Critical Appraisal of Quantitative Studies Nursing & Midwifery

Finding the Evidence

1. Formulating a Clear Clinical, Educational, or Managerial Question

Identify a relevant nursing or midwifery issue that falls within your professional scope of practice or influence. In this section:

• Describe the patient’s key clinical problems

• Explain the proposed intervention to be implemented

• Justify the need for the intervention in the current context

• Reflect on how AI tools may support decision-making or evidence synthesis

Defining the Information Gap

Provide a clear and evidence-based overview that includes:

• Description of the condition (epidemiology, burden, risk factors)

• Description of the current or usual model of care

• Description of the new or alternative intervention model

• Supportive scholarly and peer-reviewed references

• A statement identifying the existing information or evidence gap

This step demonstrates why further investigation is required.

Identification of PICO Components

Break down the clinical question into:

• P — Population / Patient group

• I — Intervention

• C — Comparator / Control

• O — Outcomes

Ensure all elements are precise and clinically relevant.

Construction of an Answerable PICO Question

Use the PICO framework to formulate a structured, answerable clinical or research question that guides your literature search and appraisal process.

Searching the Nursing and Midwifery Literature

5. Search Strategy & Database Justification

Describe the systematic search process, including:

• Databases searched (e.g., MEDLINE, CINAHL, Scopus)

• Rationale for selecting the final database(s)

• Keywords and MeSH terms used

• Synonyms and truncation strategies

• Boolean operators (AND / OR)

• Limits and filters applied (date range, study type, language)

This section should clearly demonstrate methodological search rigor.

Systematic Search Execution

Ensure the search process includes:

• Correct and logical Boolean operator use

• Appropriate application of limiters

• Transparent MEDLINE search steps

• Saved screenshots of search history (appendix)

List of Returned Studies

(Excluded from word count)

Provide a list of all studies identified from your search.

Rationale for Study Exclusion

(Grouped by exclusion criteria)

Explain why certain studies were excluded, such as:

• Wrong study design

• Non-relevant population

• Inadequate outcome reporting

• Not aligned with PICO

Justification for Selected Article

Explain why the chosen article was selected by addressing:

• Relevance to the clinical scenario

• Alignment with PICO question

• Suitability for critical appraisal

Attach a copy of the selected article.

Methodology & Hierarchy of Evidence

Identify:

• Study design (e.g., RCT, cohort study)

• Level of evidence based on established evidence hierarchies

Quality of Journal

Include:

• Journal Impact Factor (JIF)

• Quartile ranking (Q1–Q4)

• Interpretation from Journal Citation Reports

• Commentary on overall journal quality

Standing of Authors

For the first, second, and last authors, report:

• h-index

• Citation count

• Research influence/impact commentary

Critical Appraisal of the Evidence

Citation

Insert the full citation of the selected article.

Are the Results Valid?

For each appraisal criterion, indicate:

Yes / No / Unclear
and provide a brief explanatory comment.

1. Was the study designed to address a clearly focused research question?

2. Was treatment assignment randomised?

3. Was allocation concealment adequate?

4. Were groups similar at baseline?

5. Were patients and clinicians blinded?

6. Was follow-up sufficient and complete?

7. Were participants analysed in their original groups (intention-to-treat)?

8. Were outcome assessors blinded?

9. Were groups treated equally apart from the intervention?

What Are the Results?

Primary Outcome Findings

Include:

• Outcome definition

• Effect size measure

• Statistical significance

• Interpretation of findings

Magnitude of Treatment Effect

Provide commentary on:

• Clinical importance

• Practical significance

• Measured impact on outcomes

Treatment Effect Calculations

Where applicable, include:

• Control Event Rate (CER)

• Experimental Event Rate (EER)

• Relative Risk (RR)

• Relative Risk Reduction (RRR)

• Absolute Risk Reduction (ARR)

• Number Needed to Treat (NNT)

Apply for both primary and secondary outcomes.

Precision of Estimates

Interpret confidence intervals and statistical precision.

Applying the Results to Practice

For each, select:

Yes / No / Unclear
and provide supporting justification.

• Similarity of study population to practice setting

• Feasibility of intervention in real-world clinical practice

• Consideration of all clinically meaningful outcomes

Summary of Assessment Requirements

This assessment requires students to conduct a structured critical appraisal of a quantitative research study relevant to nursing or midwifery practice. The task is divided into two major components:

1. Finding the Evidence

   Students must:

   • Formulate a clear clinical, educational, or managerial question

   • Identify the information gap

   • Develop a PICO-based research question

   • Conduct a systematic database search

   • Apply Boolean operators, keywords, limits and filters

   • List retrieved studies and justify exclusions

   • Select one relevant research article

   • Evaluate study methodology and hierarchy of evidence

   • Assess journal quality and author research standing

2. Critical Appraisal of the Evidence

   Students must:

   • Evaluate study validity

   • Assess randomisation, blinding and allocation concealment

   • Examine baseline comparability and follow-up completeness

   • Interpret outcome measures and effect sizes

   • Calculate risk measures where relevant (RR, ARR, NNT etc.)

   • Assess precision via confidence intervals

   • Evaluate external validity and applicability to practice

The overall objective is to demonstrate understanding of evidence-based practice, research appraisal, and application of quantitative findings in clinical decision-making.

How the Academic Mentor Guided the Student 

The Academic Mentor supported the student through a structured learning and guidance process, ensuring clarity and progressive development across each section of the assessment.

Clarifying the Clinical Question

The mentor helped the student:

• Select a real-world nursing or midwifery issue

• Identify the patient population and key clinical concerns

• Define the intervention and comparator

• Justify the relevance and need for intervention

• Understand how AI tools may support literature search and synthesis

This ensured that the problem statement was context-specific and clinically meaningful.

Identifying the Information Gap

The mentor guided the student to:

• Review epidemiology, risk profile and burden of condition

• Describe the current model of care

• Contrast it with the potential new intervention

• Support discussion with scholarly references

• Clearly articulate the existing evidence gap

This reinforced academic writing, synthesis and critical reasoning skills.

Structuring the PICO Framework

The mentor helped the student clearly define:

• Population

• Intervention

• Comparator

• Outcomes

The student was supported in constructing an answerable, research-driven PICO question which formed the foundation for the literature search.

Conducting the Literature Search

The mentor demonstrated:

• Selection of appropriate nursing and medical databases

• Development of keywords and MeSH terms

• Use of Boolean operators and truncation

• Application of filters and inclusion/exclusion limits

• Documentation of search steps

The student was guided to conduct the search systematically and transparently.

Screening and Selecting the Article

The mentor explained how to:

• List all retrieved studies

• Group exclusions based on criteria

• Select the most relevant study aligned with PICO

• Justify suitability for appraisal

The student learned to think critically and analytically rather than selecting studies arbitrarily.

Understanding Research Methodology & Evidence Hierarchy

The mentor supported the student in:

• Identifying study design (RCT, cohort etc.)

• Determining its level within evidence hierarchies

• Evaluating appropriateness of methodology

• Assessing journal credibility and author impact metrics

This strengthened research literacy and appraisal confidence.

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