Research Methods Exam 1 Study Guide

Explain the utility of postmodernist ideas to scientific inquiry today, delineating the potential contributions, as well as limitations, to a postmodernist orientation toward science.

Arguments of postmodernism offer both valid critiques as well as (ironically) valuable contributions to contemporary research practices. In many regards, theoretical arguments are inherently limited by the language/terminology contained within them, and hypothesis testing regarding them is further bound by their concepts. In occupational therapy, there are many conceptual models that define phenomena with various independent terminologies. This creates problems within the body of research (e.g., practice theory, clinical reasoning, and outcome studies, among others) in operationalizing knowledge among the various conceptualizations. Furthermore, there is also a risk that arguments within the evidence may lose their validity when utilized within multiple conceptual frameworks. The critical argument proposed by postmodernism likely is responsible for an evolution in the types of research being conducted. For example, rather than traditional research that begets a need for ongoing research to refine its outcomes, research as a means of promoting change (i.e., transformative research) is growing in popularity. This research reworks the methodology to enable marginalized populations to enact needed change. A postmodern perspective alternatively would inhibit the professional body of research evidence from further development (specifically limiting traditional research purposes), and would limit future studies needed to promote the ongoing viability of the profession.

What are the possible roles that OT professionals can play with respect to research?

As evidence-based practice becomes more ingrained within occupational therapy practice, the diversity of roles with which practitioners will have exposure to research is also expanding. While not necessarily placing the therapist in the role of a traditional researcher, there are many other ways in which therapists may meet this professional responsibility. Such roles include research producers (traditional researcher role), research collaborators, research consumers, and research advocates. Research collaborators, consumers, and advocates don't have direct autonomous control over active research studies, though they are still critical for ensuring the proliferation of evidence within the profession. These roles are crucial for ensuring evidence-based practice is part of the culture of the profession, something that will ensure the profession will continue to thrive in an era of evidence-based medicine.

What is the role of the institutional review board (IRB) in protecting human subjects?

B. An IRB exists within a university, medical center, or other institution to review research proposals and ensure that the study is safe and ethical for all participants. IRB primary goal is to protect all persons

When selecting a research methodology, an investigator will determine many of the characteristics of the study. Which of the following is not part of the research methodology?

B. Ethical approvals All studies with or without human subjects must receive ethical approval by the Institutional Review Board (IRB) before proceeding with the study.

Formative research best seeks to identify what characteristic of an intervention of study?

B. The mechanism of change for the intervention

Applied science is used frequently within occupational therapy practice. Which of the following examples does notdepict an applied science purpose?

B. To describe the mechanism of action that underlies a common intervention technique

What is meant by "browsing," and how is it different from querying?

When conducting an electronic search for information, there are two methods that allow investigators to obtain the information they need. The first of these is browsing, wherein a search engine is used to retrieve items according to a set of terms. The path toward obtaining the results may be structured (with a hierarchical series of topics) or serendipitous (which continuously evolves over the course of the search). However, querying uses a logical method of search-query logic to build specific parameters within the searched terms to create a selective retrieval of information sources.

Why are researchers required to submit study proposals to an institutional review board?

When conducting research, especially research that involves human or animal subjects, there are a number of ethical considerations that will transpire. These ethical considerations are often not transparent, and might involve conflicting interests. The ambition for developing new knowledge through a research design might put the interests of a researcher at odds with those of the study's participants (and there are numerous historical cases where the welfare of the participants was not respected). Therefore, it is critical that institutions have a panel of individuals review research proposals to ensure that the safety and welfare of subjects is upheld. These panels themselves should be diverse to reflect the diverse perspectives and welfare of all individuals. Furthermore, in instances where risk cannot be eliminated from a research design, these panels may ensure that the potential gain from conducting a study outweighs the risk involved to the participants.

Most medical journals have complete open access availability of their full-text articles within a bibliographic citation database, eliminating the need for information "berry picking."

False- Many major medical journals require subscriptions to gain full access to their materials. Howard University has electronic subscriptions to many journals and databases. If you search through google, you may not have access to the source material, but if you log in through HU, you should have access if the University subscribes. AJOT, BJOT, and CJOT may be accessed through Aota.org

Define the three central purposes of research in occupational therapy according to research classifications.

Basic research-The foundation of occupational therapy is rooted in an interdisciplinary knowledge base of the medical, psychological, and sociological sciences. These keystone studies, as well as occupational therapy specific investigations, explain the phenomena that are encountered throughout clinical practice and serve to frame our own professional perspective. Applied research-Ongoing professional viability is arguably a byproduct of existing and future applied research, which serves to solve problems encountered in practice and provide evidence toward the efficacy of interventions. Studies that investigate commonly used instrument psychometrics, therapeutic clinical reasoning, and clinical outcomes allow for practice techniques to be continuously refined. This serves as evidence of our professional contribution to all shareholders. Applied research is conducted in "real world" settings. Transformative research-Further meeting the needs of clients through advocacy and empowerment, these studies serve to include clients as participants and as means of change. This manner of investigation uses the research process to identify needs of a marginalized/underserved population and promote change through active collaboration of the investigator and the subjects.

Why is clinical expertise important to evidence-based practice in occupational therapy?

A core tenet of occupational therapy practice is that interventions must be specific to the unique values and characteristics of the clinician's clients. Recognizing the values of clients through narrative reasoning is one of many skills acquired through practice. Clinical expertise is the skill base and reasoning that clinicians develop. Evidence-based practice requires clinicians to utilize their clinical expertise to recognize how the best available evidence best meets the unique needs of their clients.

Which research role typically involves advanced training, which may be acquired through doctoral or postdoctoral degrees?

A. Research producers In order to conduct high quality research, a clinician must receive advanced training in research methodology, including use of data collection and analysis techniques. Collaborators may support a highly trained researcher. An example of an occupational therapist research consumer is a clinician using research to inform clinical decisions. Anyone can be a research advocate.

What are three circumstances under which you might be required to write a general literature review?

A general literature review is a practical piece of writing that demonstrates an evidence- based story. There is no rigid specific protocol for conducting a general review, and typically one is not considered to be a stand-alone work of research. The aims of a general literature review are to demonstrate advanced knowledge of the topic area; establish the impact and relevance of the research question; and build a rationale for future research and/or the proposed study to be conducted or reported. These aims can serve to meet many goals; therefore, there are many circumstances that would warrant the need to do a general literature review. Students and other individuals learning about topics or preparing for advanced certification often must conduct general literature reviews to seek out evidence existing within established literature. Further, general literature reviews are required for publishing manuscripts, book chapters, or grant proposals. They are often the basis for establishing a valid research question. Finally, they may be used within clinical settings as a means for implementing an evidence-based treatment strategy or protocol: supplying evidence, justifying resources, and validating rationale for reimbursement. Next year, one of your first assignments for your independent research project course will be to write a literature review.

What are the differences between a general literature review and a systematic literature review?

A systematic literature review, by definition, is a systemic approach to assess and evaluate the quality of all research studies for a strictly defined scientific topic or question. Through use of objective and transparent methods, this approach eliminates the potential for bias when evaluating evidence and ensures replicability. Evidence-based medicine utilizes systematic reviews including only randomized control trials as a basis for delivery of services, as these are considered the highest level of evidence. These reviews may use quantitative methods, with their inclusion and statistical analysis of evidence. There are numerous protocols for conducting various forms of systematic reviews. In contrast, general literature reviews (a.k.a., unsystematic reviews) do not have any specific protocol, and are not considered stand-alone research. These are practical works that demonstrate an evidence-based story. This may serve as a foundation for learning new evidence, answering clinical questions, or serving as a basis for proposing future research endeavors.

Provide an example of a study that uses an experimental design, and justify why the study would be realistic/feasible to conduct.

An applied research outcomes study may be conducted on individuals in the chronic stage of their post-stroke recovery with spastic hemiparesis. The study would examine the impact of Constraint Induced Movement Therapy (CIMT) on this population, to determine if it can produce a statistically significant outcome. Subjects could be divided into two condition groups through random assignment, with different levels of exposure to the independent variable (i.e., the CIMT protocol). The experimental group would receive the CIMT protocol in accordance with the specification of the intervention technique. The placebo control group will receive a placebo therapy that involves similar durations of activity, but for the contralateral upper extremity. The experimental design of the study would allow for control of multiple confounding variables, including the expectancy effect and the effect of natural/spontaneous recovery.

What are two bibliographic citation databases relevant to occupational therapy, and how do you find them?

Building on a broad foundation of the basic sciences, interdisciplinary studies, and profession-specific literature, occupational therapy has a wealth of information available to inform its questions. These may be found in many of the bibliographic citation databases, which include: MEDLINE/PubMed—This is the U.S. National Library of Medicine's premierdatabase, including citations, abstracts, and full-text links (where available), as well as references to online books and other sources. It is found electronically at: http://www.nlm.nih.gov/bsd/pmresources.html. CINAHL—This is an international bibliographic database that includes citations, abstracts, and full-text links (where available) relevant to rehabilitation and nursing. It is found electronically at:https://www.ebscohost.com/nursing/products/cinahl-databases/cinahl- complete. OT SEARCH—This is a bibliographic database that includes literature pertinent to occupational therapy, including monographs, proceedings, reports, doctoraldissertations, master's theses, and most international OT journals (published inEnglish), as well as journals related to the field. It does only include the citation, or the abstract (when available). It is found electronically at http://www.aotf.org.

Key strategies for anyone who wishes to become an effective research writer include all of the following except for which?

C. Eliminating bias by using an objective and transparent methodological approach To write a literature review, a systematized methodological approach is not needed. However, to write a systematic review, a sound and transparent methodological approach is needed.

A common form of research in health care and in occupational therapy is participatory research. Which of the followingis not a characteristic of participatory research?

C. It is most commonly carried out in a controlled laboratory setting.

The philosophical foundations of research may be seen by their influence on contemporary research methods. Which of the following statements is true regarding this influence?

C. Quantitative approaches are consistent with the tradition of logical positivism.

How would you evaluate the quality of a mixed-methods study?

Currently there is no widely employed model for evaluating the quality of a mixed-methods study. Rather, individual studies may be critically appraised using techniques of both a hierarchical level of evidence and a multidimensional model. It is only fitting that a research study that employs mixed methods will rightfully require mixed methodology for appraisal.

What is the role of critical appraisal in a literature review?

Essential to the purpose of conducting a literature review is critically appraising the collected data (i.e., the included research studies). This appraisal serves as a measure of the existing state of evidence toward some research question. Critical appraisal serves to: Identify the current trends and ways of thinking about the topic and how to research it Identify the boundaries of the literature (e.g., what particular populations, settings, and perspectives were studied in the previous research?) Illuminate the gaps in the current knowledge base and the way in which it has developed Evaluate the strengths and weaknesses of existing research approaches to studying the topic Make an argument for why any conflicting or differing research findings exist (if they exist) Many articles have a summary of a literature review in the background section prior to describing the research methodology.

3. How did evidence-based practice originate? What is the difference between evidence-based medicine and evidence-based practice in occupational therapy?

Evidence-based practice developed from the concept of evidence-based medicine, wherein it is recognized that research evidence must be used as a primary foundation for informing clinical practice. With this core tenet in mind, evidence-based practice in occupational therapy is held in balance with clinical expertise, which allows a clinician to view a client among his or her unique values and context. A skilled occupational therapist must be able to develop a therapy program that is reflective of evidence-based interventions and those that best meet the holistic needs of the client.

What are the major types of presentations and research articles that allow for the dissemination (distribution) of evidence-based practice?

Evidence-based practice may be informed by knowledge presented in a variety of formats, which includes both written and visual/verbal means. Written evidence includes literature reviews, experimental reports, case reports, or opinion pieces. Live presentations (such as at professional conferences or other gatherings for information dissemination) include individual paper presentations, symposia, workshops, poster presentations, and roundtable discussions.

What are the major sections of a peer-reviewed research article?

Having standardized formatting allows for research to be efficiently reviewed and ensures standards by which information should be presented to ensure all relevant information is included. While there are various formatting guidelines, the most commonly utilized format for occupational therapy literature is APA formatting. This format requires the following sections (in sequential order): title page (with the running head, institutional affiliation, and any corresponding authors), abstract (with key words), introduction (including a statement of impact), method (including ethical approvals, the study design, participants, recruitment and retention methods, procedures, specifications of the standardized intervention, fidelity measures, follow-up procedures, measures utilized, the dependability of the measures, the analytical approach), results, and discussion (including a limitations section).

Imagine that you are assigned to conduct a research study. How would you approach the selection of an overall methodological approach?

In choosing a research methodological approach, researchers should assume a top-down decision-making process. First, once their research problem/question has been devised from a thorough literature review, they should determine what research design would best allow them to address this topic. Initially, this will begin by choosing to do a qualitative, quantitative, or triangulated study, and therefore collect various types of data/information through any of the number of study designs (e.g., experimental, quasi-experimental, case- study, survey, naturalistic, or field studies). If appropriate, they will further need to determine if a study has an experimental condition, blinding, randomization, and number of points of contact with the subjects. Next, the researcher should determine the sample/sample site to be recruited and how it will be retained. Finally, a data collection approach should be determined for answering the research question.

What are the four major requirements of sound research?

In order for evidence to contribute to the overall knowledge base, it should be sound in its creation, which may be understood according to its characteristics of rigor, an attitude of skepticism and empiricism, its logical reasoning, and its communality. Rigor includes any of the established practices within the scientific community (specific to each particular method of research), which allow for integrity with methodology. Skepticism and empiricism separate knowledge generation from opinion through critical appraisal and scientific means. Logical reasoning allows for systematic linking of knowledge directly to a phenomenon, wherein explanations and observations directly contribute to one another. Finally, communality indicates the reception and review of a study in the larger context of the scientific community.

What are five skills necessary to produce independent research?

In order to become an independent research producer, there is typically training required that goes beyond traditional entry-level practice skills. This is often the focus of Doctorate, or postdoctoral, training. The performance skills necessary to successfully perform within this role include the ability to identify original research questions and design methods for answering them; secure funding for research; supervise/oversee the implementation of research; work with interdisciplinary collaborators, statistical consultants, and others with specific research expertise; and prepare research reports for presentation or publication. Presently, the OTD is an occupational therapy doctorate and has a clinical emphasis, it is not a research degree in the traditional sense of a PhD.

Why might a person decide to become involved with research?

Just as there are a variety of roles with which a practitioner may become engaged with research, there are many reasons why an individual might take on this extra responsibility. These reasons may include deciding to become more involved in researchbecause of funding cuts or insurance denials that referenced a lack of evidence about occupational therapy; getting more involved because of daily obligations; being inspired by meeting an investigator; being fueled by personal desires; being motivated by a drive to achieve enhanced status and participate in higher-status groups where one can have an influence on important issues in occupational therapy; being motivated by a sense of obligation to contribute to research as part of one's professional identity; being fueled bya sense of generosity and gratitude toward the profession coupled with a desire to "give something back"; or developing a strategic response to opportunities for professional advancement, or for the advancement of one's interests, or for those of one'sorganization. Some of these reasons recognize a professional or ethical responsibility to enhance the profession through research, and some recognize individual circumstances that precipitate participation. Regardless of the rationale, participation with research does contribute to the growth and sustainability of the profession.

What is the role of logical reasoning in research, and how does it help to increase the rigor, verifiability, and replicability of research?

Logical reasoning uses a process of deduction and induction to reciprocally create and refine knowledge. For research purposes, induction allows for investigators to make observations of the natural environment for knowledge generation, which may be tested and refined through deductive logic. This recognizes that knowledge and theory are not absolute, but rather an evolving way of describing the occurring phenomenon and understanding it. Strict application of logical deductive processes enhances a study design when methods and logic are specified in detail so that verifiability is established, meaning others may understand exactly what was done and what reasoning occurred while determining outcomes. Also, when specifically described, this can allow for replicability, so that others could replicate the study and obtain the same findings.

What is research misconduct, and what are some of its consequences?

Misconduct in research consists of practices that seriously deviate from those that are commonly accepted within the scientific community for proposing, conducting, or reporting research. Examples of misconduct include: Fabrication—Generating fictitious data or findings and reporting them as if they were discovered during a research study Falsification—Involves changing or distorting data, data collection procedures, or research findings to portray the desired findings rather than the actual ones Plagiarism—Using another writer's ideas, methods, results, writing, or work without credit to the origin, thereby taking personal credit for it falsely These behaviors, or others that deviate from common research standards, must be intentional, knowing, or reckless. In these cases, disciplinary action may include: Requirements that federal funding be returned (paid back) Additional penalties and fines to the individual investigator and the institution for not maintaining regulatory compliance Imprisonment for up to 5 years in severe cases Institutional sanctions such as halting of all federal funding of research, or possibly even halting all ongoing human subjects research (regardless of the source of funding), until the institution is "brought into compliance"

Provide an example of a naturalistic study and describe one benefit of the approach

Naturalistic studies allow for direct observation of a phenomenon without the biasing effects of simulated environments or altered contexts imposed by non-field designs. An example of how this design may be employed within the scope of occupational therapy research would be a study evaluating the incorporation of ergonomic techniques into the workplace following a standardized intervention. Subjects could be naturalistically observed while performing their actual job duties. Occurrences where proper ergonomic techniques are not maintained may be noted for frequency, activity being performed, duration, or other significant characteristics. This would allow for more valid information regarding the outcome of the ergonomic intervention, rather than a design carried out in a clinicalenvironment (with context simulating the subjects' workspace). The simulated work environment would introduce many confounding variables into the study design, and thus generate less knowledge that would be valuable for refining the intervention.

What are the limitations of evaluating quantitative designs according to a hierarchical levels- of-evidence model?

Not all evidence is equal, and existing hierarchical models do attempt to capture the quantitative predominance of evidence. However, there are many interventions and populations that are not compatible with the rigors associated with "higher-level" designs; therefore, existing hierarchical models undervalue many of these phenomena. Furthermore, traditional rigorous designs struggle to capture the dynamic factors that contribute to the efficacy of occupational therapy practice, placing a ceiling on the types of study that may be enacted in practice.

Explain the unique contributions of occupational science to the broader field of occupational therapy.

Occupational science serves as a basic science, with occupation and the complexity of its various contexts and forms as its core phenomenon of interest. The field serves to describe, explain, and predict events relevant to occupational performance, thus creating an adjunct knowledge base for occupational therapy practice. In this role as scientific study, there is an underlying assumption that this knowledge may be logically incorporated into practice, as opposed to applied and transformative research, which integrates practice into the research design.

1. Describe three approaches to occupational therapy practice that have been informed by research. Provide specific examples.

Occupational therapy has evolved over the course of the profession to include best practices that are informed by research conducted within the profession or among similar allied health-care professionals. This can include: A shift in the treatment of post-stroke patients, with a paradigm shifting from traditional sensorimotor approaches to motor control theory with an emphasis on task-oriented approaches and repetition of discrete functional motor patterns. Incorporation of metacognitive strategies to treat individuals with mild cognitive impairments, allowing for functional programs that may be included into daily routines and serve to promote specific cognitive functions. An increasing role for occupational therapists to treat patients during their cancer recovery, including interventions to address cognitive deficits caused by chemotherapy induction and management of edema for individuals with lymphatic impairments. All of these approaches demonstrate how the clinical practice of occupational therapy raises questions that can and are answered through research studies.

What is gray literature, and can it be useful to a researcher?

Occupational therapy, as well as other professions, produces a body of gray literature in addition to the published (often peer-reviewed) articles. Gray literature includes abstracts of conference papers, dissertations or unpublished theses, and unpublished reports. These items may contain specific and beneficial knowledge; however, they have two primary limitations. The first of these is that they are less accessible (though increasingly, they are becoming more available through specific content websites and the World Wide Web). Second, they are often not peer-reviewed, so investigators must use a critical appraisal approach (and likely have some background knowledge on the topic) toward the information presented. The AOTA website makes conference abstracts from the annual conference available and through their website. However, you are typically not able to access the original source material from poster presentations and conference presentations.

How can you begin establishing a role as a researcher?

Participation with a role in research is something that should be suited to meet the needs of a professional's identity, context, and resources. Making a judicious decision with respect to this should involve controlled exposure to some of the duties associated with each role. Scenarios that would allow for this might include situations where there is exposure to role models and role alternatives; opportunities to reflect on and try out research role behaviors; opportunities to obtain feedback regarding research task performance; and opportunities to evaluate new standpoints and experiences. These situations may be a part of participation with professional service, or located in settings where research is currently being conducted. These activities would allow a practitioner to try out some of the different tasks associated with each role and make an informed decision regarding what is best for his or her professional practice. As students at HUOT, you have the opportunity to work with a faculty mentor to complete a research project in your second year, or to complete an independent research thesis projects.

4. Compare and contrast participatory research and outcomes research in occupational therapy, describing the utility of each in context.

Participatory research and outcomes research are both approaches to developing evidence for occupational therapy practice, each of which is capable of quantifying the value of therapeutic interventions or programs. Of note, participatory research may be utilized as a means for generating outcomes evidence. In contrast from one another is the method or philosophical approach with which they are carried out. Specifically, most outcomes research is more traditionally structured with a specified research question proposed, which is investigated through rigorous methods. This is quite different than participatory research, in which all shareholders collaborate to propose a research question, development of the intervention, and rigorous methods for investigation.

What is one practical method of disseminating evidence to others in a given practice community?

Published articles—whether literature reviews, experimental reports, case reports, or opinion pieces—are just one manner of knowledge dissemination. Other methods, with varying levels of formality, may be employed to inform professionals of study findings. At institutional, local, state, or national professional conferences, or conferences held with specific topics (e.g., cognition, autism, driver's rehabilitation), individuals may presentindividual paper or poster presentations, or participate with symposia, workshops, or roundtable discussions. These may also be done in a community, open to the public forum.

2. What are some likely consequences if research is not conducted or used to enhance occupational therapy practice?

Research provides the profession of occupational therapy with needs assessment, practice theory, and clinical reasoning, as well as validates evaluation and quantifies outcomes. Without a substantial and continuous body of research validating the profession, occupational therapy would stagnate and fail to thrive in an ever-changing practice arena.

What are some of the considerations in obtaining informed consent from vulnerable populations?

Respect for persons, included among the Principles of Belmont, specifies that protections be in place for vulnerable populations. This includes individuals who do not have the capacity to consent to participate in research or who may be pressured into participating for the wrong reasons. These individuals include prisoners, pregnant women, fetuses/neonates, employees and students of institutions where research is being conducted, individuals with impaired decision-making capacity, and educationally or economically disadvantaged people. Respect for these individuals includes allowing for informed consent to ensure that participation within the study is purely voluntary and not coerced in any manner.

How does a researcher use search-query logic?

Search-query logic uses controlled-language terms to effectively apply expansion and contraction set searching to maximize retrieval recall and precision. A common form of thisuses Boolean logic, which uses logical parameters, such as "AND", "OR", and "NOT", aswell as the ability to nest these terms to build a search that meets an investigator's specificneeds. This means the search may use multiple terms and specifically retrieve items that include both, include either, or exclude the specified terms within the search query.

Describe a circumstance under which using a single-subject design would be appropriate to answer an occupational therapy research question

Single-subject research designs allow for examination of individual variations in response to an intervention. Population or sample-based studies only provide information on the metrics of the whole group, and do not illustrate the complexity of the individual. A hypothetical example of this may be seen in an applied research single-subject outcomes study, in which a clinician examines the efficacy of a functional hand orthotic on a traumatic upper-extremity nerve injury population. Because of the many traumatic mechanisms that can cause this condition, and the diversity of presentations/recovery rates, individual subjects should serve as their own controls. This has two positive rationales. It reduces the various confounding variables (e.g., nerve involved, level of the nerve injury, secondary tissue injury/infection, time since injury) that would limit an experimental design study. Also, it allows for a better understanding of how the orthotic may have different advantages/disadvantages for specific individuals or groups of individuals included in the study through single-subject outcomes.

What are the Principles of Belmont, and how have they influenced the contemporary conduct of research throughout the world?

The Principles of Belmont are a code for basic ethical principles for human subject research, established by the U.S. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The three principles it defines are: Respect for persons—The most basic of the three principles of Belmont, this asserts that human persons must be respected in terms of their right to self-determination. Beneficence—The principle that requires that human subjects research minimize risk to the greatest extent possible and maximize the potential for benefits to be gained from the research (either for the individuals participating in the research or from the knowledge that will be gained). Justice—The principle of justice requires that the research impose the burden of risk and the potential for benefit upon the same groups of people. This report serves to define how human subjects' health and welfare should be maintained, and is reflected through further international reports, including the Declaration of Helsinki (revised most recently in 2000) and the HIPAA Act of 1996.

Based on the various philosophical orientations toward science, describe your own preferences toward knowledge generation. How might those preferences influence your choice of a research approach?

The body of professional literature produced by occupational therapy most aligns with the philosophical perspective of critical modernism. Within this perspective, most research endeavors are applied studies that seek to better understand (not seek an absolute truth) phenomena addressed by professionals. A majority of these studies utilize conceptual models/theoretical frameworks that are not static in their constructs, but are refined through research and continually evolve with practice. These studies include practice theory research, clinical reasoning research, and outcomes research.

How did historic ethics violations lead to the regulation of research studies?

The drive of some researchers to seek out new knowledge has led to some historical examples of abhorrent research abuses. This may be seen during World War II, where Nazi doctors experimented on human subjects with total disregard for their safety, welfare, and lives. Furthermore, during the Tuskegee experiments, subjects' health and welfare was directly compromised for multiple decades. These practices created an international prerogative to create ethical standards for research practices. Directly related to the Nazi Doctor Trials was the Nuremberg Code. The Declaration of Helsinki and the Principles of Belmont later followed to further ensure that future research practices would reflect ethical concern for subjects.

What is a primary responsibility of an OT professional as it pertains to research?

The dynamic and complex context of occupational therapy practice creates an environment wherein professionals must engage in problem-solving to develop solutions to unique client needs. Rather than relying on personal clinical expertise and anecdotal evidence to guide these decisions, therapists have a professional and ethical responsibility to incorporate evidence that exists within bodies of research to fully be aware of potential and actual outcomes of their service. Working in settings with high- impact outcomes to the decisions therapists make, decision-making in professional practice needs to be backed by rigorous and transparent evidence. This justifies not only the rationale for interventions, but also the need for services, resource distribution, and reimbursement issues. Most occupational therapy clinicians use research evidence to inform their clinical practice. Therapists need to be able to search for and evaluate research literature to inform clinical decisions and to use for advocacy.

What is a central characteristic of transformative research? How is transformation achieved?

Transformative research by definition is a methodology intentionally attempting to promote change and development within a social and contextual environment. Studies are implemented in and by participants, which empowers them as individuals to be shareholders that generate programs meeting their specific needs. By translating research methodology into a process through which individuals are able to alter circumstances (i.e., proposing questions, investigating means, effecting changes), participants are implementing research theory into practice.

What are the differences between the research problem, research question, specific aims, and research hypothesis?

The literature review will help potential researchers to identify their research problem, question, specific aims, and hypothesis. This is because a literature review allows investigators to recognize what is already known, what theories exist, what the strengths/weaknesses are of the existing studies, and any gaps in the literature. Broadly, this understanding allows a researcher to clarify a research problem, which identifies this gap or discrepancy in the existing scientific literature. In order to develop a study addressing this research problem, investigators must more specifically devise a research question, which is written to specifically be addressed/answered through the methodology of the study. The study will further have specific aims, stating what the study will accomplish and the value of this contribution to the larger knowledge base. If appropriate, investigators might also propose a research hypothesis, which is their expected result from conducting a quantitative study.

What are the four key questions that guide the literature-search process?

The literature-search process may be guided by four questions. The first of these is, "Whatam I looking for?" This question allows an investigator to consider the information that is necessary, for whom it is intended, the format that is required, and the time frame. This step is where an investigator creates a plan that may be translated into search terms. The secondstep is to identify, "Where can I find it?" At this point, the investigator determines which database, or more likely series of databases/sources, should be included within the search. This includes bibliographic citation databases, online public access catalogs, or even the World Wide Web. The third question an investigator should ask is, "How do I access and retrieve it?" This step involves building and implementing the specific search strategy, including the precise search terms, search queries, and search syntax, as well as evaluating the retrieved items to see if your parameters need further refinement or expansion. Finally,the fourth step is to ask, "How well does my information satisfy my informationrequirements?" This step involves critical appraisal of the retrieved items, reviewing themaccording to the specific requirements of the investigator's search question.

Describe the early contributions of classism and why they were rejected in favor of modernism.

The period of classism allowed for a school of thought where principles of logic were applied to the natural world to develop knowledge. Logic was both inductive and deductive, and respectively knowledge was created and tested through these reasoning processes. It was thought that with rigorous methodology, inherently flawed knowledge could be translated into absolute truths. The roots of the scientific method may be seen with this focus on logical methodology. However, despite arduous deductive reasoning to test proposed hypotheses, philosophers were forced to make logical leaps and rely on creative means to first develop their postulates. This created foundational rifts within this school of thought, because the inductive process was reliant on man-made ingenuity, and therefore "absolute" truth could not be derived. From this rift came a shift toward modernism, which further employed the logical methodology of classism. However, this philosophical perspective did not seek absolute truths; rather, it focused on refinement of methods to enhance knowledge and develop theories that were considered paramount for describing phenomena (unless ultimately disproven).

What is a rationale for critically appraising a journal article according to a levels-of-evidence approach, and why would this be helpful to an OT practitioner?

There are multiple models for critically appraising research articles, thus providing researchers with a framework and standardization for design and publication. Appropriately recognizing that there is a hierarchy with how data may be collected and analyzed allows for a better (more objective) understanding of the current state of research. Furthermore, it indicates how future research may be improved. Though, of important note, not every population or research question may be addressed with meta-analysis or randomized control trial; "lower" levels of evidence do present nonetheless valid findings. The levels-of- evidence model employed by OCEBM may be complemented with reviewing articles for their quality of evidence and statistical precision.

What is an example of a quantitative research study design, and what criteria would you use for evaluating the study according to a levels-of-evidence model?

There are numerous designs for quantitative research studies, each categorized by the Oxford Center for Evidence-Based Medicine's (OCEBM's) levels of evidence, including meta-analysis (level I), randomized trial (level II), nonrandomized controlled cohort study (level III), follow-up study (level III), between-subjects design (level III), case-series study (level IV), case-control study (level IV), historically controlled study (level IV), mechanism- based reasoning (level V), and case-study research (level V). Quantitative studies may further be evaluated by the quality of the evidence and the statistical precision as executed through the individual study.

What is one negative consequence of not engaging in or supporting OT research?

There are various reasons why a practitioner might not engage in research or any of the roles associated with it. These might include a lack of training, or a personal belief that research devalues the practioner's personal experiences/expertise. While the evidence- based practice paradigm recognizes that professional expertise is critical for applying research to practice, some individuals still might be resistant to the process. A consequence of this would include other professionals being dismissive of their expertise, as it is something unsubstantiated by objective findings and not quantifiable when establishing rationale or projected outcomes of treatment.

5. How does needs assessment research differ from practice theory research? Describe two different practice situations in which each of these approaches would be appropriate, and explain why they would be appropriate.

When working within a population receiving occupational therapy services, a first step in developing an evidence-based approach is often conducting a needs assessment, wherein the desired status or goal of the population is compared with their existing status. This allows the therapist to devise a program that best meets this objective. For example, working in new practice areas, such as with morbidly obese children unable to participate with play/recess in the school setting, there is no existing theory or model of practice to guide intervention. However, using a strategic method of needs assessment, quantifiable data may be gained through the development and provision of services that validate the novel interventions and outcomes. Practice theory research allows for examination into an established mode of practice, or therapeutic approach, to further validate the theory or indicate a need for further revision. For example, through practice theory examination of the sensorimotor recovery approach for individuals post-stroke, it was determined that there were not improved outcomes for individuals who were fitted with a dorsal blocking splint for the upper extremity (despite the recommendations of the practice model). Contemporary motor control models do not employ dorsal blocking splints for this population in response to this evidence.

What is the sequence and nature of each of the steps of the research process?

While research may vary by method, design, and purpose, there is a (not necessarily linear) process by which studies typically are conducted. These steps include conducting a literature review, generating the research problems and questions, defining the research aims and hypotheses, selecting the research methods, writing the research proposal, ensuring ethical research, securing samples and performance sites, implementing research procedures and collecting data, organizing and analyzing data, interpreting results and generating findings, as well as writing and disseminating findings. The literature review is conducted to first understand the existing evidence and background knowledge in an area of interest. This allows a researcher to recognize gaps in knowledge, indicating a need for further research, which forms the basis of their research problem. However, a research problem must be refined so that it may be addressed within the design of a proposed study, and is therefore concisely phrased as a refined research question. A researcher should use the research question as the basis for determining the aims that he or she wishes to address with the study and, when appropriate, use this to phrase the research hypothesis. This will allow for appropriate decisions to be made regarding the research methods, which include determining the design, sampling, data collection, and analysis. Once these decisions have been made, they might be composed into a research proposal (which might be used for purposes of obtaining grant funding), or may be used to submit for ethical approvals. Assurances of ethical review should be obtained whenever human or animal subjects are utilized to ensure that the study does not compromise the subjects or place them at undue risk. This may be obtained through an institutional review board. At this time, the sample used for the study and any sites should be secured. The sample should be recruited, methods of retention should be in place, and the process of the study should be implemented. Data should be collected and organized in a manner that allows for analysis, which then may be interpreted in light of the research question and aims. The analysis of this data should be written into the findings of the study, which may be disseminated to further contribute to the body of evidence.

What are the fundamental components of a literature review?

While there is significant variance in purposes and methods for conducting a general literature review, there are some common fundamental components that should be included. These components are included among a suggested structure proposed byDePoy and Gitlin (2011): An introduction, which outlines the area and topic; the impact or significance of the problem to society; the nature of the problem or issue being addressed by the review; and the relevance of the review to the professional and/or scientific community that is assumed to be the audience for the paper Discussion of each specific concept, principle, or theory in the current literature on the topic Brief overview of key studies, compared in parallel rather than serially, to achieve a critical appraisal of the current research Integration of the work reviewed, identifying the relationships, inconsistencies among findings across studies, controversies, and gaps in the literature Identification of the niche in the current knowledge base that your research fills Justification/rationale for the study and its designThis general structure should build a foundation for establishing the specific aims of an investigator conducting a review.

Of all of the strategies for effective writing, which three are most important for you to keep in mind? Explain why this is the case.

Writing, while a creative process, requires skill and discipline in order for its results to be effective and clear. Typically, this requires forethought and strategies to allow for writer productivity. This chapter highlights eight strategies for becoming an effective researchwriter: setting aside and structuring time for writing; discovering and developing one's own writing style and habits; writing for a particular audience; clarifying one's focus; mind-mapping and abstracting; finding one's story; drafting, sequencing, and rewriting; andseeking and using feedback. Any and all of these strategies may be employed to promote effective writing habits, and those that are most important depend on the unique characteristics of the individual. Obviously, an important rule for all individuals is that writing takes time. Time must be set aside and dedicated for this task, and further structured to promote a productive context for the specific writer. This might include considerations for the setting (e.g., level of stimulation/distraction), time of day, and duration of writing. Furthermore, a writer must have a specific audience in mind. Different readers have different mindsets and objectives for reading research-related materials. The specifics of anauthor's writing style, aims, and objectives should be tailored to his or her specific audience to have an increased ability to communicate the core message of the report.Finally, an author should always seek out and utilize feedback. Writing within a research arena allows for many opportunities for garnering feedback, such as through peer review, professional colleagues, practitioners, and editors. These individuals can provide invaluable information regarding a research draft or manuscript, indicating if there is clarity andcohesiveness with an individual's writing style.

What is evidence-based practice, and what is its role in occupational therapy?

evidence-based practice is an approach to practice that assumes the active application of current, methodologically sound research to informpractice decisions and treatment options in light of a client's preferences, expectations, andvalues. For occupational therapy, its role includes: Development or revision of practice guidelines Development of economic analyses of different treatment approaches Evaluation of local clinical performance against published outcomes Dissemination of information to clients and other consumers about the effectiveness of a given intervention Shaping of clinicians' choices regarding the most appropriate intervention. Occupational therapists apply evidence from a broad body of literature that includes both interprofessional and profession-specific knowledge bases. With this, evidence informs practice, which raises future research questions to be examined, and the profession continuously evolves with knowledge.