Searching and Critiquing the Evidence


Bring to mind the various practice problems you and your colleagues have been considering in this course. What insights might the literature provide with regard to these issues? How should you evaluate the research? And, why is it important to review and critique this information?

This Discussion addresses strategies for searching the literature in order to critique existing evidence. Please note that this Discussion is related to Application Assignment #4, which is assigned this week. You are strongly encouraged to read through that assignment now.

To prepare:

  • Review the Walden Library Webinars presented in the Learning Resources.
  • Recall the practice problem and theoretical framework you identified for the Week 5  Discussion (See attached file). Using the Walden Library and other professional databases, conduct a search and locate four (4) appropriate primary research articles one of which is a systematic review.
  • Review the articles and determine what level of evidence they represent. Using the critique strategies presented in the Learning Resources as a guide, consider how the articles you located either support or weaken the merit of your theoretical framework or the importance of your practice problem.

By Wednesday 7/05/17, post 550 words essay in APA format with 2 references from the list below, as well as the 4 references for the articles review that include the level one headings as numbered below:

post a cohesive response that addresses the following:

1)       How does the literature strengthen or weaken the merit of your selected theoretical framework and practice problem?

2)       What levels of evidence are most prevalent in these articles? (I, II, III, IV or V)

3)       Why do you think that level of evidence is most prevalent?


Walden Library Webinars:


 Conducting a Literature Search on a Clinical Research Question. Retrieved from:


 Evidence-Based Health Research Retried from:


 Introduction to Health Science Research. Retrieved from:


 Medical Research: Finding Reviews. Retrieved from:


 Medical Research: Finding Studies by Type. Retrieved from:


 Medical Research: Health Policies and Legal Cases. Retrieved from:


Recommended Webinars:

 Webinars on Library Skills. Retrieved from:


 Evidence Based Practice for NURS 6052. Retrieved from:


Required Readings


Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.

Chapter 3, “Introduction to Quantitative Research”

 Chapter 3 provides an overview of quantitative research, the concepts associated with this type of research, and different quantitative research designs.


Chapter 4, “Introduction to Qualitative Research”

 Chapter 4 describes the philosophy of qualitative research and provides examples of how it is used in nursing research. Understanding the basic principles of quantitative and qualitative research is necessary to effectively critique research literature.


Chapter 7, “Review of Relevant Literature”

 Chapter 7 examines the process of preparing for a literature review to support research efforts.


Chapter 13, “Outcomes Research”


Moran, K., Burson, R., & Conrad, D. (2017). The doctor of nursing practice scholarly project: A framework for success (2nd ed.). Burlington, MA: Jones & Bartlett Learning.

Review Chapter 6, “Developing the Scholarly Project”


Armola, R., Bourgault, A., Halm, M., Board, R., Bucher, L., Harrington, L., & … Medina, J. (2009). AACN levels of evidence: What’s new? Critical Care Nurse, 29(4), 70–73. doi: 10.4037/ccn2009969

 Note: You will access this article from the Walden Library databases.

 This article provides a hierarchical evidence rating system which can be used as a guide to determine the quality and level of evidence presented in different types of research studies.


Elkins, M. Y. (2010). Using PICO and the brief report to answer clinical questions. Nursing, 40(4), 59–60. doi: 10.1097/01.NURSE.0000369871.07714.39

 Note: You will access this article from the Walden Library databases.

 The article explains how to use the PICO method to develop clinical questions.



Fineout-Overholt, E., Melnyk, B., Stillwell, S., & Williamson, K. (2010). Critical appraisal of the evidence: Part I an introduction to gathering, evaluating, and recording the evidence… fifth in a series. American Journal of Nursing, 110(7), 47–52. doi: 10.1097/01.NAJ.0000383935.22721.9c

 Note: You will access this article from the Walden Library databases.

 This article discusses the process of rapid critical analysis of research and literature through the categorization of studies and utilization of an evaluation table.


Fineout-Overholt, E., Melnyk, B., Stillwell, S., & Williamson, K. (2010). Critical appraisal of the evidence: Part III the process of synthesis: Seeing similarities and differences across the body of evidence. American Journal of Nursing, 110(11), 43–51. doi: 10.1097/01.NAJ.0000390523.99066.b5

 Note: You will access this article from the Walden Library databases.

 This article continues the discussion of critical analysis of evidence and concludes with how nurses can then make decisions based on a synthesis of the findings.


 Nursing Library and Information Resources Cushing/Whitney Medical Library (n.d.). Levels of evidence pyramid. Retrieved from

 This article discusses the use of systematic reviews in evidence-based practice and provides sources for locating this type of research article.


Duke University Medical Center Library. (2009). Evidence-based clinical practice resources: Hierarchy of evidence-based medicine (EBM) resources. Retrieved from

 Duke University provides this visual representation of levels of evidence.


University of Illinois at Chicago. (n.d.) Evidence-based practice in the health sciences: Levels of evidence. Retrieved from

 This web-based tutorial provides an overview of evidence-based practice and includes a section on developing practice questions for evidence-based projects.


 Evidence-Based Nursing. (n.d.) Retrieved from

 This website surveys a wide range of international clinical journals and includes only those research articles that demonstrate high quality and validity.


Harvey Cushing/John Hay Whitney Medical Library (n.d.). Finding evidence in PubMed. Retrieved from


 The Joanna Briggs Institute (n.d.). Retrieved from

This international organization was created by the Faculty of Health Sciences at the University of Adelaide in South Australia and provides members with access to systematic reviews and other research efforts.



Optional Resources


Boss, C., & Wurmser, T. A. (2009). Searching for evidence: Mission-critical tips. Nursing Management, 40(9), 12. doi: 10.1097/01.NUMA.0000360766.29235.8e

 Note: You will access this article from the Walden Library databases.


Coughlan, M., Cronin, P., & Ryan, F. (2007). Step-by-step guide to critiquing research: Part 1: Quantitative research. British Journal of Nursing (BJN), 16(11), 658–663.

 Note: You will access this article from the Walden Library databases.

 This article provides strategies for critiquing quantitative research and includes definitions of frequently used research terms.


Cronin, P., Ryan, F., & Coughlan, M. (2008). Undertaking a literature review: A step-by-step approach. British Journal of Nursing (BJN), 17(1), 38–43.

 Note: You will access this article from the Walden Library databases.

 This article details an approach for nurses to use when analyzing research, synthesizing data, and writing and reporting research findings.

Dale, J. C. (2005). Critiquing research for use in practice. Journal of Pediatric Health Care, 19(3), 183–186. doi:10.1016/j.pedhc.2005.02.004

 Note: You will access this article from the Walden Library databases.


 Engle, M., Blumethal, A., & Cosgrave, T. (2010). How to prepare an annotated bibliography. Cornell University Library Olin & Uris Libraries: Ask a Librarian. Retrieved from



Evans, D. (2003). Hierarchy of evidence: A framework for ranking evidence evaluating healthcare interventions. Journal of Clinical Nursing, 12(1), 77–84. doi: 10.1046/j.1365-2702.2003.00662.x

 Note: You will access this article from the Walden Library databases.



Hanson, D., Hoss, B. L., & Wsorick, B. (2008). Evaluating the evidence: Guidelines. AORN Journal, 88(2), 188–196.

 Note: You will access this article from the Walden Library databases.


Holopainen, A., Hakulinen-Viitanen, T., & Tossavainen, K. (2008). Systematic review – A method for nursing research. Nurse Researcher, 16(1), 72–83.

 Note: You will access this article from the Walden Library databases.


Kleinpell, R. M., Gawlinski, A., & Burns, S. M. (2006). Searching and critiquing literature essential for acute care NPs. Nurse Practioner, 31(8), 12–13.

 Note: You will access this article from the Walden Library databases.


Parahoo, K., McCaughan, E., Noyes, J., & McDonough, S. (2010). The effectiveness of psychosocial interventions for men with prostate cancer: A systematic review. Cochrane Database of Systematic Reviews, (6). doi: 10.1002/14651858.CD008529

 Note: You will access this article from the Walden Library databases.

This systematic review provides results of psychosocial theories utilized in assisting men with prostate cancer.



Sherrod, R. A., Ford, C., & Oliver, J. (2010). Using data from the Internet to teach ethical principles for critiquing research studies. Nurse Educator, 35(1), 17–1 9. doi: 10.1097/NNE.0b013e3181c41f8d

 Note: You will access this article from the Walden Library databases.



Tatano-Beck, C. (2009). Critiquing qualitative research. AORN Journal, 90(4), 543. doi: 10.1016/j.aorn.2008.12.023

 Note: You will access this article from the Walden Library databases.



Traynor, M. (2009). Humanism and its critiques in nursing research literature. Journal of Advanced Nursing, 65(7), 1560–1567.

 Note: You will access this article from the Walden Library databases.



 Consortium Library University of Alaska Anchorage (2011). Nursing research guide. Retrieved from


 The Writing Center (2007). Literature reviews. University of North Carolina at Chapel Hill. Retrieved from


 The University of Wisconsin-Madison Writing Center. (2009). Writer’s handbook: Common writing assignments: Review of literature. Retrieved from


Selecting a Theoretical Framework

Article Reviewed and the Theoretical Framework used to Explore the Practice Problem.

In his article, Evans (2010) explores the effectiveness of advanced practice nurse (APN)-led follow-up telephone intervention to glycemic control in patients with type 2 DM (p. 318). To ensure the effectiveness of the intervention, the study employed the interpretation of daily fasting blood glucose results. The study used the Dorothea Orem’s Self-Care Deficit Theory of Nursing. The conceptual model theory has three theories expressed in it: the theory of self-care deficit, the theory of nursing systems, and theory of self-care. However, the study is based on Orem’s Mid-Range Theory of Self-Care. The theory defines self-care as “a human regulatory function that people must, with deliberation, perform themselves or have performed them to maintain life, health, development, and wellbeing (p.319)”. The research revealed that the bi-weekly telephone contact would help to guide individuals in the assumption of self-care and improved observance to the treatment administration.

Appropriateness of the Theoretical Framework

The framework was appropriate for the research because it provided sound guidelines to address the main purpose of the research decisively. The theory got selected for the evidence-based practice protocol (EBPP) since patients with type 2 diabetes mellitus should adhere to treatment guidelines (self-care) for them to maintain health, development, life, and well-being. Additionally, Orem’s Mid-Range Theory of Self-Care is important because it is the framework which provides fundamental elements of caring. It is through periodic follow-ups that there is increased adoption of self-care among the patients which in turn ensures that they maintain their life, health, well-being, and general development (Weld, Padden, Ramsey, & Garmon Bibb, 2008). The framework is also necessary for that the nurses are able to get in touch with the patients. This is an important aspect of the nursing profession which provides an avenue for the proper administration of cure among the DM patients.

New Insights Gained

From the Orem’s Mid-Range Theory of Self-Care, I could deduce several insights on the concept of self-care. The treatment process is a collaborative activity that requires collaboration between the caregivers and the patients. For chronic illness and dependent care individuals, self-care plays a central role in the treatment process. Patients should care for themselves, but the nursing intention is needed especially when there is an imbalance between self-care and self-care needs. The intervention can be in different forms. In the case of the article discussed here, the author recommends one nurse’s visit and bi-weekly follow-ups



Searching and Critiquing the Evidence

Student’s Name



Searching and Critiquing the Evidence

There are various research studies that have been done on the outcome of self-care on Type 2 Diabetes Mellitus patients. In most of the studies, the most prevalent results are that self-care is an effective method of improving the health and lifestyle outcomes of Type 2 Diabetes patients. Krishna and Boren (2008) conducted a systematic review of evidence-based studies done between 1996 and 2007. The study analyzed 18 researches done within the selected time period and found that using phone calls and text messages to assist diabetes patients could improve the self-management outcomes. Shrivastava et al. (2013) analyzed the effectiveness of self-management for the diabetes mellitus patients. The study found that self-care helps to reduce the rate of morbidity and mortality among diabetes patients.

In addition, Steinsbekk et al. (2013) conducted a meta-analysis comparing the differences between the outcomes of group based self-management education and routine treatment for Type 2 diabetes patients. The study analyzed 21 studies that included studied on 2833 participants. The results of the meta-analysis showed that group-based self-management education helped to improve the psychosocial, clinical, and lifestyle outcomes among the diabetes patients. Lastly, Tang et al. (2008) examined the impact of social support and quality of life on the self-care behaviors of African American Type 2 diabetes patients. The study followed an observational design with 89 African-American adults, who were aged 40 and above. The study found that social support is vital for self-management to be effective in diabetes treatment.

The selected studies have helped to strengthen the merit of my selected theoretical framework. The theory selected for the study was Dorothea Orem’s Self Care Theory. These studies have helped to demonstrate some important evidence-based facts about the effectiveness of self-care for diabetes patients hence helping to prove the credibility of the theory. The scrutiny of these studies has helped to discover the degree of effectiveness of this theory and the best application methods that can make it an effective approach to improving the outcomes of patients with Type 2 Diabetes Mellitus.

Levels of Evidence in the Articles

The classification of the level of evidence of a given research is important in evidence-based studies because they help to show how accurate, credible, or reliable a research is (Gray, Grove & Sutherland, 2017). The most prevalent evidence in the research articles analyzed is Level II evidence. Level II evidence is one that is obtained from at least one randomiz