Critically reviewing
qualitative papers using
a CASP critiquing tool
Di Carpenter
How to Write Your Nursing Dissertation, First Edition. Alan Glasper and Colin Rees.
© 2013 John Wiley & Sons, Ltd. Published 2013 by John Wiley & Sons, Ltd.
Scenario
Sue, the top‐up degree student,
and Sam, the MSc student, have
identified a range of qualitative
papers that they need to critically
appraise to assess the strength of
the evidence to determine
whether a change in practice is
warranted.
They have both been advised by
their supervisor to use ‘The
Critical Appraisal Skills
Programme’ (CASP) appraisal tool
suite. Sam is considering using the
version for qualitative research.
CASP has developed several
appraisal tools for different kinds
of research.
CASP Appraisal Tool
• The tool designed to make sense of qualitative
evidence has been developed for those who are not
very confident or familiar with qualitative research
and, as such, provides a starting point. The appraisal
tool is copyright protected but it may be used by
individuals so long as it is appropriately referenced –
the complete tool can be found at:
http://www.sph.nhs.uk/sph‐files/Qualitative%20Apprai
sal%20Tool.pdf (Public Health Resource Unit, 2006 )
• More details about CASP can be found at:
http://www.sph.nhs.uk/what‐we‐do/public‐health‐wor
kforce/resources/critical‐appraisalsskills‐programme
(NHS, 2012 ).
Shortcuts
• The CASP tools include two screening questions.
• If these can be answered with a ‘Yes’ it is worth
continuing with the appraisal.
• Sue and Sam were pleased to be saved
unnecessary time. They were able to affirm the
screening questions for the clown article:
(1) there was a clear statement about the aims of
the research and
(2) a qualitative methodology was appropriate.
The focus of the research
is definitely qualitative:
The perceived effects of
clown humour as
experienced by children
in a large children’s
inpatient facility in the
South of England
They could have
worded it better
though – it sounds like
a hospital for large
children – they’re
adults aren’t they?
8 Detailed Questions Followed
• Was the study design appropriate?
Did they discuss
how they chose
their research
method?
Yes, they described the
choice of ‘draw and
write / draw and tell’
which are two
complementary
qualitative research
designs.
Was the Recruitment Strategy
Appropriate?
Children were selected
between the ages of four
and eleven years as this age
group is suitable to engage
with the research methods
of ‘draw and write / draw
and tell’.
The researchers had
approached forty-two
children but initially sixteen
did not consent to
participate and a further six
were unable to complete
the second part of the data
collection (they were
discharged home early or
felt too unwell).
It wasn’t really clear why 20
children were chosen though!
Were the Data Collected in a Way That
Addressed The Research Issue?
I don’t think that the setting
for the data was entirely
justified within the article. It
was very clear, however,
how the data were
collected.
Reflexivity is the Focus of Questions
Ethical issues
6 and 7 The article makes no
and consent
were addressed
though.
reference to the
researcher having
made a critical
examination of her
role, potential bias or
influence.
Well perhaps some potential
for bias or influence was
addressed, but it was not
sufficiently focussed on the
investigator’s own potential
for influence and
interpretation.
Data Analysis
The article provided a reasonably
in-depth description of the process
of analysis; a thematic analysis was
used and an appropriate technique
of coding data was utilized to
delineate common themes.
There had been no
discussion of
contradictory data and
no critical examination of
bias or influence in the
selection of data for
presentation.
Research Findings
The findings were clear and explicit and
supported by two tables. Some
discussion of the credibility of the
findings was included, but there
appeared to be no discussion of the
evidence for and against the
researchers’ arguments although the
findings were contextualized with
respect to the original research
questions.
How Valuable is the Research?
The authors had claimed
that the study added to the
growing literature base for
the efficacy of clown
humour as experienced by
children in hospital.
The limitations of the study
were also identified and
included that data were
collected from children in
only one hospital.
In Summary
• The methodology was suitable for the nature
of the enquiry and that the research had been
conducted appropriately.
• The data collection was consistent with the
methodological approach and addressed the
research issue.
• The data analysis had also been conducted
rigorously, but that some important discussion
points were missing from the article.
And...
• One of the study’s weakest areas appeared to
Sue and Sam to be in the area of reflexivity.
There seemed to have been little
consideration of the relationship between
researcher and participants and insufficient
account made of the ethical considerations.
Finally
Further study is needed before any confidence
could be given to the transferability of the
findings or any change in practice made.
Which the
authors also
stated.
References
• Greenhalgh, T. (2010), How to Read a Paper 4th edn.
(London; Blackwell publishing).
• Weaver, K., Prudhoe, G., Battrick, C. And Glasper, E.A.
(2007), ‘Sick children’s perceptions of clown doctor
humour’, Nursing Times, Vol 1, No. 8, pp. 359-365.
• http://www.sph.nhs.uk/sphfiles/Qualitative%20Appraisal%20Tool.pdf , ‘Critical
Appraisal Skills Programme: 10 Questions to help you
make sense of Qualitative Research’ consulted on
11/02/2011
• http://www.phru.nhs.uk/casp/casp.htm , ‘Critcal
Appraisal Skills Programme’ consulted on 11/02/2011