Qualitative Research Critique - Coursework Example

Qualitative research critique Stenner, K. Carey, N. Courtenay, M. (2010). Implementing nurse prescribing: a case study in diabetes. Journal of Advanced Nursing, 66(3): 522-531. Approach and underlying foundation: Qualitative research is a study, which involves observation of people in their natural setting or analysis of their cultural symbols (Cooper, et al, 2008). Qualitative researchers usually attempt to interpret or make sense out of phenomena in form of people’s conception. A variety of empirical materials is employed to describe routine and problematic moments in addition to meanings in lives of individuals (Snowden, 2008). These materials include case study, life story, participant observation, personal experience, visual and historical texts and interview. Each qualitative research is usually unique and careful selection of the materials (methodology) is required to be able to address the research statement or problem appropriately. The ideas, principles and assumptions of the methodology should be well understood and applied appropriately to the said study for the research to be successful. A case study was used by authors to study the implementation of nurse independent prescribing (NIP) of drugs to diabetic patients. Case study is a strategy of carrying out research, which involves observation within real life context by employing multiple sources of evidence (Stenner & Courtenay, 2008). In line with this definition, the researchers used several sources of evidence to carry out their investigations (Cooper, et al, 2008). The sources included nurse prescribers, administrative staff, physicians and non-nurse prescribers. In addition, nine different case sites were used in the study. The use of case study strategy as a qualitative research method in this study was appropriate to get critical information required to understand the reception of NIP among hospitals. The ability of case study to combine various techniques to collect data is critical for obtaining information that is reliable. The study under critique used semi structured interviews to collect data and this was compared to existing knowledge on the implementation process of nurse prescription (Cooper, et al, 2008). The study also used other data sources such as video-recorded patient consultations, patients’ questionnaires and prescriptions. However, only data collected using structured interviews was used to compile the report under criticism. Given that, researchers used a single technique to report data we can say that the reliability of data reported casts some doubt. This method is criticized for having small number of cases, which interfere with its reliability (Cooper, et al, 2008). However, the authors of this study tried to use nine cases, which are large enough to get reliable data. In spite this; the case study strategy was appropriate in this study since it enabled the researchers to articulate comprehensively the perception of nurses and team members on the issue of the implementation of nurse prescribing in diabetes services. Our critical analysis will be discussed under the following subtopics: title, abstract, study purpose, literature review, study design, sample and design, sampling, sample size, data collection, data analysis, implications and limitations. Based on the critique a conclusion will be drawn at the end of discussion. Title A standard research title should have between 10 and 15 words. This enables the reader to make out the purpose the study more clearly. Shorter or longer titles are often ambiguous. The title of the article under review has full title, authors’ names, full literature title, year, volume number and page numbers. The title is shorter than the standard title. However, it is clear, accurate and lacks ambiguity (Cooper, et al, 2008). The title of research under scrutiny clearly indicates that nurses are the target population even though other sources of data have been used. The title is also informative since anyone reading it can have a general overview of issues covered in this case implementation of prescription by nurses (Snowden, 2008). The title of this article can be conclusively be said to be an effective representative of the entire article. The title has utilized the terms that are extensively used in the article: “implementing nurse prescribing”. The personal information given about authors of the article indicates that they are professionals in the area since two of them are research fellows and one is a professor of prescribing medicines. Thus, we can say that the authors are knowledgeable in the nursing profession and hence have effective ability to carry out the said research. Abstract An abstract is used to inform the reader the scope of the article and findings of the research (Courtenay, 2008). The authors had an abstract, which clearly summarized the study into the title, aim, background, method, findings and conclusion. The abstract was able to provide research question, methods used to address the question, the findings of the study and the implications of the findings. A concise abstract should have a word limit of between 150 and 300. The abstract of the authors was concise since it had 268 words, which is within the word limit. The structure of the abstract clearly and orderly outlines all the key words of the article. Study purpose Study purpose outlines the aim of the study. It often appears in the abstract and at the end of the introduction (Snowden, 2008). The aim of the study was clearly and precisely presented in the abstract and was mentioned at the end of the introduction to set the pace for literature review. The aim of the study was to explore the views of nurses and team members on the implementation of nurse prescribing in diabetes services. Literature review Literature review usually provides objective account to research studies on previous works on the topic under research. It helps the researcher to indentify gaps in literature and studies to be able to provide information that can fill these gaps. Various gaps were indentified during literature review by the authors (Cooper, et al, 2008). For instance, it was found that factors that support nurse prescribing had been identified previously but their functioning within specific contexts had not been studied. In addition, the conditions and processes, which enhance the implementation nurse prescribing in specific areas, diabetes included, have not been explored and understood. Therefore, the study was justified to be undertaken to fill the existing knowledge gap. The literature review was extensive and relevant to the research topic even though it relied much on research undertaken in UK not withstanding the fact that this may not be the case in most countries. However, the authors have mentioned in a passing glimpse on the research in other countries (Snowden, 2008). The references used were up to date. The authors were comprehensive in synthesizing the information cited in literature and were able to tailor it to fit into their study. The literature used was related to nursing profession and was relevant to the topic of study (Ryan-Woolley, et al, 2007). A look at the journals cited in the literature review reveals that the authors extensively referred to literature published by nursing related journals. In spite of this, much of journal articles seem to have been published by Journal of Advanced Nursing. This casts some doubts on the extensiveness of literature review by the authors. In spite the shortcomings of the literature review, it was able to identify the gaps in nursing profession that qualified to be studied. Study design Case study strategy was employed as a qualitative method to carry out the study. Case studies are usually used to investigate contemporary phenomenon in the context of its real life. The authors used the case study strategy to investigate implementation of nurse prescribing in real life context, that is, nurses from general practice, community clinics and hospitals. It enables the researcher to capture the complexity of a single case. These enabled the authors to get information about what was real on the ground (Courtenay, 2008). Case studies involve four stages. These include determining the present situation, gathering information about the situation at hand, gathering information that is more specific and presenting an analysis of findings and recommendations for action. The authors determined the present situation by carrying out structured interviews. Information concerning background of present situation was gathered using literature review (Ryan-Woolley, et al, 2007). Information that is more specific was gathered using the structured interviews. The final report under critique provided the presentation of findings and recommendation analysis and the necessary action to be undertaken. In case study, the unit of analysis should have a focus study and subunits to allow extensive analysis. The focus study in this study was nurses but administration staff, physicians and other workers were used to obtain the necessary data that allowed extensive analysis of data collected. Stages involved in case studies include selection of the case, preliminary investigations, data collection, data analysis and report writing. The article does not indicate how the case studies were selected. In addition, it does not indicate whether a preliminary study was undertaken prior to commissioning the study. This leaves doubt on the credibility of the data collected (Courtenay, 2008). However, data was analysed using thematic data analysis method before the data was reported. There are several types of case studies. They include snapshot case studies, longitudinal case studies, pre-post case studies, patchwork case studies and comparative case studies. The authors of the article under this critique employed a comparative case study, which involved nine case studies that had multiple research entities. This was aimed at providing cross unit comparison (Courtenay & Carey, 2008). Sample and design, sampling and sample size Study participants in qualitative research are recruited depending on their experience or exposure to the phenomenon under investigation. In the study nurses, administrative staff, physicians, and non-nurse prescribers (all working in hospital, general practice or community clinic settings) were participants. Nurses were chosen if they used NIP or nurse supplementary prescribing (NSP). The cases were found both in rural and urban setting with six of them being general practice, two community clinics and two hospitals based. A total of 31 study participants were involved in the study, which had ten nurse prescribers, nine physicians, nine receptionists and three non-prescribing nurses. The nurse prescribers were four DSNs, four nurse practitioners and two practice nurses. The rationale behind the number of different participants is not explained. In addition, the sampling criteria of the cases are not explained by the authors. Even though the inclusion criterion for nurses is given, if they used NIP or NSP, the inclusion criterion for other participants is not specified in the report (Snowden, 2008). Data collection Semi structured interviews were used to collect data in the study (Cooper, et al, 2008). The researchers also state that other methods such as video-recorded patient consultations, patients’ questionnaires and prescriptions were used to collect data but were reported elsewhere. The failure of the authors to incorporate this data collected using the other methods makes us question the reliability of the study since reliability of case studies depends on the employment of several techniques to gather and report data. Data analysis A thematic data analysis was undertaken in the study. Data analysis was undertaken by two independent qualitative researchers. This ensured validity of the results. The analysis process involved data familiarization, coding, categorization, identification of patterns and interpretation of the patterns. Existing knowledge on the implementation of nurse prescribing was used to understand issues and to develop themes through comparison. The authors did not group the data in accordance to the source of origin (Cooper, et al, 2008). The source of origin and setting of the case could have some effect on the data. Thus, the researchers could have analysed the data differently and compared the findings instead of just lumping them together. This could have compromised the credibility of the findings since what is presented is a general picture, which might not be the real case given that some data was obtained from participants in general practice, hospitals and community clinics (Ryan-Woolley, et al, 2007). Comparison of the findings could have helped as to have a better picture on the views of nurses and team members on the implementation of nurse prescribing in diabetes services in different settings and in general. Implications Cases studies and qualitative research in general is usually insufficient to make generalization of the results given the limited size of the samples. Contrary to this, the authors have generalized on the implication of their research (Cooper, et al, 2008). Furthermore, given the general form in which the data analysis was performed it is not proper to generalize the findings to the whole institution of nursing (Courtenay, 2008). More research needs to be undertaken which takes a keen interest in the different settings and a larger sample size to be statistically correct Limitations The authors have not identified limitations of their study and yet there are as seen above. Conclusion The authors made an informative conclusion that reflected their findings. However, the generalization of the finding to be a representative of the rest of nursing fraternity is not in order. This is because only small size of cases was used in addition that the research was done in a single country, which may not be a reflection of situations in other countries. References Cooper, R., Anderson, C., Avery, T., Bissell, P., Guillaume, L., Huchinson, A., Lymn, J., Murphy, E., RAtcliffe, J & Ward, P. 2008. Stakeholders’ views of K nurse and pharmacist supplementary prescribing. Journal of Health Services Research and Policy, 13(4), pp. 215-221 Courtenay, M. 2008. The prescribing practices of nurse independent prescribers caring for patients with diabetes. Practical Diabetes International, 25(4), pp. 152-157. Courtenay, M. & Carey, N. 2008. Nurse independent prescribing and nurse supplementary prescribing practice: national survey. Journal of Advanced Nursing, 61(3), pp. 291-299 Ryan-Woolley, B., McHugh, G. & Luker, K. 2007. Prescribing by specialist nurses in cancer and palliative care: results of a national survey. Palliative Medical, 21(4), pp. 273-277. Snowden, A. 2008. Quantitative analysis of mental health nurse prescribers in Scotland. Journal of Psychiatric and Mental Health Nursing, 15(6), pp. 471-478. Stenner, K. & Courtenay, M. 2008. Benefits of nurse prescribing for patients in pain: nurses’ views. Journal of Advanced Nursing, 63(1), pp. 27-35 QUANTITATIVE RESEARCH CRITIQUE O’Toole, K.O., Schoo, A.M. (2010). Retention policies for allied health professionals in rural areas: a survey of private practitioners. Rural and remote health, 10: 1331 (Online) Available from: http://www.rrh.org.au Approach and underlying foundation Quantitative research methods were designed originally in the natural sciences for studying natural phenomena. However, several quantitative methods have been accepted in social sciences and they include survey methods, formal methods, numerical methods and laboratory experiments (Smith, et al, 2008). Quantitative methods are used for empirical studies. The quantitative methods are essential in searching for truth in controlled and objective manner. Quantitative methods are characterized by their inflexibility where respondent are asked fixed questions in methods like questionnaires and surveys (Stagnitti, et al, 2005). The questions in these methods are usually closed ended. This inflexibility is advantageous in that responses can be compared across study sites and participants meaningful (Gillham & Ristevski, 2007). They are used to predict causal relationship and to describe characteristics of the population. The authors used survey method to describe the relationship between retention of rehabilitation therapists partnership between private and public practice in rural and regional areas. The researchers used survey method as a quantitative research method in their study. Surveys are used in research involving large volumes of data where analysis is done by quantitative methods. Questionnaires are usually administered to the sample population (Wilson, et al, 2009). The authors used e-mail to administer questionnaires to the sample population. Surveys are known to be advantageous because of their ability to generate findings, which are a representation of the whole population at a lower cost. However, the data collected richness depends on the good will of the participants. This is true in the study since some information like gender and place of work were not given by some respondents in the study. The findings of surveys can be used to generalize to the rest of the population unlike qualitative methods, which have limited generalization (Stagnitti, et al, 2006). The preference for this method by the authors was probably informed by the research question, which could only use survey as a quantitative data on the research topic. Simple statistics were utilized in the research to analyse the data obtained. In this paper, we analyze an article written by O’Toole and Schoo titled: Retention policies for allied health professionals in rural areas: a survey of private practitioners (Stagnitti, et al, 2005). The article will be critiqued in following order: introduction, title, abstract, purpose of the study, research problem, hypothesis or research question, literature review, theoretical framework, sample and sample size, ethical consideration, operation definitions, research design, data collection, instrument design, validity and reliability, analysis and results, discussion and conclusion. Introduction In the introduction the authors sets the pace of the study by saying that more often than not most professionals are usually visitors to rural areas. This creates a picture of how it is important to retain such professionals in rural areas (Wilson, et al, 2009). They also state that research has indicated that professionals in private sector are more likely to stay longer in rural areas than those in public sector (Stagnitti, et al, 2006). This gives as a glimpse on the importance of the research topic of authors who are seeking ways of retaining professionals in rural through public and private sector collaboration. The researchers are therefore articulate on the research topic at hand the need for the research to be undertaken what the private allied health professionals (AHPs) think and perceive about the need for collaboration between the public sector and private sector. The aim of the study is clearly outlined at the end of the introduction in line with what the literature requires of an introduction. Title The title of the article is clear, accurate and unambiguous. From the title one can easily make out that it seeks to address ways of retaining AHPs in rural areas. It also spells out the population to be studied in this case private practitioners in rural and remote areas (Gillham & Ristevski, 2007). The title also gives a glimpse on method to be used since it talks of “a survey of private practitioners” implying that survey method will be used to carry out the study. The number of words used in the title is fourteen, which is within the recommended number between 10 and 15 word. The report is well written in an orderly and grammatically correct. In spite this, the authors professional qualifications are not indicated casting some doubt on the degree of their knowledge in the area of study. Abstract The abstract of the report is concise in that it gives us a clear overview of the study (Reimer, 2006). It outlines some underlying literature under a short introduction where gaps in the existing literature are identified and the aim of the study outlined clearly (Smith, et al, 2008). The abstract then states that an online survey will be undertaken and the sample will be chosen purposively. The findings of the study are summarized for instance the authors state that 40% of response rate was gotten and that majority favoured the idea of collaboration between the public and private sector in retention of rehabilitation therapists. However, the abstract lacks recommendation even though it summarizes the study results and makes a conclusion (Wilson, et al, 2009). Purpose of the study Even though the authors have not explicitly indicated the purpose of the study in well-defined manner, it is clearly identified in the abstract and the introduction part of the report (Stagnitti, et al, 2006). The authors state that the aim of their study was to explore the thoughts and perceptions of private RTs in rural areas concerning their incorporation into broader rural health policies and concomitant programs. This is appropriate in addressing the research statement outlined in the title of the report. Research problem The author identifies the research problem in their study as the difficulties in retention of rehabilitation therapists in rural and remote areas especially those in public sector (Smith, et al, 2008). This problem is inline with research title, which seeks to establish whether collaboration between private and public sector can enhance the retention rates. Hypothesis or research question Even though the hypothesis and research questions are supposed to set the pace on how the research is to be undertaken by linking this to the title of the study, the researcher did not state neither hypothesis nor a research question. Literature review The authors have made a brief literature review, which was combined with an introduction. They have utilized much primary sources of literature with little use of secondary data (Wilson, et al, 2009). Much of these sources are mainly of empirical nature. In spite this; the literature is logically organized since it begins from a general point of view and end up addressing specific issues related to the study aim. Much of the literature sources that were used were up to date in terms of publication dates. The review was able to point out gaps in the existing literature (Stagnitti, et al, 2006). The review concentrated mainly in using the previous literature to support his study, which is commendable (Smith, et al, 2008). Only strengths of previous studies are however pointed out with little or no mention of their weaknesses. This implies that the authors did not comprehensively analyse the literature cited in their work. Theoretical framework The research undertaken by the authors was informed by the gaps identified in the literature review (Stagnitti, et al, 2006; Gillham & Ristevski, 2007). The authors have used previous data to discuss comprehensively their results even though their literature review was short. In spite the shortness, the literature review was able to point out knowledge gaps that informed the researchers to undertake this study. Sample and sample size A sample of any quantitative research should be a representation of the whole population (Reimer, 2006). The authors used purposeful chosen sample to carry out their study. The use purpose sample was based on the fact that the results were exploratory purpose and not definitive (Smith, et al, 2008). The questionnaires were sent via mails. The authors point out the method had limitations since only professionals who had their emails listed on the internet were able to receive the questionnaires. The authors were able to select 198 participants whom they sent the questionnaires via e-mail. Fourteen of these were rejected by sperm protectors and only 72 of 184 remaining responded to the questionnaires. This accounted for 40% that was more significant for the online survey. Ethical consideration The authors obtained ethics approval from Deakin University, Victoria (Smith, et al, 2008). They assumed that those who responded consented to participate in the study while those who did not respond did not consent. To ensure anonymity and confidentiality of data obtained the data from respondents went direct to database. Thus, ethical issues were adequately covered in the research. Operation definitions Most of the terms that were used in the study were explained by the authors for easy understanding of new terms and concepts. For instance, when the authors talk of rehabilitation therapists, they give examples of these in brackets to expound on its meaning. Research design The study employed survey as a method of data collection, which was appropriate given that the study was for exploratory implying that more quantitative studies need to be undertaken to make conclusions that are more definitive. Thus since specific group, rehabilitation therapists, was targeted, the method was valid. Data collection Numerous data collection strategies can be used in quantitative research (Smith, et al, 2008). These include observational tools, interviews, attitude scales and questionnaires. The authors of this study employed questionnaires, which were administered via e-mail to collect data. Instrument design A survey that employed questionnaires, which were administered via e-mail, was used to collect data. The questionnaires had 29 questions of which eight related to the perceived place that practitioners in rural areas occupy; eight related to their professional practice; seven related to retention policies; two related to education and training; and four were demographic questions. Validity and reliability The validity and reliability of the study is not strong (Stagnitti, et al, 2005). This is because sampling was done through purposively chosen sample, which is only used for exploratory studies. This implies that more quantitative researches need to be undertaken in the same area to provide more definitive conclusions that are valid and reliable. Analysis and results O’Toole and Schoo have not clearly indicated the method used to analyse their data. However, from the presentation of the results, it seems the authors used simple statistics. The method was appropriate since it provided different percentages for different data obtained. Of the 198 individuals contacted only 72 responded to the questionnaires accounting for about 40%. The results were significant given that the research was exploratory and not definitive. Discussion O’Toole and Schoo tried to link their discussion to the literature review. The authors also discussed the shortcomings of the study appropriately in their discussion (Smith, et al, 2008). They point out that their research has limited focus on rehabilitation therapists who are known to be more in private sector. However, O’Toole and Schoo do not give any recommendation on the further research in the area under study. O’Toole and Schoo also failure to have a well structured discussion mainly because their method of data analysis was not explicit. This made them to discuss all questions contained in the questionnaires independently. Thus, they need to have a well spelt out data analysis method in their future research to enable them discuss their data more easily rather than discussing all questions independently (Wilson, et al, 2009). Conclusion The role of conclusion in a study is to offer a summary of the findings and recommendations by the authors. The authors concluded that their results indicated that many privet rehabilitation therapists in Victoria perceived their greater involvement in the delivery of public health in rural areas in a positive manner. The authors recommends that the policy makers take note of the fact that it is easy to retain private rehabilitation therapists in rural and remote setting and offer incentives necessary for them to continue offering these services. Reference Gillham, S. & Ristevski, E. (2007). Where do I go from here: we've got enough seniors? Australian Journal of Rural Health, 15(5): 313-320. Smith, T., Cooper. R., Brown, L., Hemmings, R. & Greaves J. (2008). Profile of the rural allied health workforce in Northern New South Wales and comparison with previous studies. Australian Journal of Rural Health, 16(3), pp.  156-163. Stagnitti, K., Schoo, A., Dunbar, JA. & Reid, C. (2006). An exploration of issues of management and intention to stay: allied health professionals in South West Victoria, Australia. Journal of Allied Health, 35(4), pp. 226-232. Stagnitti, K., Schoo, A., Reid, C. & Dunbar, J. (2005). Retention of allied health professionals in the south-west of Victoria. Australian Journal of Rural Health, 13(6), pp. 364-365. Reimer, B. (2006). The rural context of community development in Canada. Journal of Rural and Community Development, 1(2), pp. 155-175. Wilson, R., Lewis, S. & Murray, P. (2009). Trends in the rehabilitation therapist workforce in underserved areas: 1980-2000. Journal of Rural Health, 25(1), pp. 26-32. Read More