NURS 6052 Week 7Assignment
Evidence-Based Project, Part 3: Critical Appraisal of Research
Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.
Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.
In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.
- Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high-level evidence) you selected in Module 3.
- Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
- Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.
The Assignment (Evidence-Based Project)
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Part 3A: Critical Appraisal of Research
Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.
Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.
Part 3B: Critical Appraisal of Research
Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.
By Day 7 of Week 7
Submit Part 3A and 3B of your Evidence-Based Project.
Submission and Grading Information
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Week 7 Assignment Rubric
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Submit Your Assignment by Day 7 of Week 7
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Week 7 Assignment
Module 4: Critical Appraisal, Evaluation/Summary, and Synthesis of Evidence (Weeks 6-7)
Laureate Education (Producer). (2018). Critical Appraisal [Video file]. Baltimore, MD: Author.
|Week 6, Days 1-4||Read the Learning Resources.
Begin to compose Part A of your Assignment..
|Week 6, Days 5-7||Continue to compose Part B of your Assignment.
Begin to compose Part B of your Assignment.
|Week 7, Days 1-6||Continue to compose Part A and B of your Assignment.|
|Week 7, Day 7||Deadline to submit Part A and B of your Assignment.|
- Evaluate peer-reviewed articles using critical appraisal tools
- Analyze best practices based on critical appraisal of evidence-based research
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
- Chapter 5, “Critically Appraising Quantitative Evidence for Clinical Decision Making” (pp. 124–188)
- Chapter 6, “Critically Appraising Qualitative Evidence for Clinical Decision Making” (pp. 189–218)
Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice step by step: Critical appraisal of the evidence: Part I. American Journal of Nursing, 110(7), 47–52. doi:10.1097/01.NAJ.0000383935.22721.9c
Fineout-Overhold, E., Melnyk, B.M., Stillwell, S.B., & Williamson, K.M. (2010). Evidence-based practice step-by-step: Critical appraisal of the evidence: Part II. American Journal of Nursing, 110(7), 47-52
Fineout-Overholt, E., Melnyk, B., Stillwell, S., & Williamson, K. (2010). Critical appraisal of the evidence: Part III the process of synthesis: Seeing similarities and differences across the body of evidence. American Journal of Nursing, 110(11), 43-51. doi:10.1097/01.NAJ.0000390523.99066.b5
Williamson, K. M. (2009). Evidence-based practice: Critical appraisal of qualitative evidence. Journal of the American Psychiatric Nurses Association, 15(3), 202–207. doi:10.1177/1078390309338733
Document: Critical Appraisal Tool Worksheet Template (Word document)
Laureate Education (Producer). (2018). Appraising the Research [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2018). Interpreting Statistics [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2018). Review of research: Hierarchy of evidence pyramid [Mutlimedia file]. Baltimore, MD: Author.
Schulich Library McGill. (2017, June 6). Types of reviews [Video file]. Retrieved from https://youtu.be/5Rv9z7Mp4kg
|Part 3A: Critical Appraisal of Research Conduct a critical appraisal of the four peer-reviewed articles you selected and analyzed by completing the Critical Appraisal Tool Worksheet Template. Be sure to include: · An Evaluation Table||45 (45%) – 50 (50%)
The critical appraisal accurately and clearly provides a detailed evaluation table. The responses provide a detailed, specific, and accurate evaluation of each of the peer-reviewed articles selected.
|40 (40%) – 44 (44%)
The critical appraisal accurately provides an evaluation table. The responses provide an accurate evaluation of each of the peer-reviewed articles selected with some specificity.
|35 (35%) – 39 (39%)
The critical appraisal provides an evaluation table that is inaccurate or vague. The responses provide an inaccurate or vague evaluation of each of the peer-reviewed articles selected.
|0 (0%) – 34 (34%)
The critical appraisal provides an evaluation table that is inaccurate and vague or is missing.
|Part 3B: Evidence-Based Best Practices Based on your appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.||32 (32%) – 35 (35%)
The responses accurately and clearly suggest a detailed best practice that is fully aligned to the research reviewed.
The responses accurately and clearly explain in detail the best practice, with sufficient justification of why this represents a best practice in the field. The responses provide a complete, detailed, and specific synthesis of two outside resources reviewed on the best practice explained. The response fully integrates at least two outside resources and two or three course-specific resources that fully support the responses provided.
Accurate, complete, and full APA citations are provided for the research reviewed.
|28 (28%) – 31 (31%)
The responses accurately suggest a best practice that is adequately aligned to the research reviewed.
The responses accurately explain the best practice, with adequately justification of why this represents a best practice in the field. The responses provide an accurate synthesis of at least one outside resource reviewed on the best practice explained. The response integrates at least one outside resource and two or three course-specific resources that may support the responses provided.
Accurate and complete APA citations are provided for the research reviewed.
|25 (25%) – 27 (27%)
The responses inaccurately or vaguely suggest a best practice that may be aligned to the research reviewed.
The responses inaccurately or vaguely explain the best practice, with inaccurate or vague justification for why this represents a best practice in the field. The responses provide a vague or inaccurate synthesis of outside resources reviewed on the best practice explained. The response minimally integrates resources that may support the responses provided.
Inaccurate and incomplete APA citations are provided for the research reviewed.
|0 (0%) – 24 (24%)
The responses inaccurately and vaguely suggest a best practice that may be aligned to the research reviewed or are missing.
The responses inaccurately and vaguely explain the best practice, with inaccurate and vague justification for why this represents a best practice in the field, or are missing. A vague and inaccurate synthesis of no outside resources reviewed on the best practice explained is provided or is missing. The response fails to integrate any resources to support the responses provided.
Inaccurate and incomplete APA citations are provided for the research reviewed or is missing.
|Written Expression and Formatting—Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.
|5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.
|4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
Purpose, introduction, and conclusion of the assignment is stated yet is brief and not descriptive.
|3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time.
Purpose, introduction, and conclusion of the assignment is vague or off topic.
|0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
No purpose statement, introduction, or conclusion was provided.
|Written Expression and Formatting—English Writing Standards:
Correct grammar, mechanics, and proper punctuation.
|5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
|4 (4%) – 4 (4%)
Contains a few (one or two) grammar, spelling, and punctuation errors.
|3.5 (3.5%) – 3.5 (3.5%)
Contains several (three or four) grammar, spelling, and punctuation errors.
|0 (0%) – 3 (3%)
Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
|Written Expression and Formatting—The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.||5 (5%) – 5 (5%)
Uses correct APA format with no errors.
|4 (4%) – 4 (4%)
Contains a few (one or two) APA format errors.
|3.5 (3.5%) – 3.5 (3.5%)
Contains several (three or four) APA format errors.
|0 (0%) – 3 (3%)
Contains many (five or more) APA format errors.
|Total Points: 100|
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Part 1: Evaluation Table
|Full APA formatted citation of the selected article.||Article #1||Article #2||Article #3||Article #4|
|Shi, Y., Guo, H., Zhang, S., Xie, F., Wang, J., Sun, Z., … & Fan, L. (2018). Impact of workplace incivility against new nurses on job burn-out: A cross-sectional study in China. BMJ Open, 8(4), e020461. doi:10.1136/ bmjopen-2017-020461
|Armstrong, N. (2018). Management of nursing workplace incivility in the health care settings: A systematic review. Workplace Health & Safety, 66(8), 403-410. https://doi.org/10.1177%2F2165079918771106||Abdollahzadeh, F., Asghari, E., Ebrahimi, H., Rahmani, A., & Vahidi, M. (2017). How to prevent workplace incivility?: Nurses’ perspective. Iranian Journal of Nursing and Midwifery Research, 22(2), 157-163. https://doi.org/10.4103/1735-9066.205966||Kile, D., Eaton, M., deValpine, M., & Gilbert, R. (2019). The effectiveness of education and cognitive rehearsal in managing nurse‐to‐nurse incivility: A pilot study. Journal of Nursing Management, 27(3), 543-552. https://doi.org/10.1111/jonm.12709|
|Evidence Level *
(I, II, or III)
Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**
|The study is based on the premise that anxiety predicts workplace incivility, which generates job burnout among nurses. Resilience moderates the incivility-burnout connection.
|No exact framework has been mentioned.||No theory has been mentioned.||Bandura’s social learning theory was used as the underpinning for introducing educational interventions and cognitive rehearsal techniques.|
Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).
|The study was a cross-sectional survey through anonymous questionnaires. Participants included nurses with a maximum of three years in service. Irregular nurses, those who had served for more than three years, and unwilling participants were excluded.||Armstrong (2018) critiqued and summarized relevant evidence on workplace incivility and management. Only English articles were reviewed. Articles published before 2010 were excluded.||The descriptive study design was used to describe nurses’ perspective on workplace incivility. Nurses selected had at least one year practice experience and a bachelor’s degree in nursing.||The study was a mixed method, pilot study design. It involved conducting educational programs about incivility in practice and cognitive rehearsal techniques. All registered nurses in the PACU participated in the study. Ancillary personnel and those unable to read and write in English were excluded.|
The number and characteristics of
patients, attrition rate, etc.
|696 nurses completed the questionnaire. The study took place in a hospital in China.
|The final sample had 10 articles for systematic review and analysis.||Sampling was continuous as the analysis of interviews continued.
The pilot study was conducted at educational hospitals of Tabriz University of Medical Sciences.
|The study used a convenient sample of registered nurses. It was conducted in a community hospital (post-anesthesia care unit) in Virginia.|
|Major Variables Studied
List and define dependent and independent variables
|The dependent variable was workplace incivility.
Independent variables included anxiety, burnout, and resilience.
|The dependent variable was workplace incivility whose levels can be reduced through education training, awareness training, and active learning behaviors (independent variables).||The structured interviews concentrated on nurses’ views on workplace incivility prevention.||The study variables included education on incivility and cognitive rehearsal techniques (independent variables) on workplace incivility (dependent variable).|
Identify primary statistics used to answer clinical questions (You need to list the actual tests done).
|Shi et al. (2018) explored the relationship between variables using descriptive statistical analysis. In particular, Pearson’s correlation coefficient and multiple linear regression analysis were used.||Intervention research about managing workplace incivility was the primary focus. Evidence strength was scored to determine information inclusion.||The MAXQDA software version 10 was used to analyze data on 36 interviews and 8 field notes.||Quantitative data for the Nursing Incivility Survey (NIS) was rated using 5-point Likert scale. Sources of incivility were divided into subscale. Data was analyzed using IBM SPSS website.|
|Data Analysis Statistical or
(You need to enter the actual numbers determined by the statistical tests or qualitative data).
|Workplace incivility was found to be positively correlated with anxiety and job burnout.
Anxiety (r=0.371, p<0.01)
Burnout ((r=0.238, p<0.01)
Resilience moderated (β=−0.564, p<0.01) the workplace incivility-job burnout connection.
|Education programs were ranked the highest followed by effective communication and active learning programs in workplace incivility prevention.||3 subthemes and 1 core theme emerged from the analysis.
Subthemes- nurse, organization, and public.
Core theme- a need for comprehensive attempt.
|Items under nurse incivility subscale included hostile climate, gossip and rumors, and free-riding. Displaced frustration p=0.042 was found to be the most statistically significant factor.|
|Findings and Recommendations
General findings and recommendations of the research
|Due to the prevalence nature of workplace incivility in nursing, administrators should consider resilience training to reduce incivility, particularly among new nurses.||Workplace incivility can be prevented by combining educational, awareness, and training programs. The emphasis should be civil behaviors.||Workplace incivility in nursing is complex and requires nurses, health care organizations, and the general public’s commitment to address effectively. It is an issue requiring concerted effort to minimize.||Nursing incivility can be effectively addressed by recognition and ability to confront it.|
|Appraisal and Study Quality
Describe the general worth of this research to practice.
What are the strengths and limitations of study?
What are the risks associated with implementation of the suggested practices or processes detailed in the research?
What is the feasibility of use in your practice?
|The study is a useful and detailed resource for understanding workplace incivility from a cause-and-prevention viewpoint.
The main strength includes the study innovatively examining the relationship between incivility and burnout and the moderating role of resilience. However, self-reports from participants were potential source of response bias.
On risks associated with resilience training, it can lead to physical and mental exhaustion of some nurses. The approach can also lead to the normalization of workplace incivility.
Overall, it is feasible for use in practice since it addresses a major problem in the current practice and practical solutions.
|The study expands literature on workplace incivility by illustrating how it can be prevented in nursing practice.
Majority of the studies used in the systematic review used psychometrically tested instruments. However, which was a main limitation, low research quality characterized majority of the studies.
No major risk is associated with implementing the suggested practices. They would be fairly convenient to reproduce without any risks to participants.
It is crucial to address workplace incivility by improving communication and nurses’ self-efficacy regarding the same. Thus, the study is feasible for use in practice.
|The study illustrates the need for concerted effort in workplace incivility management, which health care organizations should emulate.
The study showed how workplace incivility can be prevented from a broadened perspective. Randomization of participants’ selection could have led to selection bias.
No significant risk is associated with implementing the proposed intervention programs.
The study explains the diverse nature of workplace incivility prevention strategies; thus, feasible in practice.
|The study illustrates how job satisfaction can be improved by recognizing incivility and how to confront it.
Regarding strengths, it is a mixed method study highly detailed on workplace incivility. However, the pilot study had a small initial sample size (limitation).
No risks are associated with implementing the suggested practices in practice since the study proposes behavioral approaches.
Its usefulness and convenience in applying the proposed strategies confirm its feasibility.
|Workplace incivility is prevalent among new nurses. Anxiety is a reliable predictor, leading to workplace burnout. The adverse outcomes of incivility can be moderated through resilience-based interventions, such as resilience training.||Education training on workplace incivility is among the most effective strategies in combating the prevalent nursing problem. However, it should be supplemented with other strategies to enhance outcomes.||Nursing administrators and nursing staff cannot succeed while working alone to address workplace incivility. A broadened focus is vital to address the problem successfully.||Enhanced awareness is vital in enabling nurses cope with workplace incivility. Cognitive rehearsal techniques can help nurses to confront workplace incivility.|
|Highly resilient nurses could buffer the negative influence of workplace incivility regardless of their experience. Therefore, resilience should be adopted in health care settings as a coping style.||Improving nurses’ ability to recognize and manage workplace incivility should be the guiding principle in education programs on workplace incivility.||Workplace incivility is preventable through a comprehensive and systematic attempt. Nurses should improve their skills as the health care managers work on other strategies such as improving the image of the profession and position of nurses in organizations.||Highly aware and prepared nurses are excellently positioned to deal with workplace incivility. Awareness programs should be intensified in health care settings as buffers.|
|General Notes/Comments||The study is highly informative on workplace incivility, predictors, outcomes, and feasible solutions. It will be pivotal in developing the PICOT by illustrating the importance of resilient training as part of awareness programs for reducing workplace incivility.
|The article is a useful resource to expand literature on workplace incivility management.||The study is highly informative on the need for a more comprehensive and systematic approach in workplace incivility management.||The study expands literature on workplace incivility recognition and prevention.|
Part B: Best Practice
Research on workplace incivility is expansive and explores many strategies that can be used to prevent or buffer the prevalent nursing problem. Among the many practices suggested in the studies, enabling nurses to recognize and confront the problem through cognitive rehearsal is a highly effective strategy in incivility management.
From a practice viewpoint, cognitive rehearsal involves imagining a situation that produces self-defeating behavior and applying the necessary coping mechanism (Clark, 2019). It is a strategy that admits a problem and its adverse impacts and prepares the affected group to adopt appropriate behavior when they face the problem.
In nursing, cognitive rehearsal can help nurses cope with workplace incivility to a considerable extent. According to Clark and Gorton (2019), cognitive rehearsal involves equipping nurses with the relevant skills to respond to situations that can be emotionally and mentally harming such as workplace incivility.
It is a practical intervention in preventing workplace problems since it prepares nurses mentally to face everyday issues dominating the nursing practice. To justify its relevance in practice, cognitive rehearsal enables nurses to protect themselves and the patients. However, nurses need to implement cognitive rehearsal with other strategies to enhance outcomes.
Overall, workplace incivility is prevalent among nurses and cannot be overlooked. New nurses are more vulnerable to the devastating effects of workplace incivility since they are not used to the problem, and their resilience is low (Mohamed & MahdyAttia, 2020; Muliira et al., 2017). To avoid frustration and possible turnover, nurses should be helped to recognize incivility and respond to it effectively. Awareness and educational programs are highly effective. Training nurses through cognitive rehearsal programs is also an effective intervention to prepare them to cope with the prevalent nursing problem mentally.
Abdollahzadeh, F., Asghari, E., Ebrahimi, H., Rahmani, A., & Vahidi, M. (2017). How to prevent workplace incivility?: Nurses’ perspective. Iranian Journal of Nursing and Midwifery Research, 22(2), 157-163. https://doi.org/10.4103/1735-9066.205966
Armstrong, N. (2018). Management of nursing workplace incivility in the health care settings: A systematic review. Workplace Health & Safety, 66(8), 403-410. https://doi.org/10.1177%2F2165079918771106
Clark, C. M. (2019). Combining cognitive rehearsal, simulation, and evidence-based scripting to address incivility. Nurse Educator, 44(2), 64-68. doi: 10.1097/NNE.0000000000000563
Clark, C. M., & Gorton, K. L. (2019). Cognitive rehearsal, HeartMath, and simulation: An intervention to build resilience and address incivility. Journal of Nursing Education, 58(12), 690-697. https://doi.org/10.3928/01484834-20191120-03
Mohamed, A., & MahdyAttia, N. (2020). Factors associated with incivility behaviors, coping strategies and level of engagement among post graduate nursing students. IOSR Journal of Nursing and Health Science (IOSR-JNHS), 9(01), 2020. doi: 10.9790/1959-0901141727
Kile, D., Eaton, M., deValpine, M., & Gilbert, R. (2019). The effectiveness of education and cognitive rehearsal in managing nurse‐to‐nurse incivility: A pilot study. Journal of Nursing Management, 27(3), 543-552. https://doi.org/10.1111/jonm.12709
Muliira, J. K., Natarajan, J., & Van Der Colff, J. (2017). Nursing faculty academic incivility: perceptions of nursing students and faculty. BMC Medical Education, 17(1), 1-10. doi: 10.1186/s12909-017-1096-8
Shi, Y., Guo, H., Zhang, S., Xie, F., Wang, J., Sun, Z., … & Fan, L. (2018). Impact of workplace incivility against new nurses on job burn-out: A cross-sectional study in China. BMJ Open, 8(4), e020461. doi:10.1136/ bmjopen-2017-020461