Critically appraising qualitative evidence. In
B. M. Melnyk & E. Fineout-Overholt (Eds.), Evidence-based
practice in nursing and healthcare (pp. 127-162). Philadelphia:
Lippincott Williams & Wilkins.
Rice, M. J. (2008). Evidence-based practice in psychiatric care:
Defining levels of evidence. Journal of the American Psychiatric
Nurses Association, 14(3), 181-187.
Russell, C. K., & Gregory, D. M. (2003). Evaluation of qualitative
research studies. Evidence-Based Nursing, 6, 36-40.
Saddler, D. (2006). Research 101. Gastroenterology Nursing, 30,
314-316.
Sandelowski, M. (2004). Using qualitative research. Qualitative
Health Research, 14, 1366-1386.
Speziale, H. J. S., & Carpenter, D. R. (2003). Qualitative research
in nursing: Advancing the humanistic imperative. Philadelphia:
Lippincott Williams & Wilkins.
Strauss, A., & Corbin, J. (1990). Basics of qualitative research:
Grounded theory procedures and techniques. London: Sage.
Thorne, S. (2000). Data analysis in qualitative research. Evidence-
Based Nursing, 3, 68-70.
For reprints and permission queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav.
Evaluation Table
Use this document to complete the
evaluation table
requirement of the Module 4 Assessment,
Evidence-Based Project, Part 4A: Critical Appraisal of Research
|
Full APA formatted citation of selected article. |
Article #1 |
Article #2 |
Article #3 |
Article #4 |
|
Evidence Level * (I, II, or III) |
||||
|
Conceptual Framework Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).** |
||||
|
Design/Method Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria). |
||||
|
Sample/Setting The number and characteristics of patients, attrition rate, etc. |
||||
|
Major Variables Studied List and define dependent and independent variables |
||||
|
Measurement Identify primary statistics used to answer clinical questions (You need to list the actual tests done). |
||||
|
Data Analysis Statistical or Qualitative findings (You need to enter the actual numbers determined by the statistical tests or qualitative data). |
||||
|
Findings and Recommendations General findings and recommendations of the research |
||||
|
Appraisal and Study Quality Describe the general worth of this research to practice. What are the strengths and limitations of study? What are the risks associated with implementation of the suggested practices or processes detailed in the research? What is the feasibility of use in your practice? |
||||
|
Key findings |
||||
|
Outcomes |
||||
|
General Notes/Comments |
*
These levels are from the Johns Hopkins Nursing Evidence-Based Practice: Evidence Level and Quality Guide
· Level I
Experimental, randomized controlled trial (RCT), systematic review RTCs with or without meta-analysis
· Level II
Quasi-experimental studies, systematic review of a combination of RCTs and quasi-experimental studies, or quasi-experimental studies only, with or without meta-analysis
· Level III
Nonexperimental, systematic review of RCTs, quasi-experimental with/without meta-analysis, qualitative, qualitative systematic review with/without meta-synthesis
· Level IV
Respected authorities’ opinions, nationally recognized expert committee/consensus panel reports based on scientific evidence
· Level V
Literature reviews, quality improvement, program evaluation, financial evaluation, case reports, nationally recognized expert(s) opinion based on experiential evidence
**Note on Conceptual Framework
· The following information is from Walden academic guides which helps explain conceptual frameworks and the reasons they are used in research. Here is the link
https://academicguides.waldenu.edu/library/conceptualframework
· Researchers create theoretical and conceptual frameworks that include a philosophical and methodological model to help design their work. A formal theory provides context for the outcome of the events conducted in the research. The data collection and analysis are also based on the theoretical and conceptual framework.
· As stated by Grant and Osanloo (2014), “Without a theoretical framework, the structure and vision for a study is unclear, much like a house that cannot be constructed without a blueprint. By contrast, a research plan that contains a theoretical framework allows the dissertation study to be strong and structured with an organized flow from one chapter to the next.”
· Theoretical and conceptual frameworks provide evidence of academic standards and procedure. They also offer an explanation of why the study is pertinent and how the researcher expects to fill the gap in the literature.
· Literature does not always clearly delineate between a theoretical or conceptual framework. With that being said, there are slight differences between the two.
References
The Johns Hopkins Hospital/Johns Hopkins University (n.d.). Johns Hopkins nursing dvidence-based practice: appendix C: evidence level and quality guide. Retrieved October 23, 2019 from
https://www.hopkinsmedicine.org/evidence-based-practice/_docs/appendix_c_evidence_level_quality_guide
Grant, C., & Osanloo, A. (2014). Understanding, Selecting, and Integrating a Theoretical Framework in Dissertation Research: Creating the Blueprint for Your” House”. Administrative Issues Journal: Education, Practice, and Research, 4(2), 12-26.
Walden University Academic Guides (n.d.). Conceptual & theoretical frameworks overview. Retrieved October 23, 2019 from https://academicguides.waldenu.edu/library/conceptualframework
Critical Appraisal Tool Worksheet Template
© 2018 Laureate Education Inc.
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