Research EXAM #4

Question 1

Rating Systems for Grading levels of evidence

Answer 1

Level I (most credible/best form of evidence/full blown experiments)
– Multiple randomized controlled trials (RCTs) reported as meta-analysis, systematic review, or
meta-synthesis, with results that consistently support a specific intervention or treatment
– Randomized trials with large sample sizes and large effect sizes

Level II:
– Evidence from well-designed controlled studies, either randomized or nonrandomized, with
results that consistently support a specific intervention or treatment

Level III:
– Evidence from studies of intact groups
– Ex-post-facto and causal-comparative studies
– Case-control or cohort studies
– Evidence obtained from time series with and without an intervention Single experimental or
quasi-experimental studies with dramatic effect sizes

Level IV :
– Evidence from integrative reviews
– Systematic reviews of qualitative or descriptive studies
– Theory-based evidence and expert opinion Peer-reviewed professional organization standards

Question 2

Characteristics of Level I Grading of Evidence

Answer 2

most credible/best form of evidence/full blown experiments
– Multiple randomized controlled trials (RCTs) reported as meta-analysis, systematic review, or
meta-synthesis, with results that consistently support a specific intervention or treatment
– Randomized trials with large sample sizes and large effect sizes

Question 3

Systemic review

Answer 3

The person writing the review did the literature review

Question 4

Which design is the gold standard for testing interventions?

Answer 4

Experimental design = Level 1

Question 5

Gold standard for evidence-based practice

Answer 5

Experimental design
Randomized Controlled trials, clinical trials
Highly structured studies of cause and effect applied to determine the effectiveness of an intervention

Question 6

Why is experimental design the gold standard for evidence-based practice

Answer 6

They provide convincing support for the value of a treatment

Question 7

Uses of QUANtitative methods

Answer 7

Measure the probability of alternative explanations
for outcomes
● Isolate and evaluate the effect of an intervention
on an outcome
– e.g. patient is taking too many pills, how do you determine which one is actually working? Eliminate drug one at a time
● Answer questions about cause and effect
– Confounding or extraneous

Question 8

When you think of QUANtitative, what does it mean?

Answer 8

– Cost and effect
– Influence and relationship

Question 9

QUANtitative variables are measured by

Answer 9

– Independent variables (IV)
– Dependent variables (DV)
– Extraneous (confounding) variables

Question 10

An independent variable (IV) is

Answer 10

■Controlled by the researcher
■Introduced into the experiment
■Manipulated by the researcher

Question 11

Purpose of extraneous variables (confounding)

Answer 11

If it exists, you must:
■Identify, eliminate, control

Question 12

Use of QUANtitative measurement

Answer 12

○ Direct or indirect
○ Prospective or retrospective
○ Primary or secondary sources
○ Reliability and validity of primary concern

Question 13

Primary vs. secondary sources

Answer 13

Primary: gathering data from person directly; looking for the original author
– “I did this study. These are my outcomes.”
Secondary: data already collected
– e.g. going through medical records to go through BPs and blood sugars
– taking information and quoting me on MY study; got it from somebody else’s article

Question 14

Difference b/w retrospective vs. prospective measured data in QUANtitative measurement

Answer 14

Retrospective = taking data from something that already happened (the data was there)
– e.g. were the patient in the last 3 months satisfied with their meals?
Prospective = collecting data now to use in the future (don’t know when/how/where)
– e.g. birth cohort study

Question 15

Reliability vs. validity

Answer 15

Reliability: QUANtitatve study done over and over with different populations, AND the findings are “consistent”
Validity: when the instrument measures what it was designed to measure
– e.g. study to measure anxiety, and better not measure excitability –> study not valid, b/c instrument using is not being used the way it’s supposed to be measured
what do you do in study to check validity? instrument used

Question 16

Reliability vs. Validity

Answer 16

Reliability = consistency
Validity = instruments you are using in QUANTitative study tests what it was designed to test
— instrument to test anxiety, but realized you’re testing excitement —> using the wrong instrument/design and therefore NO longer valid

Question 17

A priori

Answer 17

The researcher has to lay out EVERYTHING in front before conducting the study (everything they’re doing, methodology, design, sample sizes, location of sample sizes, laid out) —> IRB and come back —> CANNOT change b/c jeopardize subject (even if they thought of something better that can impact the study)

Question 18

Constructivist Research

Answer 18

— Discover the meaning and interpretations of events, phenomena, or experiences
— Study cases in their natural setting and analyze the interpretations
— People construct their own knowledge based on their experiences

Question 19

Characteristics of a priori study

Answer 19

A priori selection of design
○The design is selected after the research
question is clarified
○No change applied once the design is
chosen
■Ensures credibility
■Reduces bias

Question 20

Casual design/studies

Answer 20

● Randomized group assignment
● Highly controlled conditions
● Results are quantitatively analyzed
— inferential statistics: BPs
– to analyze the demographic, will be descriptive statistics: 35 males and 45 females

Question 21

Quasi-Experimental design

Answer 21

● Similar to experimental
● Studies of cause and effect
● Subjects are not randomly assigned to groups
● Major difference
○ uses convenience sampling
○ Or existing groups

Question 22

Cause and effect examples

Answer 22

●What is the effect of continuous, low-level
zinc ingestion on the occurrence of the
common cold among young adults?
●Does ATI practice questions improve NCLEX
results of nursing students?

Question 23

Quasi-Experimental vs. Experimental

Answer 23

Quasi-experimental: will not be randomized assigned; use existing groups or convenience sampling
Experimental:

Question 24

QUANtitative designs that focus on intact groups

Answer 24

● Ex post facto research (“after the fact”)
● Causal-comparative: comparing each group b/c receiving different type of intervention
– e.g. 3 stress relieving intervention: one gets massages, one exercises, one solely education packet
● Case/control

Question 25

Time-series designs

Answer 25

● Type of quasi-experimental
● Measurement of a group over time
● IV manipulated at some point in time
● Group serves as its own control
● Enable the researcher to:
○ Determine effectiveness of intervention
○ Quantify timing of effects
– e.g. Does low carb diet decrease BG at 3 weeks, 3 months, 6months; check for trending?

Question 26

How is QUANtitative research is used in practice?

Answer 26

– Assessment of procedures
– Dx of nursing problems
– Effectiveness of interventions
– Evaluating patient outcomes

Question 27

Design used to answer this question:
How do patients with chronic pulmonary hypertension respond to a lung transplant?

Answer 27

Case research methods

Question 28

Design used to answer this question:
How do nurses on a neonatal unit respond to a medication error causing a death?

Answer 28

Case research methods

Question 29

Design used to answer this question:
How nurses are portrayed in the media?

Answer 29

Content analysis

Question 30

Design used to answer this question:
What are the perceived barriers for ethnically diverse students in nursing programs?

Answer 30

Content analysis

Question 31

Design used to answer question:
What is the nature of moral distress in nurses related to witnessing futile care in the critical care unit?

Answer 31

Phenomenology

Question 32

Design used to answer question:
What are the long-term implications for intimacy of couples in which the husband has been treated for prostate cancer?

Answer 32

Phenomenology

Question 33

Example of QUALitative design to answer question:
Which cultural issues emerge during a merger between a for-profit hospital and a not-for-profit hospital?

Answer 33

Ethnography

Question 34

Example of QUALitative design to answer question:
What is the culture of the waiting room for the open-heart surgery unit?

Answer 34

Ethnography

Question 35

Example of design to answer question:
Which relationships and interactions affect intimate-partner violence?
Why are CCRN unhappy?

Answer 35

Grounded theory (the root cause)

Question 36

Example of design to answer question:
Which relationships and reactions lead to teen pregnancy?

Answer 36

Grounded theory

Question 37

Define statistical significance + example

Answer 37

The intervention MADE A DIFFERENCE; the intervention caused the outcome; was not any extraneous variable; treatment caused the outcome based on that intervention
— e.g. people who exercise vs. who DO NOT exercise

Question 38

Define clinical significance + provide example

Answer 38

In research, can be used in practice; can make a difference in a patient’s outcomes

Question 39

Snowball sampling + example

Answer 39

— A nonprobability sampling method that relies on referrals from the initial subjects to recruit additional subjects.
— This method is best used for studies involving subjects who possess sensitive characteristics or who are difficult to find.
_____________________
E.g. members who belong to a club and encountered similar issues

Question 40

Informed consent + inclusion criteria

Answer 40

As long as their friends that they are trying to recruit meet their requirements
— e.g. nurses on the pediatric unit that has worked for >10yrs

Question 41

Difference between snowball sampling vs. extreme case sampling

Answer 41

Snowball:
Extreme case sampling: nothing in between
— e.g. interview 2 RNs, choose 1 RN that in 20yrs, have made ZERO mistakes vs. interview RN that has killed a patient;

Question 42

What is data saturation

Answer 42

The point at which no new information is being generated and the sample size is determined to be adequate.

Question 43

Field notes in a qualitative study + example

Answer 43

— Detailed descriptions of the context, environment, and nonverbal communications observed during data collection and inserted by the researcher into the transcripts to enrich the data interpretation process
— Written down as soon as possible
— e.g. When watching a group of people eating at lunch you’re writing down what they’re talking about, touching hands, friendly, people caring for each other

Question 44

Saturation in QUALitative data means

Answer 44

There is no more new information to obtain

Question 45

Trustworthiness in a QUALitative includes what specific characteristics?

Answer 45

— Credibility
— Confirmability
— Dependability
— Transferability

Question 46

Credibility

Answer 46

Results represent the realities of the participants
— As far as you know, they’re telling you the truth about their experience

Question 47

Confirmability

Answer 47

— Enhance objectivity by reducing bias in the research process
— Confirm all of this by ensuring it is the truth and free from bias

Question 48

Dependability

Answer 48

— Repetition of the study with similar subjects in similar circumstances results in consistent findings
— All of the questions you used, how its analyzed, if repeated with similar group of people in similar situations —>
— If you get anything different —> not dependable

Question 49

Transferability

Answer 49

— Results can be transferred to situations with similar subjects and settings

Question 50

Which studies look at reliability and validity?

Answer 50

QUANTitative study

Question 51

Characteristics of QUALitative designs

Answer 51

— Emergent design
— Data gathered directly from informants, through observation, or from documents
— Questions that reflect exploration of perceptions
— Constant comparison analysis
— Referred to as traditions
— Design elements are focused on achieving understanding
— must be trustworthy

Question 52

How is data gathered for QUALitative designs?

Answer 52

Through informants through observation, or from documents

Question 53

Emergent design for QUALitative designs

Answer 53

— Analyzing as the data as it is being collected
— To see the trend comparing updated data to earlier data to see trends and themes
— e.g. on participant #3, the trend will tell you if you’re on the right track after interviewing participant #1; you’ll know if you need to tweak the question

Question 54

What does a low p-value evaluate?

Question 55

To ensure triangulation of the data, the researcher may collect data in all of the following ways to prove accuracy: (select all that apply)
a. Documents
b. Interviews
c. Field notes
d. Observations
e. Reports

Answer 55

A, B, C, D, E

Question 56

Qualitative researchers strive to achieve data saturation. Which of the following explains data saturation?
a. New data continues to emerge and interviews must continue
b. No new data emerges, consistent themes are present
c. The sample size has not been achieved
d. The researcher is exhausted and must end the research

Answer 56

B. No new data emerges, consistent themes are present

Question 57

What is the first step in a quantitative or qualitative research study?
a. Establish the design
b. Conduct the literature review
c. Choose the statistical tests
d. Conduct the data collection

Answer 57

B. Conduct the literature review

Question 58

The novice researcher is conducting a qualitative study. The researcher is checking the field notes for trends. Which of the following best describe field notes?
a. Detailed information gathered by the researcher on the environment
b. Use of extreme cases within the research subjects
c. Stratified purposeful sampling
d. Separating researcher bias from the study findings

Answer 58

A. Detailed information gathered by the researcher on the environment (they’re out there and making notes)

Question 59

In a quantitative study using ‘cause and effect’, which of the following are correct?
a. The cause must precede the effect
b. The effect must precede the cause
c. The cause and effect are not related
d. Cause and effect are qualitative in nature

Answer 59

A. The cause must precede the effect

Question 60

True or False
‘Apriori’ in quantitative research refers to establishing the components of the study such as design, sample size, and statistical analyses upfront without making any changes.

Answer 60

Trueee

Question 61

T/F
In qualitative research, the researcher strives for trustworthiness to ensure credibility

Answer 61

True

Question 62

T/F
The focus of qualitative research is to identify the meaning of an experience or event

Answer 62

True

Question 63

In qualitative research, triangulation entails:
a. Cross-check data for credibility
b. Compare treatment and control groups for differences
c. Achieve a large sample size for generalizability
d. Use Nvivo to complete data analyses

Answer 63

A. Cross-checking data for credibility

Question 64

Triangulation

Answer 64

Cross-checking all the data

Question 65

NVIVO is to _________ data as SPSS is to _________ data

Answer 65

NVIVO = QUALitative
SPSS = QUANTitative data

Question 66

T/F
Bracketing and reflexivity refers to the researcher identifying their own bias

Answer 66

True

Question 67

Bracketing + its purpose

Answer 67

— Researcher separates own perspectives and assumptions from the participants information
— uses parenthesis “( )” around your bias
— Purpose: help prevent researcher bias

e.g. Researcher should not interject their feelings/bias about not eating pork does, so must bracket/separate feelings about pork from what my participants are saying

Question 68

Methods to ensure trustworthiness in QUALitative research

Answer 68

— Bracketing
— Triangulation
— Member checking
— Audit trial
— Reflexivity

Question 69

Reflexivity

Answer 69

Researcher acknowledges own bias, values and interests
— e.g. researcher uses bracketing to reduce this bias

Question 70

Types of QUALitative traditions

Answer 70

— Case research methods
— Content analysis
— Phenomenology
— Ethnography
— Grounded theory

Question 71

T/F
Qualitative researchers focus on validity rather than trustworthiness

Answer 71

False

Question 72

The qualitative researcher ensures dependability in the research study by ensuring which of the following?
a. Increase objectivity and evade bias.
b. Transfer results to similar situations and subjects = transferability = QUALitative
c. Repetition of the study to a similar situation reveals consistent results.
d. Applies audit trail

Answer 72

C. Repetition of the study to a similar situation reveals consistent results

Question 73

T/F
Transferability is to qualitative research as generalizability is to quantitative

Answer 73

True

Question 74

What are the four (4) different types of triangulation?

Answer 74

— Data source
— Investigator
— Theory
— Method

Question 75

Define fine the following types of qualitative research design.
a. Grounded theory: don’t know much , so start to gather info
b. Content analysis: analyzing content that already exists (e.g. historical documents/words from another time)
c. Phenomenology: explores a phenomenon(a); e.g. exploring the meaning of the phenomenon of people who experience hurricanes)
d. Ethnography: anything you want to know about a particular culture (e.g. food)
e. Case research method: in-depth, take time, doing everything about that person (e.g. cancer patient— diet, exercise, education status, work, alt medicine)

Answer 75

A, B, C, D

Question 76

The researcher decides to use a ‘snowball’ sampling method to recruit participants. Which of the following best describes this method?
a. Send questionnaires to all available email listings.
b. Ask the research participants to invite friends from the football team to participate who meet the inclusion criteria.
c. Ask the research participants to invite friends from the football team to participate even though they may not meet the inclusion criteria.
d. Assign participants into control and treatment groups once they meet inclusion criteria.

Answer 76

B. Ask the research participants to invite friends from the football team to participate who meet the inclusion criteria.

Question 77

T/F
During stratified purposeful sampling, the researcher adheres to the inclusion criteria to include participants and then may classify participants into age groups e.g. males aged 12 to 16 years.

Answer 77

True (it is stratified)

Question 78

Stratified purposive sampling

Answer 78

— Participants meet the inclusion criteria 1st
— Maybe stratified by demographics (e.g. according to age, gender, education, etc.)

— e.g. only obtain data with patients that only delivered their babies at Saint Mary’s

Question 79

The qualitative researcher uses purposeful sampling to ensure that:
a. Randomization occurs.
b. Participants are chosen who can best inform the research question.
c. Purposeful sampling is used by quantitative researchers.
d. A large sample size is possible.

Answer 79

B. Participants are chosen who can best inform the research question

Question 80

T/F
The qualitative researcher is able to compare the data during data collection to check for trends and themes and maybe edit the questions as needed.

Answer 80

True

Question 81

Qualitative researchers use the term ‘emergent’ design during the data collection process. What does this refer to?
a. The data are analyzed using the SPSS data sheet.
b. The data are analyzed as they are collected.
c. The data are analyzed at the end of the data collection process.
d. The data is collected in an emergency.

Answer 81

B. The data are analyzed as they are collected

Question 82

Explain in your own words how qualitative research differs from quantitative research?

Answer 82

QUALitative: used to identify the meaning of a phenomenon, event, or experience for an individual
— uses feelings, trustworthiness, data saturation, subjective; transferability
—
—
QUANTitative: based on reliability and validity; uses #s, larger sample, generalization, experimental/non-experimental, objective
—
—

Question 83

Differentiate between types of qualitative designs

Question 84

Define multivariate analysis + example

Answer 84

The simultaneous analysis of multiple variables
— e.g. determining if BP is different in the AM or PM, and is associated w/ Na intake, weight, and stress level

Question 85

Define univariate + examples

Answer 85

Analysis of a single variable in descriptive statistics or a single dependent variable in inferential analysis
— primary focus of descriptive and summary statistics
— may also be applied when only one group is included or involves a single DVariable
— e.g. differentiating whether BP is affected more by exercise in the AM or in the PM; even though 2 groups (AM & PM) are included in the study, the analysis focuses on a single dependent variable….BP

Question 86

Bivariate analysis

Answer 86

Analysis of 2 variables at a time
— Most common = correlation studies

— e.g. determining if BP is associated w/ Na intake; 2 variables = BP + Na, are analyzed to determine any relationship b/w them

Question 87

Define PICOT

Answer 87

Patient
Intervention
Comparison
Outcome
Time

Question 88

Define audit trail + example

Answer 88

Detailed documentation of sources of information, data, and design decisions
— e.g.

Question 89

Content analysis

Answer 89

a qualitative traditions
—

Question 90

differentiate between different types of qualitative designs eg. ethnography, content analysis, grounded, phenomenology
reliability, validity, triangulation (different types), confirmability, dependability, statistical significance, low p-value and statistical significance (check your text for this).
trustworthiness, types of sampling methods discussed in class e.g. purposeful, snowball
PICOT, multivariate, bivariate, univariate (number of variables)
A priori, field notes, audit trail, experimental, quasi- experimental.

Question 91

Low p-value means + statistical significance

Answer 91

Indicates that the probability the results were due to chance is also very small —> test is said to have a statistical significance

Question 92

Statistical significance

Answer 92

— Comparison of differences to standard error and the calculation of the probability of error that give inferential analysis its strength
— One important measure that dete
— Determines whether research is truly applicable to practice
— Often misinterpreted as scientific evidence when it is actually a measure of error

— e.g. Turning the button on a website from red to green will equate to more clicks

Question 93

Snowball sampling

Answer 93

— Researcher maybe unable to locate potential participants
— The chosen participants are asked to find others who meet the inclusion criteria
— Have some research participants, but since having difficulty, try to recruit friend
— interviewing at Tennis Club in Glen Allen; ask friends if they are willing to participate in research study about environment at that club

Question 94

Data source triangulation + example

Answer 94

Multiple data sources are used in a study
— e.g. interview multiple informants about a place or time to corroborate the information
— e.g. interviewing diverse key informants to give credence to the findings

Question 95

Investigator triangulation

Answer 95

More than one investigator is used to collect, analyze or interpret the data

Question 96

Theory triangulation

Answer 96

Use multiple perspectives, may use different theories to examine the situation, or use variety of published literature
— Multiple perspectives are obtained from other researchers or published literature

Question 97

Method triangulation

Answer 97

Multiple data collection methods are used
— e.g. interviews, observations, document review

Question 98

Saturation in QUALitative data means

Answer 98

There is no more new information to obtain