Critical appraisal is a systematic process of assessing the outcomes of a scientific research study based on evidence to determine the relevance, value, and its trustworthiness in a particular field of study (Zeng et al., 2015, pp.2-10). Additionally, it seeks to evaluate the way studies are conducted against the factors like the internal validity and the generalizability of the results to the entire population. This appraisal aims at critically examining two articles whereby one is based on the quantitative research while the other is based on the qualitative research study in the field of health and human services management. In this study, the first section will highlight the tools selected while the precedent parts will critically review the research methods used in the research articles’ case studies. The ethical issues and the summary of the strengths and weaknesses of the implied methodologies will also be outlined.
The critical appraisal tools selected for the research articles’ methodology are the decision analysis and the qualitative research appraisal tools. According to (Greco, Salvatore, and Ehrgott, 2016), the decision analysis is an objective critical appraisal method that uses vital models that represent the particular medical scenario and allows the application of the Evidence-Based Medicine (EBM). In this tool, the factors involved in the selection of a certain strategy from a given set of decisions are quantitatively evaluated. Moreover, this tool was suitable for the (Liang and Wollersheim, 2017, pp.16-23) article on assessing the competence of Evidence-Informed Decision-Making amongst the service managers since it was the best in evaluating the steps in this study. However, the qualitative critical appraisal tool was selected for evaluating the methodology used in the article on separation of families of Sudanese refugees that live in Australia (Savic, Chur-Hansen, and Mahmood, 2018, pp.383-387). This is due to the nature of the methodology used in collection and analysis of data, which were based on qualitative methods.
Research article 1:
This is a quantitative research study aimed at determining the competency in the use of Evidence-Informed Decision-Making by the mid-level managers in health services. The case study research also aims to demonstrate the behaviour of mid-level health managers that requires improvement both at the organizational and individual level. The decision analysis questions are varied against the methods of selection of participants, collection of data, and the data analysis methods to determine the critical issues, both the strengths and the weaknesses of the study.
The tool seeks to examine whether the following was clearly stated, the patient group over which the decision analysis should be applied? The patients’ health problem, the setting for the care, and who is providing the care? These questions in the analysis tool all answered in the abstract part of the research article on page 16 except the patient group is unspecified but rather the study applies to all groups in the two Victorian hospitals.
The tool further evaluates the results of the study using the following set of questions. Were all the strategies and outcomes included in the study? Does the model illustrate the decision tree diagram? Were all the clinical realistic strategies compared? From the research article, these questions cannot be determined since the decision tree diagram that could guide the consumers of the study results from determining these factors was not included in the research (Gokgoz and Ercan, 2015, pp.138-144). However, the tool further questions whether the relevant outcomes were considered. These are, does the study include outcomes that matter to patients? Does it address both the quantity and quality of life? From the article, these matters are covered using the assessment of the managers on a Likert scale found on page 18 of the article. Such aspects include the competence to guide the medical stuff, proficient, and superior expertise for coaching and directing the staff in the effort of caring for the patients.
Another critic from appraisal tool is whether the sensible process was explicitly used to identify, combine, and select the evidence into probabilities. Did the researcher give enough information about how they searched for the literature to identify the studies they included? Do they give enough information on how the probability values were assigned? From the research report, the author has shown enough information used to obtain the quantitative data used. The research used a 3600 subjective assessment method and an effective case study that is based on the objective assessment. The analysis methods such as the use of SPSS software used for the raw data downloaded has been identified in the study as explained on page 18 (Green and Samuel, 2016). However, the research did not explain how the probability figures displayed from the statistical competency calculation for the EIDM were arrived at on page 19 of the article.
The next section for critical appraisal was to determine whether the report has shown the credible sources for the utilities. Are the source of utility rating indicated? Are the individuals making the ratings a representative of the group the decision analysis is aimed at? The article has cleared covered the sections whereby the mean score rating of different behavioural activities of the mid-level managers at the Victorian hospitals is presented in a table format on page 19. These ratings are for the target managers at the hospitals who are the core determinant of the quality of services offered to the patients. Additionally, the researcher has outlined all the sources applied in the article, which are summarized in the reference section on page 23. The source is also well referenced according to the required standards.
Another important critique to be examined are the results. This intent to investigate the baseline analysis of the research concerning the research questions. In this section, does the strategy result in a clinical importance gain for the patients? In addition, if not, is the result a toss-up? From the article, the results indicate that most managers in the Victorian hospitals are competent in ensuring that the patients have access to a quality medical care at the hospitals. (Meys et al., 2016, pp.17-29) deduces that by application of the 3600 subjective assessment method, the results obtained are shown to be viable and implies the method can be applied to another particular hospital. Moreover, the results from the article are not a toss-up since they state the implications to the organisations while addressing the key barriers to the Evidence-Informed Decision-Making factors that should be addressed to all medical facilities. This is shown on page 21 through page 22 in the article. Therefore, the results can be projected to other medical facilities to improve the medical care to the respective patients.
This research explored the impacts of separation from the members of the family of the Sudanese refugees on their wellbeing, their mental health, and the coping strategies in Australia. The study was conducted using the qualitative research methods where the in-depth interviews were used as the major source to collect the data. Thereafter, the data analysis method used was the thematic analysis method. The research aimed at answering the implications undergone by the Sudanese immigrants in the refugee camps in Australia. Concisely, the critical appraisal tool used to criticize this research study was the qualitative critical appraisal technique as analyzed below.
The qualitative critical appraisal tool seeks to identify the following from a research study. Did the article describe the clinical problem that was addressed via the clearly formulated questions? The second item, was the qualitative research appropriate? From the article, it can be deduced that the study highlighted the problems faced by the participants in the study on page 383 to 384 that the study aimed at answering them. However, the author did not summarize nor shortlist the research question to be addressed in the study in a single sentence. The use of the qualitative approach is conclusively appropriate in the sense that it provided a platform to collect the first-hand raw data from the victims (Teherani et al., pp.669-670).
The third item examined by the technique is the sampling strategy and justification of this strategy. Under this, has the method of data sampling adequately described? Have the researchers studied the most productive range of individuals to be interviewed relevant to the question? Have the characteristics of the participants been defined? Was it clear why some participants did not participate? From the article, on page 383 under the subtopic of key informants, the method of sampling participants has been well described whereby the research used the most productive participants for the study. These participants included the psychiatrists, mental health social workers among many others who worked in the refugees’ camp. According to the research question, this class of people could give reliable information concerning the refugees, which is very productive for the study. However, the mentally ill victims were not picked as part of the participants.
The fourth issue to be criticized in the study was the method of data collection. The qualitative critical appraisal technique seeks to examine whether the following questions were answered. Were the appropriate sources of data studied? Has the method been described in detail? Were the methods reliable? Were the observations taken in a range of circumstances? From the article on page 384 under the in-depth interviews subtopic, the research explains the method of data collection in detail. Through the in-depth interviews, the research could be able to collect all the relevant information from the participants who interact with the victims on daily basis (Fusch and Patricia, 2015, pp.1408-1416). The use of audiotapes was used thus making the method reliable and independently verifiable evidenced on page 384. The researcher used a range of one year to collect the data thus making it possible to collect the data under the different range of circumstances.
Was the relationship between the research and the participants explicit? From the article, the research explains the time taken to interview a participant or an informant to be between 45 minutes to 3 hours on page 384 under in-depth interviews. Deducing from this, it is positive to claim that the researcher had created a good relationship with the subjects to the research (Rosenthal, 2016, pp.509-516). Moreover, the researcher observed the ethics, implications, and the consequences of the findings since only key informants who could reflect the issues were chosen for participation as explained on page 385 in the first paragraph.
In addition, another critical issue in the technique is the credibility of the results. Do they address the research question? What conclusions were drawn and were they justified? To what extent are the findings projected to other clinical settings? From the article under the results subheading from page 384 to 386, the researcher has clearly stated the themes that emerged from the study that answers the research question in details. Furthermore, the results can be said to be credible since the research has gone a step further to include the sequences of several direct quotations during data collection in the report seen on pages 384 and 385 respectively. The researcher has also used presented the conclusion and discussion in a simple and coherent manner that could be understood by the consumers of the findings and results on page 386 and 387.
Ethics in research is a requirement that is aimed at protecting the dignity of the participants and the publication of the information obtained from the research. The ethical issues from the summary of National Statement Content abstracted from https://www.nhmrc.gov.au/health-ethicsc website observed by the researchers in the above article are hereby discussed. From the two articles, the researchers observed an informed consent code of ethics whereby the participants were persons knowingly intelligent and volunteers to the study. An informed consent implies that the participant’s autonomy is protected against any sort of discrimination, assaults on integrity and protection of personal liberty (Tam et al., 2015, pp.186-198).
Another ethical practice observed is the beneficence (Bromley et al., 2015, pp.900-908). Moreover, (Madary and Metzinger, 2016, p.3) implies that the hypothesis of the research whether beneficial or turns out to be non-beneficial should at no cost be harmful to the participants whether emotionally, physically, or professionally. For instance, in the first article, the research is obligated not to expose the mid-level manager who might be underperforming. Concisely, from the second article, if the researcher tries to learn the intimate details of a participant they should ensure that the potential harm is minimized as much as possible in favour of the participant.
Additionally, the researchers have impressed the respect for anonymity and confidentiality code of ethics (Petrova, Elmira and Jan, 2016, pp.442-454). This is directly linked to the beneficence code of ethics where it obligates the research against disclosing personal responses by specifying the individuals. (Bertram et al., 2016, pp.3-7) in his findings suggests that the privacy code of ethics is breached when private information such as attitudes, opinions, beliefs, and records are shared without the consent of the participants or subjects. In addition, the code of ethics also serves to protect the vulnerable groups of people. (De Chesnay, 2015) elaborates vulnerability as a class of people with characteristics that are unable to protect their own welfare and rights and should be therefore exempted as participants in research studies. These include the mentally ill, children, aged people, among others.
Strengths
The research studies had reliable sources of information that could highly contribute to the accuracy of the results and findings of the research. Additionally, there was enough time for data collection for the studies. This enabled the collection of data under a wide range of themes or circumstances especially for the qualitative research (Bryman, 2015). Another strength of the appraised quantitative research is that the findings can be generalized to a larger population while maintaining the accuracy and viability of the research provided the data selection process be well designed for study. Additionally, the data in the quantitative study can be very consistent, reliable and precise. The data collected for the qualitative research is cost-effective according to (Cox, 2018).
In both the appraised research articles, the participants were voluntarily chosen thus not randomly selected. The voluntary selection despite obeying the ethics codes of conduct, could lead to some degree of biases in the findings unlike when the samples are randomly selected. Another weakness of the studies is the size of the participants (Emerson, 2018, p.164). In both the studies, small samples of the participants are used which could be inappropriate to project the findings to other similar or related scenario to a larger population. Additionally, the data collection process in the qualitative research of the second article is time-consuming and more difficult to analyze since they do not fit into standard categories (Eriksson, 2015).
References
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Bromley, E., Mikesell, L., Jones, F., & Khodyakov, D. (2015). From subject to participant: Ethics and the evolving role of community in health research. American Journal of Public Health, 105(5), 900-908.
Bryman, A., & Bell, E. (2015). Business research methods. Oxford University Press, USA.
Cox, D. R. (2018). Analysis of binary data. Routledge.
De Chesnay, M. (Ed.). (2015). Caring for the Vulnerable. Jones & Bartlett Publishers.
Emerson, R. W. (2015). Convenience sampling, random sampling, and snowball sampling: How does sampling affect the validity of research?. Journal of Visual Impairment & Blindness (Online), 109(2), 164.
Eriksson, P., & Kovalainen, A. (2015). Qualitative methods in business research: A practical guide to social research. Sage.
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Gokgoz, E., & Subasi, A. (2015). Comparison of decision tree algorithms for EMG signal classification using DWT. Biomedical Signal Processing and Control, 18, 138-144.
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