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hi everyone I just want to give you a little extra guidance on how to really format and write this final critical appraisal paper in a way that sounds scholarly and hopefully somewhat similar to the articles that you’re actually reading and this is something I would have loved to have more time on in class but as you know this class is very short and intense and I wanted to make sure you got all the content regarding just identifying your articles and appraising them first so this is just giving you some extra ideas on how to format your paper and write it with a scholarly tone so in the introduction this is a very important piece of your paper a lot of you did really well with this already but I just want to give you further guidance on how to structure your introduction um you’re all wait you know I always encourage you to read the scholarly articles that you’ve already looked at either for your critical appraisal paper or for your EBP project and they will also offer good examples of how an introduction is structured in a research article basically the first section you want to start off right away with really strong statements about your problem you want to make those strong claims that talk about just how big of a problem it is you want it to be very compelling and gets the reader interested right away it’s important to use evidence meaning other sources in the literature um you may use a textbook although a lot of times textbook statistics are a bit outdated so I recommend gathering a few additional articles on your topic outside of your critical appraisal article to help you with this section and kind of boost your evidence and you can use systematic reviews they’ll offer great information on your problem or whatever you want to do but I would just strongly suggest getting at least two to three additional articles on your topic for this section and you want to be able to give information about the prevalence of the problem how widespread it is either globally nationally or if you’re focusing on a state issue make sure you give it a test then as with everything you need to always cite sources for all of this information I’m depending on what your problem is you may need to actually explain it or describe like give a definition for your problem if it’s hypertension you know what is the actual systolic range and diastolic range given for that if it’s low birth weight infants what is the exact weight range parameters for that so in some cases you may need to actually explain your problem in more detail and then once you’ve really gotten a good idea of the problem and the prevalence of it then you’ll want to talk about consequences of your problem so what happens when this problem occurs a lot do you have mortality rates that go up do you have other morbidity issues does it cause other health problems major health problems for some of you it may cause financial problems within your hospital especially if we’re looking at the lack of reimbursement because of your issue such as having a fall and then maybe it affects staffing or it even you know in some cases maybe – affects staff satisfaction nursing satisfaction in particular so these are the things you want to be thinking about as you’re really making a strong case about the big problem that is out there in the second section of your introduction so this may be a second paragraph you’re going to want to discuss what’s currently being done about your problem so we call that usual care what’s current Nursing Practice right now so you want to describe that and kind of indicate why that’s not a good way to go why that’s not working and this is where you may have possible statistics to back that up in the group that’s doing CLABSI rates so catheter line associated bloodstream infections and if you’re looking at usual care being the scrub the hub are you able to find statistics on what happens when you use scrub the hub so what are the problems potentially associated with usual care specifically that may not be applicable to all of your problems and all of usual care for each situation but that’s something to be thinking about then you’re going to want to introduce your intervention of interest so this is the I in your pika what you’re going to be exploring in the literature so make sure you’ve introduced that and perhaps you even have a little bit of literature already to give ideas as to why that might actually be a better way to go about things I’m thinking of the group that did cancer pain and they looked at pregabalin as a possible intervention and you may have some just information about the mechanisms of action regarding the different types of medications pre Gavilan versus opioids for specific neuropathic cancer pain and so you may have an explanation pathophysiological II and with the mechanism of action of different drugs to explain why your intervention might be more helpful this is more of just a plausible section because you haven’t done a full review of your article yet in the paper but you want to at least introduce your possible intervention and why this is a possible or a better choice before we talk about tips for writing style I just want to accentuate I didn’t include this in the PowerPoint please please please don’t forget to include a section on or at least a statement or two on how this problem affects nursing for most of you it seems obvious at how it affects nursing but you need to explicitly state that in your paper why this is a significant problem that affects nursing either the problems that nursing that nurses have because of it how nursing is maybe a part of the problem or at least how nursing can be a part of the solution so um as we wrap up the introduction there are specific tips for how to write an introduction besides the formatting that I just gave you one thing that I saw in a lot of rough drafts is that you are using authors names and/or titles of articles in the actual text this is really something to avoid I know that you may have been taught in earlier years that it makes you sound more credible to say according to so-and-so in the article titled set such-and-such and then you give your information actually according to scholarly writing it’s just considered wordy it’s not necessary it takes up space scholarly writing is all about saying what you want to say is few words as possible being substantial but concise so really avoid doing that and just simply state your claims and then cite your sources in parentheses at the end you really don’t need to include that kind of information in the text and most times it’s not even necessary to say in one article bla bla bla bla bla you don’t even need to mention the article explicitly just state the information and then tell us in parentheses where it came from also make sure that every single idea or claim that you state is cited in your text if you did not personally observe this problem you have to cite a source when you’re talking about it so that means that almost every sentence in your introduction needs to have a source cited and please make sure that if a source is cited in your text it is also included in your reference page and vice-versa only only things in your reference everything in your reference page should be also be able to found in your text goes both ways the Pico section should be relatively short but what’s important is developing a transition sentence so making sure that you’re connecting your introduction to your Pico question so that it makes sense so that it flows so so develop some sort of transition sentence that’s connects those two when you’re identifying your Pico make sure you have all four of those components clearly identified I was suggesting in class that you actually put a P in parentheses behind your population and I in parentheses behind your intervention and so forth you do have some creativity and flexibility on how you word your Pico it does not have to be in an actual question although that’s totally fine you may use it as a purpose statement the purpose of this paper is to explore bla bla bla so there are many ways to do this but make sure that it’s very clear and identifiable to the reader there’s not too much to say about search strategies most of you did a really good job on this section the main point is that a reader should be able to replicate your actual searches by following your steps so you do basically just need to say based on your Pico I mean because your search terms should have come from your Pico what database you searched what the search terms were you put in and then how many hits you got or how many articles you were resulted in that search of course you have to repeat that at least two times that’s required in the rubric if you have any limiting parameters that you used either by dates by language by type of journal whatever that may be make sure you include that as well so that the reader can see exactly what you did and be able to follow that if necessary so before you start the official article synopsis make sure you introduce the actual article you’ve chosen this is the only time you will need to actually write out an articles title in the text and formally introduce the article okay so and the Annis in this case you would also need to say what search it came from did it come from cinahl and if you did multiple searches in cinahl what search did it come from so that the readers can see exactly where you got this article how you found it and then you’re going to go through the six elements that are located to your rubric the types of things are going to review again I would use for this synopsis section I would use the critical or the reviewing form that we used for the khadi article way back in week 3 it’s posted in module 3 the blank form that you can use I recommend you filling that out it will give you it will just help guide you in getting all these elements that review form probably has more than these six elements so don’t address them if they’re not in the rubric but you do need to cover these six components you do need to identify what is the purpose the a more objective statement the sample the methods the study design that is simply stating what is the study Dyne is it a randomized controlled trial is it a quasi experimental study is it a correlational study if so what kind is it prospective retrospective you know so maybe you have a descriptive study where it’s more of a survey study so check back in week 3 s PowerPoint and that will have or in your text as well and that will have all the different types of studies that are there for the findings and results this can get a little bit confusing basically what you want to do is you’re going to choose the most relevant results there will probably be a ton you want to pick the most relevant ones usually it’s the ones related to the primary outcomes that were identified earlier in the study usually in the methods section if this is still hard for you to find I recommend going to the abstract because the author’s are putting in the abstract what they think are the most important pieces of their study so I would find those results need to identify what stat test they use to get the results just give them numbers and then you need to summarize what that means what does it mean to have a p-value of such-and-such and a mean of such-and-such so just and that’s just very simple a sentence or two just interpreting what that result means I’m in the limitations section the author should state limitations of the study this would be in the discussion section of your article if they don’t state limitations then you’re gonna need to offer at least a few ideas of possible limitations that you saw in the study and then strengths usually the authors won’t say strengths and so that will be something that you will also need to identify I recommend writing out at least two strengths that you have identified that you think are great things about the study this could be related to sample size it could be related to the type of intervention it can be related to the study design the length of time done for collecting data may be that instruments used there are lots of different things that can make a study strong and so that’s what you would want to briefly mention there in the critical appraisal section of your rubric so as you can see these slides are just going chunk by chunk each session the rubric is kind of a new slide you’re welcome to also use these types of headings as level 1 headings if you’d like a synopsis section an appraisal section if you want to break it down even further like for example under the critical appraisal first level heading you could do a level 2 heading for validity a level 2 for reliability a level 2 for applicability that’s up to you you may not need to do that it’s totally up to you and how lengthy you feel this section is and if it needs to be broken up in the first part of this section you do need to identify the level of evidence this is reflecting back on what the study design is you’ll need to say again what the study design is and because of that study design it is a level what evidence is at level 2 level 3 level 4 level 5 that’s all you need to say for that when you’re talking about problems of validity reliability and applicability again you’re going to want to refer to the second form we used for the pregnancy and alcohol study that’s called the rapid critical appraisal form that is located in module 4 and the blank form on canvas and that’s broken up into those sections and so it asks questions based on validity and reliability and applicability fill that out for your article use those answers to formulate your discussion on whether or not the article is valid and reliable and applicable maybe it’s somewhat valid but not all so these are not black and white answers this is you discussing where their problems related to validity or their strengths related to validity and same with reliability problems strengths problems and strengths related to applicability make sure when you’re talking about each of these categories if you don’t have subheadings for validity reliability and applicability make sure you’re explicitly identifying that you’re talking about those things and you’re talking about whether or not the article is fat or the study is valid and reliable okay so this is all talking about external validity and reliability if you do have an article that actually uses measurement tools or instruments and the Artic and the authors identify the reliability and validity information for those tools please include that information as well but for some of you there’s no measurement tools that would apply to that or you don’t they don’t have a specific measurement tool the last section is your recommendations and these are just some questions to get you thinking about this section so based on your appraisal would you recommend using information from this article basically was it high quality evidence so was it high on the level of evidence pyramid or its chart was it valid according to your appraisal was it a fairly reliable study according to appraisal so that’s all the pieces that go into saying is it high-quality evidence and then not only that but maybe it’s high quality but it’s not really something that could be replicated in real life or in your clinical setting so that’s where you really need to think about your own setting and does this information apply or maybe it needs to be adapted in some way and so how do you recommend adapting what you’ve learned from this article to your own clinical setting in this section you are really writing as the expert in your field of Nursing and you’re really recommending how these researchers can really apply what they’ve done to real-life or maybe not maybe your article is completely inclusive in the results and you just want to talk about that and maybe give further recommendations for research in this topic or exploring a new intervention and this is again really up to you and really where you’re displaying your critical thinking and and acting as an expert in your field there is no conclusion section per se in the rubric but it may be necessary to write a brief conclusion paragraph after recommendations to summarize everything that you’ve written about your article and what you recommend going forward it’s kind of up to you and your writing style but that may be something that would be helpful for you so this is my last bit about tips for writing style on the second half of your critical appraisal paper it is in the rubric but I would just want to accentuate please please please do not use direct quotes direct quotes should not be used at all throughout the entire article actually or throughout your entire paper basically what that does when you use direct quotes is it takes away your own credibility it basically shows that you are not able to take the information that you’ve read and and interpret it in your own way so that is what I want to be able to see is that you can summarize information you can synthesize it you can pull information from different sources and come up with conclusions and so that needs to be done in your own words of course you need to cite every source that you get information from so it is not bad at all it’s actually a good thing to have sources cited after almost every sentence but it is not a good thing to use direct quotes so please do not use any direct quotes now if you are in the second half of your paper you’re going to be pulling all from one article the article that you’re if you’ve chosen to review and critique so because of that you don’t need to cite your source up to every sentence that’s pretty redundant the way APA says you can do it is you can just cite the source at the end of the paragraph so for each paragraph that you’re writing about the same source and only that source you’re able to cite this source just at the end of the paragraph when you start a new paragraph you have to start again and then if you again using just that source you would cite it at the end of that paragraph my last piece of advice for you in this is to not use personal pronouns this is a big no-no and APA and in scholarly writing do not ever use I we us etc especially in your some of you might feel that you need to use that in your recommendations or in your search strategy section and you really cannot do that if you feel absolutely necessary to refer to yourself then you would need to say this author but you cannot use I last but not least I want to leave you with this quote dr. ringing introduced me to this quote and I absolutely loved it and it is simply progress not perfection when it comes to understanding research and learning how to write in a scholarly way it is something that you may never feel that you fully get I know for me it is totally a work in progress and I am learning every time I teach this class every time I write a paper so please don’t be too hard on yourself know that this is all about just learning we the learning experience progressing in this new field I have had students say that research felt like learning a new language I completely agree with that so give yourself grace and know that you are improving you’ve learned a ton in the last six weeks and I really look forward to reading your final product as always if you feel that you are still really confused and have a lot of questions please don’t hesitate to reach out to me I’m happy to give you guidance in any way that I can’t best of luck