7/15/2019

Research Methods 850

Week 1, 2019/20
Daphne Cockwell School of Nursing, Post Diploma Degree Program, Ryerson University

What is Research?
Woo, (2019) Chapter 1, 3, & 4 p. 68-79.
Eraydin, & Avsar, (2017).
Lintona, & Farrell, (2009)
Mizock, Russinova, & Millner, (2014).
http://www.cno.org/globalassets/docs/reg/41037_entrytopracit
ic_final.pdf
Young, & Solomon (2009).

Learning Objectives
1. Define critical appraisal and its application to research
2. Discuss the College of Nurses of Ontario (CNO)
entry–to-practice competencies for research
3. Identify key historical shifts in nursing research
4. Describe the purpose of nursing research
5. Compare/contrast two philosophical paradigms that
ground research
6. Describe key attributes of Qualitative and Quantitative
designs
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Self-assessment quiz
Most students have taken a fundamentals
research course, prior to this class.
So a self assessment quiz has been loaded
for you in D2L.

Complete this week and we will take up your

answers next week.

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Critical Appraisal
To critique:

To use clear, transparent methods to

compare and contrast one thing against
another benchmark or standard or
specified set of criteria to identify strengths
and weakness

How does the concept ‘critique’ apply to

research?

“Critical appraisal= a systematic process used

to identify the strengths & weaknesses of a
research article in order to assess the
usefulness & validity of research findings. --
-an evaluation of the appropriateness of the
study design for research question & careful
assessment of the key methodological
features of this design. (Young & Solomon, 2009, p. 82)

Research

“a systematic inquiry that uses disciplined

methods to answer or solve problems”
(Loiselle et al., 2004, p. 4)

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Nursing Research

“a systematic inquiry designed to develop

knowledge about issues of importance to the
nursing profession, including nursing practice,
education, administration, and informatics”
(Polit & Beck, 2004, p. 3)

Nursing Research Areas

1. Administration
2. Education
3. Clinical practice
4. Profession
5. Research utilization
6. Trans disciplinary

Reasons for Nursing Research

Or………….
…..why should I have to take this course?
1. Address clinical problems
2. Evidence Based Practice (EBP)
3. Resource utilization
4. Understand complex phenomena

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College of Nurses of Ontario

Standards of Practice ( 2008)
National competencies entry-to-practice
Assumption:
“5. entry-level competencies have a
strong foundation in nursing theory,
concepts and knowledge, health and
sciences, humanities, research and
ethics” (p.3.)

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CNO competency statements for

entry-level practice: research
Standard: Knowledge based practice

#35. “engages in nursing or health

research by reading or critiquing
research reports and identifying
research opportunities” (p. 10)

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CNO competency statements for

entry-level practice: research

#36 “supports involvement in nursing or

health research through
collaboration with others in
conducting research, and
implementing research findings
into practice” (p. 10).

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CNO competency statements for

entry-level practice: research

#61 “ incorporates evidence from

research, clinical practice, client
preference, client and staff safety, and
other available resources to make
decisions about client care.” (p.12)

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Consumer-producer
continuum
Who are the consumers of nursing research?

R.N.’s, R.P.N.’s, administrators, educators, nurse

practitioners, C.N.S, other health care
professionals

In order to use research, you need to

understand research.

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Consumer-producer continuum
Who are the producers of nursing
research?

Researchers who design & implement studies

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Where do researchers get their

ideas?

 Clinical practice
 Nursing literature
 Social issues
 Theories
 External sources

Can you suggest some ideas for research from

your practice, readings or world?

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Your Experience of Research

Where do you see or hear
research discussed, presented, used?

What is your understanding of what you

see or hear?

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Research is important if…

 It improves patient care
 Extends the body of nursing knowledge
 Contributes to theory development
 Corresponds to national research
priorities

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Historical Review: synopsis

 1859 Nightingale (Notes on Nursing)
 1900-1940 focus on nursing education
 1940+ increase # of nurses, increase
demand for education
 1952 Journal of Nursing Research
 1960-70’s conceptual models

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Historical Review: synopsis

 1980’s increase PhD’s doing research
 1990’s programs of research versus
independent studies
 2000 increase in funding agencies for
nursing research NINR, NHRDP, CIHR,
Cochrane Collaboration

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Purpose of Nursing Research

1. Identification
2. Description
3. Exploration
4. Explanation
5. Prediction
6. Control
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Future Directions
1. Outcomes research
2. Bio-physiological
3. EBP
4. Confirmatory or replication
5. Trans-disciplinary
6. Research utilization, dissemination
7. Integrative reviews
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Types of Nursing Research

Basic: increase knowledge base

Applied: find solutions to problems

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Sources of evidence for

practice
Evidence hierarchy or levels
1. tradition & authority
2. clinical experience & intuition
3. trial & error
4. assembled information
5. disciplined research
6. evidence based practice: best practice guidelines
What are the pros and cons of each?

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Example of
Evidence Based Practice
RNAO:
Best Practice Guidelines:
e.g. Assessment of Adults at Risk for
Suicidal Ideation and Behaviour
Free download from RNAO web site
www.rnao.org
Uploaded under BB course materials
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Example of
Evidence Based Practice
BPG developers (for BPG Assessment and Care of Adults
at Risk for Suicide) challenge ‘levels’ of
evidence and replaced with ‘types’ of
evidence due to noted limitations (cons)
of the notion of ‘levels’
What did they consider to be a weakness
in ‘levels’ of evidence?

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Research Method

Techniques , procedures , processes used

by researchers to organize a study in
order that it can answer relevantly the
research question

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Clinical example
Consider possible research questions from the
clinical situation of a patient with a hip
replacement:
Eg. Pain management post hip replacement
(60 year old)

Two different types of questions can be asked:

we will use these examples for the two
research paradigms to be presented

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Different research questions from

different research paradigms.
1. What is the pain level, as measured by the
visual analogue pain scale, in post operative
hip replacement patients who receive
standing doses of Tylenol #1 p.o. q6h for 48
hours as compared to those who receive
Demerol 50 mgm I.M. q4h prn?

2. What is the patient experience of pain in

patients post hip replacement?

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What is a Paradigm?
A paradigm is a way of looking at the world
from different angles

How do you come to understand that which is

‘true’ about the world

A world view is a philosophical approach

eg do you view people as innately good
or innately bad
Your “view” frames your approach
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Two Major Research

Paradigms

1. the NATURALIST paradigm

1. the POSITIVIST paradigm

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The Philosophy of Each Paradigm

Naturalist paradigm (Qualitative

methodology/design)
Positivist paradigm (Quantitative
methodology/design)
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Naturalist paradigm &

definition of qualitative research
“The investigation of phenomena,
typically in an in-depth and holistic
fashion, through the collection of rich
narrative materials using a flexible
research design.” (Woo, 2019.p. 423)

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Positivist paradigm & definition of

quantitative research?
“The investigation of phenomena that
lend themselves to precise
measurement and quantification, often
involving a rigorous and controlled
design.” (Woo, 2019.p. 423)

The Naturalist Paradigm

(or constructivist)

 a holistic paradigm
 knowledge is subjective
 relative in context
 there are multiple realities

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Who is the Naturalist?

 someone who takes a holistic approach to

understanding ‘truth’

 researcher takes subjective view of knowledge

 reality is not fixed, but exists in a context with

others

 truth is relative and multiple

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The Naturalist’s View

 belief that reality is fluid

 knowledge is constructed with participants

 multiple interpretations of reality are

possible
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The Naturalist Research

Process

 distance between researcher and

participants are minimized
 participation and interaction are key to
understanding
 human beings are subjective
 knowledge develops in relationship in
research experience
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Qualitative Research Definition

“a systematic, interactive, subjective

approach used to describe life
experiences and give them meaning”
(Leininger, 1985 as cited in Burns & Grove, 2001,
p. 26.)

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Qualitative Research

investigation of phenomena in depth and a

holistic fashion using narrative materials

most closely aligned with a Naturalist

Paradigm

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Qualitative Research:
is for concepts that are poorly
understood;

a researcher wants to develop a rich,

comprehensive, context bound
understanding

and / or for theory development

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Characteristics of Qualitative
Research

 emphasizes understanding of human

experience
 collects and analyzes accounts of experience
 the focus is dynamic, holistic and individual in
context
 procedures are flexible as the research
experience develops

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Characteristics of Qualitative
Research (cont’d)

 develops a theory or framework that explains

the processes under observation
 visits and re-visits the data as puzzles are
unraveled in the on-going analysis and
interpretation of data
 provides rich, thick data for understanding
complex human experience and relationships
among the phenomena in research situations

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Characteristics of Qualitative
Research (cont’d)
 research takes place in the field of interest
 collection of data and analysis is on-going
 the information leads to new insights and
questions to amplify disparities or confirm
hunches
 through induction, the naturalist “integrates
evidence” as themes in text and the research
experience emerge

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Inductive Reasoning

Inherent in qualitative research or the

naturalist paradigm

Analyzing the small group and making

predictions about the larger group

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Recall the clinical scenario?

How would a “naturalist”

approach the issue of pain and
recovery after hip replacement
surgery ?

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Research question: the naturalist

or qualitative paradigm

What is the patient experience of pain

post hip replacement ?

How might a qualitative researcher

approach this question?

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The Positivist Paradigm

Reductionistic: breaks down to small
parts to understand the whole

Systematic approach to understanding

through the body’s senses

Provides empirical evidence

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Who is the Positivist?

researcher uses logic and objective

approach to knowledge

originated in 19th century philosophy

logical positivism = strict positivism

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The Positivist’s View

Determinism:
phenomena (observable facts and events)
are not haphazard or random but
orderly and predictable
(Loiselle et al., 2004, p. 14)

phenomena occurring in the world have

antecedent causes
looks for cause and effect relationships

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The Positivist Research Process

 uses strict procedures to plan a study

 follows strict protocol to test ideas

 looks for relationships among

phenomena in the study

 beliefs and biases are held in check

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Quantitative Research
 traditional scientific approach
 an objective reality
 based on assumptions/beliefs

 bias is suspended

 determinism /cause and effect

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Quantitative Research
Definition

“Formal, objective, systematic process

to describe and test relationships, and
to examine cause and effect
interactions among variables”
(Burns & Grove, 2001, p. 26)

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Recall the clinical scenario?

How would a “positivist” approach

the issue of post operative pain in
hip replacement surgery?

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Research question: a quantitative

method for a positivist paradigm.
1. What is the pain level, as measured by the
visual analogue pain scale, in post operative
hip replacement patients who receive
standing doses of Tylenol #1 p.o. q6h for 48
hours as compared to those who receive
Demerol 50 mgm I.M. q4h prn?

2. How might a quantitative researcher

approach this question?
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The Method of Each Paradigm

Naturalist (Qualitative)
Positivist (Quantitative)

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Each paradigm evolves from a

type of reasoning

There are two types of reasoning:

1. Inductive
2. Deductive

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Paradigms and Methods

different paradigms will determine the

research methods or procedures

research methods refers to accepted

techniques for data collection and
analysis relevant to the research
question
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The Qualitative Method

involves broad narrative descriptions of

phenomena

most closely aligned with naturalist

paradigm

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Characteristics of Qualitative
Methods
uses inductive reasoning to articulate
problem, study purpose, and question

identifies phenomena to be studied

determines techniques to be used in

the investigation

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Characteristics of Qualitative
Methods
 conditions of study are not controlled

 uses unstructured instruments to collect

data

 the researcher is an instrument of data

collection

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Characteristics of Qualitative
Methods

 data is narrative and analyzed in

themes

 findings are assessed for transferability

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Limitations of Qualitative
Methods
 small sample sizes limit generalizability back
to a larger population

 subjectivity restricts generalizability

 cause and effect or associations between

phenomena difficulty to ascertain with any
generalizability

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Limitations of Qualitative
(cont’d)
 human beings are fallible and the researcher
is the instrument

 the research is subjective and findings may

be idiosyncratic

 can the study be replicated?

 are findings generalizable given the small

number of participants?
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Remember that qualitative

research question?

What is the patient experience of pain post hip

replacement ?

How might a qualitative researcher design this

study?
What might be some of the limitations of such a
study?

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The Quantitative Method

involves precise measurement and

quantification

aims to predict and control

most closely aligned with the

Positivist Paradigm
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Deductive Reasoning

Inherent in quantitative research or the

positivist paradigm

Analyzing the larger group make making

predictions about the smaller group

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Characteristics of Quantitative
Methods

 uses deductive reasoning to define

problem and hypothesis

 identify concepts that will be the focus

of the study

 determine techniques to be used in the

investigation
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Characteristics of Quantitative
Methods (cont’d)
 conditions of study are controlled to
minimize bias

 uses formal instruments to collect data

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Characteristics of Quantitative
Methods (cont’d)

 usually data gathered is quantitative

(numeric) and analyzed using statistical
methods

 findings are looked at for degree of

generalizability

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Limitations of Quantitative
Methods
inability to address human dimensions
of experience

 moral, ethical and professional questions

across the health field, e.g., euthanasia,
abortion

 objective measurements of stress may

include BP, heart rate and temperature,
but patient pain or fear cannot be
accurately measured 71

Limitations (cont’d)
 complexities tend to be controlled or
ignored so that the object of study is
magnified

 obscures insights about the phenomena

 shines a light on a circumscribed area

to the exclusion of other relevant
aspects of the question
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Remember that quantitative

research question?
1. What is the pain level, as measured by the
visual analogue pain scale, in post operative
hip replacement patients who receive
standing doses of Tylenol #1 p.o. q6h for 48
hours as compared to those who receive
Demerol 50 mgm I.M. q4h prn?

How might a quantitative researcher design a

study to answer this question?

What are some limitations of such a study?

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Similarities in Paradigms

 ultimate goal is knowledge

 evidence is gathered and analyzed
through the senses-empirically
 cooperation and willingness of
participants
 ethical constraints are always involved
 virtually all studies have limitations
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References
Burns, N., Grove, S. K. (2001). The Practice of Nursing
Research: Conduct, Critique, & Utilization 4th Edition.
Philadelphia: W. B. Saunders.
Loiselle, C.G., Profetto-McGrath, J., Polit, D., F. & Beck,
C. T. (2011). Canadian Essentials of Nursing Research
3rd Edition. Philadelphia: Lippincott Williams &
Wilkins.
Polit, D., F. & Beck, C. T. (2004). Nursing Research:
Principles and Methods 7th Edition. Philadelphia:
Lippincott Williams & Wilkins:

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