nursing research critique paper example

Reading and critiquing a research article

Nurses use research to answer questions about their practice, solve problems, improve the quality of patient care, generate new research questions, and shape health policy. Nurses who confront questions about practice and policy need strong, high-quality, evidence-based research. Research articles in peer-reviewed journals typically undergo a rigorous review process to ensure scholarly standards are met. Nonetheless, standards vary among reviewers and journals. This article presents a framework nurses can use to read and critique a research article.

When deciding to read an article, determine if it’s about a question you have an interest in or if it can be of use in your practice. You may want to have a research article available to read and critique as you consider the following questions.

Does the title accurately describe the article?

A good title will pique your interest but typically you will not know until you are done reading the article if the title is an accurate description. An informative title conveys the article’s key concepts, methods, and variables.

Is the abstract representative of the article?

The abstract provides a brief overview of the purpose of the study, research questions, methods, results, and conclusions. This helps you decide if it’s an article you want to read. Some people use the abstract to discuss a study and never read further. This is unwise because the abstract is just a preview of the article and may be misleading.

Does the introduction make the purpose of the article clear?

A good introduction provides the basis for the article. It includes a statement of the problem, a rationale for the study, and the research questions. When a hypothesis is being tested, it should be clearly stated and include the expected results.

Is a theoretical framework described?

When a theoretical framework is used, it should inform the study and provide a rationale. The concepts of the theoretical framework should relate to the topic and serve as a basis for interpreting the results. Some research doesn’t use a theoretical framework, such as health services research, which examines issues such as access to care, healthcare costs, and healthcare delivery. Clinical research such as comparing the effectiveness of two drugs won’t include a theoretical framework.

Is the literature review relevant to the study and comprehensive? Does it include recent research?

The literature review provides a context for the study. It establishes what is, and is not known about the research problem. Publication dates are important but there are caveats. Most literature reviews include articles published within the last 3 to 5 years. It can take more than a year for an article to be reviewed, revised, accepted, and published, causing some references to seem outdated.

Literature reviews may include older studies to demonstrate important changes in knowledge over time. In an area of study where little or no research has been conducted, there may be only a few relevant articles that are a decade or more old. In an emerging area of study there may be no published research, in which case related research should be referenced. If you are familiar with the area of research, review the references to determine if well-known and highly regarded studies are included.

Does the methods section explain how a research question was addressed?

The methods section provides enough information to allow the study to be replicated. Components of this section indicate if the design is appropriate to answer the research question(s).

• Did the researcher select the correct sample to answer the research questions and was the size sufficient to obtain valid results?
• If a data collection instrument was used, how was it created and validated?
• If any materials were used, such as written guides or equipment, were they described?
• How were data collected?
• Was reliability and validity accounted for?
• Were the procedures listed in a step-by-step manner?

Independent and dependent variables should be described and terms defined. For example, if patient falls in the hospital are considered the dependent variable, or outcome, what are the independent variables, or factors, being investigated that may influence the rate at which patient falls occur? In this example, independent variables might include nurse staffing, registered nurse composition (such as education and certification), and hospital Magnet &#174 status.

Is the analytical approach consistent with the study questions and research design?

The analytical approach relates to the study questions and research design. A quantitative study may use descriptive statistics to summarize the data and other tests, such as chi squares, t-tests, or regression analysis, to compare or evaluate the data. A qualitative study may use such approaches as coding, content analysis, or grounded theory analysis. A reader who is unfamiliar with the analytical approach may choose to rely on the expertise of the journal’s peer reviewers who assessed whether the analytical approach was correct.

Are the results presented clearly in the text and in tables and figures?

Results should be clearly summarized in the text, tables, and figures. Tables and figures are only a partial representation of the results and critical information may be only in the text. In a quantitative study, the significance of the statistical tests is important. The presentation of qualitative results should avoid interpretation, which is reserved for the discussion.

Are the limitations presented and their implications discussed?

It is essential that the limitations of the study be presented. These are the factors that explain why the results may need to be carefully interpreted, may only be generalized to certain situations, or may provide less robust results than anticipated. Examples of limitations include a low response rate to a survey, not being able to establish causality when a cross-sectional study design was used, and having key stakeholders refuse to be interviewed.

Does the discussion explain the results in relation to the theoretical framework, research questions, and significance of the study?

The discussion serves as an opportunity to explain the results in respect to the research questions and the theoretical framework. Authors use the discussion to interpret the results and explain the meaning and significance of the study. It’s also important to distinguish the study from others that preceded it and provide recommendations for future research.

Depending on the research, it may be equally important for the investigators to present the clinical and/or practical significance of the results. Relevant policy recommendations are also important. Evaluate if the recommendations are supported by the data or seem to be more of an opinion. A succinct conclusion typically completes the article.

Once you’re done reading the article, how do you decide if the research is something you want to use?

Determine the scientific merit of the study by evaluating the level and quality of the evidence. There are many scales to use, several of which can be found in the Research Toolkit on the American Nurses Association’s website http://www.nursingworld.org/research-toolkit.aspx . Consider what you learned and decide if the study is relevant to your practice or answered your question as well as whether you can implement the findings.

A new skill

A systematic approach to reading and critiquing a research article serves as a foundation for translating evidence into practice and policy. Every nurse can acquire this skill.

Louise Kaplan is director of the nursing program at Saint Martin’s University in Lacey, Washington. At the end of this article is a checklist for evaluating an article.

Selected references

Hudson-Barr D. How to read a research article. J Spec Pediatr Nurs . 2004;9(2):70-2.

King’s College D. Leonard Corgan Library. Reading a research article. http://www.lib.jmu.edu/ilworkshop08/materials/studyguide3.pdf . Accessed September 5, 2012.

Oliver D, Mahon SM. Reading a research article part I: Types of variables. Clin J Oncol Nurs . 2005;9(1):110-12.

Oliver D, Mahon SM. Reading a research article part II: Parametric and nonparametric statistics. Clin J Oncol Nurs . 2005;9(2):238-240.

Oliver D, Mahon SM. Reading a research article part III: The data collection instrument. Clin J Oncol Nurs . 2006;10(3):423-26.

Rumrill P, Fitzgerald S, Ware, M. Guidelines for evaluating research articles. Work . 2000;14(3):257-63.

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Ethical guidelines for educational research. 2018; https://tinyurl.com/c84jm5rt

Bowling A Research methods in health, 4th edn. Maidenhead: Open University Press/McGraw-Hill Education; 2014

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Kennedy M, Burnett E Hand hygiene knowledge and attitudes: comparisons between student nurses. Journal of Infection Prevention. 2011; 12:(6)246-250 https://doi.org/10.1177/1757177411411124

Lindsay-Smith G, O'Sullivan G, Eime R, Harvey J, van Ufflen JGZ A mixed methods case study exploring the impact of membership of a multi-activity, multi-centre community group on the social wellbeing of older adults. BMC Geriatrics. 2018; 18 https://bmcgeriatr.biomedcentral.com/track/pdf/10.1186/s12877-018-0913-1.pdf

Morse JM, Pooler C, Vann-Ward T Awaiting diagnosis of breast cancer: strategies of enduring for preserving self. Oncology Nursing Forum. 2014; 41:(4)350-359 https://doi.org/10.1188/14.ONF.350-359

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Critiquing a published healthcare research paper

Angela Grainger

Nurse Lecturer/Scholarship Lead, BPP University, and editorial board member

View articles · Email Angela

Research is defined as a ‘systematic inquiry using orderly disciplined methods to answer questions or to solve problems' ( Polit and Beck, 2017 :743). Research requires academic discipline coupled with specific research competencies so that an appropriate study is designed and conducted, leading to the drawing of relevant conclusions relating to the explicit aim/s of the study.

For those embarking on a higher degree such as a master's, taught doctorate, or a doctor of philosophy, the relationship between research, knowledge production and knowledge utilisation becomes clear during their research tuition and guidance from their research supervisor. But why should other busy practitioners juggling a work/home life balance find time to be interested in healthcare research? The answer lies in the relationship between the outcomes of research and its relationship to the determination of evidence-based practice (EBP).

The Health and Care Professions Council (HCPC) and the Nursing and Midwifery Council (NMC) require registered practitioners to keep their knowledge and skills up to date. This requirement incorporates being aware of the current EBP relevant to the registrant's field of practice, and to consider its application in relation to the decisions made in the delivery of patient care.

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A guide to critical appraisal of evidence

Fineout-Overholt, Ellen PhD, RN, FNAP, FAAN

Ellen Fineout-Overholt is the Mary Coulter Dowdy Distinguished Professor of Nursing at the University of Texas at Tyler School of Nursing, Tyler, Tex.

The author has disclosed no financial relationships related to this article.

Critical appraisal is the assessment of research studies' worth to clinical practice. Critical appraisal—the heart of evidence-based practice—involves four phases: rapid critical appraisal, evaluation, synthesis, and recommendation. This article reviews each phase and provides examples, tips, and caveats to help evidence appraisers successfully determine what is known about a clinical issue. Patient outcomes are improved when clinicians apply a body of evidence to daily practice.

How do nurses assess the quality of clinical research? This article outlines a stepwise approach to critical appraisal of research studies' worth to clinical practice: rapid critical appraisal, evaluation, synthesis, and recommendation. When critical care nurses apply a body of valid, reliable, and applicable evidence to daily practice, patient outcomes are improved.

Critical care nurses can best explain the reasoning for their clinical actions when they understand the worth of the research supporting their practices. In c ritical appraisal , clinicians assess the worth of research studies to clinical practice. Given that achieving improved patient outcomes is the reason patients enter the healthcare system, nurses must be confident their care techniques will reliably achieve best outcomes.

Nurses must verify that the information supporting their clinical care is valid, reliable, and applicable. Validity of research refers to the quality of research methods used, or how good of a job researchers did conducting a study. Reliability of research means similar outcomes can be achieved when the care techniques of a study are replicated by clinicians. Applicability of research means it was conducted in a similar sample to the patients for whom the findings will be applied. These three criteria determine a study's worth in clinical practice.

Appraising the worth of research requires a standardized approach. This approach applies to both quantitative research (research that deals with counting things and comparing those counts) and qualitative research (research that describes experiences and perceptions). The word critique has a negative connotation. In the past, some clinicians were taught that studies with flaws should be discarded. Today, it is important to consider all valid and reliable research informative to what we understand as best practice. Therefore, the author developed the critical appraisal methodology that enables clinicians to determine quickly which evidence is worth keeping and which must be discarded because of poor validity, reliability, or applicability.

Evidence-based practice process

The evidence-based practice (EBP) process is a seven-step problem-solving approach that begins with data gathering (see Seven steps to EBP ). During daily practice, clinicians gather data supporting inquiry into a particular clinical issue (Step 0). The description is then framed as an answerable question (Step 1) using the PICOT question format ( P opulation of interest; I ssue of interest or intervention; C omparison to the intervention; desired O utcome; and T ime for the outcome to be achieved). 1 Consistently using the PICOT format helps ensure that all elements of the clinical issue are covered. Next, clinicians conduct a systematic search to gather data answering the PICOT question (Step 2). Using the PICOT framework, clinicians can systematically search multiple databases to find available studies to help determine the best practice to achieve the desired outcome for their patients. When the systematic search is completed, the work of critical appraisal begins (Step 3). The known group of valid and reliable studies that answers the PICOT question is called the body of evidence and is the foundation for the best practice implementation (Step 4). Next, clinicians evaluate integration of best evidence with clinical expertise and patient preferences and values to determine if the outcomes in the studies are realized in practice (Step 5). Because healthcare is a community of practice, it is important that experiences with evidence implementation be shared, whether the outcome is what was expected or not. This enables critical care nurses concerned with similar care issues to better understand what has been successful and what has not (Step 6).

Critical appraisal of evidence

The first phase of critical appraisal, rapid critical appraisal, begins with determining which studies will be kept in the body of evidence. All valid, reliable, and applicable studies on the topic should be included. This is accomplished using design-specific checklists with key markers of good research. When clinicians determine a study is one they want to keep (a “keeper” study) and that it belongs in the body of evidence, they move on to phase 2, evaluation. 2

In the evaluation phase, the keeper studies are put together in a table so that they can be compared as a body of evidence, rather than individual studies. This phase of critical appraisal helps clinicians identify what is already known about a clinical issue. In the third phase, synthesis, certain data that provide a snapshot of a particular aspect of the clinical issue are pulled out of the evaluation table to showcase what is known. These snapshots of information underpin clinicians' decision-making and lead to phase 4, recommendation. A recommendation is a specific statement based on the body of evidence indicating what should be done—best practice. Critical appraisal is not complete without a specific recommendation. Each of the phases is explained in more detail below.

Phase 1: Rapid critical appraisal . Rapid critical appraisal involves using two tools that help clinicians determine if a research study is worthy of keeping in the body of evidence. The first tool, General Appraisal Overview for All Studies (GAO), covers the basics of all research studies (see Elements of the General Appraisal Overview for All Studies ). Sometimes, clinicians find gaps in knowledge about certain elements of research studies (for example, sampling or statistics) and need to review some content. Conducting an internet search for resources that explain how to read a research paper, such as an instructional video or step-by-step guide, can be helpful. Finding basic definitions of research methods often helps resolve identified gaps.

To accomplish the GAO, it is best to begin with finding out why the study was conducted and how it answers the PICOT question (for example, does it provide information critical care nurses want to know from the literature). If the study purpose helps answer the PICOT question, then the type of study design is evaluated. The study design is compared with the hierarchy of evidence for the type of PICOT question. The higher the design falls within the hierarchy or levels of evidence, the more confidence nurses can have in its finding, if the study was conducted well. 3,4 Next, find out what the researchers wanted to learn from their study. These are called the research questions or hypotheses. Research questions are just what they imply; insufficient information from theories or the literature are available to guide an educated guess, so a question is asked. Hypotheses are reasonable expectations guided by understanding from theory and other research that predicts what will be found when the research is conducted. The research questions or hypotheses provide the purpose of the study.

Next, the sample size is evaluated. Expectations of sample size are present for every study design. As an example, consider as a rule that quantitative study designs operate best when there is a sample size large enough to establish that relationships do not exist by chance. In general, the more participants in a study, the more confidence in the findings. Qualitative designs operate best with fewer people in the sample because these designs represent a deeper dive into the understanding or experience of each person in the study. 5 It is always important to describe the sample, as clinicians need to know if the study sample resembles their patients. It is equally important to identify the major variables in the study and how they are defined because this helps clinicians best understand what the study is about.

The final step in the GAO is to consider the analyses that answer the study research questions or confirm the study hypothesis. This is another opportunity for clinicians to learn, as learning about statistics in healthcare education has traditionally focused on conducting statistical tests as opposed to interpreting statistical tests. Understanding what the statistics indicate about the study findings is an imperative of critical appraisal of quantitative evidence.

The second tool is one of the variety of rapid critical appraisal checklists that speak to validity, reliability, and applicability of specific study designs, which are available at varying locations (see Critical appraisal resources ). When choosing a checklist to implement with a group of critical care nurses, it is important to verify that the checklist is complete and simple to use. Be sure to check that the checklist has answers to three key questions. The first question is: Are the results of the study valid? Related subquestions should help nurses discern if certain markers of good research design are present within the study. For example, identifying that study participants were randomly assigned to study groups is an essential marker of good research for a randomized controlled trial. Checking these essential markers helps clinicians quickly review a study to check off these important requirements. Clinical judgment is required when the study lacks any of the identified quality markers. Clinicians must discern whether the absence of any of the essential markers negates the usefulness of the study findings. 6-9

The second question is: What are the study results? This is answered by reviewing whether the study found what it was expecting to and if those findings were meaningful to clinical practice. Basic knowledge of how to interpret statistics is important for understanding quantitative studies, and basic knowledge of qualitative analysis greatly facilitates understanding those results. 6-9

The third question is: Are the results applicable to my patients? Answering this question involves consideration of the feasibility of implementing the study findings into the clinicians' environment as well as any contraindication within the clinicians' patient populations. Consider issues such as organizational politics, financial feasibility, and patient preferences. 6-9

When these questions have been answered, clinicians must decide about whether to keep the particular study in the body of evidence. Once the final group of keeper studies is identified, clinicians are ready to move into the phase of critical appraisal. 6-9

Phase 2: Evaluation . The goal of evaluation is to determine how studies within the body of evidence agree or disagree by identifying common patterns of information across studies. For example, an evaluator may compare whether the same intervention is used or if the outcomes are measured in the same way across all studies. A useful tool to help clinicians accomplish this is an evaluation table. This table serves two purposes: first, it enables clinicians to extract data from the studies and place the information in one table for easy comparison with other studies; and second, it eliminates the need for further searching through piles of periodicals for the information. (See Bonus Content: Evaluation table headings .) Although the information for each of the columns may not be what clinicians consider as part of their daily work, the information is important for them to understand about the body of evidence so that they can explain the patterns of agreement or disagreement they identify across studies. Further, the in-depth understanding of the body of evidence from the evaluation table helps with discussing the relevant clinical issue to facilitate best practice. Their discussion comes from a place of knowledge and experience, which affords the most confidence. The patterns and in-depth understanding are what lead to the synthesis phase of critical appraisal.

The key to a successful evaluation table is simplicity. Entering data into the table in a simple, consistent manner offers more opportunity for comparing studies. 6-9 For example, using abbreviations versus complete sentences in all columns except the final one allows for ease of comparison. An example might be the dependent variable of depression defined as “feelings of severe despondency and dejection” in one study and as “feeling sad and lonely” in another study. 10 Because these are two different definitions, they need to be different dependent variables. Clinicians must use their clinical judgment to discern that these different dependent variables require different names and abbreviations and how these further their comparison across studies.

Sample and theoretical or conceptual underpinnings are important to understanding how studies compare. Similar samples and settings across studies increase agreement. Several studies with the same conceptual framework increase the likelihood of common independent variables and dependent variables. The findings of a study are dependent on the analyses conducted. That is why an analysis column is dedicated to recording the kind of analysis used (for example, the name of the statistical analyses for quantitative studies). Only statistics that help answer the clinical question belong in this column. The findings column must have a result for each of the analyses listed; however, in the actual results, not in words. For example, a clinician lists a t -test as a statistic in the analysis column, so a t -value should reflect whether the groups are different as well as probability ( P -value or confidence interval) that reflects statistical significance. The explanation for these results would go in the last column that describes worth of the research to practice. This column is much more flexible and contains other information such as the level of evidence, the studies' strengths and limitations, any caveats about the methodology, or other aspects of the study that would be helpful to its use in practice. The final piece of information in this column is a recommendation for how this study would be used in practice. Each of the studies in the body of evidence that addresses the clinical question is placed in one evaluation table to facilitate the ease of comparing across the studies. This comparison sets the stage for synthesis.

Phase 3: Synthesis . In the synthesis phase, clinicians pull out key information from the evaluation table to produce a snapshot of the body of evidence. A table also is used here to feature what is known and help all those viewing the synthesis table to come to the same conclusion. A hypothetical example table included here demonstrates that a music therapy intervention is effective in reducing the outcome of oxygen saturation (SaO 2 ) in six of the eight studies in the body of evidence that evaluated that outcome (see Sample synthesis table: Impact on outcomes ). Simply using arrows to indicate effect offers readers a collective view of the agreement across studies that prompts action. Action may be to change practice, affirm current practice, or conduct research to strengthen the body of evidence by collaborating with nurse scientists.

When synthesizing evidence, there are at least two recommended synthesis tables, including the level-of-evidence table and the impact-on-outcomes table for quantitative questions, such as therapy or relevant themes table for “meaning” questions about human experience. (See Bonus Content: Level of evidence for intervention studies: Synthesis of type .) The sample synthesis table also demonstrates that a final column labeled synthesis indicates agreement across the studies. Of the three outcomes, the most reliable for clinicians to see with music therapy is SaO 2 , with positive results in six out of eight studies. The second most reliable outcome would be reducing increased respiratory rate (RR). Parental engagement has the least support as a reliable outcome, with only two of five studies showing positive results. Synthesis tables make the recommendation clear to all those who are involved in caring for that patient population. Although the two synthesis tables mentioned are a great start, the evidence may require more synthesis tables to adequately explain what is known. These tables are the foundation that supports clinically meaningful recommendations.

Phase 4: Recommendation . Recommendations are definitive statements based on what is known from the body of evidence. For example, with an intervention question, clinicians should be able to discern from the evidence if they will reliably get the desired outcome when they deliver the intervention as it was in the studies. In the sample synthesis table, the recommendation would be to implement the music therapy intervention across all settings with the population, and measure SaO 2 and RR, with the expectation that both would be optimally improved with the intervention. When the synthesis demonstrates that studies consistently verify an outcome occurs as a result of an intervention, however that intervention is not currently practiced, care is not best practice. Therefore, a firm recommendation to deliver the intervention and measure the appropriate outcomes must be made, which concludes critical appraisal of the evidence.

A recommendation that is off limits is conducting more research, as this is not the focus of clinicians' critical appraisal. In the case of insufficient evidence to make a recommendation for practice change, the recommendation would be to continue current practice and monitor outcomes and processes until there are more reliable studies to be added to the body of evidence. Researchers who use the critical appraisal process may indeed identify gaps in knowledge, research methods, or analyses, for example, that they then recommend studies that would fill in the identified gaps. In this way, clinicians and nurse scientists work together to build relevant, efficient bodies of evidence that guide clinical practice.

Evidence into action

Critical appraisal helps clinicians understand the literature so they can implement it. Critical care nurses have a professional and ethical responsibility to make sure their care is based on a solid foundation of available evidence that is carefully appraised using the phases outlined here. Critical appraisal allows for decision-making based on evidence that demonstrates reliable outcomes. Any other approach to the literature is likely haphazard and may lead to misguided care and unreliable outcomes. 11 Evidence translated into practice should have the desired outcomes and their measurement defined from the body of evidence. It is also imperative that all critical care nurses carefully monitor care delivery outcomes to establish that best outcomes are sustained. With the EBP paradigm as the basis for decision-making and the EBP process as the basis for addressing clinical issues, critical care nurses can improve patient, provider, and system outcomes by providing best care.

Seven steps to EBP

Step 0–A spirit of inquiry to notice internal data that indicate an opportunity for positive change.

Step 1– Ask a clinical question using the PICOT question format.

Step 2–Conduct a systematic search to find out what is already known about a clinical issue.

Step 3–Conduct a critical appraisal (rapid critical appraisal, evaluation, synthesis, and recommendation).

Step 4–Implement best practices by blending external evidence with clinician expertise and patient preferences and values.

Step 5–Evaluate evidence implementation to see if study outcomes happened in practice and if the implementation went well.

Step 6–Share project results, good or bad, with others in healthcare.

Adapted from: Steps of the evidence-based practice (EBP) process leading to high-quality healthcare and best patient outcomes. © Melnyk & Fineout-Overholt, 2017. Used with permission.

Critical appraisal resources

• The Joanna Briggs Institute http://joannabriggs.org/research/critical-appraisal-tools.html
• Critical Appraisal Skills Programme (CASP) www.casp-uk.net/casp-tools-checklists
• Center for Evidence-Based Medicine www.cebm.net/critical-appraisal
• Melnyk BM, Fineout-Overholt E. Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice . 3rd ed. Philadelphia, PA: Wolters Kluwer; 2015.

A full set of critical appraisal checklists are available in the appendices.

Bonus content!

This article includes supplementary online-exclusive material. Visit the online version of this article at www.nursingcriticalcare.com to access this content.

critical appraisal; decision-making; evaluation of research; evidence-based practice; synthesis

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Making sense of research: A guide for critiquing a paper

Affiliation.

• 1 School of Nursing, Griffith University, Meadowbrook, Queensland.
• PMID: 16114192
• DOI: 10.5172/conu.14.1.38

Learning how to critique research articles is one of the fundamental skills of scholarship in any discipline. The range, quantity and quality of publications available today via print, electronic and Internet databases means it has become essential to equip students and practitioners with the prerequisites to judge the integrity and usefulness of published research. Finding, understanding and critiquing quality articles can be a difficult process. This article sets out some helpful indicators to assist the novice to make sense of research.

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• Calvin Moorley 1 ,
• Xabi Cathala 2
• 1 Nursing Research and Diversity in Care, School of Health and Social Care , London South Bank University , London , UK
• 2 Institute of Vocational Learning , School of Health and Social Care, London South Bank University , London , UK
• Correspondence to Dr Calvin Moorley, Nursing Research and Diversity in Care, School of Health and Social Care, London South Bank University, London SE1 0AA, UK; Moorleyc{at}lsbu.ac.uk

https://doi.org/10.1136/ebnurs-2018-103044

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Introduction

In order to make a decision about implementing evidence into practice, nurses need to be able to critically appraise research. Nurses also have a professional responsibility to maintain up-to-date practice. 1 This paper provides a guide on how to critically appraise a qualitative research paper.

What is qualitative research?

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Useful terms

Some of the qualitative approaches used in nursing research include grounded theory, phenomenology, ethnography, case study (can lend itself to mixed methods) and narrative analysis. The data collection methods used in qualitative research include in depth interviews, focus groups, observations and stories in the form of diaries or other documents. 3

Authenticity

Title, keywords, authors and abstract.

In a previous paper, we discussed how the title, keywords, authors’ positions and affiliations and abstract can influence the authenticity and readability of quantitative research papers, 4 the same applies to qualitative research. However, other areas such as the purpose of the study and the research question, theoretical and conceptual frameworks, sampling and methodology also need consideration when appraising a qualitative paper.

Purpose and question

The topic under investigation in the study should be guided by a clear research question or a statement of the problem or purpose. An example of a statement can be seen in table 2 . Unlike most quantitative studies, qualitative research does not seek to test a hypothesis. The research statement should be specific to the problem and should be reflected in the design. This will inform the reader of what will be studied and justify the purpose of the study. 5

Example of research question and problem statement

An appropriate literature review should have been conducted and summarised in the paper. It should be linked to the subject, using peer-reviewed primary research which is up to date. We suggest papers with a age limit of 5–8 years excluding original work. The literature review should give the reader a balanced view on what has been written on the subject. It is worth noting that for some qualitative approaches some literature reviews are conducted after the data collection to minimise bias, for example, in grounded theory studies. In phenomenological studies, the review sometimes occurs after the data analysis. If this is the case, the author(s) should make this clear.

Theoretical and conceptual frameworks

Most authors use the terms theoretical and conceptual frameworks interchangeably. Usually, a theoretical framework is used when research is underpinned by one theory that aims to help predict, explain and understand the topic investigated. A theoretical framework is the blueprint that can hold or scaffold a study’s theory. Conceptual frameworks are based on concepts from various theories and findings which help to guide the research. 6 It is the researcher’s understanding of how different variables are connected in the study, for example, the literature review and research question. Theoretical and conceptual frameworks connect the researcher to existing knowledge and these are used in a study to help to explain and understand what is being investigated. A framework is the design or map for a study. When you are appraising a qualitative paper, you should be able to see how the framework helped with (1) providing a rationale and (2) the development of research questions or statements. 7 You should be able to identify how the framework, research question, purpose and literature review all complement each other.

There remains an ongoing debate in relation to what an appropriate sample size should be for a qualitative study. We hold the view that qualitative research does not seek to power and a sample size can be as small as one (eg, a single case study) or any number above one (a grounded theory study) providing that it is appropriate and answers the research problem. Shorten and Moorley 8 explain that three main types of sampling exist in qualitative research: (1) convenience (2) judgement or (3) theoretical. In the paper , the sample size should be stated and a rationale for how it was decided should be clear.

Methodology

Qualitative research encompasses a variety of methods and designs. Based on the chosen method or design, the findings may be reported in a variety of different formats. Table 3 provides the main qualitative approaches used in nursing with a short description.

Different qualitative approaches

The authors should make it clear why they are using a qualitative methodology and the chosen theoretical approach or framework. The paper should provide details of participant inclusion and exclusion criteria as well as recruitment sites where the sample was drawn from, for example, urban, rural, hospital inpatient or community. Methods of data collection should be identified and be appropriate for the research statement/question.

Data collection

Overall there should be a clear trail of data collection. The paper should explain when and how the study was advertised, participants were recruited and consented. it should also state when and where the data collection took place. Data collection methods include interviews, this can be structured or unstructured and in depth one to one or group. 9 Group interviews are often referred to as focus group interviews these are often voice recorded and transcribed verbatim. It should be clear if these were conducted face to face, telephone or any other type of media used. Table 3 includes some data collection methods. Other collection methods not included in table 3 examples are observation, diaries, video recording, photographs, documents or objects (artefacts). The schedule of questions for interview or the protocol for non-interview data collection should be provided, available or discussed in the paper. Some authors may use the term ‘recruitment ended once data saturation was reached’. This simply mean that the researchers were not gaining any new information at subsequent interviews, so they stopped data collection.

The data collection section should include details of the ethical approval gained to carry out the study. For example, the strategies used to gain participants’ consent to take part in the study. The authors should make clear if any ethical issues arose and how these were resolved or managed.

The approach to data analysis (see ref  10 ) needs to be clearly articulated, for example, was there more than one person responsible for analysing the data? How were any discrepancies in findings resolved? An audit trail of how the data were analysed including its management should be documented. If member checking was used this should also be reported. This level of transparency contributes to the trustworthiness and credibility of qualitative research. Some researchers provide a diagram of how they approached data analysis to demonstrate the rigour applied ( figure 1 ).

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Example of data analysis diagram.

Validity and rigour

The study’s validity is reliant on the statement of the question/problem, theoretical/conceptual framework, design, method, sample and data analysis. When critiquing qualitative research, these elements will help you to determine the study’s reliability. Noble and Smith 11 explain that validity is the integrity of data methods applied and that findings should accurately reflect the data. Rigour should acknowledge the researcher’s role and involvement as well as any biases. Essentially it should focus on truth value, consistency and neutrality and applicability. 11 The authors should discuss if they used triangulation (see table 2 ) to develop the best possible understanding of the phenomena.

Themes and interpretations and implications for practice

In qualitative research no hypothesis is tested, therefore, there is no specific result. Instead, qualitative findings are often reported in themes based on the data analysed. The findings should be clearly linked to, and reflect, the data. This contributes to the soundness of the research. 11 The researchers should make it clear how they arrived at the interpretations of the findings. The theoretical or conceptual framework used should be discussed aiding the rigour of the study. The implications of the findings need to be made clear and where appropriate their applicability or transferability should be identified. 12

Discussions, recommendations and conclusions

The discussion should relate to the research findings as the authors seek to make connections with the literature reviewed earlier in the paper to contextualise their work. A strong discussion will connect the research aims and objectives to the findings and will be supported with literature if possible. A paper that seeks to influence nursing practice will have a recommendations section for clinical practice and research. A good conclusion will focus on the findings and discussion of the phenomena investigated.

Qualitative research has much to offer nursing and healthcare, in terms of understanding patients’ experience of illness, treatment and recovery, it can also help to understand better areas of healthcare practice. However, it must be done with rigour and this paper provides some guidance for appraising such research. To help you critique a qualitative research paper some guidance is provided in table 4 .

Some guidance for critiquing qualitative research

• ↵ Nursing and Midwifery Council . The code: Standard of conduct, performance and ethics for nurses and midwives . 2015 https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf ( accessed 21 Aug 18 ).
• Barrett D ,
• Cathala X ,
• Shorten A ,

Patient consent for publication Not required.

Competing interests None declared.

Provenance and peer review Commissioned; internally peer reviewed.

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How to Write a Research Critique Paper in Nursing: A Comprehensive Guide with an Example

Carla logan msn, aprn-cnp, rn.

• July 26, 2024
• Nursing Writing Guides

Introduction

A research critique paper is an academic document that systematically evaluates a research article to determine its validity, significance, and relevance. This involves a thorough analysis of the study’s methodology, data, results, and conclusions to identify the strengths and weaknesses of the research. The goal is to assess the reliability and applicability of the research findings to inform practice, guide future research, and ensure that clinical decisions are based on robust evidence. This article aims to provide a detailed guide on how to write a research critique paper in nursing and provides an example on the same.

Importance of Research Critique in Nursing

In the field of nursing, research critique is essential for several reasons:

• Evidence-Based Practice : Critiquing research ensures that nursing practices are based on the most current and high-quality evidence, leading to better patient outcomes.
• Professional Development : Engaging in research critique helps nurses develop critical thinking skills, stay updated with advancements in healthcare, and contribute to the nursing knowledge base.
• Quality Improvement : By identifying the strengths and limitations of studies, nurses can advocate for changes that improve the quality of care and patient safety .
• Educational Value : For nursing students and educators, research critique fosters a deeper understanding of research methodologies and the application of research findings in clinical settings.

Components of a Research Article

The title of a research article should be clear, concise, and informative. It should accurately reflect the content and main focus of the study. A good title helps readers understand the essence of the research at a glance.

The abstract is a brief summary of the research article, typically 150-250 words. It includes the background, objectives, methods, results, and conclusions of the study. The abstract should provide a snapshot of the research, enabling readers to decide whether to read the full article.

The introduction sets the stage for the research by providing background information, outlining the research problem, and stating the study’s objectives. It should include a rationale for the study and its significance to the field of nursing.

Literature Review

The literature review summarizes existing research related to the study topic. It identifies gaps in the current knowledge, justifies the need for the study, and shows how the study builds on previous research. The review should be comprehensive and up-to-date.

Methodology

The methodology section describes how the study was conducted. It includes:

Study Design

The study design explains the framework and strategy used to investigate the research problem (e.g., randomized controlled trial, qualitative study).

Sample and Setting

This part details the characteristics of the study participants, including how they were selected, and describes the setting where the study took place.

Data Collection Methods

The methods used to gather data (e.g., surveys, interviews, observations) are outlined here, including any tools or instruments employed.

Data Analysis

This section describes the techniques used to analyze the collected data, ensuring that the methods are appropriate for the research question and type of data.

The results section presents the findings of the study without interpretation. It includes tables, figures, and statistical analyses that summarize the data.

In the discussion section, the authors interpret the results, discuss their implications, and relate them to existing research. They also address the study’s limitations and suggest areas for future research.

The conclusion summarizes the main findings and their significance. It provides a concise overview of the study’s contributions to the field and its implications for practice.

The references list all the sources cited in the article. It should be formatted according to a specific citation style (e.g., APA , MLA) and include recent and relevant literature.

Preparing to Critique

Selecting an appropriate article.

Choose an article that is relevant to your area of interest or practice. Ensure it is published in a reputable, peer-reviewed journal and that it addresses a significant research question in nursing.

Reading the Article Thoroughly

Read the article multiple times to fully understand its content. Start with a quick overview to get a general sense, then delve deeper into each section, paying attention to details.

Note-taking and Highlighting Key Points

As you read, take notes and highlight important points, such as key findings, methodologies , and any statements that stand out. This will help you organize your thoughts and support your critique with specific examples.

Identifying Strengths and Weaknesses

Critically evaluate each section of the article. Identify strengths, such as clear research questions, robust methodologies, and significant findings, as well as weaknesses, such as methodological flaws, biases, and unsupported conclusions.

Structure of a Research Critique Paper

The title page should include the title of your critique paper, your name, institution, course, instructor, and the date of submission. Ensure the title reflects the focus of your critique.

Background Information

Provide an overview of the research topic and its relevance to nursing practice . This sets the context for your critique.

Significance of the Study

Explain why the study is important and how it contributes to the field of nursing. Highlight any gaps in the research that the study aims to address.

Objectives of the Critique

State the main objectives of your critique, outlining what you aim to achieve through your analysis.

Summary of the Research Article

Major points of the article.

Summarize the key points of the article, including the research question, methodology, results, and conclusions. Keep this section concise and focused on the main aspects of the study.

Author’s Main Arguments and Findings

Discuss the main arguments and findings presented by the authors. Highlight the significance of these findings in the context of the research question .

Critical Analysis

Evaluation of the title and abstract.

Critique the clarity and informativeness of the title and abstract. Assess whether they accurately reflect the content and scope of the study.

Assessment of the Introduction and Literature Review

Evaluate the introduction and literature review for comprehensiveness and relevance. Assess whether the literature review adequately supports the research question and identifies gaps in existing knowledge.

Critique of the Methodology

Assess the appropriateness of the study design for the research question. Discuss any strengths or limitations of the chosen design.

Evaluate the sample size and selection process. Consider whether the sample is representative of the population and whether the setting is appropriate for the study.

Data Collection and Analysis Methods

Critique the data collection methods for validity and reliability. Assess the data analysis techniques to ensure they are appropriate for the type of data and research question.

Analysis of the Results

Examine the presentation and interpretation of the results. Assess whether the findings are clearly presented, supported by data, and appropriately analyzed.

Evaluation of the Discussion and Conclusion

Critique the discussion section for its interpretation of the results. Evaluate whether the conclusions are justified by the findings and whether the limitations and implications for future research are adequately addressed.

Assessment of the References and Overall Structure

Review the references for relevance and currency. Assess the overall structure of the article, ensuring that it is logically organized and clearly written.

Personal Reflection and Application

Relevance to nursing practice.

Discuss the relevance of the study findings to nursing practice. Consider how the research can be applied in clinical settings to improve patient care .

Implications for Future Research

Reflect on the implications of the study for future research. Identify any areas that require further investigation.

Summary of Key Critique Points

Summarize the main points of your critique, highlighting the strengths and weaknesses of the study.

Final Thoughts and Recommendations

Provide your final thoughts on the study’s overall quality and significance. Offer recommendations for future research or improvements in methodology.

Writing Tips and Techniques

Maintaining objectivity and clarity.

Maintain an objective tone throughout your critique. Avoid letting personal biases influence your analysis. Write clearly and concisely, ensuring that your arguments are easy to follow.

Using Evidence to Support Critique

Support your critique with evidence from the article and other credible sources. Use specific examples to illustrate your points and strengthen your arguments.

Proper Citation and Avoiding Plagiarism

Cite all sources accurately and consistently, following the appropriate citation style. Ensure that you give credit to the original authors to avoid plagiarism.

Ensuring Coherence and Logical Flow

Organize your critique logically, with clear transitions between sections. Ensure that your paper flows smoothly and that each section builds on the previous one.

Common Pitfalls to Avoid

Overlooking important sections.

Ensure that you critique all sections of the article, not just the parts that interest you. A comprehensive critique covers the title, abstract, introduction, literature review, methodology, results, discussion, and references.

Being Overly Critical or Lenient

Strive for a balanced critique. Avoid being overly critical or too lenient. A fair evaluation recognizes both strengths and weaknesses.

Lack of Supporting Evidence

Back up your critique with evidence from the article and other sources. Avoid making unsupported claims or generalizations.

Poor Structure and Organization

Organize your paper logically, with clear headings and subheadings. Ensure that each section flows smoothly into the next, and that your arguments are clearly presented.

Example of a Nursing Research Critique

Title: A Critique of “The Effectiveness of Nurse-Led Cognitive Behavioral Therapy for Managing Chronic Pain in Cancer Patients”

Chronic pain management is a significant challenge in oncology nursing. With an increasing number of cancer survivors experiencing persistent pain, innovative interventions are necessary to improve quality of life. The study titled “The Effectiveness of Nurse-Led Cognitive Behavioral Therapy for Managing Chronic Pain in Cancer Patients” explores the efficacy of a nurse-led cognitive behavioral therapy (CBT) intervention for chronic pain management in cancer patients.

This study is significant as it addresses a gap in effective, non-pharmacological pain management strategies. Given the potential side effects of long-term opioid use, exploring alternative approaches like CBT could lead to improved patient outcomes and provide nurses with valuable tools for pain management.

The objectives of this critique are to evaluate the study’s research question, methodology, results, and conclusions. The critique will assess the strengths and weaknesses of the study and discuss its implications for nursing practice.

The study aimed to determine the effectiveness of nurse-led CBT in reducing chronic pain and improving quality of life among cancer patients . It utilized a randomized controlled trial (RCT) design with a sample of 100 patients, randomly assigned to either the CBT intervention group or a control group receiving standard care.

The authors argued that CBT, delivered by trained nurses , could significantly reduce pain levels and improve emotional well-being compared to standard care. The findings indicated that the CBT group experienced a statistically significant reduction in pain scores and improvements in quality of life measures compared to the control group.

The title is clear and informative, accurately reflecting the study’s focus on nurse-led CBT for chronic pain management in cancer patients. It effectively captures the essence of the research.

The abstract provides a concise summary of the study, including the objectives, methods, results, and conclusions. It is well-organized and allows readers to quickly assess the relevance of the study. However, it lacks details on the specific statistical methods used.

The introduction provides a comprehensive background on chronic pain in cancer patients and the potential benefits of CBT. It clearly states the research problem and objectives, establishing a strong rationale for the study.

The literature review is thorough and up-to-date, covering relevant studies on CBT for chronic pain management. It identifies gaps in existing research and justifies the need for the current study. However, it could benefit from a more detailed discussion of previous interventions and their limitations.

The use of a randomized controlled trial (RCT) design is appropriate for evaluating the effectiveness of the intervention. It allows for high internal validity and minimizes biases.

The sample size of 100 participants is adequate, but the study does not provide information on the demographic characteristics of the sample. The setting is a hospital-based oncology unit, which is appropriate for the target population.

Data collection methods included standardized pain and quality of life scales, which are reliable and valid for measuring the study outcomes. However, the study does not detail how the CBT sessions were structured or the training provided to the nurses.

The statistical analyses used to compare the outcomes between the CBT and control groups are appropriate. The study reports significant differences in pain scores and quality of life measures, supporting the effectiveness of the intervention.

The results are clearly presented with appropriate use of tables and figures. The study reports a statistically significant reduction in pain levels and improvements in quality of life for the CBT group. However, the clinical significance of these findings is not discussed in detail.

The discussion section provides a thorough interpretation of the results and their implications for practice. The authors relate their findings to previous research and discuss the potential mechanisms through which CBT may reduce pain. However, they do not address the limitations of the study in depth.

The conclusion effectively summarizes the study’s main findings and their significance. It offers practical recommendations for integrating CBT into pain management protocols but lacks suggestions for future research.

The references are relevant and current, supporting the study’s background and findings. The overall structure of the article is logical and well-organized, with clear headings and subheadings.

The study’s findings are highly relevant to nursing practice. Integrating CBT into pain management can provide nurses with an effective, non-pharmacological tool to improve patient outcomes. This approach aligns with the increasing emphasis on holistic care and patient-centered interventions.

Future research should explore the long-term effects of CBT on pain management and quality of life. Studies could also investigate the feasibility of implementing CBT in different settings and among diverse patient populations.

The study provides valuable insights into the effectiveness of nurse-led CBT for chronic pain management in cancer patients. The RCT design and use of validated measures strengthen the study’s findings. However, the lack of detail on CBT implementation and the limited discussion of limitations are areas for improvement.

Overall, the study contributes to the evidence base for non-pharmacological pain management strategies . Nurses should consider incorporating CBT into their practice while remaining aware of the study’s limitations. Future research should address these gaps to further validate and refine the intervention.

Writing a research critique paper involves a thorough analysis of the study’s methodology, data, results, and conclusions to identify the strengths and weaknesses of the research. An effective nursing research critique can help in evidence-based practice, professional development, and quality improvement. If you need further assistance in writing your nursing research critique paper, consider seeking our professional writing services . Our team of expert writers are ready to help you produce a well-crafted and insightful paper that meets academic standards.

1. What is the purpose of a nursing research critique?

The purpose of a nursing research critique is to systematically evaluate the quality, validity, and relevance of a research study to ensure its findings are reliable and applicable to clinical practice.

2. How do I select an appropriate research article for critique?

Choose an article that is relevant to your area of interest, published in a reputable, peer-reviewed journal, and addresses a significant research question in nursing.

3. What should I include in the critical analysis section of a research critique?

In the critical analysis section, evaluate the study’s design, sample, data collection methods, results, and conclusions, and assess their strengths and weaknesses.

4. How can I ensure my research critique is objective?

Maintain objectivity by focusing on evidence from the article, using clear criteria for evaluation, and avoiding personal biases or overly critical judgments.

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