Critical Appraisal Framework - Assignment Example

Critical appraisal framework Guidance for Within the MPP3 module you are expected to critically appraise one paper for each of the two EBM case studies. This framework has been prepared to help you make sense of research evidence, by considering whether the study is valid, what the results are, and whether the evidence can be put into practice. You should use this framework to review each paper. Having read the paper you should write your comments for each question in the space provided. You should complete this work before the workshops allocated for discussing these cases. Study quality – overall impression Guided question Student comments What is the study type/design? Review? Controlled trial? Other? (specify) It is a qualitative study of ideals and dilemmas in pharmacy practise. The dilemmas have emerged due to the roles that the profession of pharmacy has played in health care and in society as a whole. Place of publication Is it a peer-reviewed journal? The place of publication is Centre for Public Policy Research, FWB-WBW, Kings College London, Waterloo Road, London SE1 9NN, United Kingdom. Was funding declared? If yes, how was the study funded? What are the implications of this? This work was funded by Royal pharmaceutical society of great Britain Methods (why and how the study was done) Guided question Student comments What question(s) is the research addressing (i.e. what is the aim of the study)? The research focused on day to day practise in relation to conceptions of good practise and practise dilemma in pharmacy practise. The research addressed factors that what would make someone a good pharmacist and shared work situations that would made them uncomfortable ,or where pharmacist have to make compromises with regards to laws and make hard choices through professional judgement and decision making skills. The aim is to analyse pharmacy values across the profession . Is the question clearly focused? Consider the: population – who is included and excluded what interventions and comparisons are made (if applicable) outcomes – what are they The research focused on pharmacists reflecting something of the variety of roles and persons within UK. The a sample technique was adopted. It included 38 participants including 18 community pharmacists, 10 hospitals and 10 others (containing primary care trusts, senior management positions and academia). The pharmacists were chosen from variety of geographical locations, different ages, gender, experiences, employment statuses and ethnicities. The participants were selected via a snowballing process. It begin with contacts of the project team and was taken forward through referrals both from participants and associated institutional gatekeepers. Data collection stopped when similar account and themes emerged from the interviews. How was the study done? Consider factors such as: how interventions and comparisons were given (if applicable) method and duration of follow-up how outcomes are evaluated (and blinding, if applicable) the personnel involved at each stage The research work was conducted through a purposive sampling. Interviews were conducted of the respective samples i.e. pharmacy practitioners. The interviews were recorded and transcribed. The principles of grounded theory informed the analytical process. The analytical process involved the summarising , categorising and linking of significant collection of data (open coding) which was then merged into larger sets (axial codes). A process was run of constant comparision was used within and across interviews and both open and axial codes were revised frequently. The paper presented data analysis followed by a discussion of.steps that were taken to ensure the validity and reliability of the work. The first nine transcripts were read and analysed by all the authors. Emerging analysis was presented to the pharmacy audience and feedback was taken to rives. The data was corrected and refined according to analytical categories. Are the methods appropriate to the research question being asked? Justify your answer To understand the values of pharmacy practitioners it is important for the data to come directly or indirectly from the pharmacists. The method used is a purposive sampling so that the pharmacists interviewed reflects something that is indicative of the variety of roles and persons practised by them within UK Results Guided question Student comments Comment on the results/findings of the study: what are the benefits? what are the harms? The study reported here is making a small contribution to the development of a more socially embedded approach to bioethics. The experiences of dilemmas also serve to show that many of the ethical tensions experienced by pharmacy practitioners are not clashes within an individual’s personal value set but are rather the product of pharmacists being located in complex social fields with diverse, and sometimes computing, role expectations. The findings and analyses contribute to understanding of professional ethics. The finds show the central importance of the core values of ‘respect for medicine’ and the ‘patients best interest’. The data showed many ways in which rules from different sources, but applicable in the same situation can conflict, creating practical dilemmas and calling for value judgements Comment on the way in which the results were presented (e.g. graphs, numerical data, changes in risk) The results of the research presented in forms of practical examples from the life of pharmacists when facing dilemmas in real life scenarios. By taking interviews of participants involved in the research , who were selected through a sample. The rest of the results were presented by data analysis followed by brief discussions the results are discussed with reference to other important literature referenced in the text. Were all patients accounted for in the results (do all the numbers add up)? Why is this important? A big group of sample consisting of 38 participants were interviewed. Reported practise dilemma as a way of further highlighting and opening up the nature of pharmacy values. The research organised these data into four broad categories relating to rule breaking, resources, patient communication and teamwork. This four categries helped the study to understand properly by placing different examples in diffent categories and then the explanation of the examples of pharmacists life makes the study easy to understand and read Which results are statistically significant? How can you tell? The results may or may not be correct as different pharmacy practitioners practise different types of codes of ethics. In some countries there are strict laws for the sale of drugs and the dealing of pharmacists vary in different places due to cultural differences and rules set by the countries government. The participants involved in were picked by sampling and the data may not be accurate. The findings focus on the pharmacy and its core values which is the most significant part of the research. Are the results important/clinically relevant? The results focused on how and why pharmacy practitioner breaks the laws of ethics. This is because of a state of dilemma which the pharmacists go through when selling out drugs to customers for example underage sale of certain drugs is prohibited or without a proper doctor’s prescription no drugs to be sold to public. Can the results be applied to a wider population than that in the study (i.e. what are the implications of the study for practice)? No this studies’ target population are pharmacy practitioners and the consumers. The use of this work is only to the pharmacy practitioners so that they can be dilemma free when doing business in the UK. The consumers are a little bit related to the work here as pharmacy practitioners are in a state of dilemma because of the consumers. Do the investigators answer the posed research question? Justify your answer Yes the investigators answered the research question which was ‘understanding pharmacists values: A qualitative study of ideals and dilemmas in UK pharmacy practise’ The study showed different cases of people with different scenarios and there way of dealing with the problems, by interviewing candidates selected for the research. Discussion of finding was done analytically. Discussion/conclusions Guided question Student comments What are the authors’ conclusions? A range of developments mean that ethical issues are becoming increasingly salient to pharmacy professional practice. As the research proves that the codes of ethics are often not used by the pharmacy practitioners in some situations creating practical and ethical dilemmas and calling upon the judgement from experience. There is still a considerable challenge for the pharmacists not only in ensuring that the new code of ethics is followed too, but also make use of fundamental mechanisms to build professional structures and cultures which combine greater literacy about values and ethics with the high levels of professional commitment as seen in the research work. Are the authors’ conclusions based on their findings? Justify your answer The authors conclusions are fully based on the data provided by the research. All the ethical and professional analysis were made on behalf of the research and concluded very thoroughly. The research work could not be proved. What is your overall conclusion? The data given is a qualitative research work and has an open ended conclusion. Many pharmacists often follow the code of ethics and laws strictly for instance underage sale of a certain drug. But the scenarios presented by authors were quite justified. Further reading/resources Trisha Greenhalgh. How to Read a Paper. The Basics of Evidence-based Medicine. Third Edition. London: Blackwell BMJ Books; 2006 http://www.phru.nhs.uk/casp/critical_appraisal_tools.htm MeReC Briefing 30 (and Supplement). Using evidence to guide practice. 2005 http://www.npc.co.uk/publications_a_h.htm#E Read More