QSEN
Critiquing Nursing Research Articles: Safety Research
Submitter Information
Name: Zane Robinson Wolf
Title: Dean and Professor
Credentials: PhD, RN, FAAN
Diane M. Breckenridge
Credentials: PhD, RN
Title: Associate Professor
Organization: Nursing Programs, La Salle University School of Nursing and Health
Sciences
Address 1900 West Olney Avenue
City: Philadelphia
State: PA
Zip: 19141
Teaching Strategy
Competency Domain:
 Evidence-Based
 Safety
 Informatics
Learner Level:
 Pre-Licensure BSN
 RN-BSN
Learner Setting:
 Classroom
Strategy type:
 Test/evaluation/assessment strategies
Learning Objectives:
 Critique selected nursing research studies.
o Prior to taking the critique test, complete in-class critiques of three
published nursing research studies using guidelines.
o Complete a graded test, a critique of one published research study using
guidelines.
 Apply qualitative or quantitative critique guidelines to research study addressing
patient safety.
 Compare study to published research after consulting several databases, including
Cochran, CINAHL, and Medline.
 Describe two strengths of the study.
 Describe two weaknesses of the study.
 Discuss application of study results to a clinical setting.
Strategy Overview:
In this research assignment, students prepare to take a critique test scheduled during the
latter part of an undergraduate nursing research course. Earlier in the course schedule,
students complete in-class critiques of three research studies, including qualitative and
quantitative examples. Students will receive the article before the test, so that they are
able to prepare for the test and complete the learning objectives. They bring the article
and their notes to the test. The articles represent current research on patient safety topics
that faculty select such as:
 Chiang, H-Y., & Pepper, G. A. (2006). Barriers to nurses’ reporting of medication
administration errors in Taiwan, Journal of Nursing Scholarship, 38(4), 393-399.
(A sample test has been constructed based on this study).
 Ebright, P. R., Urden, L., Patterson, E., & Chalko, B. (2004). Themes surrounding
novice nurse near-miss and adverse-event situations. JONA, 34, 531-538.
 Eisenhauer, L. A., Hurley, A. C., & Dolan, N. (2007). Nurses’ reported thinking
during medication administration. Journal of Nursing Scholarship, 39(1), 82-87.
 Wolf, Z. R., Hicks, R., & Serembus, J. F. (2006). Characteristics of medication
errors made by students during the administration phase: A descriptive study.
Journal of Professional Nursing, 22(1), 39-51.
 Dennison, R. B. (2007). A medication safety education program to reduce the risk
of harm caused by medication errors. Journal of Continuing education in Nursing,
38(4), 176-184.
 Meurier, C. E., Vincent, C. A., & Parmar, D. G. (1997). Learning from errors in
nursing practice. Journal of Advanced Nursing, 26, 111-119.
Faculty distribute the study to be critiqued and the content domains of the test map at
least two weeks before the scheduled critique exam.
Evaluation Description:
Test Map/Content Domain
Quantitative Study
1. Main concepts/constructs of study
2. Independent versus dependent variable
3. Quality of literature review
4. Theoretical/conceptual framework
5. Design
6. Setting characteristics
7. Sampling approach
8. Sample criteria, inclusion and exclusion
9. Part or section of research report
10. Human subjects consent procedure
11. Instrument characteristics
12. Instrument reliability or validity
13. Data levels or scales
Number of
Application Items
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
14. Data quality
15. Procedures for data collection
16. Identification of hypothesis(ses) tested
17. Statistical testing of hypothesis(ses)
18. Interpretation descriptive statistical tests
19. Type of hypothesis
20. Interpretation inferential statistical tests
21. Strengths of study
22. Weaknesses of study (2)
23. Application of findings to clinical settings
24. Comparison of study to related literature using Cochran,
CINAHL, and Medline databases
Qualitative Study
1. Phenomenon/basic social process/culture, etc. of study
2. Quality of literature review
3. Framework
4. Research tradition
5. Design
6. Sources of data
7. Methodologist
8. Setting characteristics
9. Sampling approach
10. Sample criteria, inclusion and exclusion
11. Human subjects consent procedure
12. Part or section of research report
13. Data sources
14. Procedures for data collection
15. Data analysis approach
16. Rigor methods
17. Data quality
18. Presentation of findings (narrative, tables, and/or figures)
19. Conclusions
20. Implications
21. Strengths of study
22. Weaknesses of study (2)
23. Application of findings to clinical settings
24. Comparison of study to related literature using Cochran,
CINAHL, and Medline databases
Total number of items (24): Multiple choice and essay questions
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Essay question
1 Essay question
1 Essay question
1 Essay question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Multiple choice question
1 Essay question
1 Essay question
1 Essay question
1 Essay question
La Salle University
School of Nursing and Health Sciences
Undergraduate Nursing Program
Critique Examination Example
Chiang, H-Y., & Pepper, G. A. (2006). Barriers to nurses’ reporting of medication
administration errors in Taiwan. Journal of Nursing Scholarship, 38(4), 392-399.
Multiple choice questions scored at 4 points each
1.
Identify the main construct or variable in the Chiang & Pepper study:
1.
2.
3.
4.
2.
Peer relations
Power hierarchy
Work environment factors
Perceptions of reporting barriers
Which of the following exclusion criterion eliminated nurse subjects from the
study:
A.
B.
C.
D.
Nurse manager
Community nurse
Experienced nurse
Unemployed nurse
Which type of hypothesis is tested in Table 2 of Chiang & Pepper’s study?
3.
A.
B.
C.
D.
statistical
complex
research
simple
Identify the design(s) used in the Chiang & Pepper’s study.
4.
1.
2.
3.
4.
cross-sectional
correlational or ex post facto
quasi experimental
experimental
A.
B.
C.
D.
1 and 3
2 and 4
1 and 2
1, 2, and 4
5. The section of the study describing the Reason Why MAEs Are Not Reported
described an instrument that could be described as:
A.
B.
C.
D.
Reliable and valid
Valid and formatted
Open ended and summed
Theoretical and close ended
6. Identify the setting from which the sample was obtained:
A.
B.
C.
D.
Long term care facility
Short procedure unit
Medical center
Health care unit
7. In which specific section of the Chiang & Pepper’s study is found the instruments
to measure the main study variables:
A.
B.
C.
D.
Method
Analysis
Purposes
Measures
8. In addition to the main study construct, identify the following main constructs in
the literature review that frame the study:
A.
B.
C.
D.
Cultural factors and work environment
Healthcare systems and errors
Power hierarchy and attitude
Fear and authority
9. The demographic characteristics of respondents (N = 597) include the following
levels or scales of data:
A.
B.
C.
D.
Nominal and interval
Nominal and ordinal
Ordinal and interval
Ordinal and ratio
10. How many items are included in the Reason Why MAEs Are Not Reported
instrument?
A.
B.
C.
D.
15
16
20
24
11. Identify the sampling approach of Chiang & Pepper’s study:
A.
B.
C.
D.
Cohort
Purposive
Total design
Convenience
12. Select the human subjects’ consideration strategy used in the Barriers to nurses’
reporting of medication administration errors study:
A.
B.
C.
D.
Human subjects committee approval
Protection of confidentiality
Written consent to participate
Verbal consent to participate
13. Why were some respondents’ questionnaires excluded from data analysis?
A.
B.
C.
D.
Nonresponders refusal
Instrument translation problems
Lack of response on selected items
Missing values on questionnaire items
14. What was the dependent variable for the correlation coefficients calculated in
Chiang & Pepper’s study?
A.
B.
C.
D.
Reporting process
Power hierarchy
Barriers
Fear
15. Nurses were compared on perceived barriers to reporting by MAE reporting
rate group (overreporting/underreporting group versus accurate reporting of
Medication Administration Error [MAE] group). Identify the statistical test that
tested the hypothesis?
A.
B.
C.
D.
T-test
Percent
Regression
Correlation
16. How many association testing hypotheses were supported at statistically
significant levels (p<.05, p<.01) for the perceptions of barrier study instruments?
(Table 2)
A.
B.
C.
D.
7
22
28
33
17. Describe the content of the literature review:
A.
B.
C.
D.
Related
Anecdotal
Empirical
Theoretical
18. How were demographic data analyzed?
A.
B.
C.
D.
sequentially
descriptively
systematically
retrospectively
19. Identify the method used to encourage initial subject participation in the study.
A.
B.
C.
D.
Reminder
Confidentiality
Reply envelope
Introductory letter
20. Describe the internal consistency reliability coefficient that established one aspect
of reliability of the Reason Why MAEs Are Not Reported instrument?
A.
B.
C.
D.
Expert
Test-retest
Factor analysis
Cronbach’s alpha
Answer the following questions on the back of your answer sheets using complete
sentences. Write legibly or the answer will be marked as incorrect.
Describe two strengths of the study. (5 points)
Describe two weaknesses of the study. (5 points)
Specify one strategy that would improve the study. (5 points)
Describe the related literature you located on Cochran, CINAHL, and Medline databases
to this study? (5 points)
Critique Guidelines*
Students are directed to use the following critique guidelines to assist them to analyze
research articles. They must prepare for the in-class exam by applying the elements
identified in the guideline to a critical analysis of the study. This should be done before
the date of the scheduled critique exam.
Abstract
Title of research article easily understood
Title reflects content of research article
Abstract includes problem and hypotheses if hypotheses are tested
Methods are briefly described
Findings are summarized
Problem
Problem/purpose/aims/objectives are introduced early in article
Research questions as stated accurately
Problem statement is clear
Hypothesis(ses) is/are stated clearly to permit testing
Study limitations are identified
Phenomenon and variables are defined theoretically
Variables are defined operationally
Assumptions are identified
Significance of problem is described
Justification of study is described
Review of Literature
Literature is applicable to research problem
Literature provides rationale for study
Studies cited are critically examined
Connection of problem to previous research is discussed
Conceptual framework/theoretical framework is clearly stated
Review ends with summary of related literature and its implications to research problem
Methods
Design (Quantitative)
Type of design is described
Adequate description of design is provided
Random assignment or alternate assignment is discussed
Operational definition of intervention (treatment) is described
Operational definition of outcome variable is provided
Design (Qualitative)
Type of design is described
Adequate description of design is provided
Tradition from which design originated is discussed
Peculiarities of design are discussed
Methodologist used is identified and primary source is cited
Source(s) of data or material is/are described
Sample
Population is identified
Sampling technique is described
Random selection is identified, if appropriate
Subject recruitment is discussed
Subjects/participants/informants are described
Sample size is identified
Number of subjects/group is identified, if appropriate
Subject access is described
Power Analysis is described, if appropriate
Subject demographics are described
Theoretical Sampling is discussed, if appropriate
Inclusion Criteria are described
Exclusion Criteria are described
Reasons for subject attrition are described
Setting
Setting where subjects are obtained is described
Setting access is described
Ethical Considerations
Request for IRB review of the study is described
Anonymity is guaranteed, if appropriate
Confidentiality is guaranteed
Data storage is described
Destruction of data is described
Process of obtaining consent is discussed
Characteristics of consent before entering study are discussed
Incentives for participation are identified if used
Instrumentation
Instrument(s) (quantitative) or Interview Questions (qualitative)
Description of Instrument(s) (number of subconcepts [dimensions, categories], number of
items/subconcept, and scaling [including response set corrections]) are described
Instructions for administration are provided
Scoring or instrument is provided, if appropriate
Average time to complete instrument is provided
Apparatus manufacturer is identified, if appropriate
Reliability of Instrument(s), including interrater; parallel forms; internal consistency; testretest, is provided
Construct validity of instrument(s), including various types, is provided
Response rate is described
Rigor or Scientific Adequacy of Qualitative Research Study
Strategies of methodologist (rules) are described
Credibility, including prolonged engagement in field, persistent observation, and
triangulation (sources, methods, investigators, theories) is described consistent with
methodologist
Credibility, including peer check, member check (stakeholders), and negative cases in
relation to findings, is described consistent with methodologist
Transferability (others determine findings hold in different contexts) is described
Dependability (audit trail: other investigator follows field notes, personal notes,
transcribe interviews, coding schemes, codes and indicators, narrative description) is
described
Trustworthiness (confirmability [product confirms rigor]; audit trail followed) is
described
Reflexivity and validity (awareness of research of role in the process; relationship of
investigator with informants, data, reader; how open was the investigator to inducing
breakdowns in his or her understanding of the data; how was his or her confidence in
interpretations challenged and tested over the course of study) are described
Procedures for Data Collection
Sequence of activity is described, e.g., how research approval was obtained; how
informed consent was obtained; how procedures were explained to subjects
Protocol is described (operationalization) for control and experimental groups: actions
performed, if appropriate
Timing of data collection is described
Instructions for subjects are described
Training of subjects is described
Research assistants are described, along with training and periodic checking to determine
consistency in the data collection process
Site of data collection is described
Reasons for attrition are discussed
Data Analysis
Findings are sufficient of answer research questions
Software is identified
Descriptive statistical results are reported
Inferential statistical results are reported
Descriptive and inferential statistics used are appropriate
OR
Qualitative findings are reported
Tables are presented in an informative way
Figures are presented in an informative way
Conclusion
Conclusions are clearly stated
Conclusions are substantiated by evidence
Methodological problems are described
Findings are linked to conceptual/theoretical frameworks
Implications of the findings are discussed
Generalizations or transfers are discussed
Recommendations for future research are described
Form and Style
The report is clearly written
The report is logically organized
The report is objective
Application to Clinical Settings
Describe the scientific merit of the study
Describe the applicability of the findings
Discuss specifically how the findings will fit practice settings
*Adapted from Duffy, M. E. (1985). A research appraisal checklist for evaluating nursing
research reports. Nursing & Health Care, 6(10), 538-547.