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EBP > WEEK 1-9 > Flashcards

WEEK 1-9 Flashcards

1
Q

What is Evidence-based health care?

A

The contentious use of current best evidence in making decisions about the care of individual patients or the delivery of health care

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2
Q

What is “current best evidence”

A

Up to date information from relevant and valid research

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3
Q

What is evidence-based medicine

A

Means integrating the clinical expertise with the best available external clinical evidence from systematic research and patient values

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4
Q

What is evidence-based clinical practice?

A

Problem based approach, whereby research is used to inform clinical decision making

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5
Q

Why is EBP important?

A

Aims to provide the most effective care available and improve patient outcomes

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6
Q

5 main steps of EBP process

A
  1. Answerable question (develop)
  2. Best evidence (find info to answer question)
  3. Critically appraise (the evidence)
  4. Integrate (evidence into practice)
  5. Evaluate (how well you did in steps 1-4)
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7
Q

What is research

A

The systematic and rigorous process of enquiry which aims to describe phenomena and develop and test explanatory concepts and theories

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8
Q

What is critical appraisal

A

Process of deciding whether a piece of research will be useful to your practice

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9
Q

What are the 3 questions you need to ask about research

A

Is it valid?
Is it important?
Is it relevant?

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10
Q

Explain the systematic review process

A
  1. Develop review protocol
  2. Ask answerable questions
  3. Finding the evidence
  4. Appraising the evidence
  5. Judging the applicability of the evidence
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11
Q

What is qualitative research?

A

Examine a particular issue in terms of people’s feelings and values etc.

Explores the human subjective experience

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12
Q

What is the aim of taking a qualitative approach?

A

Aims to understand the world of the participants from their perspectives

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13
Q

What are the types of sampling?

Non-probability

A

Convenience sampling
Purposive sampling
Snowball sampling
Theoretical sampling

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14
Q

What is convenience sampling

A

People invited to participate because of convenience

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15
Q

What is purposive sampling

A

Participants recruited due to preselected criteria

2 types: quota sampling and maximum variation sampling

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16
Q

What is snowball sampling

A

Aka chain referral or networking

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17
Q

What is theoretical sampling

A

Mostly used in grounded theory

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18
Q

What are the 3 types of sampling criteria

A

Inclusion criteria
Exclusion criteria
Sample size

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19
Q

Data collection

A

Direct data
Indirect data
Data obtained through archives or internet

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20
Q

Examples of data collection in qualitative research

A

Interviews
Focus groups
Observation
Documents

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21
Q

2 methods of data analysis (qualitative)

A

Thematic

Coding and categorising

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22
Q

Advantages if qualitative research

A

Uses subjective info
Build new theories
In-depth examination of phenomena

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23
Q

Disadvantages of qualitative research

A

Subjectivity can lead to procedural problems
Difficult the replicate
Researcher bias is unavoidable

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24
Q

What are paradigms in research

A

The set of values, beliefs and practices that are/should be shared by the people conducting and appraising/judging research

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25
Q

What is quantitative research?

A

Measuring ‘stuff’

Using numbers and stats the can be used to describe, compare and correlate aspects of the issue

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26
Q

Examples of quantitative research data collection

A

Observation
Questionnaire
Physiological/biological measurement

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27
Q

What is a sample

A

Subset of the population that participate in a study

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28
Q

What are descriptive stats

A

Allow the researcher to describe, organise and summarise raw data

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29
Q

4 main measures of quantitative data

A

Mode - occurs most frequently
Median - middle
Mean - average
Normal distribution

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30
Q

What are inferential stats

A

Enable inferences and conclusions to be drawn from the data

Based on probability theory

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31
Q

Role of quantitative research in health care

A

Describes the size of issues
Describes relationships (causal links)
Compares and contrasts populations

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32
Q

Advantages of quantitative research

A

Objective
Ability to determine causality
Easy to replicate

33
Q

Disadvantages of quantitative research

A

Doesn’t allow in-depth examination
Test theories rather than building new ones
Objectivity - di3snt allow for further examination of feelings etc.

34
Q

Why is triangulation used

A

To provide data from two or more perspectives to increase understanding of topic of interest

35
Q

What is a mixed methods study

A

Mixing two approaches within a study (qualitative and quantitative)
Provides greater depth of understanding

36
Q

Why do we use mixed method studies

A

To achieve a deeper understanding

37
Q

Limitation of mixed method studies

A

Time consuming

Resource intensive

38
Q

What is a PICO question

A

Describes the elements of a well-formed clinical question

Works with experimental studies

39
Q

What does PICO stand for

A 
P = patient/problem
I = intervention of interest 
C = comparison 
O = outcome
40
Q

What is a PIO question

A

Describes the elements for a well formed question for qualitative studies

41
Q

What does PIO stand for

A 
P = population/patient 
I = intervention/exposure 
O = outcome      OR            Co = context
42
Q

What is literature

A

Total body of writing the deals with the topic being researched

43
Q

What is a literature review?

A

The act of reading, sorting and analysing the literature and putting it into some kind of order

44
Q

Why review the literature?

A

Develop a comprehensive understanding of the topic
Narrow the scope of the topic for the study
Find out if it has been investigated in the past

45
Q

Types of literature sources

A

Primary - written by the author

Secondary - referred to by another author

46
Q

What is a systematic review

A

A high level overview of primary research on a particular question that trie to identify, select, synthesise and appraise all high quality research evidence relevant to that question in order to answer it

47
Q

What is a population

A

All of the individuals the researchers are interested in studying

48
Q

What is a sample

A

A subset of the overall population

Representation of the population

49
Q

Possible problems with sampling process and outcomes

A

Subjects may fail to follow up or withdraw
Participants rate may be too low
Excluding/including criteria may narrow down the sample too much
Incomplete info may be collected

50
Q

How do we measure/access rigor

A 
Quantitative = reliability and validity 
Qualitative = different measures
51
Q

What are the 2 types of validity (explain)

A

Internal validity - related to participants and research design
External validity - related to sampling plan and data collection instrument

52
Q

What is reliability

A

Has to do with the accuracy and consistency of the measurement technique

53
Q

What is a pilot study

A

A way to test the data collection tool on a small sample prior to the research

54
Q

What is confirmability

A

Reflects objectivity in the study

Congruence between 2 or more independent people in terms of accuracy of data, relevance or meaning

55
Q

What is authenticity

A

The extent to which researchers fairly and faithfully show a range of different realities

56
Q

Qualitative research measures of rigor

A

Reliability
Validity
Objectivity

57
Q

Research measure of Qualitative rigor (aka: trustworthiness)

A 
Credibility 
Confirmability 
Authenticity 
Dependability 
Transferability
58
Q

What are ethics

A

A branch of philosophy concerned with moral principles and values, with what ought to be the case and how people ought to live their lives

59
Q

What is the framework for ethical research

A

Non-maleficence (do no harm)
Beneficence (do only good)
Respect for human dignity
Justice

60
Q

UNESCO core principles

A
  • Respect for autonomy and individual responsibility (informed consent)
  • Respect for privacy, anonymity and confidentiality
  • Respect for human vulnerability and personal integrity
  • Respect for cultural diversity
61
Q

What is anonymity

A

Mean that no person (not even the researchers) will be able to identify a on individual participating in the study

62
Q

What is confidentiality

A

This means that the identities of the participants will not be linked to the information they provide

63
Q

Ethics committees - what do they do

A

Consider research proposals prior to commencement

64
Q

What are some codes and policies for research ethics in general?

A 
Honesty
Integrity 
Openness
Legality 
Confidentiality 
Carefulness
65
Q

What is clinical governance

A

A systematic and integrated approach to assurance and review of clinical responsibility and accountability that improves quality and safety resulting in optimal patient outcomes

66
Q

Characteristics of high quality health care

A 
Safe
Efficient 
Person centred 
Evidence based 
Effective 
Accessible
67
Q

4 pillars of clinical governance

A

Consumer value
Clinical performance and evaluation
Clinical risk
Professional development and management

68
Q

Biggest impact of clinical governance

A

Positive change in people’s attitudes

Move towards a culture of enquiry

69
Q

Critical requirements for successful clinical governance

A

Suppotive, open and inclusive culture
Active involvement from patients, carers and the public
Multidisciplinary teamwork

70
Q

What are clinical audits

A

Method of evaluating and improving clinical practice

71
Q

What is the aim of a clinical audit

A

To identify how close the current practice is to best practice

72
Q

What are the steps in a clinical audit

A

Identify issue/problem

  1. Set criteria, define standards to be reviewed
  2. Collect data
  3. Compare performance against criteria and standards
  4. Implement change
  5. Repeat cycle
73
Q

Barriers to dissemination and publication

A 
Lack of confidence and experience 
Organisational restraints 
Fear of scrutiny 
Lack of time 
Structure 
Interactions
74
Q

How to overcome barriers

A 
Be confident 
Start small & work your way up 
Work with others 
Be patient 
Keep it simple and brief
75
Q

What is inquiry

A

Rigorous and systematic thinking about professional practice, and the context in which it occurs

76
Q

Three types of reflective practice

A

Reflect-for-practice
Reflect-in-practice
Reflect-on-practice

77
Q

What is inquiry based health care

A

Involves a commitment to personal professional development

Includes developing and refining an inquiry toolbox. Of approaches and skills

78
Q

What is a culture of inquiry

A

A culture that supports individuals in making decisions that are based upon finding and using the best available evidence and combining that with their clinical expertise and knowledge of the patient to guide decision making in health care

79
Q

What is needed to build a culture of inquiry

A

Removal of well identified barriers
Capacity/resources
Structures, process and policies and are consistent with inquiry

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