Summer School in Postgraduate Writing 2011 Associate Professor Rosemary Clerehan Director, International Postgraduate Academic Support Faculty of Medicine, Nursing, and Health Sciences, Monash University Day 4 Reporting and summarising others‘ research - Citation systems - Attribution and reporting verbs - Avoiding plagiarism; Using Turnitin Developing your critical voice - Praise and criticism - Impersonal language: using ‗It‘ clauses Improving your proof-reading Reporting and summarising others‘ research EXERCISE 1: Discussion: which system to use and why Citation systems: For comprehensive style guide information see Monash Library http://www.lib.monash.edu.au/tutorials/citing/ Attribution and reporting verbs Use of Tenses The tenses you select for your verbs in your review reveal a great deal more to your reader than just the time frame. They tell your reader: whose idea is being put forward (yours or someone else's) something about your attitude to the ideas you are reporting on if you have attributed them to an author/theorist how general or specific your point/description is. 1 Tense use example Definition of patient satisfaction Comleyi has noted that “patient satisfaction is a frequently used but seldom defined term”. A review conducted by Bowlingii in 1992 looked at over 100 references and found the term was only defined once. Comley3 has collected a number of definitions of patient satisfaction in the context of nursing care. Approaches to the Ordering of Citations In a literature review, all citations move toward the specific focus of the author‟s own study: chronological distant to close different categories of approach by researchers, or combination of the above. EXERCISE 2: Which approaches are used in the following? Example 1 The general text for the area of information retrieval is more than 10 years old (Salton and McGill, Introduction to Modern Information Retrieval, 1983). Yet, the methods of information retrieval mentioned are still relevant today. Van Rijsbergen (1979) describes probabilistic retrieval, which is the model that the Bayesian network implementation of information retrieval system is based on. Of the implementations of such systems, Turtle‟s (1990) implementation appears to be the most well-known and demonstrates superior performance compared to Boolean and vector space methods. Ghazfan et al. (1994) have produced a different implementation which has not been tested in an actual information retrieval system. It is the purpose of this investigation to obtain performance results in an actual information retrieval system. Example 2 The situational approach to investigating the spoken English of L2 speakers was very much a product of the 1960s, one of its pioneering achievements being Neile 2 Osman's work with Australian immigrants (Osman, 1959). As a movement, however, it did not really survive the attack made on it by Wilkins in the early 70's (e.g. Wilkins, 1973). Wilkins‟ main objection therefore is that the situational approach is superficial. [...] Widdowson, for instance, observes that `The danger of such analysis is that ...' [...] Recent work by Ventola (1983; 1984), Martin (1985), Coupland (1983) and others opts for...[...] Current trends are towards reconstructing accounts that include... Speech community has been an evolving concept [...] and the variety of [...] criteria has been discussed by Hudson (1980), Saville-Troike (1982) and especially by Braithwaite (1984). At the outset, a speech community was seen as being composed of those who share similar linguistic rules (Bloomfield, 1933) [...] Later, Labov will emphasize `shared norms' [...] (Labov, 1966:7). Finally, there are those such as Hymes who argue for multiple criteria. Use of direct quotations (in qualitative research): These are commonly used to highlight: Author‟s definitions of important terms Assumptions underlying the author‟s choice of words Particularly illustrative examples of an author‟s specific view, difficult to paraphrase Particularly tellingly-expressed opinions, revealing insights which a paraphrase could not capture. When you use direct quotation, it needs to fit grammatically with the rest of your sentence. (1) Aid agencies have been known to take the view that such communities consist of “helpless victims with no capacity or expertise for responding to their own needs” (Leung et al., 1994). You can see that the quotation is the grammatical continuation of that part of the sentence used to introduce it, i.e. consists of + noun. (2) Hancock (1987) more recently summarized the concept as follows: During disasters, “charitable” advertising may succumb to the temptation of making appeals for public money which can function to humiliate the supposed beneficiaries and misrepresent them as passive victims. With as follows, no grammatical constraints apply to the quote, whereas an expression such as Hancock (1987) can be criticized for [...] must be followed by a verb ending in „-ing‟' (eg comparing ) or a noun (eg his neglect of …). 3 In some cases you will need to modify the quote using square brackets[ ] to include e.g. a verb ending or to change a pronoun etc. to make it follow grammatically. Omitted information is indicated by [...]. (3) The system was designed to show “how expert systems [could be used to] help in the decision making for investments in real estate” (Ostler & Branard, 1996, p. 77). A variety of constructions is available. The important thing to consider is how you put this all together to give a picture of your own research in relation to others'. You will be showing your attitude towards that research: whether you consider it outdated or still viable, close to your own perspective, etc. Avoiding plagiarism Plagiarism means using the ideas or words from other writers without acknowledging them. When you submit your thesis, you must be very confident that all sources are acknowledged; hence the Declaration statement. This is why you must use a method of note-taking which allows you to easily distinguish your own work from that of others. Acknowledging sources To share knowledge effectively we need to be open about the knowledge we have gained from other sources. We need to make it easy for the reader to locate and examine our sources. By doing this we also avoid plagiarism, which means 'to use another person's ideas or work and pass these off as one's own by failing to give proper acknowledgement'. We need to recognise and honour the contribution of others. See Language and Learning Online –Plagiarism http://www.monash.edu.au/lls/llonline/writing/general/plagiarism/index.xml As researchers, when we link our efforts to the work of others, we put our own work in context and allow distinctions and comparisons to be made. Good referencing technique also demonstrates your skills as a researcher. It shows that you know your way around the world of knowledge. Plagiarism can sometimes be the result of poor note taking, or paraphrasing without properly citing the reference. You can avoid plagiarism by: citing your references referencing correctly 4 recording direct quotes and paraphrases correctly when note taking. Paraphrasing and summarising Paraphrasing is when you take someone else's concepts and put them into your own words without changing the original meaning. Even though you are not using the same words you still need to state where the concepts came from. Note taking Poor note taking can lead to plagiarism. You should always take care to: record all reference information correctly (or use Endnote) paraphrase correctly clearly distinguish your own ideas from the ideas of other authors and researchers. What to reference You should provide references to both ideas and information: data statistics tables the opinions and ideas of other researchers. There are two instances where you do not need to reference. 1. You do not have to reference what is known as 'common knowledge': that is, what most people in a particular field would be expected to know, and which has the status of established fact. 2. You also don't need to reference an idea or words (phrases or sentences) which are totally your own. But if you haven't referenced a particular point, the implication is that you are claiming the idea as your own. EXERCISE 6: Discuss Successful vs. unsuccessful paraphrases (Embryology example) Read the text and paraphrases on the next page. Consider the merits of each paraphrase, and decide which is the most legitimate. What factors do you need to consider in evaluating each paraphrase? Could any be accused of plagiarism? Why? 5 Which is? ‗Patchwork‘ Paraphrase with no acknowledgement of source – i.e. Plagiarism Direct (word-for-word) i.e Plagiarism Legitimate Paraphrase The original text The potential benefits of treating diseases by using specialized cells generated in vivo are enormous. But much further work is needed. Possible risks include the tendency of embryonic stem (ES) cells to form teratomas, and the unknown hazards of using cells – whether ES cells or multipotent adult progenitor cells (MAPCs) – that have been cultured for long periods. And, although MAPCs seem to have normal chromosomes, it is important to establish that the pathways governing cell proliferation are unperturbed. Otherwise, short-term gains might fall prey to long-term complications. Orkin, S.H. & Morrison, S.J. 2002, Stem-cell competition, Nature, Vol 418, 4 Jul, pp. 25-27. Paraphrase 1 According to Orkin and Morrison (2002) much still needs to be done before the potential medical benefits of embryonic stem (ES) cells and multipotent adult progenitor cells (MAPCs) can be realised in clinical practice. At this stage, issues around the use of cultured cells (particularly when cultivated for extended periods) are unresolved, and it is unclear the extent to which cell proliferation occurs appropriately. In addition, in relation to ES cells there are concerns regarding formation of teratomas. Paraphrase 1 The benefits of treating diseases using specialized cells generated in vivo are considerable. But further work is needed because there are possible risks which include the tendency of embryonic stem (ES) cells to form teratomas, and the unknown hazards of using cells that have been cultured for a long time. It is important to establish that the pathways of cell proliferation are unperturbed (Orkin & Morrison, 2002). Paraphrase 2 Treatment of disease using specialized cells generated in vivo has enormous potential. However, more research is required because problems exist in relation to the tendency of embryonic stem (ES) cells to form teratomas, and the risks in using multipotent adult progenitor cells (MAPCs) that have been cultured for long periods. MAPCs have normal chromosomes, but it is important to establish that the pathways governing cell proliferation are not affected. Otherwise, short-term gains may be followed by long-term problems. [Adapted from: John Hamilton, ‘Writing Skills Tutorial’ 2008, pp. 11-14]. 6 Praise and criticism Critically evaluating research reports This means judging a number of the following AND finding the language to express it in. Whether: Definitions are adequate The question/problem/hypothesis has been adequately identified The approach/methodology is appropriate Any unjustified/invisible assumptions have been made Statements are specific enough A statement is actually the application of a certain principle Observations appear reliable Any reasoning is ambiguous or not There is any contradiction The conclusion follows The research is sufficiently current The research is sufficiently comprehensive The study differentiates itself clearly from other studies. EXERCISE 3: Try to identify those words in the following passage which indicate a ‗critical voice‘. Example (Introduction from article, ―Myocyte Hypertrophy in Neonatal Rat Heart Cultures and Its Regulation by Serum and by Catecholamines‖) VERY little is known about the role of hormones or other humoral factors in myocardial hypertrophy (Cohen, 1974). Experiments in vivo are complicated by hemodynamic, 7 In order to explore extracellular, nonhemodynamic factors that might be important in the regulation of MC hypertrophy, we have developed a single-cell culture preparation characterized hormonal, and neural reflexes elicited by endocrine ablations or hormone treatments. In vitro models such as the isolated perfused heart or the heart in organ culture offer greater experimental control, but growth does not occur in these preparations (Morkin, 1974; Wildenthal et al., 1976). Cell cultures have been widely used to study the regulation of cell proliferation, and it has recently been proposed (Clark and Zak, 1981; Frelin, 1980; Speicher et al., 1981) that heart cells in primary culture may be a useful model system for studies on myocardial growth. In typical cultures, however, demonstration of possible myocyte (MC) hypertrophy is confounded .by the presence of proliferating nonmyocardial cells (NMCs). These latter cells eventually comprise the major fraction of the culture population and may physically overgrow the MCs. by MC predominance, morphological and functional MC differentiation, and absence of cell proliferation (Simpson and Savion, 1982). The sparse nature of the cultures facilitates the measurement of cell numbers and MC surface areas; and the absence of hyperplastic growth means that time-related increases in cell protein can be taken as an index of hypertrophic growth. In the present report, we demonstrate the occurrence of MC hypertrophy in culture, using photomicroscopy and measurements of cell volume, surface area, and protein concentration. We also show that MC hypertrophy is regulated by manipulation of the culture medium, including variation in the serum concentration and addition of catecholamines. Reporting Words The following section lists some useful expressions for critically presenting other writers' ideas. Reporting verbs or expressions are used to report on what other authors have done: whether they have made claims, argued a case, established findings, drawn conclusions, etc. Note the differences in these verbs: your choice of word will reveal to your reader your attitude toward the status of the author's theories/research; it will also indicate whether or not you consider her/his claims to be substantiated. _____________________________________________________________________ EXERCISE 4: Categorise as many of the following “reporting verds” as you can: Maintain Acknowledge Insist Assume Challenge Claim Contend Dispute Draw attention to Focus on Establish Assert Hold Illustrate 8 Note Observe Point out Propose Take for granted Recognise Recommend Reiterate Reject Remark Underline Suggest Support The following may be regarded as the major ways other researchers („authors‟) can be referred to by you as the writer: Group 1 Author’s argument (author making a point to develop or justify his/her argument) Group 2 Author’s emphasis (author drawing reader’s attention to a particular point) Group 3 Author’s references to other authors (author positioning him/herself against other opinion) Group 4 Author’s omissions (author not fully arguing a point) There are a number of ways of indicating your position in relation to previous research. Signalling Your Position - The I/We Debate In a thesis, the relevance and importance of you as the author can change from section to section. The way your identity intrudes into the text depends to a large extent on accepted use in your particular discipline. Take your cues from the way this is done in published articles in your field (although note the different vehicle and audience), and seek the advice of your supervisor. 9 ―I‖ and ―my‖ can commonly be important for psychoanalytic writing, for instance – and case-study writing in a number of disciplines – but not for microbiology, for instance. Traditionally in much academic writing, it is not generally accepted to write: ―I think...‖ or ―It is my opinion...‖, because this detracts from the supposed objectivity of scholarship. It is true that too much insertion of yourself swings the focus on to you, rather than the material you are investigating. However, under the influence of a number of (post-)modern philosophers and other theorists, this may even be desirable in some disciplines. It is an area in flux. EXERCISE 5 : Can you think of any evaluative expressions (positive and negative) in your discipline? Do you use any in the list below? Positive and negative connotations depend on the discipline and what it values. The research/theory is: incomplete inconclusive questionable unsatisfactory cumbersome over-simplified too general overly subjective too sweeping unsubstantiated specious in its reasoning unconvincing groundless short sighted in its … biased robust efficient useful comprehensive complex reliable simple has disregarded X has been limited to X neglected to consider X overestimated X overlooked X underestimated X suffers from X requires excessive amounts of (time/storage, etc) has taken no account of X. pays particular attention to X includes X also considers X 10 gives a comprehensive account has the advantage of has the added benefit of You can expand your repertoire of evaluative expressions by reading articles or other theses attentively. Example of negative comment Criticism of patient satisfaction surveys Critics have pointed out that “constructs of patient satisfaction are poorly defined”.27,iii Too much effort has gone into producing data at the expense of concept development. In other words there has been not enough qualitative study and too much quantitative. It has been noted that there are high levels of reported satisfaction amongst health care users. However unstructured and in depth interviews indicate that many “satisfied” evaluations hid a variety of “negative” experiences.iv This casts doubt on the usefulness of satisfied responses when respondents are unable or unwilling to flag the negative aspects of care. There are also problems with the way in which healthcare providers respond to feedback. Observational and interview studies indicate that doctors often have less than favourable opinions about patient feedback when received.v,vi,vii They felt that a patient survey required considerable time and energy and saw little reason for change. One large randomized controlled trial in the Netherlands demonstrated no improvement in patient evaluations following feedback from a satisfaction survey.viii There were no changes in patient‟s evaluation even in areas that GPs had indicated that they had taken action to remedy an aspect of care. 11 Check out how theses in your field use their sources: see Learning Support for Higher Degree Research Students - Guide to analysing sample theses http://www.monash.edu.au/lls/hdr/write/5.2.1.html Impersonal language Remember your audience is an expert one, but they want to know what you know. It sounds awkward to style yourself as 'the author', 'the present writer', or 'the researcher'. There are more graceful ways of expressing your own opinion. If you are uncertain how to avoid an over-personalised tone in sections of the thesis where you do not want this, or too much passive voice, you can use the following expressions to make your position clear in relation to your sources: Using “It-clauses” and other 3rd person expressions Showing support or agreement Example: 'Recent studies have confirmed a critical role for ….' Example: 'This work clearly demonstrates that …' Example: 'The results of our study and those of Steinmann et al (22).' Example: 'The following discussion is based on the work in Murray et al.(1990).' Showing disagreement Example: 'Bruegge et al. (1992) review OMT; however, their paper is from a project management and team communication perspective and is not relevant to the argument presented here.' Example: 'Neither mathematics nor the classic Newell and Simon (1972) descriptions of human problem solving are particularly useful in domains where absolute correctness, resolution, proof and related concepts are inappropriate.' Example: ‘It is not clear whether … Example: ‘Information about x was not included; therefore we do not know …. 12 Improving your proofreading Moving from editing to proofreading Editing may seem like something you don‘t need to do until just before you hand your thesis in, but it should be part of your writing cycle. The objective here is to abandon your emotional commitment and switch to your reader's perspective. You can think of the preparation of any piece of writing as taking place in stages, like this: thinking & writing organising, writing & revising feedback editing proofreading giving to reader Steps in the Revision Process It‘s always best to put your writing aside for a day or so before editing. Printing out a hard copy also makes it much easier to see your work as another reader would. 1. 2. 3. 4. 5. 6. 7. Set your work aside for a day or more. Think about the main points you want to stay in the reader‘s mind. Is all the material in the right sections? Check for accuracy of data Read through, chapter by chapter. Are any sections too long/brief?. Read each sentence carefully, reading aloud any parts you had trouble with or are not happy about. 8. Check for clarity. 9. Spell-check your work, remembering that this will not pick up everything 10. Check for remaining errors. 11. Ask a fellow student or other native speaker to read your work. What do you look for? You need to check three aspects of your work: 13 1. How this piece fits into the larger unit it belongs to: What is its function of this section in the overall thesis/chapter/research paper? (Are you introducing a topic, giving background, arguing a particular position…?) Have you made clear how this section relates to the big picture? Does it actually do what it says it is going to do? 2. How well it works internally: Are there logical connections between the points of the argument? evidence—does it support what it is supposed to support? relevance—does every point contribute to the argument? language—are the right words/ expressions used to make the points you want to make? (clarity, conventions and terms of your discipline, consistency of register). 3. Presentation (checking at this level, usually referred to as proofreading, is done after the other two). These are some examples of the kinds of detail you should check at this stage: spelling punctuation grammatical accuracy formatting Tips: Try to automate for consistency (use styles, templates, referencemanaging software) Build up a writing guide for abbreviations, capitalisation, spelling (-ise/ize) Do small chunks at a time Proofread for one specific thing Create a checklist of your common errors. Update it each time you edit Find ways of looking at the text differently (to focus on form), e.g: Print out a proofreading copy in large font Put in a page return at the end of each paragraph. Sentence doesn't read well? Is the problem that it doesn't link well to the surrounding sentences? Check sentence linking by reading out loud. Try taking the key words and making sure that you are saying what you want to say about them. 14 Sounds too abstract? See if you are overusing abstract nouns and under-using their verbal equivalents (e.g. growth/grow, production/produce, identification/identify); this can have the effect of removing the dynamism from your text: "Temperatures showed an increase during the day." compared to "Temperatures increased during the day." "Weights of the specimens were taken." compared to "The specimens were weighed." Try to choose the most appropriate and interesting verbs (verbs such as be, have, get are fairly content-free, i.e. they don't do enough work. Use remains, develops, arises). 'Filler' verbs may not be needed at all: "we studied" is better than "we conducted a study"; "pressure improved" is better than "an improvement in pressure occurred". Stop and ask yourself 'What do I really want to say?' Chapters/sections too long? Check your paragraphs. Your reader should be able to glance at the first sentence of each paragraph in a section or chapter and this should constitute the framework of your logical argument. Have you elaborated these points more than is necessary? Remove unnecessary words, clauses or sentences. Check if you are including more examples or quotations than are necessary to make your point. Replace lengthy descriptions with tables or figures. Chapters/sections too short? Say to yourself, 'the point I want to get across here is...'; then, 'the specifics of this point are...'. At this point, you can try asking who, what, when, where, why and how: you are guaranteed to come up with more useful things to say. (This can also help with writer's block). Check that you have introduced and concluded each chapter sufficiently. Make sure you have explained your methodology adequately. See if there are more references to include. Does all the Appendix material belong there? 15 Proof-reading Technicalities Format of headings and sub-headings checked? Numbers, symbols and abbreviations correct and consistent? Italicising/bolding consistent? Capitalisation correct and consistent? Punctuation consistent? Eg double/single inverted commas Citations cross-checked with Reference List? Common problems Have you spelt the same word in the same (correct) way throughout? Eg. targeted, operationalise, honour Use the spellcheck on your word processor, but be warned: it will not find everything, and it will give you American spelling.. Do subjects and their verbs agree in number, particularly when a long or complex subject precedes the main verb? Pick the error: The proteolytic activity of extracts of X from these organs were expected to reach a high level. (See exercise below) Are participles attached to their subjects? Studying these examples, the conclusions were clear. The solution is to substitute an active or passive verb: When we studied these examples/When these examples were studied. Do pronouns refer clearly to an antecedent? In older strata the effect is different and may be found throughout the layers, but not in X. This is not a boundary, however, between two types of layer. Is it clear what This refers to? Have you include any meaningless phrases? Eg In this connection, we may say that ... Studies some years ago by Phipps and Green (1981), cf the investigation by Phipps and Green (1989) which showed ... Check for sentence fragments, ie sentences lacking a complete verb: eg For example, the increase in the cost of manufacturing. Ensuring that subjects and verbs agree. EXERCISE 7: Correct any examples of subject-verb agreement, where needed, in the following paragraph: 16 Nitrifying bacteria are sensitive organism and extremely sensitive to a wide variety of inhibitor. A variety of organic and inorganic agent can inhibit the growth and action of these organisms. High concentration of ammonia and nitrous acid can be inhibitory. The effect of PH is also significant. A narrow optimal range between PH 7.5 to 8.6 exist, but systems acclimated to lower PH condition has successfully nitrified. Temperature also exerts a tremendous influence on the growth of nitrifying bacteria. However, quantification of this effect has been difficult. Dissolved oxygen concentration above 1 mg/L are essential for nitrification to occur. If DO levels drop below this value, oxygen become the limiting nutrient and nitrification slow or cease. Editing and Proof reading checklist Structural aspects Editing Paragraphing: does each have clear topic sentences? Do the ideas 'hang together' cohesively? Are there links between paragraphs and sections (implicit / explicit connectors)? Coverage of your topic Have you answered your question? Have you covered the topic in sufficient depth? Analysis and argument Have you provided adequate analysis? Have you demonstrated an independent approach, using your own critical voice? Is your argument thorough, with evidence and supporting information? Citations, paraphrasing Are the citations all from reliable, current, representative sources? Are the paraphrases in your own words? Coherence (logical development) Is the content in the right sections 17 Notes Are the thought relationships clear? Are headings clear and concise? Cohesion (flow of writing) Are there signposts throughout to indicate where you have come from within the argument, and where you are going next? Is it in a consistent style, appropriate to an academic audience? Is the flow of ideas smooth? Proofreading your work Notes Formatting Check for consistency of heading levels, diagrams and tables, margins and indentation, bibliography Referencing information Are all sources listed in the bibliography or list of references? Are all reference details complete? Are all references presented in the required style? Sentence-level language Check grammar, word choice, sentence fragments, punctuation (see below) Checklist Subject-verb agreement Examples and comments Incorrect Do subjects and their verbs agree in number, particularly when a long or complex subjectCorrect precedes the main verb? ‘The lecturer, as well as some of the tutors, are planning a test for next week.’ ‘The lecturer, as well as some of the tutors, is planning a test for next week.’ Tenses Are your tenses consistent? 18 The present tense is used for stating main Is there a logical reason for you to change the tense? points, stating a scientific fact, reporting the position of a writer, and for making your own statements. The past tense is used to report or describe the contents, findings or conclusions of past research. Sentence fragments Have you used complete sentences? Run-on sentences Have you divided run-on sentences into two by using either a full stop or a semi colon? Sentence fragments lack a subject, a verb or both. Incorrect ‘We can see changes but not learning itself, the concept is theoretical and hence not directly observable.’ Correct ‘We can see changes but not learning itself; the concept is theoretical and hence not directly observable.’ Articles (a/an/the/zero article) Is the noun countable or uncountable, specific or general? Does the noun require an article, and if so, which one? Parallel structures Are components of your sentence grammatically equal? Normally, uncountable nouns cannot be pluralised in English: eg information, evidence, advice, knowledge. Incorrect ‘The following actions were taken: advertising the product, improve quality control and bring the retail price down.’ Correct ‘The following actions were taken: advertising the product, improving quality control and bringing the retail price down.’ Logical connectors Have you over-used or under19 For example, however, although, thus, as a used linking words? Do they provide clear links between sentences and paragraphs? Pronouns Do pronouns refer clearly to an antecedent? result of, in comparison are some common linking words. ‘If you leave the book on the table, you can take it after the class.’ Does the it refer to the table or the book? Punctuation Have you used apostrophes correctly? Spelling and capitalisation Have you spelt the same word in the same (correct) way throughout? eg targeted, operationalise, honour. Have you used capital letters consistently throughout? 20 Apostrophes show possession. For example: The hospital’s profitability declined in the second quarter of 2008. Contractions such as it's are not usually used in academic writing. Use the spellcheck, but be warned: it will not find everything, and it will give you American spelling unless you set it to UK or Australian EXERCISE 8: Improve this extract from the beginning of the Methodology Chapter of a Masters thesis: Description of the Instrument Scoring The study based on the Barriers scale which is originally developed in the USA in the 1980s and modified later by Funk et al. (1991a). However, The BARRIERS scale has been used widely since it was developed in 1991 as one method to explore the perceived influences on nurses utilization of research finding in their practice. The nursing literature has been reported about 17 studies which adopted the Barrier scale to elicit nurse attitudes regarding obstacles to research utilization in practice (Hutchinson and Johnston, 2003). __________________________________________________________ i Comley A.L., Beard M.T., Toward a derived theory of patient satisfaction: Journal of theory construction & testing, Fall 1998, 2,2. p44 ii Bowling A. Assessing Health needs and measuring patient satisfaction. Nursing Times 1992 88(31), 31-33 iii Sitzia J, How valid and reliable are patient satisfaction data? An anlysis of 195 studies. International Journal for quality in health care 1999 Volume 11, number 4; pp319-328 iv Williams B. Coyle J. Healy D. The meaning of Patient Satisfaction: An explanation of high reported levels. Social science medicine 1998 Nov 47(9) 1351-9 v Rider EA, Perrin JM., Performance profiles: the influence of patient satisfaction data on physicians' practice., Pediatrics. 2002 May;109(5):752-7. vi Kvamme OJ, Sandvik L, Hjortdahl P., Quality of general practice as experienced by patients, Tidsskr Nor Laegeforen. 2000 Sep 10;120(21):2503-6. vii Wensing M, Vingerhoets E, Grol R., Feedback based on patient evaluations: a tool for quality improvement?, Patient Educ Couns. 2003 Oct;51(2):149-53. viii Vingerhoets E, Wensing M, Grol R., Feedback of patients' evaluations of general practice care: a randomised trial., Qual Health Care. 2001 Dec;10(4):224-8. 21