Week 1-3 Lecture and Review Flashcards
What is the first step in the evidence informed practice framework?
Ask a well framed clinical question
What is the second step in the evidence informed practice framework?
Gather
What is the third step in the evidence informed practice framework?
Assess/Appraise
What is the fourth step in the evidence informed practice framework?
Act
What is the fifth step in the evidence informed practice framework?
Evaluate
What are the five components of a clinical question?
(PICOT Format)
Population
Intervention
Comparison
Outcome
Time
What are the five components of the SPIDER tool?
(Spider tool)
S: Sample
PI: Phenomenon of interest
D: Design
E: Evaluation
R: Research type
(Tool adapted from PICOT)
Where do research questions come from?
- Lots of times they come from unanswered clinical questions where there isn’t substantial evidence
- Desire to improve patient/population outcomes
- Practice issues e.g. workplace bullying
Define research question
A concise, interrogative statement written in the present tense and including one or more variables/concepts
(it needs to have at least three components to be useful; variables, population being studied, examining testable relationships among variables)
What do research questions focus on?
- Describing variables
- Specifying the population being studied
- Examining testable relationships among variables
Define independent variable (X)
Independent variable (X) - the variable that has the presumed effect on the dependent variable (Y)
Define dependent variable (Y)
Dependent variable (Y) - the presumed effect that varies with a change in the independent variable (X)
- It is not manipulated
Describe population
- the population is a well-defined set that has certain properties
- it is either specified or implied in the research question
What does PICOT stand for?
Population, intervention, comparison, outcome, time
What is a hypothesis?
A hypothesis is something that states a prediction and must involve at least two variables
Describe a simple hypothesis
Expresses a predicted relationship between one independent variable and one dependent variable
What is the difference between a simple and complex hypothesis
the number of variables
Describe a complex hypothesis
States a predicted relationship between two or more independent variables and/or two or more dependent variables
Describe a research hypothesis?
It states the actual prediction of a relationship
Describe a statistical or null hypothesis?
It expresses the absence of a relationship between variables (used only in statistical testing; you will not see a null hypothesis written in a research paper)
The SPIDER tool is best suited for what types of research?
qualitative and mixed method research
Define research
Research is the systematic, rigorous, logical investigation with the aim of answering questions about nursing phenomena
Define phenomena
Phenomena can be defined as occurrences, circumstances, or fact that are perceptible by the senses. Can often be experiences that are not easily observed (but can be explored/described).
What is research?
A structured process for gathering and synthesizing facts and theories
What are some characteristics of good research?
- Systemic and objective
- Valid and reliable
- Scientific method
- Dynamic and creative (it evolves)
- Examines conditions and outcomes
- Purpose is to improve methods of practice
- Done ethically
Define (research) quality/rigour
the extent to which a study’s design, implementation and analysis minimizes bias
Define (research) quantity
the number of studies in which the research question has been evaluated, including overall sample size across studies as well as strength of the findings from the data analyses
Define (research) consistency
the degree to which similar findings are reported from investigations of the same research question in studies that have similar and different designs
What is critical appraisal?
the assessment of a study’s methodological quality - taking into consideration:
- it’s validity (is it true? does it represent reality?)
- it’s results (statically/clinically significant? replicable?)
- it’s relevancy (aka utility in clinical practice)
What is the significance of research to nursing practice?
- expands the discipline’s unique body of scientific knowledge
- forms the foundation for evidence-informed nursing practice
- allows practice to change with work environments and the most common health issues
- maintains the profession’s societal relevance
Define evidence-informed practice
With evidence-informed practice, the methods for gathering evidence are the same as the processes used for evidence-based practice (valid, relevant research evidence); however, the evidence also incorporates expert opinion, clinical expertise, patient preference, and other available resources.
What is absolutely essential in conducting research?
The voluntary consent of the human subject
The experiment should be so conducted as to avoid what?
all unnecessary physical and mental suffering and injury
The experiment should be conducted only by who?
scientifically qualified persons
The degree of risk to be taken should never exceed what?
that determined by the humanitarian importance of the problem to be solved by the experiment
During the course of an experiment, the human subject should be allowed to do what?
bring the experiment to an end
What are the human rights when conducting research?
- right to self-determination (autonomy)
- right to privacy
- right to anonymity and confidentiality
- right to fair treatment
- right to protection from discomfort and harm
What are the ethical principles when conducting research?
- respect for persons - by means of informed consent, respect for privacy
- beneficence - sound research design, competent investigators, favourable risk-benefit ratio
- justice - equitable selection of participants
Define beneficence
the doing of good; active goodness or kindness; charity
Informed consent is what?
a legal principle
What must informed consent disclose?
It must have full disclosure including:
- purpose of research
- expected duration for participant
- description of procedures
- identification of experimental procedure
- reasonable foreseeable risks or discomforts and how these can be minimized
- reasonable foreseeable benefits for participants or others
- how can benefits be maximized?
- alternative procedures or treatments
- how records will be kept secure and who will access
- who can answer any questions
- compensation for research-related injury
- voluntary participation
- situations where researcher can terminate participant’s participation
- consequences and procedures for participant’s early withdrawal (that there are none)
Is it necessary for participants to get a copy of the consent form?
Yes!
What does REB stand for?
Research ethics board = panel that review research protocols
Define “minimal risk” research
“Minimal risk” research is defined as research in which the probability and magnitude of possible harms implied by participation in the research is no greater than those encountered by participants in those aspects of their everyday life that relate to research.
- studies using existing database/registries or linking information between databases
Define “above minimal risk” research
“Above minimal risk” is defined as research in which the probability and magnitude of possible harms implied by participation in the research is greater than those encountered by participants in the aspects of their everyday life that relate the research
Define physical risk
risk of harm through bodily contact or administration of any substance, device, or other intervention
Define psychological or emotional harm
risks of harm due to feeling embarrassed, uncomfortable, anxious, or upset
When are special considerations necessary when selecting research participants?
In vulnerable participants including:
- children
- prisoners
- mentally disabled persons
- economically disadvantaged
- educationally disadvantaged
- subtle vulnerability: language, culture, pregnancy, students, employees, substance abuse, health status
What is OCAP?
Developed by first nations statistics initiative - stands for “Ownership, Control, Access, and Possession”
- to respect the culture, traditions, and knowledge of the indigenous group
- to conceptualize and conduct research with the indigenous group as a partnership
- etc.
Why is it important to implement critical thinking and critical reading when reviewing research?
the best way to become a knowledgable consumer of research is to use critical thinking and critical reading skills when you read research articles
What is critical reading?
an active, intellectually engaging process in which the reader participates in an inner dialogue with the writer.
- Careful, active, reflective, and analytic reading
What are the goals of critical reading?
- recognize author/paper’s purpose
- understand tone and convincing elements
- to recognize strengths and weaknesses
- ask yourself: how does this text work? how is it argued? how is the evidence used and interpreted? how does the text reach its conclusions? is there a counter argument?
In the critical reading process, preliminary understanding includes what?
Skim article and title
In the critical reading process, comprehensive understanding includes what?
understand authors intent, understand terms in relation to context
In the critical reading process, analysis understanding includes what?
Understand parts, critique soundness
In the critical reading process, synthesis understanding is what?
put together and make sense of article
What are the four pieces to the critical reading process?
- Preliminary understanding
- Comprehensive understanding
- Analysis understanding
- Synthesis understanding
What is the abstract of a research article?
the abstract includes key points, quick review
What are the components of a research article?
- abstract
- introduction
- Methods
- Results/Findings
- Discussion
- Conclusion
What is included in the introduction of a research article?
- literature review - provides context
- theoretical framework
- purpose/objectives,
What is included in the introduction of a research article?
- literature review - provides context
- theoretical framework
- purpose/objectives, questions, hypothesis
Describe the methods of a research article?
Methods include the who, what, where, when, why?
What is the best order to read a research article (this is subjective)?
- Abstract
- Discussion
- Introduction, literature review, purpose
- Methods, results
What is a literature review?
- systematic and critical appraisal of the most important literature on a topic, a key step in the research process that provides the basis of a research study
What are primary sources?
author(s) are those who conducted the study or developed the theory/model
e.g. researchers’ report of their study
What are secondary sources?
- author is someone other than the person who conducted the study, developed the theory/model
e.g. response critique of research or systematic review
What does it mean if an article is peer reviewed?
A refereed or peer reviewed journal has a panel of internal and external reviewers who review submitted manuscripts for possible publication
- often blinded
- critically appraised according to a specific criteria
What is grey literature?
grey literature is from inter-governmental agencies, non-gov. organizations, etc. and includes reports, working papers, speeches, thesis/dissertations and is NOT technically peer reviewed
What are some good databases to use when doing focused research?
CINAHL, Scopus, google scholar
What is focused research?
Looking for answers to specific problems/questions
What are predatory journals?
Predatory journals—also called fraudulent, deceptive, or pseudo-journals—are publications that claim to be legitimate scholarly journals, but misrepresent their publishing practices
How can you spot a predatory journal?
- poor grammar/spelling on journal website
- not a member of a reputable organization that vet their members for adherence to publishing standards
- description of the manuscript handling process is lacking
- requested that manuscripts be submitted via email
- rapid publication is promised
- the article processing charge is very low (<$150 US)
- Journal is not indexed in any of the established journal databases
What is research utilization?
is a subset of evidence-informed practice that focuses on the application of research findings
What is the significance of research to nursing practice?
- expands the discipline’s unique body of scientific knowledge
- forms the foundation for evidence-informed nursing practice
- allows practice to change with work environments and the most common health issues
- maintains the profession’s societal relevance
What is a variable?
A variable is an attribute in which organisms vary (people, events, objects)
