The University of Texas at Arlington School of Nursing



COMPLETE SYLLABUS

Assignment for First Class: Read Burns & Grove (2009) Textbook Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence

Chapters 1, 2, 3, and 5

Review Study Guide Exercises

Bring Syllabus to Class

THE UNIVERSITY OF TEXAS

AT ARLINGTON

SCHOOL OF NURSING

N5301 Section 001

Research in Nursing

Summer 2009

Classroom #: 227

The University of Texas at Arlington School of Nursing

Graduate Program

N5301 Section 001 Research in Nursing (3.0)

Summer 2009

Wednesday 1:00 pm to 6:00 pm

Pickard Hall, Room #227

|INSTRUCTOR: |Susan K. Grove, PhD, RN, ANP-BC, GNP-BC |

| |Professor |

| |Office: Pickard Hall - 610 |

| |Office Hours: By appointment |

| |Office Phone: (817) 272-2776 |

| |Office Fax: (817) 272-5006 |

| |Campus Mailbox: 19407 |

| |E-mail: grove@uta.edu |

|COURSE WEB SITE OR WORLD WIDE WEB SITE: | |

|COURSE PREREQUISITES: |N5327 Nursing Theory Prerequisite or concurrent & Elementary Statistics prerequisite |

|REQUIRED TEXTBOOKS & MATERIALS: |Burns, N., & Grove, S. K. (2009). The practice of nursing research: Appraisal, synthesis, |

| |and generation of evidence, 6th ed. Philadelphia: Saunders. ISBN: 978-1-4160-5468-9 |

| | |

| |Grove, S. K. (2007). Statistics for health care research: A practical workbook. |

| |Philadelphia: Saunders. ISBN: 9781416002260 |

| | |

| |American Psychological Association. (2001) Publication manual of the American Psychological|

| |Association, 5th ed. Washington, DC: Author. ISBN: 1557987912 |

|RECOMMENDED MATERIALS: |Burns, N., & Grove, S. K. (2009). Study guide for: Practice of nursing research, 6th ed. |

| |Philadelphia: Saunders. ISBN: 978-1-4160-6108-3 |

| | |

| |Salkind, N. J. (2004). Statistics for people who think they hate statistics, 2nd ed. |

| |Thousand Oaks: Sage. ISBN: 076192776X |

|COURSE DESCRIPTION: |Exploration of the research process and critical examination of published studies with |

| |emphasis on research critical appraisal, interpretation of statistical results, and |

| |evidence-based practice. |

|STUDENT LEARNING OUTCOMES: |Link theory, research, and practice (MSN Program Outcomes 2 & 3). |

| |Critically evaluate research (MSN Program Outcome 3). |

| |Interpret statistical results (MSN Program Outcome 2). |

| |Plan use of research knowledge to facilitate an evidenced-based practice for nursing (MSN |

| |Program Outcome 2). |

|ATTENDANCE AND |Regular class attendance and participation is expected of all students. |

|DROP POLICY: |Students are responsible for all missed course information. |

| |Graduate students who wish to change a schedule by either dropping or adding a course must |

| |first consult with their Graduate Advisor. Regulations pertaining to adding or dropping |

| |courses are described below. Adds and drops may be made through late registration either on |

| |the Web at MyMav or in person through the student’s academic department. Drops may occur |

| |until a point in time two-thirds of the way through the semester, session, or term. The last|

| |day to drop a course is listed in the Academic Calendar available at |

| |. |

| |A student may not add a course after the end of late registration. |

| |A student dropping a graduate course after the Census Date but on or before the end of the |

| |10th week of class may with the agreement of the instructor, receive a grade of W but only |

| |if passing the course with a C or better average. A grade of W will not be given if the |

| |student does not have at least a C average. In such instances, the student will receive a |

| |grade of F if he or she withdraws from the class. Students dropping a course must: (1) |

| |complete a Course Drop Form (available online |

| | or MSN office rooms 605 or 606); (2)|

| |obtain faculty signature and current course grade; and (3) submit the form to MSN office |

| |rooms 605 or 606. |

| |A student desiring to drop all courses in which he or she is enrolled is reminded that such |

| |action constitutes withdrawal (resignation) from the University. The student must indicate |

| |intention to withdraw and drop all courses by filing a resignation form in the Office of the|

| |Registrar or by: (1) Completing a resignation form (available online |

| | or MSN office rooms 605 or 606; (2) |

| |obtaining faculty signature for each course enrolled and current course grade; (3) Filing |

| |the resignation form in the School of Nursing office room 606 or 606; and (4) Filing the |

| |resignation form in the Office of the Registrar in Davis Hall room 333. |

| |In most cases, a student may not drop a graduate course or withdraw (resign) from the |

| |University after the 10th week of class. Under extreme circumstances, the Dean of Graduate |

| |Studies may consider a petition to withdraw (resign) from the University after the 10th week|

| |of class, but in no case may a graduate student selectively drop a course after the 10th |

| |week and remain enrolled in any other course. Students should use the special Petition to |

| |Withdraw for this purpose. See the section titled Withdrawal (Resignation) From the |

| |University for additional information concerning withdrawal. |

| |Last Date Drop or Withdraw: - July 16, 2009 |

|TENTATIVE LECTURE/TOPIC SCHEDULE (COURSE CONTENT): |Knowledge development in nursing |

| |Nursing research |

| |Link of research, theory, and practice |

| |Nursing research process |

| |Quantitative research process: Problem, purpose, literature review, framework, objectives, |

| |questions or hypotheses, design, sample, measurement method, data collection, data analysis,|

| |results, findings, limitations, conclusions, generalizations, implications for practice, |

| |future research |

| |Critical appraisal of nursing research: Comprehension, comparison, analysis, and evaluation |

| |Qualitative research |

| |Introduction to outcomes research |

| |Theoretical basis for using research evidence in practice |

| |Evidence-based interventions and guidelines |

| |Evidence-based nursing practice and health care |

| |Measurement theory and methods |

| |Statistical concepts and Data analysis techniques |

| |Interpretation of research results in published studies |

|SPECIFIC COURSE REQUIREMENTS: |Research Critical Appraisals: Each student will complete two critical appraisals on an |

| |assigned study. The first critical appraisal is at the comprehension level that includes |

| |identification of the steps of the research process. The second critical appraisal includes |

| |analysis of the strengths and weaknesses of the study, and evaluation of the study’s quality|

| |and usefulness for practice. Guidelines for developing and grading each of these critical |

| |appraisals are later in the syllabus. |

| | |

| |Statistical Exercises |

| |Students will complete assigned Statistical Exercises. You will be turning in only the |

| |“Questions to be Graded” from the statistical exercises. The exercises will be reviewed in |

| |class on the day they are due and no exercises will be accepted after the due date. |

| | |

| |Evidence-Based Practice Assignment |

| |Students will describe a patient care problem or issue and select an evidenced-based |

| |protocol, algorithm, or procedure that might be used to change practice. The issue can apply|

| |to your current practice or might be used in the advanced role you will be assuming on |

| |graduation, such as administrator, educator, or nurse practitioner. Guidelines for this |

| |assignment are later in this syllabus. |

| | |

| |Statistics Final Exam |

| |Multiple choice questions and short answer essay exam will cover all assigned statistical |

| |exercises, graded and ungraded. Students will be allowed to use a hand calculator during |

| |this exam but no cell phones or any other electronic device. |

|TEACHING |Lecture, discussion, WebCT, current textbooks and articles, research critical appraisals, |

|METHODS/STRATEGIES |evidence-based practice project, evidence-based websites, student presentations, statistical|

| |exercises, statistical exam, Internet activities, e-mail communication, and student |

| |conferences. |

| | |

|GRADE CALCULATION |Critical Appraisal # 1 20% |

|(COURSE EVALUATION & |Critical Appraisal # 2 20% |

|FINAL GRADING): |Evidenced-Based Practice Paper 20% |

| |Evidence-Based Practice Presentation 10% |

| |Statistical Exercises 15% |

| |Statistics Exam 15% |

| | |

| |TOTAL 100% |

| | |

| |The instructor will impose penalties for late work. Five (5) percent will be deducted from |

| |the final grade of the assignment for each day the work is late. Work is considered “late” |

| |if it is received after the scheduled due date and time. All papers are due at the start of |

| |class on the due date. |

| | |

| |GRADING SCALE FOR COURSE: |

| |A = 92 – 100 |

| |B = 83 – 91 |

| |C = 74 – 82 |

| |D = 68 – 73 |

|STATUS OF RN LICENSURE: |All graduate nursing students must have an unencumbered license as designated by the Board |

| |of Nurse Examiners (BNE) to participate in graduate clinical nursing courses. It is also |

| |imperative that any student whose license becomes encumbered by the BNE must immediately |

| |notify the Interim Associate Dean for the MSN Program, Dr. Mary Schira. The complete policy|

| |about encumbered licenses is available online at: |

| | |

|CONFIDENTIALITY AGREEMENT: |You signed a Confidentiality Form in orientation and were provided a copy of the form. |

| |Please take your copy of this Confidentiality Form with you to your clinical sites. Please |

| |do not sign other agency confidentiality forms. Contact your faculty if the agency requires|

| |you to sign their confidentiality form. |

|GRADUATE STUDENT HANDBOOK: |Students are responsible for knowing and complying with all policies and information |

| |contained in the Graduate Student handbook online at:

|AMERICANS WITH |The University of Texas at Arlington is on record as being committed to both the spirit and |

|DISABILITIES ACT: |letter of federal equal opportunity legislation; reference Public Law 92-112 - The |

| |Rehabilitation Act of 1973 as amended. With the passage of federal legislation entitled |

| |Americans with Disabilities Act (ADA), pursuant to section 504 of the Rehabilitation Act, |

| |there is renewed focus on providing this population with the same opportunities enjoyed by |

| |all citizens. |

| | |

| |As a faculty member, I am required by law to provide "reasonable accommodations" to students|

| |with disabilities, so as not to discriminate on the basis of that disability. Student |

| |responsibility primarily rests with informing faculty of their need for accommodation and in|

| |providing authorized documentation through designated administrative channels.  Information |

| |regarding specific diagnostic criteria and policies for obtaining academic accommodations |

| |can be found at uta.edu/disability.   Also, you may visit the Office for Students with |

| |Disabilities in room 102 of University Hall or call them at (817) 272-3364. |

|STUDENT SUPPORT SERVICES |The University of Texas at Arlington supports a variety of student success programs to help |

| |you connect with the University and achieve academic success. These programs include |

| |learning assistance, developmental education, advising and mentoring, admission and |

| |transition, and federally funded programs. Students requiring assistance academically, |

| |personally, or socially should contact the Office of Student Success Programs at |

| |817-272-6107 for more information and appropriate referrals. |

|STUDENT CODE OF ETHICS: |The University of Texas at Arlington School of Nursing supports the Student Code of Ethics |

| |Policy. Students are responsible for knowing and complying with the Code. The Code can be |

| |found in the student Handbook online: . |

|ACADEMIC INTEGRITY: |It is the philosophy of The University of Texas at Arlington that academic dishonesty is a |

| |completely unacceptable mode of conduct and will not be tolerated in any form. All persons |

| |involved in academic dishonesty will be disciplined in accordance with University |

| |regulations and procedures. Discipline may include suspension or expulsion from the |

| |University. |

| | |

| |"Scholastic dishonesty includes but is not limited to cheating, plagiarism, collusion, the |

| |submission for credit of any work or materials that are attributable in whole or in part to |

| |another person, taking an examination for another person, any act designed to give unfair |

| |advantage to a student or the attempt to commit such acts." (Regents’ Rules and Regulations,|

| |Series 50101, Section 2.2) |

|PLAGIARISM: |Copying another student’s paper or any portion of it is |

| |plagiarism. Additionally, copying a portion of |

| |published material (e.g., books or journals) without |

| |adequately documenting the source is plagiarism. If |

| |five or more words in sequence are taken from a source, |

| |those words must be placed in quotes and the source |

| |referenced with author’s name, date of publication, and |

| |page number of publication. If the author’s ideas are |

| |rephrased, by transposing words or expressing the same |

| |idea using different words, the idea must be attributed |

| |to the author by proper referencing, giving the author’s |

| |name and date of publication. If a single author’s ideas |

| |are discussed in more than one paragraph, the author |

| |must be referenced at the end of each paragraph. |

| |Authors whose words or ideas have been used in the |

| |preparation of a paper must be listed in the references |

| |cited at the end of the paper. Students are encouraged to review the plagiarism module from |

| |the UT Arlington Central Library via |

|BOMB THREATS: |If anyone is tempted to call in a bomb threat, be aware that UTA will attempt to trace the |

| |phone call and prosecute all responsible parties. Every effort will be made to avoid |

| |cancellation of presentations/tests caused by bomb threats. Unannounced alternate sites |

| |will be available for these classes. Your instructor will make you aware of alternate class |

| |sites in the event that your classroom is not available. |

|E-CULTURE POLICY: |The University of Texas at Arlington has adopted the University email address as an official|

| |means of communication with students. Through the use of email, UT-Arlington is able to |

| |provide students with relevant and timely information, designed to facilitate student |

| |success. In particular, important information concerning department requirements, |

| |registration, financial aid and scholarships, payment of bills, and graduation may be sent |

| |to students through email. All students are assigned an email account and information about |

| |activating and using it is available at uta.edu/email. Students are responsible for |

| |checking their email regularly. |

|NO GIFT POLICY: |In accordance with Regent Rules and Regulations and the UTA Standards of Conduct, the School|

| |of Nursing has a “no gift” policy. A donation to the UTA School of Nursing Scholarship Funds|

| |would be appropriate ways to recognize a faculty member’s contribution to your learning. For|

| |information regarding Scholarship Funds, please contact the Dean’s office. |

| | |

|GRADUATE COURSE SUPPORT STAFF: |Sheri Decker, Assistant Graduate MSN Advisor |

| |Office: 604 Pickard Hall |

| |Phone: (817) 272-2776 Ext. 24794 |

| |E-mail: s.decker@uta.edu |

| | |

| |Rose Olivier, Administrative Assistant |

| |Office: 605 Pickard Hall |

| |Phone: (817) 272-2776 Ext. 24796 |

| |E-mail: olivier@uta.edu |

| | |

| |Brittany Bazile, Sr. Secretary |

| |Office: 624 Pickard Hall |

| |Phone: (817) 272-2043, Ext. 24798 |

| |E-mail: Bazile@uta.edu |

| | |

| | |

|LIBRARY INFORMATION: |Helen Hough, Nursing Librarian |

| |Phone: (817) 272-7429 |

| |E-mail: hough@uta.edu |

| |Research Information on Nursing: |

| | |

|MISCELLANEOUS INFORMATION: |Inclement Weather (School Closing) Inquiries: |

| |Metro: (972) 601-2049 |

| |Fax Number UTA School of Nursing: (817) 272-5006 |

| |Attn: Graduate MSN Office |

| |UTA Police (Emergency Only): (817) 272-3003 |

| | |

| |Mailing Address for Packages Related to the Course |

| |UTA School of Nursing |

| |c/o Dr. Susan K. Grove |

| |411 S. Nedderman Drive |

| |Box 19407, Pickard Hall |

| |Arlington, Texas 76019-0407 |

GRADUATE NURSING WEBSITES

|Description |Website |

|University of Texas Home Page | |

|Graduate Catalog & Faculty | |

|Graduate Nursing Programs | |

| | |

|Graduate Nursing Courses & Syllabi | |

|Faculty and Staff Email Contacts and Biosketches | |

|Graduate Student Handbook | |

|Miscellaneous Graduate MSN Forms: | |

|Banking Clinical Hours | |

|Code of Ethics | |

|Drop Request | |

|E-log Consent Form | |

|Liability Policy | |

|Master’s Completion Project Forms | |

|Nurse Admin Preceptor Package | |

|Nurse Practitioner Preceptor Package | |

|Personal Insurance Verification Form | |

|Petition to Graduate Faculty | |

|Resignation Request | |

|Student Confidentiality Statement | |

|Traineeship Statement Forms | |

| |Clinical Evaluation MSN Forms: |

| |Educator Evaluation |

| |Faculty Evaluation of Preceptor |

| |NP Clinical Evaluation (Practicum Tools) |

| |Nurse Admin Faculty Eval of Preceptor |

| |Nurse Admin Preceptor Eval of Student |

| |Preceptor Evaluation of Student |

| |Psych Therapy Preceptor Eval of Student |

| |Student Evaluation of Preceptor |

| |Student Self Evaluation |

|Clinical Online Submission (Elogs) | |

|Criminal Background Check (Group One) | |

|Instructions for E-Reserves | |

| |Select under Library Catalogs |

| |(UTA Library Catalogs) |

| |Select Course Reserves |

| |Look for Instructor’s Name, Click Search, Select Article |

| |Password is course abbreviation and course number. |

| |ALL CAPS no spaces (ex. NURS5340). |

CRITICAL APPRAISAL

GUIDELINES

General Guidelines for Papers

These guidelines have been developed to help students know the mechanics of writing a paper. The 5th Edition APA Manual (2001) is to be used in conjunction with the guidelines to demonstrate referencing style, levels of headings, and proper ways of including direct quotations in the paper. The APA Manual also gives additional information about grammar and punctuation, use of numbers and abbreviations, and development of tables or figures, which should be helpful in developing the paper.

1. Each paper is to have a formal title page (see example below).

2. OMIT an abstract and table of contents.

3. Pagination: Page numbering starts with the first page of text. Numbering continues through the reference list and any appendices. Arabic (1, 2 etc.) numbers are to be used.

4. Margins: Margins are to be at least 1 inch and no more than 1.25 inches on all sides. Text should be left justified only. This means that the right margin may appear irregular. If a word is too long to be completed on one line, it should not be hyphenated.

5. Type size and font: Type should be 12 characters per inch. The font should be clean and easy to read (e.g. Arial or Times New Roman). Print should be of letter quality.

6. Spacing: Double spacing is to be used for the body of the paper. Single spacing may be used within references (with double spacing between references), and long quotations. Long quotations may also be indented five spaces. DO NOT leave any blank lines between paragraphs or sections.

7. Headers: Running headers are acceptable but not required.

8. Headings within the paper are essential. First develop an outline of your paper count the number of levels you plan to incorporate. Grading Criteria Sheets are helpful in determining appropriate headings for specific assignments. See the APA Manual for further guidance.

9. Quotations: In general, avoid the use of direct quotes. Re-state the point in your own words and include the appropriate citation. For ways to properly cite quotations of greater than 40 words see the APA Manual.

10. Referencing primary and secondary references in the text: See the APA Manual (2001).

11. Reference list: See the APA Manual. The reference list includes only the references cited within the text of the paper.

12. Other: All pages are to be stapled, no folders required. Make a copy of the finished paper to keep for your records.

Note: Be sure the paper you submit for grading is complete, since that is the paper that will be graded. Submit two (2) hard copies of the paper and include the grade sheet with each paper.

TITLE OF THE PAPER-FOR EXAMPLE:

CRITICAL APPRAISAL # 1

by

[YOUR NAME HERE]

Presented to

[Faculty Name here]

In partial fulfillment of the requirements of

[course number and name]

THE UNIVERSITY OF TEXAS AT ARLINGTON

SCHOOL OF NURSING

[Date]

GUIDELINES FOR CRITICAL APPRAISAL # 1: Comprehension

Article to be used is: Padula, C. A., Yeaw, E., & Mistry, S. (2009). A home-based nurse-coached inspiratory muscle training intervention in heart failure. Applied Nursing Research, 22(1), 18-25.

Write the critical appraisal of this article in narrative format using the guidelines below. Be sure and use the headings, such as Introduction, Problem, Purpose, etc. in the guidelines.

1. Introduction

a. Describe the qualifications of the author(s) of the critical appraisal article (such as research expertise, clinical experience, educational preparation). If the author information is not in the article, find it on the WEB.

b. Discuss the article title (type of study, variables, and population identified or missing).

c. Identify any missing elements in the abstract (purpose, design, sample, data collection, and key results).

2. Problem statement. Describe the health care problem or issue that was the impetus for this study including significance, background, and problem statement.

3. Purpose: State the study purpose from the article, whether explicit or implied.

4. Literature review.

a. Provide an example of one relevant previous study and one theory article described in the literature review.

b. Give the number and percentage of sources (references) published in the last 5 years, the last 10 years, and those older than 10 years from the literature review.

c. Describe the current knowledge (what is known and not known) about the research problem, as described in the literature review.

5. Theoretical framework (theory and/or concepts):

a. State whether the theoretical framework is based on scientific, substantive, or tentative theory as defined by Burns and Grove (2009).

b. Develop a model or map of the framework and describe this model. OR If the theorist has a model, you can include it in the paper and describe it.

c. Link the concepts to the relevant study variables using a table format (2 columns).

6. List any research objectives, questions, or hypotheses. Were they appropriate for the study?

7. Major study variables.

Identify the study variables by examining the purpose, the objectives, questions or hypotheses, and the results section of the article. Identify the type of each variable (independent, dependent, or research).

a. Independent variables: Identify and define conceptually and operationally

b. Dependent variables: Identify and define conceptually and operationally

OR

c. Research variables: Identify and define conceptually and operationally.

8. List the demographic variables or characteristics of the population.

9. Research design.

a. Identify the specific design of the study.

b. Identify the treatment or intervention if included in the study.

c. Describe how subjects were assigned to groups if groups were compared.

d. Describe how pilot study findings were used to design this study, if present.

10. Sample and setting.

a. State the inclusion and exclusion sample criteria.

b. Indicate the method used to obtain the sample.

c. State the sample size. Indicate if a power analysis was conducted to determine the sample size.

d. Identify the refusal to participate number and percentage.

e. Identify the sample mortality (or attrition) number and percentage.

f. Describe the informed consent process used and any institutional review board approval.

g. Describe the study setting.

11. Measurements:

Identify each measurement method used in the study with the following guidelines and put the information in a table (See example below).

a. Identify the author of each instrument

b. Identify the type of each measurement method (i.e. Likert scale, visual analog scale, physiological measure, questionnaire, observation, or interview).

c. Report the reliability of each instrument from previous studies and the current study.

d. Report the validity of each instrument from previous studies and the current study.

e. If a physiological measure was used, report the precision and accuracy of the measure for previous studies and the current study.

Table of Study Measurements (Example)

|Name of Measurement |Author |Type of Measurement |Reliability or |Validity or Accuracy |

|Method | |Method |Precision | |

|Beck Depression |Beck |Likert scale |Cronbach alpha of |Construct Validity: Content validity, reading level |

|Inventory | | |0.82-0.92 from |6th grade. Convergent validity with Zung Depression |

| | | |previous research |Scale. Factor analysis to document sub-concepts. |

| | | |and 0.87 for this |Prediction of future depression episodes. Successive |

| | | |study. |use validity with this study. |

|Omron Blood Pressure |Health care |Physiologic |Recalibration every|Accuracy systolic and diastolic pressures ensured to |

|Cuff |Equipment |measurement method |50 BP readings to |1 mm mercury by company. Designated steps to take BP |

| | | |promote precision |followed to promote accuracy. |

| | | |of measures. | |

12. Data collection.

Describe how the data were collected.

13. Researcher's interpretation of findings.

a. Describe how the findings are related back to the theory framework.

b. Describe which findings are in keeping with those expected.

c. List any unexpected findings.

d. State whether the findings are consistent with previous research findings.

14. Describe the study limitations identified by the researcher.

15. Describe how the researcher generalized the findings.

16. List the implications of the findings for nursing practice.

17. Identify any suggestions for further study.

Reference List:

Provide APA formatted references for both the critical appraisal research article and the Burns and Grove (2009) textbook that you will reference throughout the paper. Include any other references that you used in the critical appraisal.

GRADE SHEET FOR CRITICAL Appraisal # 1

POINTS CONTENT

6 Introduction

3 Problem

2 Purpose

7 Literature Review

10 Framework/Theoretical Perspective

2 Research objectives, questions, or hypotheses

8 Definition of Variables

2 Attribute/Demographic Variables

7 Research Design

13 Sample/setting

15 Measurement Methods & Instruments

2 Data Collection

5 Interpretation of the Findings

2 Limitations

2 Generalization of Findings

2 Implications of the Findings

2 Suggestions for Further Studies

10 Format: APA references, writing style, sentence structure, spelling, punctuation

_________________________________________________________________________

__________Total Points Earned out of possible 100 points

_______ Grade for Critical Appraisal #1 (20% of Final Course Grade)

GUIDELINES FOR CRITICAL APPRAISAL # 2

USE THE SAME RESEARCH ARTICLE AS IN CRITICAL APPRIASAL #1.

Guidelines for Preparing Critical Appraisal:

A. Review the chapters of your textbook and other research sources for what good research looks like.

B. Compare the steps in this study to criteria established in your textbook or other research sources (Step II Comparison).

C. Evaluate the study findings using the questions in your text as a guideline (Step IV Evaluation).

D. Prepare the critical appraisal using the following guidelines: Paper should be a maximum of 15 double spaced pages of text (excluding reference list). Use appropriate documentation and APA format. Write in a narrative style, not an outline form.

F. Use the questions in your text as a guide but do not answer each question. Summarize information related to each step of the research process using the questions as a guide.

G. Document throughout your paper using your textbook and other research sources.

FORMAT FOR CRITICAL APPRISAL #2

A. Discuss the strengths or weaknesses of each part of the study. Compare the steps in the study with published research sources(s) to determine if the step is a strength or weakness and provide a rationale to support your decision. Document throughout. Example: strengths and threats to design validity.

a) Purpose/Problem

b) Literature review

c) Framework

d) Objectives, questions, or hypotheses

e) Definition of variables

f) Study design

g) Intervention

h) Sampling process

i) Measurement methods

j) Data analysis

k) Discussion Section: Findings, limitations, generalizations, implications for practice, and future research.

B. Develop a final evaluation of the quality of the study. Do not just restate strengths and weaknesses. Discuss:

a) Your confidence in the study findings.

b) Consistency of this study’s findings with the findings from other studies.

c) Readiness of findings for use in practice.

d) Contribution of the study to nursing knowledge. Document your statements with references from nursing literature.

GRADE SHEET FOR CRITICAL APPRAISAL # 2

POINTS CONTENT

65 Points for Strengths & Weaknesses

5 Purpose/Problem

5 Literature review

6 Theory framework

5 Variable definitions

2 Objectives, questions, or hypotheses

15 Study design—Threats and Strength of Design Validity; Intervention if applicable

10 Sample selection

10 Measurement tools

7 Data analysis

Evaluation

6 Your confidence in the study findings,

7 Consistency of this study’s findings with the findings from other studies,

7 Readiness of findings for use in practice

5 Contribution of the study to nursing knowledge.

10 Format: APA format and references, writing style, sentence structure, punctuation.

_________________________________________________________________________

_____________ Total points earned out of a possible 65 points.

_________ = Grade on Critical Appraisal #2 Paper is 20% of your final course grade.

EVIDENCE-BASED

PRACTICE

PROJECT

Evidenced Based Practice Paper

Ideas for Selection of an Evidence-Based Intervention for Practice

1. Describe a Clinical Problem that you see or have seen in your practice. It can be any patient care problem or issue that is of interest to you in your current practice, or for your future role as an administrator, nurse practitioner, or educator. A way to identify an area of interest may be to ask yourself or colleagues questions such as: Is there a better way of doing something? Would another intervention be more effective and improve patient outcomes? Give some data (at least one rate, ratio or cost) from your agency or from the health care literature that supports the fact that this is a patient care problem.

2. Review recent research and practice literature and select an intervention that might address this patient care issue. The intervention may be in the form of a new policy, protocol, algorithm or procedure that would change patient care. What evidence-based intervention exists to improve current care in terms of patient, provider, or health care agency outcomes? Try to identify something for which you really want an answer. You might also get ideas from Research for Practice, an ongoing section in AJN, or research articles from nursing specialty journals.

3. Review a variety of evidence-based websites such as:

Agency for Healthcare Research and Quality ()

National Guideline Clearinghouse ()

Professional Organization Websites

4. Summarize what is known and not known about the problem area selected.

5. Identify, revise, or develop a policy, protocol, algorithm or procedure to be used in your practice site.

6. Provide a copy of the policy, protocol, algorithm, or procedure with its references.

7. Provide a reference list for your paper.

Grade Sheet and Guidelines for Evidence-Based Practice Paper

POINTS

10 I. Introduction to the Evidence-Based Practice Project: Identify the problem in practice and the intervention to be used to address the problem. Document your introduction.

45 II. Review of relevant sources. Summary/Synthesis of Current Research Knowledge (what is known and not known). Summary must be documented. Summary provides the knowledge base or evidence for making a change in practice.

(30 points) A. What is known?

(15 points) B. What is not known?

30 III. Protocol, Algorithm, or Standardized Guideline for Evidence-Based Project

(20 points) A. Provide a copy of the documented protocol, algorithm, or standardized guideline.

(10 points) B. Discuss your development of your protocol, algorithm, or standardized guideline. Indicate if you developed the protocol or algorithm; revised it from an agency document; used a document that was previously published; or used a national standardized guideline found in the literature or on the WEB. If it is based on existing document, include a copy of this document. Briefly identify any revisions you might have made to the existing document.

15 III. Reference Lists: APA Format and Limit the paper to 10 pages

EVIDENCE-BASED PROJECT

PRESENTATION GRADE SHEET

POINTS

10 I. INTRODUCTION

A. Identify the practice problem

B. Personal and/or professional interest in the topic

10 II. DECISION

A. Who would need to be involved in making the decisions, be specific?

B. What is the process for making an evidence-based change in your agency?

20 III. IMPLEMENTATION

A. Detail your plan for the implementation of your evidence-based change in practice. How can findings be used, by whom, where, and when?

15 IV. EVALUATION

A. How will protocol, algorithm, or guideline be evaluated? Give specific information on outcomes (patient, provider, and agency) to be measure; who will collect the data; who will analyze the data; and how will the data be used to make additional changes in practice.

5 V. PROTOCOL, ALGORITHM, OR GUIDELINE

Provide a copy of the documented protocol, algorithm, or guideline and empirical reference list for class members.

15 VI. FORMAT & PRESENTATION OF SLIDES

Creativity

Clarity & Readability: Slides and/or Poster

Presentation style

Presentation 20 minutes long and with 5 minutes for questions. Total presentation no more than 25 minutes

Statistics

Statistical Analysis for Quantitative Research

Descriptive (or Summary) Statistics

1. Frequency Distributions

2. Measures of Central Tendency

a. Mode

b. Median

c. Mean (X)

3. Measures of Dispersion

a. Modal Percentage

b. Range

c. Difference Scores (D)

d. The Sum of Squares (D)

e. Variance (V)

f. Standard Deviation (SD)

Inferential Statistics and Concepts

Normal Curve, Skewness, and Kurtosis

Level of significance (.05, .01. .001)

Tailedness

Type I and Type II Errors

Power Analysis

Degrees of Freedom

Confidence Intervals

Parametric Statistical Analyses

a. Assumptions

(1) the sample was drawn from a normal distribution

(2) random sampling techniques

(3) interval level data

b. Examples of Statistical Procedures

(1) t-test

(2) Analysis of Variance

(3) Pearson=s Correlation

(4) Most Multivariate Procedures

9. Nonparametric statistical analyses

a. Assumptions

(1) nominal or ordinal data

(2) sample not from a normal distribution

b. Examples of Statistical Procedures

(1) chi-square

(2) Mann-Whitney U

(3) Kolmogorov-Smirnov Two-Sample Test

(4) Wilcoxon Matched-Pairs Signed-Ranks Test

10. Testing for Difference

Statistical analysis used to examine differences between groups. Usually, the mean of each group is used to conduct the statistical analyses. Purpose is to determine if the differences in mean values are great enough to suggest that the groups are from two different populations.

a. Statistical tests of differences

(1) t-test

(2) ANOVA

(3) Chi-square

11. Testing for Relationships

Statistical analysis used to examine relationships between variables within a sample. Values must be obtained on measures of at least two variables from each subject in the study. The individual scores from each subject on each variable are used to conduct the analysis. Purpose is to determine the degree of relationship of the variables.

a. Statistical tests of relationships

(1) Pearson=s Correlation

(2) Regression Analysis

(3) Factor Analysis

(4) Path Analysis

12. Statistical Analyses and their statistic

a. Analysis of Variance F

b. Mann-Whitney U Test U

c. t-test t

d. Pearson=s Correlation r

e. Regression Analysis R

Link of Level of Measurement and Statistical Techniques

|Level of |Descriptive vs. |Purpose of Statistical Analysis|Statistical Analysis Techniques |

|Measurement |Inferential & Nonparametric vs. Parametric Statistics | | |

| |Descriptive Statistics | | |

|Nominal | |Description | |

| |Nonparametric Inferential Statistics | | |

| | |Relationships | |

| |Nonparametric Inferential Statistics | | |

| | |Differences | |

| |Descriptive Statistics | | |

|Ordinal | |Description | |

| |Nonparametric Inferential Statistics | | |

| | | | |

| | |Relationships | |

| |Nonparametric Inferential Statistics | | |

| | | | |

| | |Differences | |

| |Descriptive Statistics | | |

|Interval/Ratio | | | |

| | |Description | |

| |Parametric Inferential Statistics | | |

| | | | |

| | | | |

| | |Relationships | |

| |Parametric Inferential Statistics | | |

| | | | |

| | | | |

| | |Differences | |

ANALYSIS OF DEMOGRAPHIC DATA

|Demographic Variables |Level Measurement |Analysis Technique |

|1. Age | | |

|a. Specific Age | | |

| b. Age Range | | |

|2. Education | | |

|a. Specific Number of Years or Degree | | |

| b. Range of Education Years | | |

|3. Ethnic Group | | |

|4. Gender | | |

|5. Income | | |

|a. Specific Income | | |

| b. Income Range | | |

|6. Length of Disability | | |

|7. Length of Illness | | |

|8. Marital Status | | |

|9. Medical Diagnosis | | |

|10. Occupational Status | | |

|11. Years of Employment | | |

ANALYSIS OF STUDY VARIABLES

|Study Variables & Focus of Objective Questions, or |Level of Measurement |Analysis Technique |

|Hypotheses | | |

|Physiologic Measurement: | | |

| | | |

|1. Oxygen Saturation | | |

| | | |

|Description | | |

| | | |

|Differences | | |

|2 groups | | |

|3 or more groups | | |

| | | |

|Relationships | | |

|Scales: | | |

|Likert or Semantic Differential | | |

| | | |

|Description | | |

| | | |

|Differences | | |

|2 groups | | |

|3 or more groups | | |

| | | |

|Relationships | | |

|Diabetic or not Diabetic | | |

| | | |

|Description | | |

| | | |

|Differences | | |

|2 groups | | |

|3 or more groups | | |

| | | |

|Relationships | | |

|Functional Status: Poor, Average, or Strong | | |

| | | |

|Description | | |

| | | |

|Differences | | |

|2 groups | | |

|3 or more groups | | |

| | | |

|c. Relationships | | |

WAYS OF INTERPRETING CORRELATION COEFFICIENTS

1. A correlation coefficient is a number indicating the degree of relationship between two variables. It measures to what extent variations in one go with variations in the other:

1.00 A perfect positive correlation: changes in one variable are accompanied by equivalent changes in the same direction in the other variable, without exception.

.00 No correlation: changes in one variable have no relationship, or are randomly related, to changes in the other variable.

-1.00 A perfect negative correlation: changes in one variable are accompanied by equivalent changes in the opposite direction in the other variable, without exception.

2. A correlation coefficient requires two sets of measurements on the same groups of individuals, or on matched pairs of individuals, and cannot be computed on one person alone.

3. Coefficient of Determination , r2

The correlation coefficient, r, is a measure of the strength of relationship between two variables. It does not represent a percentage of the determinants they have in common unless it is squared and becomes an estimate of variance called the coefficient of determination. When the latter is multiplied by 100, it indicates the percentage of variance held in common by the two variables: x and y, assuming linear regression. It answers the question. How much of the variance in y is accounted for, associated with, or determined by the variance in x? The following table identifies r and r2 values and the percentage of variance explained.

Percent of Variance Percent of Variance r r2 r r2

|.00 |0% |.55 |30% |

|.05 |0 |.60 |36 |

|.10 |1 |.65 |42 |

|.15 |2 |.70 |49 |

|.20 |4 |.75 |56 |

|.25 |6 |.80 |64 |

|.30 |9 |.85 |72 |

|.35 |12 |.90 |81 |

|.40 |16 |.95 |90 |

|.45 |20 |.98 |96 |

|.50 |25 |.99 |98 |

For example: The relationship between GPA and IQ is r = .50. This suggests that, in variance terms, 25% of factors accounting for GPA can be attributed to factors also accounting for IQ.

Relevant Resources

Bindler, R. C. M., Massey, L. K., Shultz, J. A., Mills, P. E., & Short, R. (2009). Metabolic syndrome in a multiethnic sample of school children: Implications for the pediatric nurse. Journal of Pediatric Nursing, 22(1), 43-58. (Working Article Critically Appraised in Class)

Brown, S. J. (2002). Focus on research methods. Nursing intervention studies: A descriptive analysis of issues important to clinicians. Research in Nursing & Health, 25(4), 317-327.

Chobanian, A. V., Bakris, G. L., Black, H. R., Cushman, W. C., Green, L. A., Izzo, J. L., et al., (2003). The Seventh Report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. JAMA, 289(19), 2560-2572.

Duffy, M. E. (1987). Statistics: Friend or foe? Nursing & Health Care, 8(2), 73-75.

Olsen, D. P. (2003). Methods: HIPAA privacy regulations and nursing research. Nursing Research, 52(5), 344-348.

Roberts, W. D., & Stone, P. W. (2003). Ask an expert: How to choose and evaluate a research instrument. Applied Nursing Research, 16(1), 70-72.

Robinson, J. H. (2001). Mastering research critique and statistical interpretation: Guidelines and golden rules. Nurse Educator, 26(3), 136-141.

Santacroce, S. J., Maccarelli, L. M., & Grey, M. (2004). Methods: Intervention fidelity. Nursing Research, 53(1), 63-66.

Stone, P. W. (2002). What is a systematic review? Applied Nursing Research, 15(1), 52-53.

Whittemore, R. (2005). Combining evidence in nursing research: Methods and implications. Nursing Research, 54(1), 56-62.

Wright, V. L. (2003). A phenomenological exploration of spirituality among African American women recovering from substance abuse. Archives of Psychiatric Nursing, 17(4), 173-185. (Working Article Critically Appraised in Class)

THE UNIVERSITY OF TEXAS AT ARLINGTON

SCHOOL OF NURSING

GRADUATE PROGRAM

N5301 RESEARCH IN NURSING

SCHEDULE FOR SUMMER 2009

Class is Wednesday 1-6 p.m. in Room 227

June 3 Introduction

Review of Syllabus & Summer Schedule

Knowledge Development in Nursing

Framework of the Research Text

Introduction to Quantitative & Qualitative Research

Steps of the Quantitative Research Process

Reading Research Articles

Statistics Pretest (take home)

Use of Research Findings in Practice

Evidence-Based Practice

Best Practice Network

National Guideline Clearinghouse

Overview of Critical Appraisal Process

Introduction to the Research Problem and Purpose

Preparation for First Class

Burns & Grove Text: Chapters 1, 2, 3, & 5 and study guide exercises

Recommend doing supportive exercises in the Study Guide

Preparation for Next Class

Burns & Grove Text: Chapters 6, 7, 8, & 26 and study guide exercises

Complete statistics pretest

Review guidelines for first critical appraisal

Read Critical Appraisal Article and start writing Critical Appraisal # 1

Review working article for steps of quantitative research process

Bring content on Web searches to share with class

JUNE 10 Continue Problem and Purpose

Literature Review

Objectives, Questions, & Hypotheses

Frameworks for Research

Introduction to Research Design

Discussion of Working Article

Discussion of Web Searches

Discussion of Statistics Pretest

Preparation for Next Class

Burns & Grove Text: Chapters 14 & 15 and skim Chapter 16 and study guide exercises

Develop framework models for working article

Define variables in working article

Identify design, sample, & measurement for working article

JUNE 17 Discussion of Frameworks for Working Article

Conceptual & Operational Definitions of Variables from Working Article

Introduction to Design

Sample

Measurement

Questions on Critical Appraisal #1

Preparation for Next Class

Burns & Grove Text: Chapters 10, 16, & 18, Skim Chapter 11 and study guide exercises

Review guidelines for Critical Appraisal # 2

JUNE 24 First Critical Appraisal is Due

Design Validity

Developing Design Model

Measurement

Statistical Concepts

Discussion of Statistical Exercises

Discussion of Critical Appraisal # 2

Begin Writing 2nd Critical Appraisal

Preparation for Next Class

Burns & Grove Text: Chapters 19 and 22

Required Grove Statistical Exercises for a Grade: Exercise 3 Level of Measurement: Interval/Ratio l; Exercise 9 Sampling Methods; Exercise 13 Understanding Reliability Values of Measurement Methods; Exercise 14 Understanding Validity Values of Measurement Methods; and Exercise 18 Mean, Standard Deviation, and 95% and 99% of Normal Curve

Recommended Statistical Exercises: Exercise 1 Identifying Level of Measurement: Nominal; Exercise 4 Understanding Percentages; Exercise 10 Understanding Sampling Section in a Research Report; Exercise 12 Power Analysis; Exercise 15 Measures of Central Tendency: Mean, Median, and Mode; Exercise 17 Mean, Standard Deviation, and 68% of Normal Curve

JULY 1 No Class

JULY 8 Required Grove Statistics Exercise Due

Review Critical Appraisal # 1

Data Collection Process

Statistic Concepts

Discussion of Evidence-Based Practice Projects

Begin Evidence-Based Project

Preparation for Next Class

Burns & Grove Text: Chapters 20, 27

Read articles on utilization and evidence-based practice

JULY 15 Second Critical Appraisal is Due

Evidence-Based Practice Project

Statistical Analysis Techniques

Start writing Evidence-Based Practice Project

Preparation for Next Class

Burns & Grove Text: Review Chapters 18, 19, 20, 22

Review guidelines for evidence-based project

Identify area of interest for evidence-based project & share with

class

Required Grove Statistical Exercises for a Grade: Exercise 21 Effect Size; Exercise 24 Understanding Pearson’s r, Effect Size, and Percentage of Variance Explained

Recommended Statistical Exercises: Exercise 27 Simple Linear Regression; Exercise 23 Pearson’s Product-Moment Correlation Coefficient; Exercise 31 t-test for Dependent Groups

JULY 22 Required Grove Statistics Exercise Due

Discussion and Approval of Topics for Your Evidence-Based Project

Statistical Analysis Techniques

Preparation for Next Class

Burns & Grove Text: Chapter 21; Review Chapters 18, 19, 20, 22

Begin a literature review for evidence-based project

Required Grove Statistical Exercises for a Grade: Exercise 28 Multiple Regression; Exercise 29 t-test for Independent Groups I;

Exercise 33 Standard Error of the Mean, 95th Confidence Interval; Exercise 36 ANOVA I; and Exercise 45 Sensitivity and Specificity

Recommended Statistical Exercises: Exercise 40 Chi Square I; Exercise 42 Spearman Rank Order; Exercise 43 Mann-Whitney U Test

JULY 29 Grove Statistics Exercises Due

Discussion of Evidence-Based Projects: Paper and Presentation

Statistical Analysis

Preparation for Next Class

Complete Evidence-Based Projects

AUGUST 5 Evidence-Based Project Paper Due

Presentation of Evidence-Based Projects

Finish up statistical exercises

AUGUST 12 Final Exam: Statistics/Research Process Exam

Course Evaluations

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