Lecture 1 Flashcards
What else do you include besides best research evidence?
clinical expertise, patient preference and values
Give an example of paradigm shift?
EBP, before practice would be implemented because “it worked”
DNP base practice on..
When DNP do this what is the outcome?
- Scientific evidence: qualitative and quantitative
- Expert opinion
- Experience
- Pathophysiologic rationale
- The outcome is care that is EBP, individualized, and reflective
What is the difference between EBP and research?
Research: You’re making new knowledge or validating/refining existing knowledge. it is key to building EBP
EBP: integrates best research evidence and clinical expertise, patient needs and values.
What is the goal of EBP?
to promote quality, safe, and cost effective outcomes from patients, families, and healthcare providers, and healthcare system.
nursing research
scientific process that validates or generates new knowledge that directly or indirectly influences nursing practice
Best research evidence
knowledge made from the synthesis of quality study findings to address a practice problem
Ecological validity
Ecological validity - of a study means that the methods, materials and setting of the study must approximate the real-world that is being examined. Unlikeinternalandexternal validity, ecological validity is not necessary to the overallvalidityof a study. Ecological validity is often confused withexternal validity—the property of a study that reflects our ability to generalize from a its results to circumstances beyond the research setting. While the two forms of validity are closely related, they are independent—a study may possess external validity but not ecological validity. How?
external validity
the property of a study that reflects our ability to generalize from a its results to circumstances beyond the research setting.
Quantitative Research
empirical, objective, uses scientific method, systematic approach to test hypothesis
Qualitative Research
subject, understanding experience
its a holistic approach to research
Ex. hip fracture
pls refer to pp 1 slide 8
the differences between qualitative and quantitative data
qualitative: researcher involved, small sample, observations,
Why would you use qualitative data
- understand issue or problem
- explain quantitative study
- provide information to make quantitive study
- Uncover the why of which influences decisions and opinions
- look for range of ideas or feelings about something
- understand different perspectives between groups and categories of people
why would you use Quantitative research
- Recommend final course of action
- find if there was a consensus on a particular issue
- project results to larger population
- ID relationship in a cause-effect way
- describe characteristics of relevant groups of people
- test hypothesis and look at specific relationships
- ID and size market segments
DNP responsibilities
- critically appraise studies from both paradigms
- synthesize findings across multiple studies
- derive guidelines or protocols for your work setting
- update your own practice in terms of new evidence
- lead quality improvement initiatives
T or F studies can be from both paradigms?
true, may be qualitative or quantitative
list the evidence hierarchy from the one with the most validity to the least
need to make notecards on the different levels
Things that effect internal validity:
Validityis the extent to which aconclusion is a well-founded one given the design and analysis of a study. It comes in two different types: external validity and internal validity.
Things that effect internal validity: Selection bias (who’s doing the experiment and who gets put in which condition), can be from both parties – the sample or the researcher Performance bias (differences between conditions other than the ones of interest, e.g. running people in condition one in the morning and condition two in the afternoon) Detection bias (how the outcomes measures are coded and interpreted,blinding which condition a participant is in before coding is paramount to reduce the researcher’s bias to want to find a difference between conditions. A lot of retractions lately have been down to failures to act against detection bias.) (ex) cute data collection method is cute, the participants might be affected. Attrition bias (Ignoring drop-outs, especially if one condition is especially stressful, causing high drop-out rates and therefore bias in the participants who completed it. This probably isn’t a big problem in most evolutionary linguistics research, but may be in other psychological stuff.) “Intention to treat”
External validity is the extent to which the results of an experiment or study can be extrapolated to different situations.
A third type of validity has become important in the world of EBP: Ecological validity. When a study has ecological validity, it means that the methods, materials and setting of the study approximate the real-world that is being examined. Unlikeinternalandexternal validity, ecological validity is not necessary to the overallvalidityof a study. Ecological validity is often confused withexternal validity—the property of a study that reflects our ability to generalize from a its results to circumstances beyond the research setting. While the two forms of validity are closely related, they are independent—a study may possess external validity but not ecological validity. How?
Eco: needs to resemble the real world
External: how a sample can be replicated.
Clinical practice guidelines are
gold standard for patient care
based on strength of evidence
what is the process of EBP
Problem identification Search for evidence Critique/synthesize evidence Implement practice changes Evaluation
List examples of EBP models
Commonly used by hospitals and organization Iowa Model Johns Hopkins Model Mentorship models (e.g., that of Melnyk and colleagues)
iPARIHS Model
slide 23
List the strongest to weakest research evidence
- systematic review of experimental studies (RCT)
- Meta analyses of experimental (RCT) and quasi-experimental studies
- Integrative reviews of experimental (RCT) and quasi experimental studies
- single experimental RCT
- Single quasi experimental study
- Meta Analysis of correctional studies
- Integrative reviews of correlational and descriptive studies
- Qualitative research meta-synthesis and meta summaries
- Single correlational study
- Single qualitative or descriptive study
- Opinions of respected authorities based upon clinical evidence, reports of expert committees
independent variable
the variable that is being changed and known by the researcher
dependent variable
the variable that can be measured, response
conceptual and operational variables
operational put a # on it
state the format of reports
IM RAD abstract introduction purpose methods results discussion
steps in doing research
Conceptualization Design Procedures Analysis Dissemination
discrete
numerical value, number of people at the club
categorical
also called qualitative data where there is a fixed number of defined categories into which data is organized and this can be either nominal or ordinal. First, second, third.
continuous
quantitative
nominal
categorical
interval
1-7 interval
ratio
d
