The purpose of this assignment is to critique and evaluate the chosen article in terms of strengths and weaknesses, and to demonstrate an understanding of the research process. This article takes you through a critical appraisal exercise using an article from a Medical Journal. It describes how you decide whether to read and use an article that may be relevant to one’s research. Polit and Hungler (1997), believe that a true understanding of ‘a sound theoretical foundation to guide practice is enhanced by the ability of nurses to critique research.’ For the purpose of this critique the model chosen is that of Parahoo (1997).The purpose of this critique, the framework of Parahoo (1997) and Polit and Hugler (1999) have been used as a guide.
The title of ‘A qualitative study of nursing student experiences of clinical practice,’ shows a clear indication of what the purpose of the study is and the research problem is clearly identified. Cormack (2000) and Marshall and Kelly (2007) agree, stating a title should be concise and reflect the content of the study. The title is not too long and complicated, and reflects as much as possible what the research is about.
According to Parahoo and Reid (1988), ‘the title does not validate or invalidate the research.’ Qualitative research does not regard truth as objective, but as a subjective reality that is experienced differently by each individual (Vishnevsky and Beanlands, 2004). The grammar within the study is quite poor but this could be due to the translation from Iranain into english Author(s)
The author(s) qualifications are not given which could indicate that they don’t have an educational background also it does not mention of their clinical knowledge or experience to carry out valid research. The email addresses are personnel addresses and aren’t typical to a university but this may be due to censorship restrictions placed on Iranian institutions. Shiraz University of Medical Sciences where this study was conducted is one of the top universities of the Middle East having looked at the university’s website it appears to be one of the top university’s for medical science it has many medical course up to PHD level in many subjects. www.sums.ac.
The purpose of this abstract is to define the breakdown of the article and gives direct access to the section of the study which is of most interest to the reader. The type script is clear to the eye and the headings are in bold, so it’s easy to the read. The abstract clearly introduces and states the main objective of the study. Polit and Hungler (1997), state that ‘An abstract or summary should clearly outline the problem, the hypothesis or research question/s, aims and objectives of the study’.
This section also summarises what the paper has attempted to investigate and will give a sound indication about whether the paper is likely to be relevant to the area of interest and how interesting the results are likely to be. Overall the abstract gives a clear overview of the study, including the research problems, samples, methodology, findings and recommendations. This gives a high level overview of the paper to allow the reader to quickly understand the research topic.
The purpose of the study was to explore the clinical experience of student nurses in practice; this paper explains evidence-based practice within a qualitative research. My search strategy is to utilise the internet and to look at published articles in scientific journals. The author Farkhondeh Sharif has several papers published in scientific journals. Farkhondeh Sharif has several scientific research papers published The effect of peer-led education on the life quality of mastectomy patients, 2009. Effect of a psycho-educational intervention for family members on caregiver burdens and psychiatric symptoms in patients with schizophrenia, 2012.
Sara Masoumi the second author does not seem to have any papers published as this could be their first research paper. The method used in the study of Sharif and Maousmi (2005) is one of a qualitative nature in the form of a focus group study that “involves organized discussion with a selected group of individuals to gain information about their views and experiences of a topic and is particularly suited for obtaining several perspectives about the same topic.
The literature review is titled background. This Background section although not attempting to detail all other research on nursing clinical practice, does nevertheless; establish the study’s place in the spectrum of other nursing clinical practice research. All books and journals sourced in the article are accurately referenced. Unlike many academic articles the authors of this article do not use Harvard Referencing. The authors prefer to use the more recognised scientific and medical referencing approach. This article uses what is known as the Vancouver style referencing. The Vancouver Style, is the numbered referencing style commonly used in medicine and science. This consists of citations in the text, using numbers and a number referencing list at the end of the document.
It follows rules established by the International Committee of Medical Journal Editors, now maintained by the US National Library of Medicine. It is also known as uniform manuscript submitted to Biomedical Journals. A number is allocated to a source in the order in which it is cited in the text. If the source is referred to again, the same number is used. References are listed in numerical order in the references in the article.In this journal data has been gathered and been analysed statistically.
The methodological approach from a nurse’s point of view is realistic and practically described, and therefore, easy to understand. Sharif and Masounmi introduced firstly the focus group, explaining about the participants from which the clinical study took place. They also provided a list of questions used in the trial. Then they move on to describe all the steps that where untaken in the focus group data analysis. They even go on further to describe the three levels of coding selected as appropriate for coding the data. Finally, they consider the author makes us aware of the ethical considerations.
The work of Sharif and Masoumi (2005) examine the problem of anxiety that components of the nursing program produce. This problem is important to understand due to the possibility of stress diminishing the potential learning of students during clinical placements. The group interview were a method used to gather data in this study and also is a method which involves the focus being placed on and observations to express reality and attempts to describe people in natural situations.” (Sharif and Maousmi, 2005;)This study was conducted from a sample drawn of 90 baccalaureate-nursing students from 200 nursing students at Shiraz University Medical Sciences, Faculty of Nursing and Midwifery.
Sharif and Masoumi conduct the study under review for the purpose of understanding the stress experienced by nursing students in clinical practice. Questions addressed in the research of Sharif and Masoumi (2005) include questions relating to how the student feels about their education and nursing in general. Other questions asked of the students in this include the question of whether there is anything about the clinical field that causes the student to feel anxious and asks if the student would like to discuss the clinical experiences, which they found to be the most anxiety producing and which experiences the student found enjoyable. This study further asked the question of ‘what are the best and worst things do you think might happen during the clinical experience?
‘What do nursing students worry about regarding clinical experience? This interview also included the questions of ‘how do you think clinical experiences can be improved’ and ‘what is your expectation of clinical experiences. Data was collected in the group interview, stated by Sharif and Masoumi to be “essentially a qualitative data gathering technique that may be used at any point in a research program and one of the most common uses of it is to obtain general background information about a topic of interest.
Data analysis involved “immediate debriefing after each focus group with the observer” and during this time, debriefing notes were recorded containing comments related to the process of the focus group and the data’s significance. Secondly, the tape was listened too and the content of the tape transcribed. Third checking the tape’s content with the observer noting and considering any non-verbal behaviour
Ethics are an important part of nursing and nursing research. It is about researchers doing what is fair, decent and moral and underpinned by values and believes of the community ( Crookes and Davies 2004).
There is a section for ethical considerations; this article addresses this under the heading ethical considerations. The study was conducted after approval was obtained from the vice –chancellor of Shiraz University also from the Dean of Faculty of Nursing and Midwifery. Individual nursing students had to give written consent and where given the option to exit from the focus group if they wished. Ethical issues are important and should be considered at every step of the research process.
This is not just about obtaining ‘ethical approval’ for a study but also ensuring the rights of participants are not violated. When reporting qualitative research, participants’ anonymity and confidentiality must not be breached. Within this research the main tools used are data collection, interview and participant observation. The participants are therefore known to the researcher and anonymity is not possible. The researcher must therefore assure participants that their identities will not be revealed to the reader and the raw data collected will not be released to any third party (Parahoo. 2006).
The researcher(s) in this study presented the data in sufficient form with adequate discussion, but organise their findings under subheadings. The author(s) presented their findings using a table. Table 1shows a table of codes broken down into three headings. Results were explained and summarised but in a repetitive way. Otherwise the document is most readable with a convenient summary of findings at the end. The presentation format is good, as it’s easy to read and understand.
The information was not sufficient or descriptive to interpret the results, quite vague the findings. This could be seen to be as a problem with this piece of qualitative research as the author(s) uses only uses three charts. What came out of the overall results four themes emerged from the focus groups date which where initial clinical anxiety, theory practice gap, clinical supervision, professional role where considered important in clinical experience but the main theme was clinical anxiety in the student nurses on clinical placement .
The article presents a small conclusion, but no separate recommendations for practice. The conclusion summarizes the findings.With clinical training being one of the most vital components of the nursing education, it is imperative that nurse educators help nursing students manage their stress and anxiety during this important process. In Iran they have different cultural perceptions from the UK, the females are not supposed to be in the presence of males outside the family this contribute to high anxiety levels in the student nurses to begin with especially in an environment where they feel under pressure. Within the Iranian culture introduction are generally restricted to members of the same sex, men and women socialise separately.
Referring to the WHO, 2009 there are global international standards within nursing this would apply to both the UK and Iranian nursing standards. This is an internal document that stipulates internal standards in nursing and midwifery education and training.
The global standards are to establish educational, criteria and assure outcomes that, a) are based on evidence and competency. Promote the progressive nature of education and lifelong. Learning, and ensure the employment of practitioners who are competent and who, by providing quality care, promote positive health outcomes in the populations they serve. The UK and Iranian nursing standards both countries have to adhere to these professional standards.