Research Article Critique, Part Two
The Effect of Reported Sleep, Perceived Fatigue, and Sleepiness on Cognitive Performance in a Sample of Emergency Nurses
(Wolf, Perhats, Delao, & Martinovich, 2017)
Instructions: A major skill that is learned in this course is how to critically read and critique nursing research articles. The purpose for critiquing an article is to critically evaluate the research process followed by the author(s) of the assigned article. This is an information-intensive, time-intensive process that is not learned overnight. To demonstrate your skill at critiquing an article, you will complete this open-book multiple choice assignment.
Here's how you should approach completing this week’s assignment to finish critiquing an article:
1. First, do your assigned reading in Grove, Gray, and Burns (2015) and complete the reading worksheets early in the week. This will introduce you to the critique skills you will need for the week.
2. Skim the entire instructor assigned research article that has been posted on Blackboard for you so that you will have an idea of what it is about. Lightly cross out the abstract for the article (you won't be using it). Then, for this week, re-read carefully from the study’s methods section through the end of the article.
3. Print this document and find the best answer to each question below based on your Grove, Gray, and Burns (2015) assigned reading for the week and what you have read in the instructor assigned research article.
4. Some of the questions in the critique assignment below will seem unfamiliar to you. Look up key terms from the question in your textbook. Some examples of these terms might be: power analysis, inter-rater reliability, and generalization. You can also look in Chapter 12 for an example of a critical appraisal (or critique) of a quantitative research article.
5. Once you have completed this assignment “on paper”, go into blackboard and enter your answers by the assignment due date and time listed in the syllabus. Ignore any wording from Blackboard that indicates that “this is a test” and carefully enter your answers from this document.
6. You will have two access attempts to record your answers. This is given to you so that if you encounter technical difficulties on your first attempt, or you would like a second attempt to try to improve your grade, you may do so. You will not be able to see the questions that you missed when you submit your attempt. Blackboard will record the highest grade from the two submissions.
If you have questions about this assignment, you can post them to your group discussion board for help. Please do not post the exact question from the assignment below and ask the group for the answer as this would constitute academic dishonesty.
Questions 1 - 9: Sample. (For help with these questions, refer to chapters: 9 & 12)
1. What sampling method or plan was used by the authors in this study?
a. Simple random sampling
b. Systematic sampling
c. Convenience sampling
d. Network sampling
2. According to Grove, Gray, and Burns (2015), what are the potential biases of this sampling method?
a. This is a strong probability sampling method with very little potential for bias.
b. This method is used when an ordered list of all members of the population are available, and provides a random but not equal chance for inclusion in the study.
c. This method provides little opportunity to control for bias because subjects are included in the study merely because they happen to be in the right place at the right time.
d. This method is specific to the individuals who were recruited and the information gained cannot be generalized to others who don't share these types of experiences.
e. None of the above biases best describe the sampling method chosen by the author.
3. What was the final sample size reported by the authors for this study?
a. 2,010 participants
b. 2,419 participants
c. 1,506 participants
d. 504 participants
4. Was a power analysis conducted? If so, which statement best describes the results of the power analysis?
a. The authors mention that a power analysis was conducted using a power of 0.8, an alpha value of 0.05, and a moderate effect size of 0.30.
b. The authors mention that an a priori power analysis was conducted, and 1500 subjects were determined to be needed for the study.
c. The authors do not report that a power analysis was conducted.
5. Which of these statements would be considered to be specific inclusion criterion for the sample in the research article? (Select all that apply)
a. Able to understand English
b. At least 25 years of age or older
c. Report fatigue symptoms
d. Working at least 1 shift per week in the ED
6. Which of these statements would be considered to be exclusion criterion specifically identified by the author for the sample in the research article?
a. Under treatment for stress related illness.
b. Did not complete the surveys in one sitting.
c. No exclusion criteria were described.
d. Must have a minimum of 12 months of ED experience.
7. What is the acceptance rate for this study? (Hint: see page 253 in your text)
a. 1506/2010 X 100% = 74.92%
b. 504/1506 X 100% = 33.5%%
c. unknown / cannot be calculated
d. 100%
8. Which of the following would be accurate for the attrition rate for this study?
a. 1506/2010 X 100% = 74.92%
b. 0%
c. 2010 / 2419 X 100% = 83%
d. 100%
9. What was the setting for this research study? Briefly describe the setting and indicate whether it was appropriate for conducting this study.
a. The setting for this study was a partially controlled setting and was appropriate for this study's research design.
b. The setting for this study was a natural or field setting and was appropriate for this study's research design.
c. The setting for this study was a highly controlled setting and was appropriate for this study's research design.
d. The setting for this study was not well described by the authors and therefore not appropriate for conducting this study.
Question 10 - 14: Measurement Methods. (For help with these questions, refer to chapters 10 & 12.)
10. Which ones of these questionnaires, scales, or physiologic measures are used in this research study? (Select all that apply)
a. Attitude regarding Chronic Illness Questionnaire
b. The Occupational Fatigue Exhaustion Recovery Questionnaire
c. Epworth Sleepiness Scale
d. Timed Medication Calculation
e. The Pittsburgh Sleep Quality Index
f. Brief Illness Perception Questionnaire
11. How do the authors describe the CURRENT reliability of the Pittsburgh Sleep Quality Index?
a. They compared the odd and even questions on the test to determine their equivalence.
b. A team of staff nurses was trained by the primary investigator to ensure that all physiologic measurements were taken using the same methods.
c. They tested the current group of subjects using two different versions of the same questionnaire (alternate forms reliability).
d. They computed a Cronbach's alpha on the questionnaire that was administered to this group of subjects.
12. How do the authors describe the validity of the The Occupational Fatigue Exhaustion Recovery Questionnaire used in this study?
a. The The Occupational Fatigue Exhaustion Recovery Questionnaire was examined by face, construct, and discriminant validity methods.
b. The The Occupational Fatigue Exhaustion Recovery Questionnaire was examined by convergence and divergent validity methods.
c. The questionnaires were reviewed by five experts prior to being used in this study.
d. The readability levels were identified prior to being used in this study.
13. What types of questionnaires or surveys were used in this research study?
(Select all that apply)
a. The author developed the Pittsburgh Aleep Quality Index.
b. The authors developed their own questions to ask about demographic information.
c. Interviews were reportedly used, but the author does not explain what was included in them.
d. The authors used previously developed questionnaires or surveys and modified to reflect the needs of the Emergency Nurse to measure the study variables.
e. The authors developed their own questions to assess timed cognitive performance.
e. This study did not use any questionnaires or surveys.
14. Were any physiological measurements collected from the subjects for the purpose of this study?
a. Yes
b. No
Question 15- 16: Data Collection. (For help with these questions, refer to chapters 10 & 12)
15. Which of the following best describes the data collection process used in this study?
(Select all that apply)
a. Participants were contacted by phone by nurse researcher.
b. Participants were given the questionnaires on enrollment in the study
c. Questionnaires / surveys were mailed to the prospective returned in a self-addressed stamped envelope.
d. Research assistants consented participants after screening for cognitive deficits.
e. Questionnaires were distributed through a Web-based platform.
16. Based on the study's data collection methods, if there were more than one data collector, would an estimation of inter-rater reliability be an important concept for the authors to report on for this study?
a. Yes, and the authors reported their efforts to achieve inter-rater reliability.
b. Yes, but the authors do not discuss any efforts to achieve inter-rater reliability.
c. No, the issue of inter-rater reliability does not apply here.
Question 17 - 19: Data Analysis. (For help with these questions, refer to chapters 11 & 12)
17. What descriptive statistics are used in this study? (Select all that apply)
a. mean
b. median
c. frequencies
d. standard deviation
e. percentage distributions
f. range
g. Pearson correlations
18. What inferential statistics were used to examine the data obtained from the subjects?
(Select all that apply)
a. Pearson correlations
b. Factor Analysis
c. t-Test
d. Cox regression analysis
e. ANCOVA
f. ANOVA
g. Logistical regression analysis
h. z score
h. None of the above inferential statistics were used in this study.
19. What is the level of significance (alpha level) set at for this study?
a. .01 or 1%
b. .05 or 5%
c. .10 or 10%
d. An alpha level or level of significance chosen by the authors was not specifically mentioned in the text of the article.
Question 20-25: Researcher’s Interpretation of the Findings. (For help with these questions, refer to chapters 11 & 12)
20. There are several statistically significant findings in this study. Which of these statements from the article would be considered a significant result? (Select all that apply)
a. Nurses working 7AM to 7PM were more likely to give an incorrect dose calculations.
b. ED nurses self-report that they have some difficulty providing safe care when fatigued.
c. Most nurses (> 60%) reported moderate to high levels of fatigue.
d. Night shift nurses had poorer response on accuracy on doseage calculations than day shift nurses.
21. Which one of these statements from the article would be considered a non-significant result?
a. There was a relationship between an individuals' stress and fatigue and response accuracy.
b. EN’s who work second jobs or are caregivers completed the problem sets faster and more accurately than those who do not work more than one job or are caregivers.
c. Nurses working 7AM to 7PM were more likely to give an incorrect dose calculations.
d. There was no significant effect of shift type on the time in minutes that it took to complete the medication problems.
22. Which one of these statements from the article would be considered clinically important? (Select all that apply)
a. EN Nurses self-report that they have some difficulty providing safe care when fatigued.
b. Administrators can use this information to help identify individuals who may be at risk for medication errors.
c. The differences between day and night shift performance may be due to environmental stress factors.
d. Institutional Review Board (IRB) approval was obtained from university and hospital institutional review boards.
23. Which statements below, as reported by the author, would be considered a limitation of the study? (Select all that apply)
a. The use of a convenience sample of decreases sample bias.
b. These study instruments have not been used in other studies on work-related fatigue in ENs.
c. Results using self-report data may decrease accuracy and validity.
d. The longitudinal design does not allow for assessment of changes in variables over time.
e. The hypotheses that work related fatigue has an effect on cognitive function cannot be supported due to lack of data on when the questionnaires were completed.
24. Which of these statements would be considered a statement regarding generalization of these results? (Select all that apply)
a. The sample inclusion criterion included critical care nurses and therefore decreases the ability to generalize to all EN nurses.
b. Cannot be generalized to non-English speaking individuals.
c. The Epworth Sleepiness Scale has demonstrated acceptable reliability and validity in in this study; as such, the results of this study can be generalized across all nursing populations.
d. The recruitment method of these EN nurses was not well described and therefore results should be interpreted with caution to all other EN nurses.
25. Which of these statements from the article would be considered a recommendation for future studies? (Select all that apply)
a. The study should be performed with an educational intervention to teach nurse managers and leaders about the risks of fatigue.
b. Further research on the effect of ENs’ work schedules, physical and emotional fatigue, patterns and quality of sleep, and workplace conditions on their ability to safely and effectively perform their jobs in the high-demand environment of the ED is required.
c. Given the considerable costs of work-related fatigue further research is warranted using chronobiological objective sleep measures to more effectively evaluate the effects of sleep deprivation.
d. The frequent extension of 12-hour shifts, inadequate time off between shifts, and constant exposure to demanding work may have contributed to difficulties with performing some nursing tasks.