Discussion: Theory, Research, and Evidence-Based Practice

As they explore the world around them, young children often want to know the “why” and “how” of the things they observe. This is similar to what researchers do when they approach a new problem. Researchers develop new theories or build on old ones to explain the “why” of the world around them. They use models and conceptual frameworks to help explain “how” the processes and events they observe occur. Together, theories and models provide an understanding of the world and allow researchers to explore it in meaningful ways. 

Virtually all research questions can benefit from the use of an existing theory or model. Researchers should consider their research questions and select the most suitable theory or model, which then serves as a foundation for the research design. The selection of a theory or model is an important part of the research process. 

In this Discussion, you focus on the role of theory and models in research and evidence-based practice.

                                                        To prepare:

• Review the information in Chapter 6 of the course text. Focus on the various conceptual theories and models that are currently used in nursing research.

• Select one of the theories or models described that is of interest to you.

• Using the Walden Library, search for and identify a research article that uses the theory or model you selected.

• Reflect on how the theory or model provides structure to the research study described in the article.

• Now, think about an issue in your practice area that you would be interested in exploring through research.

• Review this week’s media presentation and consider strategies for locating and identifying a relevant theory or model for a research study.

Post a summary of the article that you located and explain how the theory or model that you selected was used in the research study. Assess the value of basing research on an established theory or model.

88 NURSERESEARCHER 2010, 17, 2

reviews

Nursing Research –
Generating and Assessing
Evidence for Nursing Practice
Authors: Denise
F Polit, Cheryl
Tatano Beck
Publisher:
Lippincott
Williams and
Wilkins
Pages: 816
Price: £35
ISBN: 0781794684

Nursing Research – Generating and Assessing

Evidence for Nursing Practice starts from

a basic level and gradually builds to

provide guidance in the complexities

and nuances of research in the nursing

field. The book also reflects the growing

maturity of nurse-led research and

reinforces the intrinsic worth of the

expertise and knowledge that we have

as a profession.

This is the book’s eighth edition and

has new chapters relating to systematic

reviews, self-reporting scales and

enhancing and assessing integrity in

qualitative enquiry.

It is readable – and I say this

acknowledging the fact that I teach

this subject – and presents concepts

in a simple yet professional way.

In addition, points are contextualised

using different tools. Examples are given

to illustrate concepts, tips are included to

aid novice researchers in their decision

making, main points are summarised

at the end of each chapter and study

activities are detailed to enhance the

reader’s learning. All of these tools help

to broaden the book’s appeal.

One tool that seems particularly useful,

especially to a lecturer such as me who

teaches research and evidence-based

practice to undergraduate nursing

students, are the examples of how to

critique quantitative and qualitative

research reports. This is something that

often causes confusion among students

and tools such as these can help them

and qualified nurses enormously to

review the importance of the evidence

they find.

Similarly to other books written in,

and perhaps predominantly for, the

United States, some of the terms used

may be confusing outside the US.

For example, the book refers to

institutional review boards – rather than

or as well as research ethics committees

– the US National Institute for Health

and other American organisations.

While this is not a huge disadvantage

to the non-American reader, it could have

been mediated by greater awareness

of the international reach of this book.

There is also a CD-ROM that contains

‘dozens upon dozens’ of documents that

the reader can use. I had some difficulty

in accessing the documents because it

NURSERESEARCHER 2010, 17, 2 89

requ

Rubric Detail

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Content

Name: NURS_5052_Week_3_Discussion_Rubric

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Outstanding Performance

Excellent Performance

Competent Performance

Proficient Performance

Room for Improvement

Main Posting:
Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

Points Range: 44 (44%) – 44 (44%)

Thoroughly responds to the discussion question(s)

is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

supported by at least 3 current, credible sources

Points Range: 40 (40%) – 43 (43%)

Responds to the discussion question(s)

is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

75% of post has exceptional depth and breadth

supported by at least 3 credible references

Points Range: 35 (35%) – 39 (39%)

Responds to most of the discussion question(s)

is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

50% of post has exceptional depth and breadth

supported by at least 3 credible references

Points Range: 31 (31%) – 34 (34%)

Responds to some of the discussion question(s)

one to two criteria are not addressed or are superficially addressed

is somewhat lacking reflection and critical analysis and synthesis

somewhat represents knowledge gained from the course readings for the module.

post is cited with fewer than 2 credible references

Points Range: 0 (0%) – 30 (30%)

Does not respond to the discussion question(s)

lacks depth or superficially addresses criteria

lacks reflection and critical analysis and synthesis

does not represent knowledge gained from the course readings for the module.

contains only 1 or no credible references

Main Posting:
Writing

Points Range: 6 (6%) – 6 (6%)

Written clearly and concisely

Contai

Required Readings

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

· Chapter 2, “Evidence-Based Nursing: Translating Research Evidence into Practice” (Review pages 14–31)

· Chapter 6, “Theoretical Frameworks”

In this chapter, you are introduced to the concept of theories, models, and frameworks and how they serve as the foundation for research. The chapter examines key theories for both quantitative and qualitative research. Finally, critiquing frameworks in research reports is detailed.

Cantrell, M. A. (2011). Demystifying the research process: Understanding a descriptive comparative research design. Pediatric Nursing, 37(4), 188–189.

Retrieved from the Walden Library databases.

 

This article discusses the primary aspects of a prominent quantitative research design as used in a specific research study. The author analyzes the advantages and disadvantages of the design, along with the rationale for choosing that design.

Finn, P. (2011). Critical thinking: Knowledge and skills for evidence-based practice. Language, Speech, and Hearing Services in Schools, 42(1), 69–72.

Retrieved from the Walden Library databases.

 

This article responds to the assertion that “rational or critical thinking is an essential complement to evidence-based practice.” The author stipulates how critical thinking is relevant to EBP, what skills and thinking dispositions are important, and how thinking can go wrong.

Tagney, J., & Haines, C. (2009). Using evidence-based practice to address gaps in nursing knowledge. British Journal of Nursing (BJN), 18(8), 484–489.

Retrieved from the Walden Library databases.

 

This article illuminates key barriers to undertaking and implementing nursing research. The authors suggest a framework for improving the implementation of evidence and research.

Media

Laureate Education (Producer). (2012i). Selecting a framework. Baltimore, MD: Author.

 



LSHSS

Clinical Forum

Critical Thinking: Knowledge and Skills
for Evidence-Based Practice

Patrick Finn
University of Georgia, Athens

F or decades, our profession’s scientists have arguedthat scientific thinking is an essential complement toclinical thinking (e.g., Ringel, 1972; Costello, 1979;
Perkins, 1985). Kamhi (1984) is sympathetic but suggests that
science’s most important safeguards may be impossible to imple-
ment in clinical practice (Kamhi, 2011). He is concerned that sci-
entists are fallible, clinicians are fallible, and, in fact, that all of us
are fallible because we develop erroneous beliefs and make wrong
decisions not because of the absence of thinking but because of
flaws in our reasoning process (Halpern, 1998). Kamhi (2011)
argues, however, that the fallibility of a scientist’s thinking can
be minimized by the presence of the larger scientific community
and its questioning attitude, willingness to embrace disconfirming
evidence, and openness to change. In contrast, Kamhi (2011) feels

that the fallibility of a clinician’s thinking is not as amenable
because the self-corrective mechanisms of science are most effec-
tive at the community level, not the individual level at which most
clinicians operate.

Kamhi (2011) hopes that evidence-based practice (EBP) will
offset the fallibility of clinicians’ thinking. But, he is concerned that
the complex integration of different kinds of evidence will make
this difficult to achieve. Although Kamhi suggests that a case-based
model may guide clinicians on how to weigh evidence and justify
clinical choices, in the end, he believes that clinicians’ thinking will
probably be influenced more by their personal beliefs and think-
ing style. Ultimately, Kamhi concludes that the only safeguard
against clinicians’ potentially unbalanced decisions will be rational
thinking in the clinic.

I believe that Kamhi (2011) is correct in his conclusion that
rational—or critical—thinking is an essential clinical skill and
important complement to EBP in our profession. What is not
clear, however, is what clinicians need to know so they can think
critically within EBP. In what follows, I will sketch the core
information that I believe is necessary for clinicians to know
in order to become more balanced thinkers. I also suggest that
critical thinking should be a required skill of our professional
training programs.

What Is Critical Thinking and How Is It Relevant
to EBP?

Critical thinking is applied rationality. It is a way of thinking that
is based on principles of rationality (Nickerson, 2008). Critical
thinking has been conceptualized as a set of skills that people can
learn and apply in their everyday or professional lives. In fact,
critical thinking and rationality are terms that are sometimes used
interchangeably (e.g., Stanovich, 1999).

ABSTRACT: Purpose: I respond to Kamhi’s (2011) conc

Using evidence-based practice to
address gaps in nursing knowledge

B
oth here in Britain and internationally, the public’s
expectations of quality and evidence-based care
are increasing (Biron et al, 2007; Department
of Health (DH), 2008). Consideration must,

therefore, be given to ways of supporting nursing practice
and research that help to identify and address gaps in
knowledge, thus expanding the evidence base (ICN, 2007;
Priest, 2007). However, research suggests that nurses may
not access the most up-to-date sources of evidence and

Jenny Tagney, Caroline Haines

may lack the necessary critical appraisal skills to evaluate
what constitutes ‘best practice’ (Gerrish and Clayton, 2004;
Nicholas et al, 2005). Therefore, how can nurses be sure
that the quality agenda is being addressed and that the best
evidence-based practice is being delivered? This article
explores a potential model for enhancing evidence-based
care through developing nursing research and critical
appraisal skills within a nursing environment. While the
authors focus on an English perspective, the broad principles
are applicable in any clinical nursing organization.

Evidence-based care
Over the past decade, the development of evidence-based
care in England has received significant attention through
a variety of central government policies. The introduction
of national standards of excellence for the NHS were
identified as part of what would make the new NHS
‘modern and dependable’ (DH, 1997), providing higher
quality care to patients through improving efficiency
and excellence. This was to be achieved through new
evidence-based National Service Frameworks (NSFs),
developed to help ensure equitable access to and quality
within services. Additionally, the National Institute for
Health and Clinical Excellence (NICE) was established, to
draw up evidence guidelines from scientific research (DH,
1997), and the Commission for Health Improvement
(CHI), was established to support and oversee the quality
of clinical services.

The DH worked with the clinical professions to develop
the NSFs and, for the first time, the NHS was to conduct
and publish annual national surveys to find out what
patients and their carers’ thought of NHS services.

Within A First Class Service – Setting Quality Standards
(DH 1998), the NHS research and development strategy
was outlined as providing access to a rapidly expanding
evidence base for health-care interventions and services,
although development of guidance from this appeared
inconsistent. It was suggested that clinical decisions
should be based either on contradictory advice about
service provision, or, in some cases, a complete lack of
evidence. The strategic vision in A First Class Service
– Setting Quality Standards emphasised that NSFs would
set common standards across the country for the treatment
of pa