Guidance
The following structure is recommended:
Section Title
Indicative Content
Indicative Word Count
Introduction
Outline the structure and content of the work. Provide some rationale for choosing your subject and justify why the topic is important to nursing practice.( 200 words)
*200
Literature search
Here you need to precisely detail your search strategy:
• Start by generating a literature search question. You should use a structure to help with this. A question will help to focus your search and make it easier to identify search terms.
• Which databases did you use and why?
• What key search terms did you use? How did you use them? How did you use Boolean Operators and truncation to improve your search? (see Assignment Guide 1 on Blackboard)
• How many results did this yield?
• How did you increase the specificity of your search using filters? You may consider tabulating some of this section. (600 words)
*600
Selection of literature
In this section:
• You need to outline how you selected the two research papers to review from those you identified in the search.
• You are required to identify one quantitative and one qualitative paper. You need to justify your choice.
• Please see Assignment Guide 1 on Blackboard. Consider enhancing this section with a diagrammatic representation of your selection procedure. (200 words)
*200
Critique
In this section you need to critique the two research papers that you have selected.
The papers should be critiqued separately and in a sequential way (please see Assignment Guide 2).
You should use an appropriate framework to guide this process.
The focus here is on your ability to critique research literature.
You should utilise a variety of views (research literature) to develop your arguments and critical writing.(800 words for qualitative and 800 words for quantitative equal to 1600 words together)
*1600
Discussion
Compare the critiqued papers.
Discuss the strengths and limitations of both research papers and their associated research paradigms (i.e. quantitative and qualitative).
Summarise your critique – what does this research tell you about your topic/research question. Where are the gaps? To what extent do they provide an answer to your literature search question?
Discuss what the findings contribute to current nursing practice in the UK. (300 words)
*300
Conclusion
Make conclusions about the assignment process as a whole. Do not introduce new material but tie all of the preceding sections together.(100 words)
*100
References
Follow the Harvard referencing style. Ensure that you include a sufficient number of references to demonstrate level 5 writing.
Appendices
Optional- if you require one
ASSIGNMENT GUIDE
WHERE DO I START?
You might have not yet decided on an area of focus; or you may have several areas of interest, but cannot decide which would be best. With regards to motivation, it is often useful to pick an area you are genuinely interested in. However, you need to choose an area for which there is sufficient research. Motivation for your chosen area can come from various sources. Think about your time on placement; was there anything that you found especially interesting?
Let’s say you’re a student mental health nurse who has had placement working with individuals who experience depression. You might be aware of the side-effects associated with anti-depressant use and wonder whether these drugs are over-prescribed. You might have read about other (less harmful) approaches to treating depression. Therefore, you could choose to examine the effectiveness of newer talking therapies, such as Acceptance and Commitment Therapy (ACT), or mindfulness in treating depression. Alternatively, you may want to examine the effects of herbal medications in alleviating symptoms of depression.
Maybe there is something you have experienced in placement that you want to know more about. If not, you could always conduct a web-search, or look at nursing organisations to see what they are talking about.
To further assist with this assignment guide, a fictitious example will be used. It will involve a herbal alternative for treating depression called FX43. This herbal medication was originally sold as a diet-pill, but failed to have any significant impact on weight loss. However, some users reported that the medication had a positive effect on their mood. As a result, there have been a series of research studies examining the effects of this medication as an anti-depressant. Whilst quantitative research studies (i.e. RCTs) have examined how effective this medication is in reducing symptoms of depression, qualitative studies have explored the experiences of taking the medication and have helped to develop theory as to how it works.
INTRODUCTION: Outline the structure and content of the work. Describe why this topic is important to nursing practice.
You may also briefly describe the structure of the assignment in your introduction. However, don’t just describe a generic structure:
E.g. ‘This assignment will start with a literature search using databases and then critique two pieces of literature in a chosen area….. It will end with a conclusion and reference list.’
Be specific to your area:
E.g. ‘Due to the challenges surrounding anti-depressant use, the current assignment will identify two pieces of research (one qualitative; one quantitative) exploring the effects of FX43 in treating depression. A systematic search will be conducted using three relevant databases (CINAHL, BND and PsycINFO). Both studies will be stringently examined using Polit and Beck’s (2010) critiquing framework. Their strengths, limitations, and contributions to theory and practice will be discussed.
A good introduction will use evidence to emphasise a problem and demonstrate rationale for the exploring the area. So, your rationale might be (again, this is fictitious):
Depression is a growing concern in the UK (Mind, 2015). Increasing numbers of individuals are being prescribed anti-depressant medication to alleviate symptoms and promote well-being (REF). A series of recent research studies have highlighted a range of negative side effects which can be particularly detrimental to patients with depression (e.g. REF; REF; REF). Whilst talking therapies are a valuable alternative to pharmacological interventions, waiting times in the UK can be high (REF). In some instances, this has been particularly detrimental to patients. FX43 is a herbal medication developed to assist with weight loss. A systematic review suggested FX43 was ineffective at controlling weight gain (REF), but tended to increase the mood of participants. This assignment will report a systematic literature search and critically examination of two pieces of research (1 quantitative and 1 qualitative) exploring the effects of FX43 as an antidepressant medication.
LITERATURE SEARCH QUESTION:
To assist with your literature search and selection, it is useful to generate a literature search or clinical question after the introduction. This question is mainly for the literature search section and will help you identify two similar articles for your critique. You could use the PIO or PICO system to help generate a question (see Polit & Beck, 2014). Whilst a PICO question is more suitable for identifying quantitative research articles, a PIO question is more basic and might be more relevant for this assignment, as it more easily accommodates both qualitative and quantitative studies. The PIO components for the hypothetical question for this assignment guide are listed below:
Population: Adults with depression
Intervention: FX43
Outcome: reduce symptoms of depression / promote well-being
Using these criteria, the following question was generated:
To what extent can FX43 reduce negative symptoms and promote well-being among clinically depressed adults?
An alternative approach would be to propose two related questions (one for quantitative and another for quantitative):
How does FX43 compare to Prozac in treating adults diagnosed with depression?
What are the experiences of experiences of individuals taking FX43?
LITERATURE SEARCH:
This section should precisely detail your literature search strategy and the process for selecting your two articles. Ideally, your search should be transparent enough to be replicated by the reader. Try to display your information in a way that shows every step of the process.
Which databases did you use? - Think about why you used these particular databases and justify your choice. We recommend at least two databases that are relevant to your chosen topic area.
What key search terms did you use? – When conducting a search, it is important to consider the most appropriate search terms for your chosen area. For the fictitious example presented above, the following search terms were generated for identifying papers surrounding depression:
‘depression’, ‘depressed’, ‘depressive illness’, ‘unipolar depression’, ‘affective disorder’.
Unlike a Google search, many database search engines only search for the exact word that you type in. Therefore, if you type in ‘depression’, it will identify articles containing the work ‘depression’. It will not identify articles which have used the term ‘depressed’, or ‘depressive’ instead of ‘depression’. This could limit your findings, because some authors may not use ‘depression’ as a term. After all, it is perfectively acceptable to use ‘depressive illness’ or ‘depressed individuals’.
So, does that mean we need to type all of these variations of depression into the search box?
Not necessarily. As we can see, there are three terms here that start with the letters ‘depress’. Therefore, we can use an asterisk symbol (e.g. *) to tell the search engine that we are looking for all terms that start with ‘depress’.
Typing ‘depress’ will identify articles that use either ‘depression’, ‘depressive’ and ‘depressed’. It is also useful to put on the end of words where the plural of the word may also be valid for the search. For example: ‘Nurse’ and ‘Nurses’ – to search for both of these, you could type in ‘Nurse’. If you also wanted to search for ‘Nursing’, you could type in ‘Nurs*’.
However, you will have noticed that there were some other terms we have not covered with depress* (i.e. ‘affective disorder’). These terms would need to be entered separately. You may consider using the ‘OR’ operator when using different terms. For example:
(depress* OR affective disorder*)
In addition, the AND and NOT operators can also be used. See Polit and Beck for further details on using these. Table 1 on the next page provides an example of how AND and OR were used in this fictitious search.
How many results did this yield?
A great way to show this is by using a table similar to the one below. It shows the number of articles for each search term for three databases. You will see that the search terms were entered progressively and the number of hits were recorder for each search. In addition, two filters were added after the final search which reduced the findings even further. You may choose to add the filters at the start of the search. You would need to specify this.
Table 1:
Quantitative and Qualitative search strategy for the three databases
Search
PSYCinfo
CINAHL
BND
Quantitative
(depress* OR affective disorder*)
36, 623
32, 345
1, 023
(depress* OR affective disorder*) AND FX23
102
89
56
(depress* OR affective disorder) AND FX23 AND effective
87
57
42
(depress* OR affective disorder) AND FX23 AND effective AND (trial OR RCT)
23
18
3
Filters: 2010-present
21
16
3
Filters: full-text
9
6
1
Qualitative
(depress* OR affective disorder*)
36, 623
32, 345
1, 023
(depress* OR affective disorder*) AND FX23
102
89
56
(depress* OR affective disorder) AND FX23 AND (qualitative OR experience)
32
23
14
Filters: 2010-present
30
21
14
Filters: full-text
8
6
4
After this fictitious search, we are left with a total of 34 studies (16 quantitative studies and 18 quantitative studies) when we combine the final search results from the three databases.
How do we choose the two studies that we want?
It is likely that your databases will have identified duplicate results, and many of these will not be appropriate. You may choose to demonstrate how you identified your articles, using a flow diagram. On the following page, there is a 7-step flow chart which show the 34 articles were reduced to one qualitative study and one quantitative study (see Figure 1).
• STEP 1 involves totalling all studies from the three databases (or however many you have used).
• STEP 2 involves the removal of duplicates (i.e. duplicate studies that were identified in more than one database).
• STEP 3 provides the total number of studies after duplicates were removed.
• STEP 4 involves the removal of studies after their titles and abstracts were examined. These studies would have likely been deemed as not quite appropriate or relevant to the area of interest.
• STEP 5 provides the total number of studies after.
• STEP 4 was conducted and less relevant papers were removed.
• STEP 6 is a major step, where the remaining papers were examined in depth. Often the hierarchy of evidence is used to assist with this step. It mainly involves reading through the remaining studies and identifying those most relevant to your assignment and chosen area.
• STEP 7 reports the two selected studies after the previous steps.
Please note that it is not essential to use a flow diagram in this assignment. If you do use one, it might be more relevant to use in the SELECTION OF LITERATURE section. However, if you do use a flow diagram, make sure it is discussed in the main-body of the assignment. The selection of literature and the critiquing components will be discussed in the Assignment Guide Part 2
STEP 1: Total Studies from all three databases: (N = 34)
Quantitative (n = 16); Qualitative (n = 18)
STEP 2: Removing duplicates: (n = 18)
STEP 3: Studies left after duplicates removed: (n = 16)
Quantitative (n = 9); Qualitative (n = 7)
STEP 4: Studies excluded after reading
abstract and title: (n = 9)
PART 2: Critiquing Research
(Please read ASSIGNMENT GUIDE PART 1 first on the NURS2001 Blackboard shell)
Research evidence is typically communicated via research reports, which describe what was studied, how it was studied and what was found (Polit & Beck, 2014). However, research is not always scientifically sound, even though it has been published. Therefore, it is important that Nurses can critically assess a research paper.
The next part of this assignment involves critiquing your two articles and critically discussing this process. A critique generally examines the strengths and weaknesses of the research and its contribution to theory and practice. Various critiquing tools are available to help with this process (e.g. Polit & Beck, 2010; 2014; Holland & Rees, 2010; or a CASP framework suited to the type of evidence you have used).
There is no one-right-way of doing this; some students structure their critique section around the different sections of the reports (i.e. ‘Introduction/Literature-review’, ‘Methods’, ‘Results’ and ‘Discussion’) whilst others may structure it around the categories suggested by Polit and Beck (2010): ‘Substantive’, ‘Theoretical’, ‘Methodological’, ‘Interpretive’, ‘Ethical’ and ‘Stylistic’. You should also consider discussing more general quality indicators arising from your critique (e.g. bias, validity and reliability for quantitative studies and Trustworthiness for qualitative studies).
Before you attempt to do this, please look at the NURS2001 Blackboard site under the assignment tab, for the two articles about critical writing. Critiquing research and writing about the process requires skills in critical analysis and critical writing, so these guides should be able to help in these areas. Both articles are taken from nursing journals and show how critical analysis and writing are relevant to nursing studies.
It is advisable to critique both of your studies in draft, before writing this part of the assignment. This section should be about 1600 words (approx. 800 per study). It is recommended that you write about both of the studies separately in this section.
You may wish to structure this part of the assignment around the key sections of the research reports. For example: ‘introductory sections’ (i.e. title, abstract, introduction/literature review); ‘methods sections’ (i.e. sample, design, procedures, theoretical background etc.); ‘results’ (statistical analysis or themes), and ‘Discussion’.
For each section, it is useful to provide a short DESCRIPTION (keep this succinct and focused). Then ANALYSE what this actually means, or what can be interpreted. Then discuss your CRITIQUE by looking at positive factors as well as limitations/gaps and drawbacks.
Remember, do not just describe the studies – you need to show evidence of having critiqued them and writing about them in a critical way (this is what will get you high marks).
Some preliminary areas you may wish to briefly critically discuss:
Who wrote the research papers? Was it a single author or collaboration (more than one author)? Were they experts in the area? To what extent might these things impact the study?
What type of journals do the articles appear in? What is the impact factor? Why does this matter? Who were they aimed at? Were they peer-reviewed? Was the research sponsored (paid for) by a third party? – could this lead to ethical implications?
Latterly, you may wish to consider ethics, bias, lack of diversity considerations, problems applying to nursing practice, etc. Below are some areas of the critique you may wish to discuss.
Whist each critiquing tool is a little different, here are some examples of the things you might choose to critically discuss:
Introductory sections – Are the title and abstract clear, informative and accessible? – What are the implications for this? Does the introduction clearly describe and discuss the phenomena, concepts or variables to be examined? Des the literature they review help to justify and provide rationale for their study? Do they show the clinical importance, public awareness or theoretical implications behind the research? Are the aims clearly stated? Do they lead to one or more hypotheses or research questions?
Method – This part of a research paper usually consists of a variety of subsections which can include: Participants, Design (quantitative) or Methodological Background (qualitative), Materials, Procedure and Analysis. This is an important section and will require some reading about research methodology. You may also refer back to the lecture slides surrounding methods, methodology and research design. Methods sections usually begin with a description of the sample of participants used. You may want to focus on whether the population and sample was clearly described, and whether the sampling strategy was effective. Was the sample size adequate? – What are the implications for this? is there any sampling bias? Depending on your study, the authors may make use of inclusion and exclusion criteria, and then may also include discussion on attrition (people may leave or die before results can be obtained). The following snippet provides two examples of what this may look like using two fictitious studies. These are a quantitative experimental study by Griffin el al. (2010) and a qualitative thematic study by Knifton et al. (2015):
Method
Griffin et al.’s (2015) participants were a convenience sample of 36 adults diagnosed with depression. In their discussion, they acknowledged the limitation of using such a small sample size. Polit and Beck (2014) argue that small samples in experimental studies can lead researchers to erroneously reject, or support their hypotheses. This could have a serious impact on the reliability of the findings, and is potentially a substantial limitation of this research. However, Griffin et al. reported large effect sizes (i.e. Cohen’s D > .7) and significance values of <.001. Barksby (2016) suggests that such parameters may better indicate an effect on a smaller sample than lower effect sizes and statistical significance. Whilst the evidence here should not be dismissed, it should be treated with caution. It would be of particular value for additional studies, but not for drawing conclusions about the phenomena.
Knifton et al.’s (2015) sample (N= 12) was considered appropriate for thematic analysis (Braun & Clarke, 2006). However, the critiquing process revealed concerns about the sample characteristics. It consisted of largely female participants (n= 11) and just one male. This raises questions as to whether the themes are more reflective of female experiences of depression than those of males. Indeed, research (e.g. REF, REF) has suggested that females may experience depression differently to…….
You will need to show some understanding of the methods and offer critique (remember again that critique can be both positive as well as negative). What research design or methodology was used? Was it an RCT / experimental design? Quasi-experiment? Correlational design? Survey? Longitudinal study? (quants) Or was it a thematic analysis, IPA study, grounded theory? Framework analysis? (quals). What are the strengths and limitations of the approach used (use additional literature to read about the type of approach that was used?) Was it the most rigorous approach considering the research aims? What data collection tools were used? If it is a questionnaire, was it developed by the research team? Or was it developed elsewhere? Is it valid and reliable? What variables were measured? (quants). If it was an experiment what were the IV(s) and DV(s)? Critically discuss these areas.
Was the procedure clearly described? Was it appropriate? Was data collected in a manner that minimised bias?
What about ethics? – Are these discussed? Look at the slides from the session you have had on research ethics.
Analysis and Results – How do the studies describe, analyse and present their results? This may include you critically discussing the type of statistical tests used, the data characteristics and distributions (quants), or the categories / themes, theories or models generated from the data (quals). For your quantitative paper, consider what level of data were analysed? (i.e. nominal, ordinal, interval, ratio) – If it were an experiment/quasi-experiment, what level were the DVs? – Was the statistical test appropriate? Do you think there was any measurement bias? If it was more of a survey, how were the results presented? (i.e. graphs, pie charts, tables, box-plots etc). Look at the lecture slides on qualitative and quantitative research. These should help you pick out things to look at.
If your quantitative paper uses inferential statistics (i.e. tests of difference, multivariate analysis, correlation or regression), you should discuss the numerical components, including effect sizes, p-values, (were the findings statistically significant?) and the statistical tests used.
Were the researchers comparing scores from two groups? If so, they may have used chi-square (x2) for ordinal level variables (e.g. stages of cancer), or an independent-samples t-test (t) for interval/ratio level data (e.g. weight). If they were comparing scores for more than two groups, they may have used ANOVA (F) for interval/ratio level data, or Kruskal Wallis for ordinal data. Some studies may look for differences in a groups before and after an intervention and use a paired-samples t-test or a mixed ANOVA. MANOVA (F) is more complicated and is for comparing scores on two or more dependent variables between two or more groups.
Some researchers may be interested in looking for relationships between variables (i.e. blood-pressure and weight). They may use Pearson’s correlation (r) for interval/ratio data, or Spearman’s correlation (rs) for ordinal data. Regression (R), is sometimes used to examine whether changes in one or more variables (i.e. smoking frequency and BMI) can predict changes in another variable (i.e. fitness). Analyse and critique not only what was done, but the ways in which the studies communicated this to the reader. The following snippet reflects a section of the critique discussing the analysis of two fictitious papers:
“Using a thematic approach, Knifton et al. (2015) examined the experiences of taking FX43 to treat depression. They conducted semi-structured interviews with adults diagnosed with affective disorder (N = 12). Braun and Clarke (2006) emphasise the importance of rigour and transparency when conducting thematic analysis and suggest six sequential steps involved in generating themes. However, Knifton et al (2015) do not provide much detail as to how their themes were derived, which brings into question how rigorous the analysis was.”
“Griffin et al.’s (2010) experimental study offered only vague details about the data analysis. Whilst they reported a significant reduction in depression using ANOVA, they did not discuss the size of the effect. Whilst this lack of detail may reflect word limitations of the journal, it raises questions surrounding the methodological rigour and trustworthiness of the findings. Field (2010) argues that effect sizes are important to understand the………”
Discussion and Conclusion Sections – You may wish to critique the discussion and conclusion sections of the papers. These sections are meant to interpret the results and to put them in context for the reader. How the two papers have done this? Do they refer back to the research question(s) or hypotheses? Do they relate their research to practice, theory and to the ‘bigger picture’? It should also indicate the authors thoughts – do they discuss the limitations of their study? Again, refer back to the lecture on ethics to help you critique this. Discussions should never contain new data/findings. If it does, critique this. Consider why this has been done.
Your Discussion Section (300 words):
Summarise your critique, and discuss the papers together - Compare them. Discuss the strengths and limitations of each and their associated research paradigms (i.e. quantitative and qualitative). Is one approach more suitable for your research area? – Or maybe both approaches are needed to develop understanding in the area. To what extent do the papers provide an answer to your literature search question? Discuss what the findings contribute to current nursing practice in the UK.
Conclusion (100 words)
Make conclusions about the assignment process as a whole, including the need to search for and critique evidence and the application of this to practice.
Sample Solution