Ch. 12 Critical Appraisal of Quantitative and Qualitative Research for Nursing Practice

34. In a critical appraisal, a reviewer conducts an audit of the transcripts of interviews and determines that the author's conclusions are correct. This is an example of a. confirmability. b. credibility. c. dependability. d. trustworthiness.

ANS A Confirmability is determined when the reviewer compares transcripts from interviews to the author's conclusions and agrees with the conclusions. Credibility is the confidence that the results produced in the study reflect the views of the participants. Dependability is documentation of steps taken and decisions made during analysis. Trustworthiness is an evaluation of the value of qualitative studies.

25. A reviewer conducts a critical appraisal of a study and notes that the study abstract does not include key results. The reviewer will discuss this omission in which part of the appraisal? a. Introduction b. Literature review c. Problem d. Purpose

ANS A The abstract is part of the introduction. The abstract is not a part of the literature review. The abstract is not included in the discussion of the study problem or study purpose.

13. An intellectual critical appraisal differs from other kinds of critiques because it a. focuses solely on the strengths of the study. b. evaluates the quality and meaning of empirical evidence. c. judges the researcher's ability and credentials. d. regards both the work itself as well as the study author.

ANS B An intellectual critical appraisal is directed at the study and is used to determine credibility and meaning. An intellectual critical appraisal looks at both strengths and weaknesses equally. An intellectual critical appraisal is directed at the study, not the researcher.

19. What key principle for critically appraising research studies involves the report being complete, concise, clearly presented, and logically organized? a. Be objective and realistic in identifying the study's strengths and weaknesses. b. Examine the organization and presentation of the research report. c. Provide a rationale for your critical appraisal comments. d. Evaluate the quality of the study.

ANS B Examine the organization and presentation of the research report involves a well-prepared report being complete, concise, clearly presented, and logically organized. It does not include excessive jargon that is difficult to read. Be objective and realistic in identifying the study's strengths and weaknesses involves being balanced in your critical appraisal of a study. Provide a rationale for your critical appraisal comments involves the justification for your critical appraisal, and documenting your ideas with sources from the current literature. Evaluate the quality of the study involves describing the credibility of the findings, consistency of the findings with those from other studies, and quality of the study conclusions.

22. A reviewer conducting a critical appraisal of a research study compares and contrasts study methods with those that are ideal, representing which step of the research process? a. Analysis b. Comparison c. Comprehension d. Evaluation

ANS B The comparison phase requires knowledge of what each step of the research process should be like, and then that is compared with the ideal. The analysis phase involves a critique of the logical links connecting one study element with another. The comprehension phase requires the reviewer to thoroughly understand the study. The evaluation phase highlights the meaning and significance of the study.

31. What are the three steps of critical appraisal of qualitative research? a. Assess the study design, evaluate sampling methods, and review study conclusions. b. Determine the study purpose, review study data, and evaluate implications for further research. c. Identify the components of the research process, determine strengths and weaknesses, and evaluate the trustworthiness of the study. d. Identify the steps in the research process, determine strengths and weaknesses, and evaluate the credibility and meaning of the findings.

ANS C Identifying the components of the research process, determining strengths and weaknesses, and evaluating the trustworthiness of the study are the components of critical appraisal of qualitative research studies. Assessing study design, evaluating sampling methods, and reviewing study conclusions are parts of the critical appraisal of qualitative research, but are not the three main steps. Determining the study purpose, reviewing study data, and evaluating implications for further research are parts of the critical appraisal of qualitative research, but are not the three main steps. Identifying the steps in the research process, determining strengths and weaknesses, and evaluating the credibility and meaning of the findings are parts of the critical appraisal of qualitative research, but are not the three main steps.

32. What standard may be applied to determine the strengths and weaknesses in a qualitative research study? a. Consistency of study methods with guidelines of expert researchers b. Determination of the generalizability of the study findings c. Reliability of scales of measurement used in data collection d. Validity of statistical analyses used in data analysis

ANS: A A critical appraisal may review a qualitative study and note whether study methods follow guidelines set by expert researchers because there are no hard and fast rules for study methods in qualitative research. Study findings are regarded as transferable and not generalizable in qualitative research. Reliability of measurement is part of quantitative research. Validity of statistical analyses is part of quantitative research.

38. All nurses need to have expertise in which skill regarding research? a. Critical appraisal b. Interviewing techniques c. Literature review d. Statistical analysis

ANS: A Critical appraisal of research is necessary to read and review research studies to consider their application for practice. All nurses should be able to critically appraise research. The other skills are important for nurses engaging in research.

11. When appraising the introduction section of a research study, what will the reviewer look for? a. Completeness and quality of the study abstract b. Evaluation of a comprehensive review of the literature c. Significance of the research problem to practice d. Study purpose and design

ANS: A During a critical appraisal, the reviewer will review the introduction and evaluate the completeness of the study abstract along with the description of the qualifications of the study authors and the clarity of the article title. The literature review, the significance of the research problem to practice, and the study purpose and design are not part of the introduction.

20. When assessing the conclusions, findings, and implications of a study, the appraiser will a. determine whether alternate hypotheses are possible. b. ensure that results are not based on past research. c. identify that findings are specific to the sample population. d. refute the study if limitations are identified.

ANS: A During this phase of study review, the critical appraiser will evaluate, based on the study results, whether alternate hypotheses are possible. Results should be based on the study but may also build on other study findings as well. The appraiser should determine whether findings may be generalized to the larger population. Limitations should be discussed, but they do not necessarily refute the study.

2. When critically appraising a research study, the reviewer will expect to find a. identification of new research problems. b. implementation of a perfect research design. c. precise understanding of the real world. d. tools to control outcomes in nursing practice.

ANS: A Good scientific inquiry will likely include identification of additional problems. There is no perfect research design. All studies have flaws. Although an improved understanding of the real world is realistic, no study will lead to precise understandings of the real world. Experimental research strives to predict and control outcomes in practice, but each study only leads to improvements in this ability.

33. When critically appraising the dependability of qualitative research, the reviewer evaluates a. documentation of decisions made during analysis of the findings. b. if interrater reliability has been determined. c. whether measurement tools have internal validity. d. whether statistical analysis has been performed.

ANS: A In qualitative research, statistical processes are not used. The reviewer should evaluate whether the researcher clearly documents how decisions about the data have been made.

23. During an initial review of a study, the reviewer will expect the methods section of the research report to include a. a description of the study design and sampling methods. b. the limitations and generalizations of the study. c. tables and figures representing study results. d. the framework and definitions of study variables.

ANS: A The methods section of a study report will contain a description of the study design and the sampling methods used to obtain the study population. The limitations and generalizations of the study will be discussed in the conclusion section. Tables and figures will appear in the results section. The framework and definitions will be included in a discussion of the study framework.

15. A reviewer is critically appraising a study's variables. What will the researcher evaluate? a. Conceptual and operational definitions of variables b. Relationships of demographic variables to key concepts in the study framework c. Whether variables and key concepts are linked d. Use of all types of variables, including independent, dependent, and research variables

ANS: A When appraising the study variables, the reviewer will note whether variables are conceptually and operationally defined. It is not necessary to relate demographic variables to concepts. The evaluation of the link between variables and key concepts occurs during appraisal of the study framework. Not all types of variables are included in all study types.

16. While critically appraising a study, a reviewer notes that the study includes an intervention. What will the reviewer assess? a. If the intervention is consistently implemented using a clearly described protocol b. How the intervention is administered to each subject in the study sample c. If the intervention is consistently administered to both experimental and control subjects d. Whether the intervention has been used in prior studies

ANS: A When evaluating a study intervention, the reviewer should note whether the intervention is clearly described with a protocol and consistently implemented. The intervention should be administered in the same way to all members of the experimental group only. It is not necessary to identify, at this stage of the critique, whether the intervention has been used in previous studies.

18. A reviewer critically appraising a study about self-care behaviors of adolescents who have cystic fibrosis evaluates comparisons of this sample to those from studies of young adults with cystic fibrosis. This appraiser is evaluating the a. credibility and meaning of the study. b. framework and key concepts of the study. c. limitations of the study. d. reliability and validity of the study.

ANS: A When evaluating the credibility and meaning of the study, the reviewer may examine the relationships among the current study compared with those of previous studies. The framework and key concepts are included in the evaluation of the study framework. The review of a study's limitations occurs when evaluating the study discussion and conclusions. The reliability and validity are included in the evaluation of the study methods and design.

5. Which group of nurses need expertise in the critical appraisal of research? Select all that apply. a. Practicing nurses b. Student nurses c. Retired nurses d. Nurse educators e. Inactive nurses

ANS: A, B, D Nursing students, practicing nurses, nurse educators, and nurse researchers are all involved in the critical appraisal of studies. Retired nurses and inactive nurses are identified as not currently practicing in nursing.

4. While critically appraising a quantitative research study, what will the reviewer assess when critiquing the title of the study? Select all that apply. a. Clarity of the title's focus b. All study variables and population c. Type of study conducted such as phenomenology and the variables d. Type of study conducted such as descriptive and the variables e. Key study variables and population

ANS: A, D, E The following questions are asked when critiquing the title: Is the title clearly focused? Does the title include key study variables and population? Does the title indicate the type of study conducted (descriptive, correlational, quasi-experimental, or experimental) and the variables? Phenomenology is a tradition of qualitative research. Variables are not typically used in qualitative research.

35. When establishing that a researcher has produced a result consistent with the views of the participants interviewed for a study, the critical appraiser has determined which strength of a qualitative study? a. Confirmability b. Credibility c. Dependability d. Trustworthiness

ANS: B Credibility is the confidence that the results produced in the study reflect the views of the participants. Confirmability is determined when the reviewer compares transcripts from interviews to the author's conclusions and agrees with the conclusions. Dependability is documentation of steps taken and decisions made during analysis. Trustworthiness is an evaluation of the value of qualitative studies.

4. A nurse researcher explains the importance of critically appraising research to a group of graduate-level nursing students. Which statement by a nursing student indicates the need for further teaching? a. "Research is critically appraised to broaden understanding for conducting a study." b. "Critical appraisal is an examination of the quantity of a study to determine the credibility and meaning of the findings for nursing." c. "Research is critically appraised to improve practice and provide a background for conducting a study." d. "Critical appraisal or critique is associated with critical thinking and evaluation."

ANS: B Critical appraisal or critique is an examination of the quality of a study to determine the credibility and meaning of the findings for nursing. Research is critically appraised to broaden understanding, improve practice, and provide a background for conducting a study.

5. What will the reviewer do during the evaluation portion of a critical appraisal of a research study? a. Assess whether the measurement tools are consistent with the phenomena of interest. b. Determine whether the study findings are meaningful and should be implemented in practice. c. Discuss the statistical analysis of the study's findings including demographic and experimental data. d. Review the components of the study to gain an overall understanding of the study report.

ANS: B During the evaluation of a critical appraisal, the reviewer determines the credibility and meaning of a study and decides whether the findings are relevant to practice. Analysis involves identifying incongruence between the phenomenon of interest and the measurement tool. Reviewing statistical data is part of the methodology review. The reviewer reads through a study for comprehension to gain an overall understanding at the beginning of the critique.

8. What is the goal of an intellectual critical appraisal of a research study? a. To determine whether a study should be replicated b. To identify strengths and weaknesses in a study c. To determine whether a study should be implemented into practice d. To weed out and discard studies that are flawed

ANS: B The purpose of intellectual critical appraisal includes identifying strengths and weaknesses in studies to help determine their credibility and meaning. Determining whether a study should be replicated is not the goal of intellectual critical appraisal. Determining whether a study should be implemented into practice is not the goal of intellectual critical appraisal. Many studies are flawed, but this does not mean that they are useless and need to be discarded. Flaws must be identified and discussed.

27. What is not necessary for a reviewer to include in a critical appraisal when evaluating study sampling methods? a. Characteristics of the sample b. Eligibility criteria c. Sample attrition d. Study setting

ANS: D When discussing the sampling methods, the reviewer may address characteristics of the sample, eligibility criteria to determine the sample, and sample attrition. The study setting is not part of the discussion about the sample. Sample characteristics are an important part of a critical appraisal when evaluating study methods. Eligibility criteria are an important part of a critical appraisal when evaluating study methods.

2. Which of the following are accurate statements about critical appraisal of research following presentation and publication? Select all that apply. a. Nurses who attend research conferences note that critical appraisals and questions often precede presentations of studies. b. Critical appraisals assist researchers in identifying the strengths and weaknesses of their studies and generating ideas for further research. c. Participants listening to critiques of studies always gain insight into the conduct of research. d. Experiencing the critique process can increase the conference participants' ability to evaluate studies. e. Published research critiques often decrease the reader's understanding of the study and the quality of the study findings.

ANS: B, D Critical appraisals assist researchers in identifying the strengths and weaknesses of their studies and generating ideas for further research. Experiencing the critical appraisal (critique) process can increase the conference participants' ability to evaluate studies and judge the usefulness of the research evidence for practice. Nurses who attend research conferences note that critical appraisals and questions often follow presentations of studies. Participants listening to critiques of studies might gain insight into the conduct of research. Published research critiques often increase the reader's understanding of the study and the quality of the study findings.

3. Which of the following are true statements about critical appraisal of research proposals? Select all that apply. a. Conducted to improve student research projects b. To permit data collection in an institution c. To select the best studies for funding by local organizations only d. Reviewed for funding from selected government agencies, corporations, and foundations e. Government agencies develop their own format for reviewing and funding research projects.

ANS: B, D Critical appraisals of research proposals permit data collection in an institution and are reviewed for funding from selected government agencies, corporations, and foundations. Critical appraisals of research proposals are conducted to approve student research projects, and select the best studies for funding by local, state, national, and international organizations and agencies. Corporations and foundations develop their own format for reviewing and funding research projects

37. Once a qualitative study has been evaluated for credibility, transferability, dependability, and confirmability, the study is considered to be a. generalizable. b. reliable. c. trustworthy. d. valid.

ANS: C A critical appraisal of qualitative studies is performed to evaluate trustworthiness, rather than meaning and credibility as with quantitative studies. Because statistical analysis is not applied to qualitative research, generalizability, reliability, and validity cannot be determined.

9. How are study results utilized to develop evidence for practice? a. Only evidence and data from strong studies are used. b. Only quantitative studies are used to build evidence. c. Strong points from multiple studies are used to build evidence. d. Studies must be replicated successfully to be used for evidence.

ANS: C Adding together the strong points from multiple studies slowly builds a solid base of evidence for practice. Many flawed studies contain strong points that may be used to build evidence. Qualitative and quantitative studies are both used in evidence building. It is not necessary to replicate every study to use data for evidence.

1. The goal of a critical appraisal should be to a. determine where faults exist in the study design. b. evaluate whether a proposed study is feasible. c. identify the meaning and credibility of the study. d. review the credentials and expertise of the researcher.

ANS: C An intellectual critical appraisal involves careful examination of all aspects of a study to judge the strengths, weaknesses, meaning, credibility, and significance of a study. Identifying faults in the study design is part of a critical appraisal but not the end goal. Reviewers conduct feasibility analyses prior to approval of a study. Evaluating the researcher's credentials is part of a critical appraisal but not the end goal.

17. In which type of study design would a reviewer expect to find a discussion of extraneous variables? a. Ethnographic b. Qualitative c. Quasi-experimental d. Phenomenological

ANS: C Extraneous variables are of most concern in experimental and quasi-experimental studies in which the researcher seeks to learn the effect of an independent variable on a dependent variable and must rule out the influence of other variables. An ethnographic study is not concerned with the effects of one variable on another; therefore, extraneous variables that may affect a variable are not usually discussed. A qualitative study is not concerned with the effects of one variable on another; therefore extraneous variables that may affect a variable are not usually discussed. A phenomenological study is not concerned with the effects of one variable on another; therefore extraneous variables that may affect a variable are not usually discussed.

3. How do practicing nurses participate in critical appraisal of research? a. By adhering to evidence-based practice guidelines and best practices b. By presenting findings from their own outcomes research c. By questioning the quality, credibility, and meaning of studies d. By reading research journals to keep current in knowledge and practice

ANS: C For critical appraisal to occur, nurses need to question the quality of the studies, the credibility of the findings, and the meaning of the findings for practice. Using EBP guidelines and best practices are part of research translation but are not part of critical appraisal. Presenting research findings and reading research journals are part of research utilization but are not part of critical appraisal. Presenting research findings and reading research journals are part of research utilization but are not part of critical appraisal.

36. A determination that findings in a qualitative study are applicable to other populations is an evaluation of a study's a. generalizability. b. reliability. c. transferability. d. validity.

ANS: C In qualitative studies, analysis of results can yield information about the transferability of the findings to others. Because statistical analysis is not applied to qualitative research, generalizability, reliability, and validity cannot be determined.

30. What is the focus of a critical appraisal of qualitative research studies? a. Completeness of the literature review b. Conceptual and operational definition of variables c. Integrity of study design and methods d. Validity of study measures

ANS: C Integrity of study design and methods is a key component of critical appraisal of qualitative research studies. Completeness of the literature review is a component of the critical appraisal but not the focus. Conceptual and operational definition of variables is part of the critical appraisal of quantitative studies. Validity of the study measures is a component of the critical appraisal but is not the focus.

1. Which of the following are true statements about the purpose of conducting critical appraisals of studies in nursing? Select all that apply. a. Critical appraisals are seldom conducted for a class project. b. Critical appraisals are often conducted before verbal presentations of studies. c. Critical appraisals are often conducted after a published research report. d. Critical appraisals are seldom conducted for article selection for publication. e. Critical appraisals are often conducted for selection of abstracts when studies are presented at conferences.

ANS: C, E In general, studies are criticallyUapSpraiNsedTto broaOden understanding, summarize knowledge for practice, provide a knowledge base for future research, and determine the research evidence ready for use in practice. Critical appraisals are often conducted after a published research report and for selection of abstracts when studies are presented at conferences. In addition, critical appraisals are often conducted for a class project, after verbal presentations of studies, for article selection for publication, and for evaluation of research proposals for implementation or funding.

7. A reviewer is asked to critically appraise a report to help determine whether funding will be allocated for a research study. This reviewer will be appraising a research a. abstract. b. article. c. literature review. d. proposal.

ANS: D Critical appraisals of research proposals are conducted to approve student research projects, to permit data collection in institutions, and to select studies for funding. Abstracts, articles, and literature reviews may all be critically appraised when evaluating research study reports after the research has been conducted.

6. When reading a research article in a refereed journal, the nurse researcher is assured that the article a. describes a study undergoing review. b. has been previously published. c. is printed in abstract form only. d. is of high quality and standards.

ANS: D Journals that are refereed are critically appraised by expert peer reviews and tend to be of high quality. Articles published in refereed journals have already undergone review. Refereed journals contain new research not previously published. Articles published in refereed journals include abstracts as well as a full report of the study.

21. A reviewer reads through a study from beginning to end, noting whether the title and abstract are clear, if relevant terms are defined, and if the introduction,methods,results,and discussion are plainly identified. This represents which part of a critical appraisal? a. Analysis of the study methods b. Comprehension of the study outcomes c. Evaluation of the literature review d. Identification of the steps of the research process

ANS: D Reviewing the abstract and reading the study from beginning to end are the first steps of a critical appraisal and are part of identifying the steps in the research process. The other actions occur when evaluating the strengths and weaknesses and the credibility and meaning of the findings.

24. During a critical appraisal of a research study, the reviewer determines that a study about blood glucose monitoring of patients with type 1 diabetes mellitus has implications for patients with type 2 diabetes. The reviewer will determine this during which phase of the research critique? a. Analysis b. Comparison c. Comprehension d. Evaluation

ANS: D The evaluation phase highlights the meaning and significance of the study and includes discussion about application and generalizability of the findings to other populations. The analysis phase involves a critique of the logical links connecting one study element with another. The comparison phase requires knowledge of what each step of the research process should be like, and then that is compared with the ideal. The comprehension phase requires the reviewer to thoroughly understand the study.

12. What is important to assess when critically appraising a literature review? a. If previous studies support the research problem b. If textbooks are included in the reference list c. What sources are used to provide study funding d. Whether relevant studies are discussed

ANS: D The literature review should evaluate whether relevant studies are discussed, if the sources are current, whether the studies are critically appraised and synthesized and if they are from refereed journals, and if a summary of current knowledge is provided. Individual studies do not necessarily support the research problem but are used to show what is known and not known about a subject. Textbooks may be used, but refereed journals with current research are preferred. The sources of funding for studies may be mentioned if relevant to study outcomes.

29. A reviewer critically appraises a study. Which aspect of the review indicates a weakness in the study? a. The conceptual definitions of variables are consistent with operational definitions. b. The literature review identifies what is known and not known about the problem. c. The researcher identifies and discusses threats to design validity. d. The statement of purpose provides a broad, general focus for the study.

ANS: D The purpose should provide a narrow, clear focus for the study, so this is a study weakness. The conceptual and operational definitions should be consistent, so this is a strength. The literature review should identify what is known and not known, so this is a strength. The researcher should identify and discuss known threats to validity, so this is a strength.

14. What will the reviewer assess when critically appraising a study framework? a. How the variables and concepts are evaluated and measured b. What the research hypothesis is and how it was developed c. Whether the literature review is complete d. Whether the study variables link to key concepts

ANS: D The reviewer of a study should identify key concepts in the study framework and then evaluate whether the key variables that will be measured link to those concepts. The methodology is concerned with how variables are evaluated and measured, but not necessarily how they link to the framework and concepts. The research hypothesis is derived from the study purpose. The framework critique is not concerned directly with the literature review.

10. What are the steps used to evaluate quantitative research studies? a. Assess the study design, evaluate the sampling methods, and review the study conclusions. b. Determine the study purpose, review the study data, and evaluate the implications for further research. c. Evaluate the study methods, validate the measurement tools, and determine the quality of results. d. Identify the steps in the research process, determine the strengths and weaknesses, and evaluate the credibility and meaning of the findings.

ANS: D There are three steps in the quantitative research critical appraisal process: identifying the steps of the research process in studies, determining study strengths and weaknesses, and evaluating the credibility and meaning of the study findings. All the other tasks listed are part of the process but do not represent the three steps in evaluating quantitative research.

26. A reviewer performs a critical appraisal of a study and notes that the researcher conducted a previous pilot study. The reviewer will a. discount any findings not congruent with the pilot study. b. ensure that the larger study and pilot study used identical data collection methods. c. ignore the findings of the pilot study because they are not relevant to this study. d. note whether the pilot study findings were used to design the current study.

ANS: D When reviewing a study in which a pilot study was performed, the reviewer may note whether findings of the pilot study led to changes in study methods in the subsequent study. Findings in the pilot study may differ from those in the larger study if changes are made based on the pilot. Identical data collection methods may not be used if results from the pilot indicated a need for change. The findings of the pilot study provide information that guides the researcher to change study methods in the subsequent study.

28. Which is true about the evaluation of study variables in a critical appraisal of a research study? a. It is not necessary to identify whether the measures are nominal, ordinal, ratio, or interval. b. The reviewer will be concerned only with the reliability of measures in the current study. c. The reviewer will identify the names and authors of the measurement strategies. d. The reviewer will make sure research variables are defined conceptually but not operationally. ANS C

When discussing study variables, the reviewer will evaluate the measurement strategies, including the names and authors of the various strategies. The reviewer will identify the types of measurement scales used. The reviewer will be concerned with the reliability and validity of measures. The reviewer will ensure that variables are defined conceptually and operationally.