A Review of Qualitative and Quantitative Studies

Introduction

The concept of evidence-based practice has triggered many propositions from scholars on its importance and why all nurses must have evidence-based skills. For instance, Pryce-Miller (2011) claim that nurses must put the evidence-based practice at the core of their professional development. Similarly, Huser & Oman (2011) argue the development of evidence-based skills among pre-registered nurses is a challenge for nurse educators. The current essay seeks to add on to this discourse by evaluating evidence on the value of evidence-based practise among nurses. Therefore, the main question that the author seeks to answer by the end of the essay is whether there is value in developing evidence-based practice skills among nurses. To answer this question, the researcher will review two peer-reviewed studies (i.e. one qualitative and one quantitative study). The first paper is a qualitative study by Roberts & Ousey (2010) published in the Nurse Education in Practice journal and seeks to evaluate the ability of UK pre-registered nurses’ ability to find and use evidence in nursing academic assignments. The second paper is a quantitative study by Kim et al. (2018) published in the journal of Nursing Education and seeks to evaluate the Korean students’ ability to acquire evidence-based practice and critical thinking skills.

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Roberts & Ousey (2010)

Focus

The main topic of concern for this study is the ability of nursing students to find and use clinical research evidence in practice. Finding and using clinical research evidence is an important topic because it builds the foundation for evidence-based practice and provides measurement criteria for the nurses’ ability to deliver quality care based on underlying practice evidence (Barker, 2009). Therefore, Roberts & Ousey’s (2010) study is important in evaluating student’s nurses’ skills ability to search, find and apply research evidence in nursing practice. This study will enable identification of how pre-registered nurses develop their evidence-based practice skills through academic assignments in nursing schools, and how important those skills are in enhancing the quality of care.

Background

The author justifies the topic by arguing that pre-registered nurses in the UK must acquire evidence-based practice skills to qualify for registration as practising nurses by the UK’s Nursing and Midwifery Council (Longley et al, 2007). Furthermore, as Longley et al (2007) argues, the elevation of nursing practice academic entry-level to University degree means that all nurses are required to have a minimum level of knowledge in core practice elements such as evidence-based practice before they are qualified to practice. Additionally, the authors draw from studies by Thorne (2006) to make an argument that the increasing need for nurses to qualify with doctoral and master degrees implies that most nurses will have to develop evidence-based practice skills to help with their degree thesis as well as for use in actual practice. These arguments form a strong background and thesis for the study.

Aim

The aim of the study by Roberts & Ousey (2010) is to explore the experiences of pre-registered student nurses to search and use research evidence, and their perception of the value of evidence-based practice skills to their future career as nurses.

Methodology

The researchers adopt a broad qualitative research methodology to achieve their research objective. In doing so, the researchers relied on an exploratory pilot design, whereby students in their final year of study were allowed to participate in a questionnaire seeking their opinion on experiences and how they thing evidence-based practice skills will be beneficial to their future careers as qualified nurses. This research design is considered appropriate for the research aim because exploratory research design provides a better understanding of the phenomenon under investigation (Given, 2008). However, because exploratory qualitative research design does not provide conclusive solutions to the problem under investigation, the researcher must be ready to change their direction of research in case new information emerges (Gisselle & Lotte, 2018). This, perhaps, justifies why Roberts & Ousey (2010) termed their study as a ‘pilot study.’

Data Collection Tools

Roberts & Ousey (2010) used questionnaires as their method of data collection. While the literature search did not identify a similar study that used questionnaires as a method of data collection, evidence by Keegan (2009) argues that questionnaires are a good tool for collecting data on perceptions and attitudes because they allow the participants to express themselves in their own words. Therefore, while Roberts & Ousey (2010) do not give clear details on the circumstances and environment under which the questionnaires were filled (i.e. which could have been useful in judging the credibility of data collection process), the selection of questionnaires as the tool for data collection was appropriate.

Data Analysis and Presentation

The researchers use observed description to analyse and present the data. Besides, there is a graphical representation of specific data such as participant demographics and open-ended questions. Leavy (2014) argues that analysing descriptive data by reviewing what was recorded and synthesizing the data with the words and observations of the participants present a good way of analysing qualitative data by enhancing the researcher’s ability to develop insights into the respondent’s perceptions about the phenomenon under investigation. Therefore, the observed description approach of data analysis was appropriate and effective in allowing Roberts & Ousey (2010) to explore the participants’ ability to identify and use research evidence as well as their perspective on the value of evidence-based practice skills.

Study Sample

Roberts & Ousey (2010) selected a sample of 110 students for two nursing schools in the UK. The selection was based on the inclusion criteria that all participants had to be in their final year of study. However, the researchers did not mention any exclusion criteria; neither did they mention any specific sampling strategy applied in the sample selection. Ideally, according to Maxwell (2013), failure to mention important aspects of sampling such as the sampling strategy and exclusion criteria affects the generalizability of the study because readers may not know which population the study findings apply to. Furthermore, the researchers fail to make comments on or give details to enable the identification of sampling bias, a phenomenon that affects the credibility and validity of the study findings (Maxwell, 2013).

Ethical Considerations

Leavy (2014) argues that ethical considerations are an important element in ascertaining the credibility of qualitative and quantitative studies. Thus, researchers are bound to make specific ethical consideration based on the nature of their study. In Roberts & Ousey (2010), the researchers sought ethical approval from each of the university’s ethical committee to allow them to conduct the study in those respective universities. Furthermore, each participant in the study by Roberts & Ousey (2010) was guaranteed anonymity, a phenomenon that was useful in enhancing their individual confidentiality.

Focus

The main topic of concern in Kim et al. (2018) is the nursing students’ knowledge, skills and attitudes towards evidence-based practise (EBP), and critical thinking abilities. Therefore, the study sets out to investigate Korean nursing students’ ability to acquire evidence-based practise skills and critical thinking skills for their future practice. There are several measurable variables in the study by Kim et al. (2018). For instance, the students’ EBP skills can be measured through an EBP questionnaire while the students’ critical thinking abilities can be measured through a critical thinking disposition (CTD) questionnaire. Ideally, the topic of focus is important because the ability of nurses to deliver care depends on their ability to apply their EBP and critical thinking skills. Therefore, by identifying and measuring the participants’ EBP and critical thinking skills, the researchers were able to gauge the participants’ ability to deliver quality care.

Background

Kim et al (2018) justify their study by claiming that whereas evidence-based practice is a well-known concept among healthcare providers and most of them systematically apply it in solving patients’ problems based on existing information, there is a tendency of nurses to overly rely on their own experience rather than on sound scientific evidence when faced with various problem solving and decision-making situations. Thus, Kim et al. (2018) claim that it is important to explore the nurses’ acquisition of evidence-based practice and critical thinking skills for use in such situations. More importantly, the researchers have provided a clear definition of EBP practice and critical thinking, drawing from other pieces of literature such as Brown et al. (2013) and Sackett et al. (2000).

Research Aim and Broad Approach

The main aim of Kim et al. (2018) is to explore nursing students’ knowledge, attitude, and practices of EBP and critical thinking. The researchers intended to achieve this aim by applying the questionnaire approach of quantitative study. Best & Khan (2016) argue that questionnaires provide an effective framework for measuring participants’ knowledge and attitude towards a particular phenomenon because the questionnaires can be designed into scales for measuring various levels of knowledge and different types of attitudes. Therefore, by using the questionnaire approach, the researchers were able to develop EBP and CTD scales for achieving their objectives.

Tools of Data Collection

The questionnaire method of measuring EBP has successfully been used in several earlier studies including Upton and Upton (2006). This hints to the validity of the findings, especially considering that Kim et al. (2018) sought permission from Upton and Upton (2006) to use their tool. With regards to CTD, the researchers used the CTD criteria created and used by Yoon (2004). This implies that the researchers measured the participants’ critical thinking abilities with a tested tool, thus contributing to validity of the outcomes. The use of pre-existing tools in the measurement of CTD and EBP proved convenient, cheap and time saving for the researchers because otherwise they would have been forced to develop their own tools.

Method of Data Analysis

Kim et al. (2018) have clearly illustrated that they used SPSS version 21.0 to analyse the participants’ EBP questionnaire scores, while the CTD scores were statistically analysed through t-tests, Kruskal-Wallis test and t-test. Furthermore, the researchers have clearly presented the results in the Results section, beginning with the participants’ knowledge, level of practice and attitudes regarding EBP, then the students’ mean CTD scores and finally a tabulated correlation between EBP and CTD scores. This presents a clear analysis and explanation of methods used measurement outcomes.

Sample

The study included 266 participants conveniently selected. At first, 300 people received the selection questionnaire, but only 288 returned their questionnaires. Form the 288, 14 were eliminated due to questionnaire response errors, leaving 288 participants to proceed with the study. To determine the most appropriate sample size for the statistical analysis, the researchers used the G*power tool, leading to a selection of 266 participants who satisfied the data analysis tool (i.e. ANOVA).

Ethical Considerations

There is a clear indication by the researchers that before they began the study, they sought ethical approval by submitting the research proposal to an ethics committee. Furthermore, the researchers sought informed consent from each participant before engaging them in the study. As part of the informed consent, the researchers were notified that their participation in the study would not affect their grades and that all their responses council be kept confidential.

Main Findings

The researchers successfully measured the respondents’ EBP and CTD and found the total scores to be 0.64 and 3.56, respectively. Male students of age 23 years or above, satisfied with their major, demonstrated a higher level of CTD and EBPQ scores. These findings answer the main research question, which is how Korean nursing students acquire their evidence-based practice and critical thinking skills. As an answer to the research question, the study has revealed that the main driver for the acquisition of EBP and critical thinking skills is satisfaction with the course major.

Conclusion and Recommendations

Ultimately, the study concluded that considering the importance of EBP and critical thinking skills in delivering quality care, nursing educators should develop comprehensive teaching strategies that aimed at helping pre-registered nurses to develop their EBP and critical skills in undergraduate programs.

Overall Strengths and Limitations

While there are no strengths explicitly mentioned by the researchers, a major limitation of the study is its limited generalizability because only the nursing student in their last year of study was eligible to participate. This affects the application of the study results to the general student population because the data was not evenly represented across the student level of education.

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Conclusion

While the study by Roberts & Ousey (2010) was directly useful in evaluating the value of evidence-based practice skills among nurses, data by Kim et al. (2018) was not directly useful in achieving the original research question, and therefore the researcher evaluated the study findings and evidence presented within the study to deduce the importance of evidence-based practice skills. When Roberts & Ousey (2010) asked the respondents how useful they think evidence-based practice skills would be to their future careers, it was clear from the respondents that a majority of the respondents were unclear about the potential usefulness of EBP skills in their future careers. In fact, 25% of the respondents mentioned that the skills would only be useful when they took post-graduate studies. However, when asked whether the EBP skills were useful in developing their critical thinking, a majority of the students answered to the affirmative, meaning that there was a positive correlation between EBP skills and critical thinking.

Whereas the study by Kim et al. (2018) did not directly focus on the value of evidence-based practise skills, its results are supportive of the results by Roberts & Ousey (2010) that EBP practice skills have a positive correlation with the critical thinking skills. In fact, Kim et al. (2018) fund a significant correlation between EBPQ and critical thinking abilities among the participants. Therefore, to answer the underlying question of the current essay, it is possible to conclude that evidence-based practice skills have the value of enhancing nurses’ critical thinking disposition. This implies that nurses who develop effective evidence-based practice skills are also capable of developing critical thinking in their practice, thereby enhancing positive patient outcome.

References

APAN, S. D., QUARTAROLI, M. T., & RIEMER, F. J. (2012). Qualitative research: an introduction to methods and designs. San Francisco, Jossey-Bass.

BEST, J. W., & KAHN, J. V. (2016). Research in education. Pearson Education India.

BRYMAN, A., & BELL, E. (2015). Business research methods. Oxford University Press, USA.

BARKER, J. H. (2009). Evidence-Based Practice for Nurses. London, Sage Publications.

GIVEN, L. M. (2008). The Sage encyclopedia of qualitative research methods. Los Angeles, Calif, Sage Publications.

GISSELLE GALLEGO and LOTTE STIG NØRGAARD (2018) ‘Qualitative Methods in Pharmacy Research’, Pharmacy, Vol 6, Iss 3, p 79 (2018), (3), p. 79.

HOUSER, J., & OMAN, K. S. (2011). Evidence based practice an implementation guide for healthcare organizations. Sudbury, Mass, Jones & Bartlett

KEEGAN, S. (2009). Qualitative research: good decision making through understanding people, cultures and markets. London, Kogan Page.

LEAVY, P. (2014). The Oxford handbook of qualitative research. Ebooks.

LONGLEY, M., SHAW, C., DOLAN, G., (2007). Nursing: Towards 2015 alternative scenarios for healthcare. Available at. In: Nursing and Nurse Education in the UK in 2015.

MAXWELL, J. A. (2013). Qualitative research design: an interactive approach. Thousand Oaks, SAGE Publications.

PRYCE-MILLER M. (2011) Developing evidence-based practice among Nurses. Nursing times · December 2011.

ROBERTS D. & OUSEY K. (2011). Finding and using evidence in academic assignments: The

bane of student life, Nurse Education in Practice 11 (2011) 333e3.

KIM ET AL (2018) Korean Nursing Students Acquisition of evidence-based practice and critical thinking skills. Journal of Nursing Education • Vol. 57, No. 1, 20.

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