The article to be critiqued is located in the Journal of Advanced Nursing (2007) which evaluates the valuing of altruism in nursing students (Johnson, Haigh and Yates-Bolton (2007).
Research for Healthcare professionals
Hek et al (1996) suggested Research is imperative in healthcare today and is part of the evidence-based practice that underpins nursing. Burns & Grove (1999) further proclaimed critiquing research involves careful examination of all aspects of a study, to judge strengths, limitations, meaning and significance. Research is critiqued to provide knowledge, improve practice and provide essential data for conducting further studies. The aim of this assignment is to critique a chosen piece of nursing research, to analyse the rigor and validity using a critical framework as guidelines. Although, many critical frameworks exist, the one to be utilised in this assignment shall be Benton and Cormack's framework (1996). Using the systematic headings within the chosen frameworks will help to facilitate the understanding and preparation for the journal article to be critiqued (see appendix 1).
The article to be critiqued is located in the Journal of Advanced Nursing (2007) which evaluates the valuing of altruism in nursing students (Johnson, Haigh and Yates-Bolton (2007).
Benton and Cormack's framework is initiated by looking at the following;
Title
The details or the vagueness within the title alone can decide whether the research report is read or not suggested Parahoo (1997).
When the author examines the subject matter which shall be appraised in this instance, it is evident that the title is informative with the first part explaining the research which has been conducted and the second part clearly indicating the type of research methods used, however the word 'study' is used in the title which overall is misleading as Johnson et al (2007) conducted a survey not a study.
Author(s)
There are three authors who participated in the comparative survey in all, which is clearly illustrated on the front page. Also details of the researcher's qualifications are noted. It is also quoted that the authors were primarily registered nurses.
All the researchers from the study have furthered their educations to either MSc or PhD level, this suggests that all the authors have studied at a high level and have at one point conducted their own research independently; therefore all three have the appropriate professional qualifications.
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Abstract
An abstract lets the reader know whether a research article would be relevant to their practice or development, recommended Benton and Cormack (2000). Researchers are aware that some people chose only to read the abstract. Parahoo (1997) & Polit, Beck & Hungler (2001), suggest that the abstract should briefly state the problem to be studied, the design, the setting, the population and its sample size, the methods used to collect the data, and the main findings.
An abstract is included within the article being appraised which is rich in information and categorised into subheadings. The abstract gives an excellent description wrote concisely throughout with approximately 250 words being used. The abstract clearly identifies the research which is being conducted, identifying problems relating to the target population used and also problems are identified in regard to the actual research.
The abstract does not stage a direct hypothesis; however the appraiser is aware of the ideology behind the research, due to the way the text is wrote. Ideally researchers should quote an hypothesise early on in the study explained Benton and Cormack (2000), however in surveys such as Johnson et al (2007) hypothesises are inappropriate as outcomes can not be predicted due to the individuality of participants taking part.
Methodology is mentioned briefly and the sample used is stated, although the word 'student' is used it would have been useful at this stage to see the target population's age or gender mentioned in the abstract, as these factors may have an impact on results gathered.
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Introduction
The introduction is not always exclusively labeled 'introduction' and is sometimes incorporated in the abstract (Polit et al 2001). According to Burns & Grove (1999), Hek et al (1996) & Benton and Cormack (2000) a general introduction to the study should identify the research intent.
In Johnson et al's (2007) comparative survey the introduction is clearly illustrated. Within the first paragraph, furthermore the problem which is being studied is clearly identified.
Although the purpose of the research has been clearly acknowledged in respect to the value of altruism and honesty in nursing students Johnson et al (2007) ceases to provide a rationale for why they chose to carry out the study. Limitations are noted which mainly reflect on the sample population used and differences in nurse training over a period of time, which could all have an effect on the results ...
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In Johnson et al's (2007) comparative survey the introduction is clearly illustrated. Within the first paragraph, furthermore the problem which is being studied is clearly identified.
Although the purpose of the research has been clearly acknowledged in respect to the value of altruism and honesty in nursing students Johnson et al (2007) ceases to provide a rationale for why they chose to carry out the study. Limitations are noted which mainly reflect on the sample population used and differences in nurse training over a period of time, which could all have an effect on the results especially in relation to the later study.
Literature Review
The principal rationale for reviewing literature is to gain a broad background and understanding of information that is available to support the study intention (Burns & Grove 1999).
When examining the research conducted by Johnson et al (2007); it should be considered that the comparative study took place within the years 1983-2005, therefore some references used are quite dated. The earliest of these dates back to 1955 with the more modern ones dated 2004, the earlier ones certainly cause concern as society has changed and one could question the ecological validity in regard to these references.
A theoretical framework which draws mainly on psychological aspects e.g. psychoanalysis, cognitive dissonance and behaviour, all of which are suggested to have an impact on altruism and honestly amongst nursing students, is included in Johnson et al (2007) research. The literature does however, present a balanced evaluation which both supports and challenges the area being studied. Epidemiologic sources are included which give the appraiser a more in-depth generalisation of nursing students and their attitude towards altruism and honesty. Nevertheless there is no strong indication to the ideology behind the study, other than reference to the demographic changes in regard to nursing students. Although references are adequate they are, as mentioned earlier dated. More current references would have been more appropriate in studying nursing students in this decade. Overall the literature review covers the articles intentions sufficiently.
Hypothesis
Johnson et al's (2007) is not an experiment but more a survey which compares attitudes and behaviours amongst student nurses over a certain time span, therefore a hypothesis is unsuitable for this kind of research, suggested Benton and Cormack (2000). Therefore the study is ambiguous as there is some uncertainty to what Johnson et al (2007) expected the outcome to be.
Operational definitions
Definitions of wordage such as altruism and honesty are offered, within the text which assists in gaining an understanding to the study in hand.
Methodology
Johnson et al (2007) chose a quantitative approach to their research, although no direct statements are used to support this. The appraiser instantly knows ordinal data has been used because words 'Likert Scale', 'p values' and 'demographic items' are stated. Wordage such as this strongly indicates that the study was quantitative. Methods such as those used by Johnson et al (2007) are appropriate in making generalisations on human behaviour however, usage of open questionnaires would have given the researchers more an in-depth analysis on the actual thoughts and feelings of student nurses, therefore rendering the research more ecologically valid.
The strengths and weaknesses are clearly acknowledged, mainly relating to the downfalls of quantitative research opposed to qualitative research in relation to human values.
Subjects and sample selection
Participants are clearly indicated within the text but a variation to sample size is noted. In the 1983 study 142 general nursing students and 34 children's nursing students where used in the research, however in the 2005 this figure had risen to 618 nursing students, with no explanation as to if these are general or children's nurses. Therefore the sample size is not congruent with both separate studies. The approach to the type of sample collection is clearly mentioned in the text.
The appraiser is under no illusion that a 5 point scale was used to collect data.
Data collection.
All data collection procedures are adequately described in detail, Mann Whitney tests have been used in this instance. The Mann Whitney test is a non-parametric test, which assesses whether two samples of observations come from the same distribution, it is a statistical test suggested Burns and Grove (1999).
The results were all gathered from the use of Likert scales, defined by Graziano and Raulin (2000) as a scale which ranges from agree to strongly disagree, which a participant marks accordingly. This type of research is vague and does not record actual inner thoughts and feelings of an individual.
The research was repeated over a ten year period, using an instrument designed by William Scott, this is explained as a tool which observes certain attributes of characteristics in a nursing context, no acknowledgement to the actual reliability or validity is stated.
Ethical considerations.
When research involves human subjects it is imperative that ethical guidelines are adhered to. The report by Johnson et al (2007) clearly states that considerations were given scrutiny, although the report recognises that the first study was conducted in an era (1983) when ethical guidelines were less strictly adhered to. It is clearly stated that during the 2005 study ethical approval was granted, this could however raise question to the results gathered. In both instances the report states that consent was granted, confidentiality assured and anonymity guaranteed.
Results
Johnson et al's (2007) written arrangement of the results was undoubtedly understood in simple, objective, well-organised comprehensible language. The results are also internally consistent with no variance. Sufficient detail is included which enables the appraiser to place confidence in the findings. The results are rich in detail and fully clarify the results being presented.
P values are used to express differences in accordance to altruism and honesty in regard to nursing students. Results gathered showed that students in 1983 appeared to be more altruistic than students in 2005; however these results are reversed when looking at the statistical data in reference to students valuing honesty, with students in 2005 valuing this more.
Data analysis
The appropriateness of the type of data collected differs according to the decade the research took place. This could merely be the result of advanced technology in 2005 and also results are going to be greater due to the increase in the target population used.
The data analysis from 1983 was analysed using computerised means (multiframe), when ideally a nonparametric analysis would have been more appropriate. The data analysis of the 2005 results showed more consistency and a more normal distribution, however it is documented that the raw data from 1983 was incomplete which again brings in to question the overall validity.
Discussion
The discussion presented by Johnson et al (2007) is balanced, looking at all possibilities on how altruism and honesty is valued by different groups. All external variables are discussed fully from religion, age and qualifications. There are weaknesses to the study which raise question to the actual validity of the research. The main weakness being in the design, no mention of a pilot scheme being conducted, the word 'pilot' is mentioned briefly but reading further it is evident no pilot took place, the researchers merely compared their research with one similar which makes the appraiser dubious in believing the reliability of results gathered.
Other weaknesses to the study are mentioned, issues such as raw data from the 1983 survey being unavailable raises serious question to results gathered. Limitations of cross sectional studies which pre- proclaim the way people think, act or behave can have a huge impact on influencing the way people answer such surveys (demand characteristics). Also the word 'replication' in the initial title gives a false representation of the kind of research to be conducted, replication studies involve a study with no changes or variances or either carefully planned changes in the procedure. With Johnson et al's (2007) research it is evident that changes have occurred especially in regard to the number of participants and also in the way data was collected and analysed, therefore results could be rendered as unreliable and cannot be used as a generalisation of values and behaviours amongst student nurses.
Conclusions
Conclusions are supported by the results obtained, the main findings being demographical changes. Student nurses are more likely to be older in today's society than of 1983, suggesting honesty and altruism are more evident in mature students. However this can not be used as a generalisation as human beings are individual, each with their own set of rules regarding morality and values, one can not assume that all mature students are more honest to patients than younger ones, which is what this study strongly suggests.
Implications of the study are briefly mentioned, suggesting longitudinal studies, looking at differing cultures and demographic settings may be more suitable in researching the behaviour and values in nursing students.
Recommendations
Recommendations in the text suggest further studies in this field; mainly the recommendations are for qualitative studies to be conducted. It is suggested that qualitative studies produce results which would be richer in information, especially in regard to behaviour, values and attitudes of student nurses towards patients.
With the use of structured interviews or questionnaires, the participant has the opportunity to open up and express their true feelings, the disadvantage of using likert scales is that they do not fully allow the participant to express fully what their views are and only limits the participant in their response. Benefits of likert scales are they are quick and less time consuming than other research methods but are unsuitable when measuring personal attributes such as behaviour, thoughts and feelings
It is also suggested that higher education institutes should emphasise the importance of such matters accordingly and incorporate these matters into their nurse education.
This would result in patients getting the highest calibre of care off future nurses.
Word count 2,280
Appendix one
Title
Title Is the title consistent?
Is the title concise?
Does the title clearly indicate the content?
Does the title clearly indicate the research approach used?
Author(s)
Does the authors have appropriate academic qualifications?
Does the author have appropriate professional qualifications?
Abstract
Is there an abstract included?
Does the abstract identify the research problem?
Does the abstract state the hypotheses (if appropriate)?
Does the abstract outline the methodology?
Does the abstract give details of sample subjects?
Does the abstract report major findings?
Introduction
Is the problem clearly identified?
Is a rationale for the study stated?
Are limitations of the study clearly stated?
Literature review
Is the literature up to date?
Does the literature review identify the underlying theoretical framework?
Does the literature review present a balanced evaluation of material both supporting and challenging the position being proposed?
Does the literature clearly identify the need for the research proposed?
Are important references omitted?
Hypothesis
Does the study use an experimental approach?
Is the hypothesis capable of testing?
Is the hypothesis unambiguous?
Operational definitions
Are the terms used in the research question/problem clearly identified?
Methodology
Does the methodology section clearly state the research approach used?
Is the methodology appropriate to the research problem?
Are the strengths and weaknesses of the chosen approach stated?
Subjects
Are the subjects clearly identified?
Sample selection
Is the sample selection congruent with the method used?
Is the approach to sample selection clearly stated?
Is the sample size clearly stated?
Data collection
Are the data collection procedures adequately described?
Has the validity and reliability of any instruments or questionnaires been clearly stated?
Ethical considerations
If the study involves human subjects has the study received ethics committee approval?
Is informed consent sought?
Is confidentiality assured?
Is anonymity guaranteed?
Results
Are the results clearly presented?
Are results internally consistent?
Is sufficient detail given to enable the reader to judge how much confidence can be place in the findings?
Data analysis
Is the approach appropriate to the type of data collected?
Is there sufficient analysis to determine whether 'significant differences' are not attributable to variations in other relevant variables?
Is complete information (test, value, degrees of freedom and probability) reported?
Discussion
Is the discussion balanced?
Does the discussion draw upon previous research?
Are the weaknesses of the study acknowledged?
Are the clinical implications discussed?
Conclusion
Are conclusions supported by the results obtained?
Are the implications of the study identified?
Recommendations
Do the recommendations identify how any weaknesses in the study design could be avoided in future research?
Source
Benton & Cormack (1996) Reviewing and evaluating the literature: The research process in nursing 3rd Ed Blackwell science, London
Reference list
Benton & Cormack (1996) Reviewing and evaluating the literature: The research process in nursing 3rd Ed Blackwell science, London
Burns, N., & Grove, K.S. (1999). Understanding Nursing Research. (4th ed.). United States Of America: W. B. Saunders Company.
Burns, N., & Grove, K.S. (1999). Understanding Nursing Research. (4th ed.). United States Of America: W. B. Saunders Company.
Clamp C G L (1994) Resources for Nursing Research; An annotated bibliography,( 2nd edition) London, Library Association Publishing
Cormack, D. (2000) The Research Process in Nursing.( 4th ed). Oxford: Blackwell
Cormack, D. (2000). The Research Process in Nursing. (4th ed.). Great Britain: Blackwell Science Ltd.
Graziano A M, Raulin M L (2000) Research methods; A Process Inquiry, London , Allyn and Bacon Publishers
Hek G, Judd M, Moule P 2003, Making Sense of Research An Introduction for Health and Social Care Practitioners, Sage Publications, London
Hewitt-Taylor, J. (2001). Use of constant comparative analysis in qualitative research. Nursing standard. 15, 52, p39-42.
Johnson M, Haige C, Yates-Bolton N, (2007) Valung of altruism and honesty in nursing students: a two-decade replication study. Journal of Advanced Nursing 57 (4) 366-374.
Ogier, M. (1999). Reading Research. (2nd ed.). Glasgow: Baillière
Parahoo, K. (1997). Nursing Research: Principles, Process and Issues. London: Macmillan Press Ltd.
Polit, D. F., Beck, C. T., & Hungler, B. P. (2001). Essentials of Nursing Research: Methods, Appraisal, and Utilization. (5th ed.). Philadelphia: Lippincott.
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HECS 2073 Research for Healthcare Professionals
Student: 200210328 Module Manager: Julie Maguire
HECS 2073 Research for Healthcare Professionals
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Student: 200210328 module manager: Julie Maguire
