Critical appraisal of qualitative research Sarah Lawson sarah.lawson@kcl.ac.uk

Critical appraisal of qualitative research Sarah Lawson sarah.lawson@kcl.ac.uk www.phwiki.com

Critical appraisal of qualitative research Sarah Lawson sarah.lawson@kcl.ac.uk

Weber, Matt, In House Editor has reference to this Academic Journal, PHwiki organized this Journal Critical appraisal of qualitative research Sarah Lawson sarah.lawson@kcl.ac.uk Learning objectives Underst in addition to the principles of critical appraisal in addition to its role in evidence based practice Be aware of the key elements of qualitative research Be able to appraise the validity in addition to reliability of qualitative research Be able to assess the relevance of published research to your own work Know about resources available to help them to critically appraise research Be able to critically appraise quantitative research as a group What is evidence based practice Evidence-based practice is the integration of individual clinical expertise with the best available external clinical evidence from systematic research in addition to patient’s values in addition to expectations

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The evidence-based practice (EBP) process. Decision or question arising from a patient’s care. Formulate a focused question. Search as long as the best evidence. Appraise the evidence. Apply the evidence. EBP in practice depending upon speciality, between 50 in addition to 80 per cent of all ‘medical activity’ is evidence based. www.shef.ac.uk/scharr/ir.percent.html Why does evidence from research fail to get into practice 75% cannot underst in addition to the statistics 70% cannot critically appraise a research paper Using research as long as Practice: a UK experience of the barriers scale. Dunn, V. et al.

What is critical appraisal Weighing up evidence to see how useful it is in decision making Balanced assessment of benefits in addition to strengths of research against its flaws in addition to weaknesses Assess research process in addition to results Skill that needs to be practiced by all health professionals as part of their work Why do we need to critically appraise “It usually comes as a surprise to students to learn that some (the purists would say 99% of) published articles belong in the bin in addition to should not be used to in as long as m practice” Greenhalgh 2001 How do I appraise Mostly common sense. You don’t have to be a statistical expert! Checklists help you focus on the most important aspects of the article. Different checklists as long as different types of research. Will help you decide if research is valid in addition to relevant.

Research methods Quantitative Uses numbers to describe in addition to analyse Useful as long as finding precise answers to defined questions Qualitative Uses words to describe in addition to analyse Useful as long as finding detailed in as long as mation about people’s perceptions in addition to attitudes What is qualitative research “The goal of qualitative research is the development of concepts which help us to underst in addition to social phenomena in natural settings, giving due emphasis to the meanings, experiences in addition to views of all the participants” Pope in addition to Mays, BMJ 1995; 311; 42-45 Why use qualitative research “Quantitative methods provided either no answers or the wrong answers to important questions in both clinical care in addition to service delivery” “qualitative methods reach the parts of a subject matter that other methods cannot reach” How to read a paper. BMJ, 2006 (3rd edition)

How does it complement quantitative research Be as long as e quantitative – Evaluating research questions in new field Alongside – Multi-method approach Following – Better underst in addition to ing of underlying processes Also, as st in addition to -alone research. When to use qualitative Contextual – Identify in addition to describe: Experiences, feelings, attitudes, beliefs, perceptions Diagnostic – Explanations: reasons as long as behaviours Evaluative – Effectiveness: satisfaction, needs, barriers, improvements Different methodologies No ‘gold st in addition to ard’ or hierarchy – researcher selects most suitable method(s) to research question Grounded theory- most commonly used themes generated purely from data observation – ‘emergence’ ‘inductive’ process data collection in addition to analysis simultaneous

Data collection Interviews Structured limited response choices, large numbers in short time, ease of analysis Semi-structured overall structure – major questions in addition to more open questions, more individualised, detailed in addition to accurate Data collection In-depth/unstructured interviews (‘Gold St in addition to ard’): open-ended, respondent-led very detailed, loose structure, emergent issues (‘inductive’) recorded in addition to transcribed as long as analysis Data collection Focus groups – 6-10 people; discuss commonly shared issue; facilitated; non-directive questioning, observation; wide breadth of opinion; BUT issues of group dynamics, depth in addition to validity Observation – best as long as behavioural questions; impact of observer; covert methods

Recruitment “purposeful sampling” : strategic, active, systematic in addition to deliberate – chosen as long as potential as long as providing in as long as mation to in as long as m research “theoretical sampling” guided by emerging theories Sampling strategies are revised in addition to modified during research process Sampling Convenience – accessible/available Quota – fulfil quotas as long as set of criteria Typical case – possess set of characteristics Maximum variation – most divergent or dissimilar characteristics – validity Snowball – contacts obtained via key subjects Sample size Does not need to be representative of population – not statistical Practical constraints – time in addition to resources Saturation – recruitment of additional cases no longer provides additional in as long as mation or insights

Data analysis Continuous process starting from data collection Transcribed in textual as long as mat; Systematic – identify major recurrent themes; Sorted, coded, organised into categories – ‘thematic framework’; Examine in addition to chart themes – record in addition to theorise emergent trends & associations Independent analysis Respondent validation Triangulation Area under investigation is looked at from different perspectives Two or more research methods: data sources,sample groups or investigators Ensure underst in addition to ing is complete as possible or confirm interpretations ‘Iterative’ approach – alter methods as study progresses. Appraising original research Are the results valid Is the research question focused Was the method appropriate How was it conducted What are the results How was data collected in addition to analysed Are they significant Will the results help my work with patients

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Research question in addition to design Are the aims of the research clear Important Modification Is qualitative methodology appropriate Was the research design appropriate Justification Sampling, data collection in addition to analysis Are the following justified, systematic in addition to transparent: How were subjects recruited How was data collected How was data analysed (including selection as long as analysis) Reflexivity in addition to ethics Researcher’s role, potential bias, in addition to influence on research process Theoretical approach Relationships with participants Ethical st in addition to ards Approval Issues discussed

Findings Clearly stated Evidence as long as in addition to against Original material included Reliability in addition to validity Triangulation, independent analysis, respondent validation Relation to original research questions Contribution to knowledge, practice in addition to policy Need as long as further research Transferability Applicability . Summary Complements quantitative research Natural settings, examining experiences, feelings, attitudes, beliefs, perceptions, behaviours Inductive in addition to iterative No gold st in addition to ard research method – grounded theory most common Purposive sampling used – not statistical Triangulation – varied research methods Analysis should be done using explicit, systematic, justified in addition to reproducible methods Questions

Weber, Matt In House Editor

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