Learning Objectives for This Module:

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. Describe/contrast two paradigms that ground research
6. Describe key attributes of quantitative and qualitative designs

Readings:
 

Woo, (2019) Chapter 1, 3, & 4 p. 68-79.

Eraydin, & Avsar, (2017).
Lintona,
& Farrell, (2009)
Mizock, Russinova,  & Millner, (2014).
https://www.cno.org/globalassets/docs/reg/41037-entry-to-practice-
competencies-2020.pdf
Young & Solomon (2009).

What is Research?
Welcome to CNUR 850 Research Methods! This course supports your learning of the foundations of research, its critical application in nursing, by
helping you to develop the skills to critically appraise research studies. Undergraduate level research skills are a competency for entry-to-practice as
BScNs with the College of Nurses of Ontario. A sound understanding of research is fundamental to evidence-based nursing practice and health care
practice. It is crucial for nurses, as independent, inter-dependent, and dependent clinicians to be able to engage in evidence-based practices along
with all members of the health care team. Therefore, each semester this course will introduce you to one RNAO Best Practice Guideline (BPG), as
the exemplar of evidence based practice.
The reading list includes a selection of articles that further exemplify types of studies and research designs. We suggest that you download these
articles during the first week of the semester so that you have them handy for reading, as we work through the course content. Many of the articles
will be used several times over the 12 weeks of study. Therefore, you may have a preliminary
read of them in weeks one and two; and then reread in
future weeks, as we delve in to the content more deeply.
Whether you are taking the in-class, hybrid or online version of this course, you will be covering and will be accessing the same material. In addition
to the module content, online students will also have access to PowerPoint presentations used in the in-class version of this course. You can access
these PowerPoints in D2L under Course Materials. Throughout each module, you
will encounter quizzes and interactive questions to test your
knowledge. In week 12, there is a full review of the content.
The course begins with this week’s overview of the two research paradigms: naturalism and positivism; and the research methodologies that are
most commonly associated with each: qualitative and quantitative. From the selected BPG for the semester, different qualitative and quantitative
articles that support the selected BPG are utilized to develop and apply critical appraisal skills.
Remember! Research articles are written very densely. There is a lot of information on any one page of an article to think through, reflect upon, and
learn about. So expect to read, reread and reread again. All of this takes time. So plot out uninterrupted, focused time throughout your week, in your
schedule, to concentrate on reading. Make notes on the articles, underline them, and raise questions about them in class! Most of all – enjoy the
incredible world of learning and knowledge that opens up to you as you explore the science of nursing!
Start this week and this course with a poll about your attitudes towards research.
Then dive in to a mini Self-Assessment Quiz. Most of you have had a previous introductory research course. Many students say they do not
understand why they need to "take it again", as they "understand" it all already! Therefore, this quiz will help you assess your baseline knowledge
that you recall from previous education. If your scores are high, that is terrific! You are ready to build upon your knowledge with greater depth of
understanding and critically apply it to research studies. If your score is not as high as you might have thought, then that will provide great information
for you to go back and review. Certainly raise questions in class or during the weekly synchronous chats if you are an online student to make sure
your instructor has an opportunity to explain core content with examples.
One concept many students find most challenging, as they transition from Community College education to University, is the notion of critical
appraisal. As the ability to critically appraise research literature is fundamental to success in this course, we will begin new content this week by
describing critical appraisal through the definition of the word "critique", which is the essence
of what we are doing in this research course. We will
link the concept of critical appraisal with the College of Nurses entry-to-practice competencies for BScN’s with which you are already familiar, and to
which you are accountable, once you graduate and pass the NCLEX exam!
Then we will move on to understand our history in nursing research, key research terms that we need to know, at the tips of our tongues, and the
basic steps of all research studies.
There is lots to do in week one so…
Remember! Pace yourself throughout the week! This is too much to do the night before class!

Opinion Poll

Poll:
When you hear the term "research", what thought or feeling do you experience? Choose one option
only. (Opens lightbox window)
This week, your instructor will send you a self-assessment quiz to complete on your own time to test your baseline knowledge of research!
You will be sent the answers at the end of the week. Check your scores!
Research, regardless of the professional focus, is described as “a systematic inquiry that uses disciplined methods to answer or solve problems”
(Loiselle et al., 2007, p.4). The definition of research within the nursing profession is modified only slightly “a systematic inquiry designed to develop
knowledge about issues of importance to the nursing profession” (Loiselle et al., p.4 ). Research, as a phenomenon, is the same across professions
and disciplines with respect to its overall purposes, paradigms, processes, methodologies and transmission of knowledge.
As consumers and producers of research, we critically appraise research.
Take a moment and write down your definition of “critique”. How does your understanding compere with this definition?
To critique is 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 do you critique?

Scenario:
Consider this clinical example of a critique: A patient’s temperature is 39.5C.
Question: How would you critique this?
Answer: The patient is febrile.
Question: What is the benchmark or standard or specific set of criteria against which you made this critique?
Answer: Normal temperature range in Celsius is 36.5 to 37.5. This temperature score is above that, so the patient is warmer than normal and has a
fever!
So, how does this apply to critical appraisal of research?
“Critical appraisal is a systematic process used to identify the strengths and weaknesses of a research article in order to assess the usefulness and
validity of research findings. The most important components of a critical appraisal are an evaluation of the appropriateness of the study design for
the research question and a careful assessment of the key methodological features of this design.” (Young & Solomon, 2009, p. 82).
This, critical appraisal of research, is a key objective of this research course.

Nursing Research Areas

There are common broad areas of focus for nursing research: administration, education, clinical practice, professionalism and professional issues,
research utilization, and trans-disciplinary topics. Each of these main topics has its own areas of specialty and programs of research. Examples might
include the following:
Administration: retention and recruitment; workload and work design, leadership
Education: online education versus traditional classroom modality 
Clinical practice: health policy, health promotion, illness prevention, treatment, palliation, patient safety
 Professionalism & issues: horizontal violence, standards of practice, scope of practice, nursing shortage 
Research utilization: dissemination of research findings in practice
Interdisciplinary topics: multi-disciplinary discharge planning

Pause and Reflect

1. The Consumer – Producer Research Continuum.
Who are the Consumers of Nursing Research?
Suggest who you think are the consumers of nursing research and compare your responses with those of your colleagues!
Who are the Producers of Nursing Research?
Suggest who you think are the producers of nursing research and compare your responses with those of your colleagues!
Have you ever benefited from research in general and/or from Nursing Research in particular? 
Suggest ways do you think you have benefited from research in general and nursing research in particular in your life? Compare your responses
with those of your colleagues!

Reasons for Nursing Research

Why do nurses at the Baccalaureate, Masters and PhD levels need to know about and participate in research? Or….why should I have to take this
course?   How do nurses know to practice according to the best standards? How do they/we know what the best possible care for our patients is?
What the best possible way to manage and teach nurses? What is the best way for nursing to develop as a profession? How might nurses best utilize
nursing research and transmit nursing knowledge? How might nurses work in a complementary fashion with other disciplines?
First let's look at the College of Nurses of Ontario requirements of RNs regarding research at the entry to practice level:
The College has 101 competency statements under nine standards in the competency framework. These competencies govern our practice and we
are professioanlly accountable to the public to practice according to them at the time we enter the profession. Here are some of the competency
statements that govern our practice that are specific to research.
National competencies entry-to-practice:
Our practice is based upon the assumption that “5. Entry-level RNs have a strong foundation
in nursing theory, concepts and knowledge,
health and
sciences, humanities, research and
ethics from education at the baccalaureate
level” ( (College of Nurses of Ontario: Standards of Practice, 2020, 
p.4.)  
Under the Standard: 
1. Clinician Registered nurses are clinicians who provide safe,
competent, ethical, compassionate, and evidence informed care across the lifespan in
response to
client needs
    1.23 3 Uses knowledge of the impact of evidence informed registered nursing practice on client
health outcomes.
    1.27 Implements evidence-informed practices for
infection prevention and control.

3. Communicator
    3.3 Uses evidence-informed communication
skills to build trusting, compassionate, and
therapeutic relationships with clients
9. Scholar: Registered nurses are scholars who demonstrate
a lifelong commitment to excellence in practice
through critical inquiry, continuous
learning,
application of evidence to practice, and support of
research activities
    9.1 Uses best evidence to make informed
decisions. 
    9.2 Translates knowledge from relevant sources
into professional practice.
    9.7 Supports research activities and develops own
research skills.
 
 
Nurses who re upgrading to a baccalauareate RN now receive the formal education that is based upon these competencies for practice.
The notion of nurses as knowledge seekers is not new. Nurses have pursued questions about practice to determine nursing care from the beginning
of our profession’s development. Determination of what was ‘true’ or ‘right’, (the discovery of knowledge), had several methods prior to the advance
of research.

Sources of Evidence of Knowledge

Evidence has been determined by levels of hierarchy from the least to the greatest according to the degree of dependability and validity of the
knowledge. They are presented here in order of the lowest level of evidence (or least reliable and valid, least rigorous) up to the highest level of
evidence (or greatest reliability and validity, most rigorous).
Some examples of evidence hierarchy follow.
1) Tradition has been used to determine ‘truth’. ‘It has always been done this way’, is a common adage that most RNS can recall.   Tradition implies
that practice is embedded in customs which are based down from one generation of nurses to another: from the senior nurse to the junior nurse.

Pause and Reflect

2. Can you think of examples of practice that have been supported by tradition only?
    What might be some advantages and disadvantages of tradition?
 2) Another means to determine evidence is by authority. The person deemed to be the authoritative figure or the person with the expert knowledge
determined the ‘truth’. 

Pause and Reflect

3. Which positions of authority might have had a strong influence on determining nursing practice?
     What might be some advantages and disadvantages of authority?

 3) Clinical experience, through trial and error and intuition, has also been utilized to decide what is ‘right’. If a particular treatment or care approach
appeared to be effective for one or a few patients, then it was thought to be effective for others. Interventions were tried to see if they ‘worked’. If so,
they were tried again.

Pause and Reflect

4.  Can you identify practices that you may have seen or heard of that were determined by trial and error?   What might be some advantages and
disadvantages of trial and error?

 4) Assembled information is knowledge or data gathered for several possible reasons in order to address clinical problems, or understand complex
phenomena and processes. Some examples of assembled information are bench-marking, quality improvement and risk management.

Pause and Reflect

5. What might be some advantages and disadvantages of assembled information?

 5) Research is considered the most dependable and valid form of evidence. It is primarily based upon logical reasoning. Logical reasoning is the
foundation of research.
  RNAO has funding from the Ministry of Health to develop best practice guidelines (BPG) for nurses from the existing empirical evidence, research.
To date they have developed numerous BPGs to guide nursing practice. One example of a BPG is the guideline for Assessment of Adults at Risk for
Suicidal Ideation and Behaviour. A copy has been uploaded for you under BB, course materials. Both the long version of the guideline and the
synthesis of its recommendations are uploaded. All BPGs are free from RNAO for download from the RNAO web site: www.rnao.org .
Check p 14 of this BPG. You will see that the developers challenged the notion of 'levels' of evidence and instead presented 'types' of evidence. They
did this because of inherent weaknesses in teh notion of levels. Read their work and think about it in advance of answering question 6 below.
.

Pause and Reflect

 6. What might be some advantages and disadvantages of evidence based in research or best practice guidelines?

An Overview of Nursing Research’s Past, Present and Future.

 
RN’s, administrators, educators, nurse practitioners, CNS, Nurse Practitioners, public health nurses, nurses in pharmaceutical companies, health
policy nurses in the government and nurse researchers use research outcomes.
They use it to guide practice, develop policy, and inform future research.
In order for them to use it effectively and meaningfully, they need to be able to critique it. Not all research is good research. Even good information
from good research at some point will be replaced by better research. It is a continuous process. Therefore, in order to be able to use research,
nurses need to understand research.   This course will help you to become a consumer of research by providing you with the knowledge to interpret
and critically review or appraise it.
 
Nurse researchers design and implement studies across the breadth of topics identified previously.

Pause and Reflect

7. Where do you see, hear or learn about research?  Where is research discussed, presented, and used?
What is your understanding, or how much do you understand, of what you see or hear?
Compare your experiences with those of your colleagues.

An Historical Synopsis of Nursing Research

Nursing research began as early as Florence Nightingale, with Notes on Nursing in 1859 (Loiselle et al, 2007, p. 7). During the 1900’s to 1940’s, the
focus of nursing was on education. With the advent of World War II, the demand for the numbers of nurses increased. In 1952, the first Journal of
Nursing Research was published (Loiselle et al, 2007, p. 7). Conceptual models were developing in the 1960’s and 1970’s. By the 1980’s, an
increase in nurses with PhDs conducted research. By 1990’s, it was apparent that independent research studies were not sustainable or influential
and therefore large programs of research evolved according to broad topics such as HIV nursing. With this came an increase in the number of
funding agencies and available dollars for nursing research from such agencies as the National Institute of Health Research in the United States, the
Canadian Institute of Health research, and the Cochrane Collaboration (Loiselle et al, 2007, p. 7)

Future Directions
Future directions for nursing research seem almost limitless. Currently there is a large emphasis on outcomes based research that is the
measurement of the outcome of treatments, the delivery of services, and models of care. There is also research that focuses on bio-physiological
responses to illness, interventions, adaptation etc. The Evidence Based Practice movement bridges research findings with clinical expertise and
patient preferences to support best practice guidelines. Additionally, research focuses on the confirmation of previous research findings through
attempts to replicate under similar or differing conditions. Lately, nursing has engaged in trans-disciplinary research to enrich the research process
and findings with expertise from across a variety of professions. Then there is research on how research is actually utilized and how its findings are
disseminated to a broader audience. Now nursing research focuses on increasing its visibility in health care research.

Purposes of Nursing Research

There are two purposes of research in general and hence two types of nursing research. Basic research is research that increases the nursing
knowledge base. An example of this is research about nursing theory and theory development.

Pause and Reflect

8. Suggest other topics for basic research and compare your responses with your colleagues.

Applied research is research that seeks to find solutions to problems. An example of this research is research about intravenous site duration to
provide evidence for the optimal length of time for an intravenous site without incidence of infection, cellulitis, or thrombosis.

Pause and Reflect

9. Suggest other topics for applied research and compare your responses with your colleagues.

For research purpose, one or more phenomenon will be identified, described, explored, explained, predicted, or controlled.

Research Method
The steps or techniques, by which the research is conducted, are known as the research method. This includes the procedures and processes used
by the researchers to organize a study so that it can relevantly answer the research question as it has been asked or worded.  You will learn that the
actual wording of a research question, the choice of words and placement of the words in the research question, is extremely important.
Research questions are founded upon a philosophical paradigm.

Clinical Example
 To demonstrate the concept of paradigm and the differences between a quantitative and qualitative paradigm in a clinical research study, we will
refer to the following case scenario.
You are a nurse researcher on a unit that provides care to clients with total hip replacements for arthritis. The average age of your clients is 60 and
you have an even number of male and female clients. One of the postoperative deterrents to ambulation is pain. As a researcher, whose goal is to
provide evidence that supports the most efficacious pain management for post total hip replacement patients, you have different questions. Your first
question is to know what is the most effective analgesia, its medication type, dose, frequency, and route to promote early ambulation and minimal
drug side effects?  However, you also realize from practice that pain is a unique, multidimensional experience. Therefore, you are also interested to
know the patient experience of post operative hip replacement in a 60 year old.
So, from this clinical example there are two (at least) different research questions and each will evolve from a different research paradigm!
1) What is the pain level, as measured by the visual analogue pain scale, in postoperative 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 experience of pain in 60 year olds who have total hip replacements for arthritis?

What is a Paradigm?
In order to begin to know how to approach these research questions it is helpful to understand how one comes to now what might be considered
“true”. A paradigm provides guidance. A paradigm is a way of looking at the world from different angles. It is a worldview or a philosophical approach
to life and its phenomena. For example: some philosophers believe that people are innately good while others believe that people are innately bad.
How one might approach people in general in life might be very different depending upon which philosophical approach one takes. In other words,
your "view" frames your approach.
 

An example of a worldview or paradigm that is not research is a worldview or paradigm on the value of money. Do you think money
is to be spent and enjoyed or saved and counted? Your world view about money will influence your habits and behaviours about
how you treat money and your priorities with spending and saving.
Pause and Reflect
10. If your view of people is that they are innately bad, how might you approach the stranger on the street? If your view is that people are innately
good, how might you approach the stranger on the street?

Two Major Research Paradigms

In research, there are two major approaches to discovering “truth” or learning about a phenomenon. The first is the POSITIVIST paradigm; the
second is the NATURALIST paradigm.
Let’s do an over view of positivism and naturalism, and their respective methodologies: quantitative and qualitative, so we understand their respective
worldviews on “getting to truth about the world we live in”. Most of this should be a review as you have studied this in diploma level nursing courses.
Now you need to be so familiar with the differences that your knowledge will support your ability to critically analyze the appropriateness of a
particular paradigm for a research question.
What is your definition of qualitative research? How does it compare with this formal definition?
“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)
What is your definition of quantitative research? How does it compare with this formal definition?
“The investigation of phenomena that lend themselves to precise measurement and quantification, often involving a rigorous and controlled design.”
(Woo, 2019. p. 423)

Who is the Positivist?

A person, who conducts positivistic research is known as a positivist researcher, and uses logic and an objective approach to knowledge inquiry.
Positivism originated in 19th century philosophy.It is also known as logical positivism, or strict positivism. This worldview is inherent in quantitative
research.

The Positivist's View

The positivist believes that events are not haphazard and that phenomena that occur in the world have antecedent causes.  This is referred to as
determinism. The positivist looks for cause and effect relationships.

The Positivist Research Process

The positivist uses strict procedures to plan a research study, follows strict protocols to test ideas, and looks for relationships among phenomena in
the study. It is essentially critical for the positivist to be objective and work with that, which can be known by the senses: that which can be seen,
heard, touched, felt, smelt, and/or tasted. The positivist deals with what can therefore be measured objectively and quantified with numbers. In order
to do this, the positivist holds his/her personal beliefs and biases aside. 

Quantitative Research Has Evolved from the Positivist Paradigm

As quantitative research has its roots in positivist thinking, it is the traditional scientific approach. It deals with objective reality and is based upon
certain assumptions and beliefs. The first is that subjective bias (feelings, values, beliefs) can be suspended and removed from the research process.
Another is that of determinism or that there is cause and effect in life and that everything can be reduced to its smallest parts and ultimately be
measured. Hence, the term reductionism is also frequently applied to describe quantitative research.

Quantitative Research Definition

A definition of quantitative research is: "Formal, objective, systematic process to describe and test relationships, and to examine cause and effect
interactions among variables" (Burns & Grove, 2001, p. 26)

Pause and Reflect

11. So, coming back to the previous clinical example……

How would a "positivist" approach the research question:

 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?
Compare your suggestions with your colleagues.

The Naturalist Paradigm

The naturalist paradigm is counter to positivism in several ways. This paradigm holds that knowledge is a subjective experience and relative in
context.

Who is the Naturalist?

A person who conducts naturalistic research is known as a naturalistic researcher, and takes a subjective approach to knowledge inquiry. He/she
perceives reality as not fixed but that it is in context. Truth is considered relative. The naturalist paradigm is also known as holistic. This worldview is
inherent in qualitative research.

The Naturalist's View

The naturalist believes that reality is fluid and that knowledge is constructed with participants and their subjectivity. "Truth" is not comprised of a
single reality rather; multiple interpretations of reality are possible.

The Naturalist Research Process

In the naturalist research process, the subjective distance between researcher and participants is minimized. Participation and interaction between
the researcher and the participant are key to understanding. The subjective nature of human beings is valued and embraced and knowledge is
understood to develop in the relationship in research experience

Qualitative Research Definition

A definition for qualitative research is "a systematic, interactive, subjective approach used to describe life experiences and give them meaning"
(Leininger, 1985 as cited in Burns & Grove, 2001, p. 26)

Pause and Reflect

12. So, coming back to the previous clinical example…

How would a "naturalist" approach the research question: What is the experience of pain in 60 year olds with arthritis, who have total hip
replacements?
Compare your responses with your colleagues.
Paradigms and Research Methods
Different paradigms will determine different research methods. The research method refers to accepted techniques for data collection and analysis
relevant to the research question.

The Quantitative Method

Quantitative research involves precise measurement and quantification (reductionism) and is most closely aligned with the Positivist  Paradigm.
Remember, it values what can be known by objective reality  through the body's senses. So its methods enable it to collect and analyze data as
objectively as possible.

Characteristics of Quantitative Research

The key characteristics of quantitative research are
1. deductive reasoning to define the research problem and the hypothesis (es)
2. identifies concepts that will be the focus of the study
3. determines techniques to be used in the investigation
4. conditions of study are controlled to minimize bias
5. uses formal instruments to collect data
6. data collection is quantitative (numeric) and analyzed using statistical methods
7. findings are looked at for degree of generalizability

All research has limitations. No single research paradigm or study provides the absolute truth. The very strengths of each paradigm are also the
limits.

Limitations of Quantitative Research

The fundamental limitations of quantitative research are:
1. an inability to address human dimensions of experience
2. an inability to address moral, ethical and professional questions across the health field, e.g., euthanasia, abortion  due to their highly subjective,
value laden nature
3. some concepts are less measurable objectively, e.g. stress may include BP, heart rate and temperature, but patient pain, anxiety or fear cannot
be accurately objectively measured
4. complexities tend to be controlled or ignored so that the object of study is magnified 
5. obscures insights about the phenomena 
6. focuses on a specific area to the exclusion of other relevant aspects of the question
The Qualitative Method
The qualitative research method investigates phenomena in an in-depth and holistic fashion using narrative reports. It is most closely aligned with a
Naturalist Paradigm. Remember, it values subjectivity. So its methods enable it to collect and analyze data, inclusive of the rich, subjective
experience of the participant and the researcher.

Characteristics of Qualitative Method

The key characteristics of a qualitative paradigm facilitate the emphasis of an understanding of the human experience:
1. inductive reasoning
2. collect and analyze narrative accounts of the human experience
3. the focus is dynamic, holistic and individual in context
4. procedures are flexible and fluid as the research experience develops
5. develops a theory or framework that explains the processes under observation
6. visits and re-visits the data as puzzles are unraveled in the on-going analysis and interpretation of data
7. provides rich, thick data for understanding complex human experience and relationships among the phenomena in research situations
8. research takes place in the field of interest
9. collection of data and analysis is on-going
10. the information leads to new insights and questions to amplify disparities or  confirm hunches 
11. findings are looked at for transferability

Limitations of Qualitative Research

The fundamental limitations of qualitative research are:
1. human beings are fallible  and the researcher as the instrument is susceptible  to error
2. the research is subjective and findings may be idiosyncratic
3. as the research focuses on the individual experience, can the study be replicated?
4. are findings transferable given the small number of participants?

Similarities in Both Positivist and Naturalist Paradigms

There are several similarities in both research paradigms. Their ultimate goal is to acquire knowledge. Evidence is gathered and analyzed through
the senses-empirically. Both require the cooperation and willingness of participants. Ethical constraints are always involved. Virtually all
studies have limitations.

Research Process
The core and essential steps of the research process are listed below and we will spend considerable time exploring each step in detail for both the
qualitative and quantitative paradigms. 
1. identify the research question (s)
2. conduct a thorough literature review
3. describe the conceptual framework which will frame the research
4. design study according to the most appropriate paradigm and design type
5. identify the target population and the sample
6. identify all methods and procedures
7. conduct the data collection
8. analyze the data
9. write the research report
10. disseminate the research findings

The manner by which each step of the research process is conducted varies between quantitative and qualitative research based upon the
philosophical assumptions inherent in each.

Quantitative Research Process

1.  The research question is precisely worded so that it may be objectively and accurately measured. Each word and the position of each word
within the question directs the study design, population, and analysis.
2. The conceptual base to form the question is clearly described. The conceptual framework provide direction and indication of the relationships of
the variables in the question.
3. The literature review includes all concepts identified in the question
4. Hypothesis (es) are predicted and articulated and are based upon the concept of statistical significance.
5. the design includes determination of  population, the research setting, the instruments to measure the variables, the feasibility of collecting the
sample, the sample size
6. Data collection is numeric
7. Data analysis is conducted through appropriate statistical tests
8. Results are interpreted within the statistical significance
9. Results are critiqued based upon generalizability, reliability and validity

Qualitative Research Process

1. The research question may be broad and be described in terms of a purpose only.
 2. Conceptualization of topic may be limited if a all as the topic is usually a  poorly known area
3. There are no hypothesis (es) or predictions of relationships.
4. Data collection is iterative, interview  process, loosely structured, narrative & observational and sample sizes are small
5. Data is narrative
6. Analysis is conducted by the identification of narrative themes, seeks subjectivity, confirmation, and validation from the participants.
7. Findings are disseminated in raw verbatim passages
8. Findings may form future hypotheses to be tested quantitatively, and are critiqued in terms of transferability and credibility

Similarities in Both Positivist and Naturalist Paradigms

There are several similarities in both research paradigms. Their ultimate goal is to acquire knowledge. Evidence is gathered and analyzed through
the senses-empirically. Both require the cooperation and willingness of participants. Ethical constraints are always involved. Virtually all studies have
limitations

An Introduction to Key Terms in Research

Before advancing in the discussion of the research process, it is important to have a basic understanding of key research terms that will be used and
their definitions.
Phenomenon (a=plural): this refers to an abstract idea or experience of something in life example the phenomenon of grieving. Everyone knows what
grieving is, its manifestations can be observed, such as crying, not eating or sleeping, sadness. However grieving itself is an abstraction that cannot
itself be objectively measured. A phenomenon refers to an abstract concept and is frequently used in qualitative research to describe the concept of
interest for investigation. In comparison, in quantitative research, variables are the objective ideas for research interest and measurement example
temperature.

A construct is a concept that is deliberately invented by the researcher for scientific purpose eg. unresolved grief. It may have many dimensions to be
considered in the measurement.

A theory is an abstract presentation of an explanation regarding relationships between concepts eg: Kubler Ross's  theory of death and dying to
explain the grieving process
In a conceptual model the  inter relationship of concepts are described and their relevance to a theme eg: the step by step process of working thru
stages of grieving
Variables are the attributes of a person or an object that is measurable objectively and may be subject to change by itself, relative to other conditions,
or conditions are subject to change relative to it eg gender, age, level of pain, height
Continuous variables have a range of measures along a continuum with equal distance between each point of measure eg: age
Categorical  variables have discrete values without equal distance between points of measurement  eg marital status, religion
An independent variable is the cause or predictor of a condition or event or is the variable that is manipulated variable eg: childhood abuse; treatment
for ulcer
A dependent variable is the effect or outcome variable;  eg adult self-harm, skin integrity

Inductive and Deductive reasoning

There are two main types of logical reasoning:  inductive and deductive.
Inductive reasoning is the process of observation at the micro level or small unit of analysis and making predictions of the macro level or the large
unit of analysis.
In your daily life, you might discover one morning that the bus arrived a few minutes earlier than scheduled and left without you! Inductive reasoning
would lead you to predict that this could happen again in the future for you or other friends or family members! So you plan, and advise others to
plan, to be at the bus stop a few minutes earlier than the scheduled time to avoid the potential frustration!

In your nursing practice, you might discover that a patient is angry because she was not informed of the change in her discharge date. Inductive
reasoning would lead you to predict that most patients will be annoyed if they are not kept informed of changes in their discharge plans. So you
ensure that you communicate effectively with all patients about changes in their care plans! 
Deductive reasoning is the process of observation at the macro level and the subsequent predictions at the micro or small unit of analysis.
In your daily life, you have learned about the significant increases in debit card fraud in your community. Deductive reasoning will lead you to
conclude that this could happen to you as well, if you do not protect yourself! So you enhance your security of your PIN each time you use it!

In your nursing practice, you have learned that  deep breathing and coughing is important to prevent post operative pneumonia. Deductive reasoning
will lead you to predict that if your post operative patient does not receive deep breathing and coughing exercises that she will be at risk for
pneumonia. So you incorporate this intervention in her post operative care plan.
There are some advantages and disadvantages of either inductive or deductive reasoning. In either situation you can draw erroneous conclusions!
There may be factors distinct to an indivudual or a group, i.e. at either the micro or macro level, that do not apply to the other.  
 
 

Steps to Retrieve Research Articles

Steps to Retrieve Research Articles
To retrieve the articles for this course, go to the Ryerson library online; click on articles and indexes (you will need your Ryerson library card at this
point)
 Step 1.   Choose a search engine and a database. For this course all research articles can be located full text through the OVID search
engine and CINAHL database. As all topics in this course are nursing topics, this database is one that is dedicated to nursing literature
and will save a lot of wasted time looking in other databases that do not focus specifically on nursing.
Step 2.   Identify the key terms for the article search either by: Author, Journal title, or Article title
Step 3.   Set the limits to English only articles, human subjects only, and full text.
Step 4.   Make note of the number of articles or 'hits' retrieved from the search. Click on the display articles and search though till you
have found the one required for the readings  This is a skill and it takes time and practice to develop. The more you know your topic area
the more adept you will be at efficiently searching for relevant literature.
Step 5.  (and the most fun step!) Retrieve the article, then click on full text, download, and either save or print, and read and enjoy!!!
References for this Module 
Loiselle, C. G., Profetto-McGrath, J. Polit, P., D., & Tatano Beck C. (2011). Canadian Essentials of Nursing Research (3rd Ed.)
Chapter 1 Philadelphia: Lippincott Williams & Wilkins.
 

Group Discussions on Research Articles

Discussion
Each week, in the communication section of Learning Management System, (click the section labeled Group Pages, then click All
Group Work, then click Group Discussion Board,) you will find three research articles which have been referenced for you. Questions
have been posed to apply the module content to the nursing research article.
Three research articles for this course have been referenced (one qualitative, one quantitative, and one mixed- methods). Each week (module), questions,
relevant to that week’s content, have been posed for each article, under the ‘group discussion board’ area of the ‘communication’ section in Learning
Management System.  the same two articles will be used for most of the course. Then, towards the end of the course, we will use the third article. For those
weeks with two referenced articles, choose one (1) only of these articles and post your answers to  the respective questions each week online, for your colleagues
and instructor to read and comment. Concurrently each week, other students and your instructor will provide feedback, and clarification for your postings just as
you will also respond to other students’ postings. This provides you with an opportunity to correct and expand your answers and comprehension, and clarify
your capacity to provide an articulate, scholarly response for a critical appraisal of the initial steps of the research process.
Each student will respond online to other students' submitted responses to other questions; to create a dynamic learning environment. The course
instructor will engage online with the students to affirm learning, to clarify areas of confusion, to correct misinterpretations, to encourage further
critique, and to participate in the scholarly debate of ideas. There will not be an assigned grade for these specific postings.  It is in the process of
writing that comprehension is clarified. Students who participate actively and regularly in the discussion board area generally tend to do better
overall in the examination and the written assignments as they have practiced and received feedback on application of course content.
This discussion area is to replicate, in written format, a traditional in-class discussion, in which ideas and understandings of the content are
explored. There is no penalty for incorrect analyses or interpretations. It is through the process of online discussion and written application of
course content to actual research that learning occurs (ie what is understood and misunderstood becomes clearer;  areas of uncertainty are open
for clarification; and perspectives of academic debate are open for discussion of differing views).
The evaluation of the student's comprehension of and ability to apply key aspects of the research process to actual research will be via the
first quiz and the final examination. A maximum of 10 % of the multiple choice questions on the quiz and examination will be derived from actual
journal articles. All content from the article required to answer the question will be provided in the examination question.  Additional questions are
application questions on other research scenarios.  
You will notice the articles are not preloaded for you; but all are available full text online from the library. The rationale for not preloading the
articles is to meet the second objective for this course. In order to evaluate research articles the nurse, academic or researcher needs to be able
to search for relevant references. This is a skill that takes time to develop, so this course provides frequent opportunities for you to develop
search skills. So in module one the basic skills for a simple article search have been provided for you. Then in module three a full explanation of
complete literature searches will be given. So seek out the weekly articles online through the Ryerson library and initiate your discussions with
your colleagues.

E-articles 
Based on your readings from the text and the critical appraisal strategies by Young, &
Solomon (2009), answer the following questions.
Research Article 1.
Lintona, & Farrell, (2009)
Mizock, Russinova,  & Millner, (2014).
http://www.cno.org/globalassets/docs/reg/41037_entrytopracitic_final.pdf
 
Question 1.
In the article by Eraydin, & Avsar, (2017), what paradigm was used for this study and describe aspects of the research process that indicate that
paradigm?
Question 2.
How might this research question have been asked from the perspective of a different paradigm?
Research Article 2.

Question 1.
in each of the two articles by Lintona, & Farrell, (2009) and Mizock, Russinova,  & Millner, (2014), what paradigm was used for each study
and describe aspects of the research process that indicate that paradigm?
Question 2.
How might the respective research questions from each study have been asked from the perspective of a different paradigm?