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final exam Flashcards

1
Q

t-test

A

the difference between means of either
1. 2 diff groups like male vs female
2. 2 groups in one concept like pre-surgery and post surgery patients

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2
Q

Confidence Interval

A

it’s basically standard deviation but between homogenous groups
eg) 3 groups of LPNs. You have a CI of probability that it would apply to all the groups so you can generalize it to all LPNs

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3
Q

Inferential statistics demonstrates what?

A

a relationship between variables
draw conclusions
makes predictions

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4
Q

descriptive statistics describes what?

A

certain elements in the population
DOES not demonstrate relationships between variables

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5
Q

what does standard deviation measure?

A

variability

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6
Q

What is included in measures of central tendancy?

A

Mean
median
mode (frequency distribution)

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7
Q

What are the key elements of a Quantitative research study?

A
  1. hypothesis
  2. theoretical framework
  3. literature review
  4. Problem statement (the question)
  5. Design
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8
Q

Which research design for quantitative does not have a hypothesis?

A

descriptive design (non-experimental)

just needs a good research question

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9
Q

Which research design for quantitative typically has a hypothesis?

A

experimental design

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10
Q

point of descriptive design

A

describe
explore
compare variables

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11
Q

what sampling is used for descriptive design?

A

non-probable/no randomized

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12
Q

advantage/disadvantage of descriptive design?

A

Lots of data, accurate, economical/but it’s superficial & there’s almost too much

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13
Q

advantages/disadvantages of correlational design

A

good for complex relationships between variables
- application to clinical situations
-*foundation for experimental research
cannot manipulate variables. can’t determine casual relationships

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14
Q

what non-experimental design is foundational to experimental research?

A

correlational

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15
Q

What does correlational design not do?

A

comparison between variables

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16
Q

Which design is considered gold standard for quantitative?

A

Experimental - randomized control groups

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17
Q

What are the advantages & disadvantages of experimental design?

A

DETERMINE cause and effect
does not account for some confounding variables like social determinents of health

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18
Q

What is the point of quasi-experimental?

A

TEST not prove - cause and effect

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19
Q

what does Quasiexperimental typically not have?

A

Randomization
Control group

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20
Q

What are the advantages/disadvantages of quasi?

A

more practical and feasible than experimental (RCT)
EVALUATE the effect of the independent variable

can’t establish clear cause and effect, only TEST it

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21
Q

What is the difference between systematic review and meta-analysis?

A

meta analysis - combine and focus on statistical results of numerous studies

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22
Q

Heirarchy of evidence is ranked according to possibility of what?

A

Possibility of bias

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23
Q

Are clinical protocols general or specific to the setting?

A

setting specific

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24
Q

What is hypothesis in research

A

relationship between two or more variables related to the research purpose

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25
Q

What is the goal of qualitative research?

A

find meaning of social or human issues within a particular context

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26
Q

What are the 5 steps of qualitative research?

A
  1. determine focus/aim/goal/purpose
  2. develop research question
  3. identify data and sources and ethics
  4. data collection and analysis
  5. synthesis and writing
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27
Q

What is a good definition of EIP?

A

ongoing process
incorporates evidence from: research, clinical expertise, client preferences and other resources
goal: make nursing decisions with clients

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28
Q

What is the order of Hierarchy of Evidence?
Clinical practice guidelines
case reports/case studies
RCTs
Cohort studies
Meta-analysis/systematic reviews

A

top - clinical practice guidelines
- Meta-analysis/systematic reviews
- RCTs
- Cohort studies
- case reports/case studies

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29
Q

What are the medical data bases?

A

CINAHL - nursing/allied health
PubMED/Mediline

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30
Q

What is the systematic review database in nursing?

A

Joanna Briggs Institute

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31
Q

What does PICo stand for ? (qualitative)

A

Population
Interest (phenomenon)
Context

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32
Q

What does PICOT stand for? (quantitative)

A

Population
Intervention/issue
comparison intervention
outcomes
timing
setting (sometimes added)

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33
Q

What are the 5 phases of quantitative study?

A
  1. conceptual
  2. design and planning
  3. empirical
  4. analytic
  5. dissemination
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34
Q

What are the 4 non-experimental designs?

A
  1. descriptive (observational)
  2. Exploratory
  3. comparative
    4 .Correlational
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35
Q

What are 3 correlational research designs?

A
  1. retrospective (past)
  2. crosssectional (present)
  3. prospective (future)
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36
Q

What are the 3 main types of quantitative research designs?

A
  1. non experimental
  2. Quasi-experimental
  3. Experimental
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37
Q

How is homogenity determined in descriptive (observational ) design?

A

inclusion & exclusion criteria

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38
Q

What type of data collection method does descriptive (observational) design use?

A

surveys & questionnaires

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39
Q

in correlational design, how are examined variables chosen and management of extraneous variables?

A

inclusion and exclusion criteria

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40
Q

What are disadvantages to correlational design?

A

can’t manipulate variables of interest
decreased generalizability
can’t determine causal relationship

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41
Q

What research method is gold standard for cause and effect relationships?

A

Experimental design

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42
Q

What 3 properties does Experimental design have that quasi may not include (quasi always has 1 of the 3 though)?

A
  1. randomization
  2. control
  3. Manipulation
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43
Q

How does experimental design account for confounding and extraneous variables?

A

Sampling
randomization

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44
Q

What is the control in experimental design?

A

the comparison/control group (the constant) - we do not give the intervention we are testing to this group. They just get the normal/usual care so we can compare them to the group with the intervention

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45
Q

What is manipulation in experimental design?

A

administration of the intervention. It is the independent variable that acts on dependent variable

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46
Q

Which property is almost always missing in quasi-experimental design?

A

usually randomization
often control is not possible or practical (no control group)

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47
Q

Which design evaluates the effect of the independent variable?

A

quasi-experimental

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48
Q

In quantitative research what 2 things make up rigor?

A

validity
reliability

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49
Q

What are the 5 threats to internal validity?

A

Temporal ambiguity
selection
history
maturation
mortality/attrition

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50
Q

Is internal validity qualitative or quantitative?

A

Quantitative

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51
Q

What is temporal ambiguity?

A
  • order in which variables influence each other
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52
Q

what is “selection” as a threat to internal validity?

A

preexisting differences between groups (you want homogeneity )

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53
Q

how does history affect internal validity?

A

concurrent events happening during the study

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54
Q

What is maturation?

A

changes that occur with time such as fatigue

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55
Q

What is mortality/attrition?

A

loss of subjects

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56
Q

what affects validity?

A

Temporal ambiguity
selection
history
maturation
mortality/attrition

Bias:
Selection bias
Attrition bias
Measurement bias
Performance bias
Reporting bias
Sampling bias
Biased survey questions
non-response bias

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57
Q

What are the 8 types of bias in qualitative research?

A

Selection bias
Attrition bias
Measurement bias
Performance bias
Reporting bias
Sampling bias
biased survey questions
non-response bias

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58
Q

What is selection bias?

A

people are chosen in a way that is not proper and allows for too much bias or not enough randomness to be able to generalize to the population

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59
Q

What is attrition bias?

A

When people are lost from a study it could be because of differences between them and others who were not lost (remember we want homogeneity )

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60
Q

What is measurement bias?

A

How data was collected
we thought it would measure one thing but it picked up something else

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61
Q

What is performance bias?

A

Hawthorne effect - saying what you think the researcher wants

62
Q

What is reporting bias?

A

what authors and journals present

63
Q

What is sampling bias?

A

sample is not representative of the population

64
Q

What is biophysiological measurements?

A

Anything to do with the body physically, labs, temp, vitals, etc.

65
Q

What is psychometric measurements (assessments)

A

perceptions/thoughts/feelings

66
Q

What is psychometrics ?

A

theory and development of measurement instruments

67
Q

What are 2 types of quantitative data measurment strategies?

A
  1. biophysiological measures : in vivo, in vitro
  2. Psychometric measures:
    • Direct observation
    • Structured self-reported data
68
Q

What is in vivo data?

A

what is directly on the body :
weight, BP, etc

69
Q

What is in vitro data?

A

What you take from the body:
blood work, tissue samples

70
Q

What is a mix of biophysiological measures and psychometric measures called?

A

Existing data - ie) medical records

71
Q

What questions are typically used in psychometric (self-reported) tools?

A

Closed-ended questions

72
Q

What are the 5 closed-ended questions typically used in psychometric tools?

A
  1. Dichotomous (yes/no)
  2. Rating (0-10)
  3. Likert scale (strongly agree to strongly disagree)
  4. M/C
  5. Forced choice (must pick a statement)
73
Q

Why is expertise, testing and refinement over time needed when developing psychometric tools?

A

ensure validity and reliability

73
Q

What are the 3 types of reliability when it comes to measurement tools?

A

Test-retest reliability
Interrater reliability
Internal consistency

74
Q

What are the 4 types of validity when it comes to measurement tools?

A

Face validity
Content validity
Criterion validity
construct validity

75
Q

What type of reliability is pre/post test after an intervention?

A

test-retest reliability

76
Q

Consistency of results when the same test is independently conducted by two diff people is what type of reliability?

A

Interrater reliability

77
Q

consistency within the tool itself (wording, etc) is considered what type of reliability?

A

Internal consistency

78
Q

What is non probability samping?

A

choose by nonrandom methods

79
Q

What research designs typically use non probability sampling?

A

Descriptive (observational)
Correlational
quasi-experimental
qualitative

80
Q

What is probability samping?

A

random selection

81
Q

What type of designs use probability sampling?

A

experimental required
quasi-experimental (sometimes)

82
Q

What are the 5 types of non probability sampling?

A
  1. specifying inclusion/exclusion criteria
  2. purposive sampling
  3. convenience sampling
  4. consecutive sampling
  5. snowball sampling
83
Q

What is a key word/concept when determining if a study is descriptive (observational) design?

A

How- gathering more info about something

“How does attending a “student-infused” pulmonary rehabilitation program impact adults in the Saint John area with COPD in management of their health condition?”

84
Q

What is a key word/concept when determining if a study is correlational design?

A

Influence - how variables interplay- relationships

“What physiological dimensions of adults with COPD are influenced when attending an 8-week student infused pulmonary rehabilitation program

85
Q

What are the 4 types of probability sampling ?

A
  1. random
  2. stratified random - i divide them
  3. cluster - already divided
  4. systematic - every kth
86
Q

What is a key word/concept when determining if a study is quasi-experimental design?

A

What is the impact of … - it’s about testing

What is the impact of attending an 8-week “student-infused”
pulmonary rehabilitation program on the quality of life of
adults living with COPD?

87
Q

What are the 7 aspects of decriptive statistics in quantitative research?

A

Measures of Central tendency
frequency distribution
levels of significance
standard deviation
confidence interval
t-Test
p-value

88
Q

What are measures of central tendency?

A

mean
median
mode
frequency distribution

89
Q

What are the 2 measures of variability?

A

S.D
variance (how flat or tall the bell curve is)
-low variability is better because then the population is more homogeneous

90
Q

what are the 3 inferential statistics? (ie) generalizability

A

confidence interval
t-Test
p-value

91
Q

What are 4 reasons statistical analysis is used in quantitataive research?

A
  1. make sense of numeric info
  2. describe sample (n) characteristics
  3. test hypothesis - p-value (0.05)
  4. provide evidence of measurement properties of quantified variables
92
Q

What are the 4 levels of measurment?

A

Nominal - lowest - categorize - numbers - 1= gender, 2= prof. role etc

Ordinal- 1-5- agree/disagree

Interval - no absolute zero- IQ scale, temp

Ratio- highest - meaningful zero - cases of H1N1

93
Q

Of the 4 levels of measurement, which can we do inferrential statistics with?

A

Ordinal
Interval
Ratio

not Nominal

94
Q

Is there more variability with homogeneity or heterogeneity?

A

heterogeneity

95
Q

What is a parameter in confidence intervals?

A

the characteristic of a population (eg) age

96
Q

What are threats to external validity?

A

inadequate sample size
inability to generalize

97
Q

What are the three hallmarks of critical appraisal of quantitative research?

A
  1. credibility
  2. clinical significance
  3. applicability
98
Q

In qualitative research, what affects rigor?

A

The researcher - trustworthiness

99
Q

What about the researcher influences rigor in qual?

A

philisophical orientations
paradigms
personal values

100
Q

What comes first, the research question or the methodological approach?

A

The research question
so you know what approach to pick

101
Q

in qual how do we decide what the best methodological approach is?

A

Ask if there are basic gaps of knowledge in what is already out there

102
Q

If i don’t know what want to look at (study), what qual methodological approach would I pick?

A

Qualitative descriptive

103
Q

What design includes elements of grounded theory, ethnography and phenomenology?

A

Interpretative description

104
Q

If I want to focus on someone’s lived experience, what methodological approach do i choose?

A

Phenomonology

105
Q

If i want to look at “culture” what methodological approach would i choose?

A

ethnography

106
Q

If I want to look at a specific phenomenon, like a program, event, experience, what methodological approach would I choose?

A

Case study (can include quant data)

107
Q

If I want to focus on psychosocial process what methodological approach would I choose?

A

Grounded theory

108
Q

What is the end goal of grounded theory?

A

development of a theory

109
Q

What are the 3 types of grounded theory?

A
  1. glassarian - classic
  2. straussian - qual analysis
  3. charmaz- constructivist
110
Q

What are the seven ethical principles for research and EIP?

A

Social or scientific value.
Scientific validity.
Fair subject selection.
Favorable risk-benefit ratio.
Independent review.
Respect for potential and enrolled subjects (participants).
Informed consent.

111
Q

What is Social or scientific value in ethics?

A

human subject research should have both scientific and social merit.

if not then it is unjustifiable

112
Q

What is scientific validity in ethics?

A

how well a scientific test or piece of research actually measures what it sets out to, or how well it reflects the reality it claims to represent.

113
Q

what is fair subject selection in ethics?

A

vulnerable people receive special protections and perhaps also be excluded from participation

114
Q

What is favorable risk-benefit ratio?

A

Everything should be done to minimize the risks and inconvenience to research participants to maximize the potential benefits, and to determine that the potential benefits are proportionate to, or outweigh, the risks

115
Q

what is independent review with ethics?

A

This occurs before any research activities involving human subjects, including recruitment, are allowed to begin.

116
Q

What are four distinct categories of reasons why research has a poor reputation amongst Indigenous, Inuit, and Métis peoples?

A
  1. Reason for research /goal of research - Indigenous is self- determination. Western vary between knowledge creation to policy development
  2. Data management and data ownership - lack of respect for past research participants equals distrust .
  3. Views on knowledge. Ideas are accepted or rejected based on usefulness - not so much on methodical research methods . Ways of knowing are different
  4. Disrespectful research methods of the past need to go and make room for Indigenous methodology.
116
Q

What is respect for potential and enrolled subjects in ethics?

A

Individuals should be treated with respect from the time they are approached for possible participation — even if they refuse enrollment in a study — throughout their participation and after their participation ends. This includes: Respecting their privacy and keeping their private information confidential

117
Q

What are the implications of the Five “Rs” of Higher Education for Indigenous, Inuit, and Métis peoples as it relates to research

A
  1. Respect – egalitarian relationships – the researcher adapts to participants, express humility and honour, and acknowledge contributions (Justice/Autonomy)
  2. Relevance – research should be relevant to the community – ideally initiated by the community (beneficence)
  3. Reciprocity – research should serve a purpose to the community, ideally improve the community, the community chooses the researcher (non-maleficence)
  4. Responsibility – as a human being in relationship with others, network of family and community to ensure research is done in a good way; ensure research is not misused or used in a way that causes harm. (both beneficience and non-maleficence)
  5. Relationships – foundation of research. Relationship with knowledge, researcher, participants, land, ancestors, future generations . (both beneficience and non-maleficence)
118
Q

What are four common tenets (principles) when considering research involving Indigenous peoples?

A
  1. Ownership- the community/groups owns their information
    2.Control- they control all aspects of research
  2. Access – access to info about themselves and their communities. They manage the right to access their collective information
  3. Possession – the physical control of data. Possession is how ownership is asserted and protected.
119
Q

What is the philosophy behind “Two-Eyed Seeing” and its application to research methodology?

A

“refers to learning to see from one eye with the strengths of Indigenous knowledge and way of knowing and from the other eye with the strengths of western knowledges and use both these eyes together for the benefit of all.”
They wanted to weave together Western and Indigenous knowledges and ways of knowing.

120
Q

What are the seven issues that Indigenous communities have had with wester research(ers) ?

A

Misrepresentation
inhumane
lack of consent
maleficence
lack of autonomy
lack of cultural safety

121
Q

in qual, why is adequate demographic info important?

A

so the person knows if the info is transferable (transferability)

to show credibility of sources

122
Q

What are 4 data sources in Qual?

A

Interviews
observation - emic/etic
Textual info
Literature - existing evidence

123
Q

What is emic perspective?

A

Insiders perspective

124
Q

What is etic perspective?

A

Outsiders perspective

125
Q

What is content or initial coding?

A

basic first level of coding where the researcher identifies codes what they “see” in the data

126
Q

Which element(s) would you assess as part of quality for a primary research article, systematic review, and clinical practice guideline?

A

Credibility - useful for both qual and quant

demographic info - should be present in all

fidelity of process - yes for all

127
Q

What is thematic coding?

A

Thematic coding involves grouping content or initial codes into categories or themes.

128
Q

What is constant comparison?

A

grounded theory method used in analysis. It involves constantly comparing data across and within levels of coding.

128
Q

What element would we not assess as part of quality for primary resarch articles, systematic reviews and clinical practice guidelines?

A

internal validity - because that’s only quant

129
Q

in quant we say rigor, in qual we say what?

A

trustworthiness - measuring tools & statistics & researcher

130
Q

in quant we say validity (external/internal). in qual we say what?

A

credibility (external/internal) - researchers

131
Q

what are the 3 factors that make up trustworthiness in Qual?

A
  1. credibility
  2. Fittingness
  3. Auditability
132
Q

What is PRISMA?

A

a checklist - not a methodological approach to conducting a systematic review

133
Q

What helps us decide what we might use from the CPG?

A
  1. Feasibility and practicality – does this work for my population
  2. Context – can you do the recommendations at home instead?
  3. Population- are people interested?
  4. Age of the CPG- always takes time to get published
  5. New information that comes up
134
Q

What is similar between clinical expertise, clinical judgement and clinical wisdom?

A
  1. Knowledge
  2. Time sequence
  3. Novice to expert
135
Q

What is clinical expertise?

A

combination of competency with multiple observations of patients and phenomenon (e.g., reaction to interventions).

136
Q

What is clinical judgement?

A
  • An interpretation or conclusion about a patient’s needs, concerns or health problems
  • The decision to take action (or not)
  • Decision to use or modify standard approaches or improvise new ones
  • Appropriateness is based on patient’s response
  • A requirement for clinicians to discern what is good/appropriate in a particular situation
137
Q

What is clinical wisdom?

A

the ability to determine and apply appropriate evidence to a situation in conjunction with ones own expertise, experience, and judgement

138
Q

What is a brief overview of the 7 phases of JBI model for implementing EBP?

A

Phase 1 - find the problem

Phase 2 - Find the agents of change

Phase 3 - Are peeps ready to change and is the change appropriate for context

Phase 4- compare the practice with evidence based criteria

Phase 5- implement changes – getting research into practice

Phase 6- reassess

Phase 7 - need sustainability

139
Q

What is Lewin’s Force Field Analysis ?

A

driving forces of change - facilitators

restraining forces - barriers to change

140
Q

What are lewins driving forces of change?

A
  1. willingness
  2. backing of leadership
  3. identify the need
  4. have the evidence
141
Q

What are lewins barriers to change?

A
  1. entrenched views
  2. assumptions made
  3. cost
  4. technology
142
Q

What are Clinical decision supports (CDS) ?

A

clinical decision making tools
- they must always be adapted to the patient thought!

143
Q

Why do we want to implement change in a clinical setting?

A
  1. keep care up to date
  2. want better outcomes for people
  3. stop cycle of readmittance
  4. risk management & patient safety
144
Q

what 2 things do we look at to determine if EIP is working?

A
  1. Outcomes - decide what they are and need tools to measure them
  2. Process - what is the benefit(s)
145
Q

what are the biggest challenges to promoting EIP in clinical setting?

A

1.Time
2.Concrete thinkers – some people just don’t get it
3.Culture of the unit – do they support EIP?
4.Attitude – this doesn’t apply to me. I just want to do my job

146
Q

What makes something Quasi-experimental?

A

it has an intervention (manipulation) but no randomization.

  • cuz you’re doing it to test (not prove) cause and effect
146
Q
A
146
Q
A

EIP & research (2 decks)

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