What are The Nursing Research Design Issues and Strategic Planning for Clinical Questions to Evidence-Based Practice. Encourage collaboration between nurses, researchers, and other healthcare professionals to advance the EBP agenda.
The Nursing Research Design Issues and Strategic Planning for Clinical Questions to Evidence-Based Practice
Strategic planning for evidence-based practice (EBP) in nursing involves a systematic process: encouraging inquiry, formulating clinical questions using frameworks such as PICO, conducting research, critically appraising the evidence, integrating it with clinical experience and patient preferences, and finally, interpreting the results.
Key aspects include overcoming barriers such as lack of time and knowledge. Strategic planning focuses on creating an enabling environment and developing skills in question formulation, evidence searching, and critical appraisal to improve patient care and outcomes.
Art and Science of Nursing Research Design
Research design is governed by the notion of ‘fitness for purpose’. The purposes of the research determine the methodology and design of the research. For example, if the purpose of the research is to map the field, or to make generalizable comments then a survey approach might be desirable, using some form of stratified sample; if the effects of a specific intervention are to be evaluated then maybe an experimental or action research model is appropriate; if an in-depth study of a particular situation or group is important then an ethnographic model might be more appropriate.
That said, it is possible, nevertheless, to identify a set of issues that researchers need to address, regardless of the specifics of their research. It is this set of issues that this blog post addresses. It acts as a bridge between the theoretical discussions of the opening blog post and the subsequent blog post that cover:
(a) specific styles of research (Part Three)
(b) specific issues in planning a research design, e.g. sampling, validity, reliability, ethics (Part Two)
(c) planning data collection (instrumentation, Part Four)
(d) data analysis
The intention here is to provide a set of issues that need to be addressed in practice so that an area of research interest can become practicable, feasible and capable of being undertaken. This post indicates how research might be operationalized, i.e. how a general set of research aims and purposes can be translated into a practical, researchable topic. To change the ‘rules of the game’ in midstream once the research has commenced is a sure recipe for problems.
The terms of the research and the mechanism of its operation must be ironed out in advance if it is to be credible, legitimate and practicable. Once they have been decided upon the researcher is in a very positive position to undertake the research. The setting up of the research is a balancing act, for it requires the harmonization of planned possibilities with workable, coherent practice, i.e. the resolution of the difference between idealism and reality, between what could be done and what will actually work, for at the end of the day research must work.
Two-Phase Planning Process
In planning research there are two phases—a divergent phase and a convergent phase. The divergent phase will open up a range of possible options facing the researcher, whilst the convergent phase will sift through these possibilities, see which ones are desirable, which ones are compatible with each other, which ones will work in the situation, and move towards an action plan that can realistically operate. This can be approached through the establishment of a framework of planning issues.
Four-Domain Framework for Research Planning
Though, clearly, the set of issues that constitute a framework for planning research will need to be interpreted differently for different styles of research, nevertheless, it is useful to indicate what those issues might be. These include:
1 the general aims and purposes of the research.
2 how to operationalize research aims and purposes.
3 generating research questions.
4 identifying and setting in order the priori ties for and constraints on the research.
5 approaching the research design.
6 focusing the research.
7 research methodology.
8 ethical issues.
9 audiences of the research.
10 instrumentations.
11 sampling
12 time frames.
13 resources required.
14 validity and reliability.
15 data analysis.
16 verifying and validating the data
17 reporting and writing up the research.
These can be arranged into four main areas (Morrison, 1993):
(i) orienting decisions
(ii) research design and methodology
(iii) data analysis
(iv) presenting and reporting the results
Strategic Orienting Decisions
Orienting decisions are those decisions which will set the boundaries or the parameters of constraints on the research. For example, let us say that the overriding feature of the research is that it has to be completed within six months; this will exert an effect on the enterprise.
Resource Assessment / Constraints on Research
On the one hand it will ‘focus the mind’s, really requiring priorities to be settled and data to be provided in a relatively short time. On the other hand, this may reduce the variety of possibilities available to the researcher. Hence questions of time scale will affect:
- the research questions which might be answered feasibly and fairly (for example, some research questions might require a long data collection period).
- the number of data collection instruments used (for example, there might be only enough time for a few instruments to be used).
- the sources (people) to whom the researcher might go (for example, there might only be enough time to interview a handful of people).
- the number of foci which can be covered in the time (for example, for some foci it will take a long time to gather relevant data).
- the size and nature of the reporting (there might only be time to produce one interim report). By clarifying the time scale a valuable note of realism is injected into the research, which enables questions of practicability to be answered. Let us take another example. Suppose the overriding feature of the research is that the costs in terms of time, people and materials for carrying it out are to be negligible. This, too, will exert an effect on the research. On the one hand it will inject a sense of realism into proposals, identifying what is and what is not manageable. On the other it will reduce, again, the variety of possibilities which are available to the researcher. Questions of cost will affect:
- the research questions which might be feasibly and fairly answered (for example, some research questions might require:
(a) interviewing which is costly in time both to add minister and transcribe
(b) expensive commercially produced data collection instruments, e.g. tests, and costly computer services, which may include purchasing software for example).
- the number of data collection instruments used (for example, some data collection instruments, e.g. postal questionnaires, are costly for reprographics and postage);
- the people, to whom the researcher might go (for example, if teachers are to be released from teaching in order to interviewed then cover for their teaching may need to be found);
- the number of foci which can be covered in the time (for example, in uncovering relevant data, some foci might be costly in researcher’s time);
- the size and nature of the reporting (for example, the number of written reports produced, the costs of convening meetings).
Certain time scales permit certain types of research, e.g. a short time scale permits answers to short-term issues, whilst long-term or large questions might require a long-term data col lection period to cover a range of foci. Costs in terms of time, resources and people might affect the choice of data collection instruments. Time and cost will require the researcher to determine, for example, what will be the mini mum representative sample of teachers or students in a school, for interviews are time-consuming and questionnaires are expensive to produce.
These are only two examples of the real constraints on the research which must be addressed. Planning the research early on will enable the researcher to identify the boundaries within which the research must operate and what the constraints are on it. With these preliminary comments, let us turn to the four main areas of the framework for planning research.
Orienting Decisions
Decisions in this field are strategic; they set the general nature of the research, and the questions that researchers may need to consider are:
Who wants the research?
Who will receive the research/who is it for?
Who are the possible/likely audiences of the research?
What powers do the recipients of the research have?
What are the general aims and purposes of the research?
What are the main priorities for and constraints on research?
What are the time scales and time frames of the research?
Who will own the research?
At what point will the ownership of the research pass from the participants to the researcher and from the researcher to the recipients of the research?
Who owns the data?
What ethical issues are to be faced in undertaking the research?
What resources (e.g. physical, material, temporal, human, and administrative) are required for the research?
It can be seen that decisions here establish some key parameters of the research, including some political decisions (for example, on ownership and on the power of the recipients to take action on the basis of the research). At this stage the overall feasibility of the research will be ad dressed.
Research Design and Clinical Methodology
Operationalizing Clinical Research Questions
If the preceding orienting decisions are strategic then decisions in this field are tactical; they establish the practicalities of the research, assuming that, generally, it is feasible (i.e. that the orienting decisions have been taken). Decisions here include addressing such questions as:
What are the specific purposes of the research?
How are the general research purposes and aims operationalized into specific research questions?
What are the specific research questions?
What needs to be the focus of the research in or der to answer the research questions?
What is the main methodology of the research (e.g. quantitative survey, qualitative research, ethnographic study, an experiment, a case study, a piece of action research etc.)?
How will validity and reliability be addressed?
What kinds of data are required?
From whom will data be acquired (i.e. sampling)?
Where else will data be available (e.g. documentary sources)?
How will the data be gathered (i.e. instrumentation)?
Who will undertake the research?
The process of operationalization is critical for effective research.
What is required here is translating a very general research aim or purpose into specific, concrete questions to which specific, concrete answers can be given. The process moves from the general to the, from the abstract to the concrete. Thus, the researcher breaks down each general research purpose or general aim into more specific research purposes and constituent elements, continuing the proc ess until specific, concrete questions have been reached to which specific answers can be provided. An example of this is provided below Let us imagine that the overall research aim is to ascertain the continuity between primary and secondary education (Morrison, 1993:31 3).
This is very general and needs to be trans lasted into more specific terms. Hence the re searcher might deconstruct the term ‘continuity’ into several components, for example experiences, syllabus content, teaching and learning styles, skills, concepts, organizational arrangements, aims and objectives, ethos, assessment. Given the vast scope of this, the decision is taken to focus on continuity of pedagogy.
This is then broken down into its component areas: the level of continuity of pedagogy; the nature of continuity of pedagogy; the degree of success of continuity of pedagogy; the responsibility for continuity; record keeping and documentation of continuity; resources available to support continuity. The researcher might take this further into investigating: the nature of continuity (i.e. the provision of information about continuity); the degree of continuity (i.e. a measure against a given criterion); the level of success of the continuities. a judgement). An operationalized set of research questions, then, might be:
- How much continuity of pedagogy has occurred ring across the transition stages in each curriculum area?
What kind of evidence is required to answer this question?
On what criteria will the level of continuity be decided?
- What pedagogical styles operate in each curriculum area?
What are the most frequent and most preferred?
What is the balance of pedagogical styles?
How is pedagogy influenced by resources?
To what extent is continuity planned and recorded?
On what criteria will the nature of continuity be decided?
What kind of evidence is required to answer this question?
- On what aspects of pedagogy do planning take place?
By what criteria will the level of success of continuity be judged?
Over how many students/teachers/curriculum areas will the incidence of continuity have to occur for it to be judged successful?
What kind of evidence is required to answer this question?
- Is continuity occurring by accident or design?
How will the extent of planned and unplanned continuity be gauged?
What kind of evidence is required to answer this question?
- Who has responsibility for continuity at the transition points?
What is being undertaken by these people?
- How are records kept continuing in the schools?
Who keeps these records?
What is recorded?
How frequently are the records updated and reviewed?
What kind of evidence is required to answer this question?
- What resources are there to support continuity at the point of transition?
How adequate are these resources?
What kind of evidence is required to answer this question?
These questions, several in number, have moved the research from simply an expression of interest (or a general aim) into a series of issues that lend themselves to being investigated in concrete terms. This is precisely what we mean by the process of operationalization. It is now possible not only to formulate the specific questions to be posed, but also to select appropriate instruments that will gather the data to answer them (e.g. semi structured interviews, rating scales on questionnaires, or documentary analysis).
By this process of operationalization, we thus make a general purpose amenable to investigation, e.g. by measurement (Rose and Sullivan, 1993:6) or some other means. In planning research, it is important to clarify a distinction that needs to be made between methodology and methods, approaches and instruments, styles of research and ways of collecting data. Several of the later posts of this website are devoted to specific instruments for collecting data, e.g.:
- interviews
- questionnaires
- observation
- tests
- accounts
- biographies and case studies
- role playing
- simulations
- personal constructs.
The decision on which instrument to use frequently follows from an important earlier decision on which kind of research to undertake, for example:
- a survey
- an experiment
- an in-depth ethnography
- action research
- case study research
- testing and assessment.
Selecting Appropriate Research Methodologies
Subsequent posts of this webpage examine each of these research styles, their principles, rationales and purposes, and the instrumentation and data types that seem suitable for them. For conceptual clarity it is possible to set out some key features of these models. It is intended that, when decisions have been reached on the stage of research design and methodology, a clear plan of action will have been prepared. To this end, considering models of research might be useful (Morrison, 1993).
Data Analysis in Nursing Research
The prepared researcher will need to consider the mode of data analysis to be employed. In some cases, this is very important as it has a specific bearing on the form of the instrumentation. For example, a researcher will need to plan the layout and structure of a questionnaire survey very carefully in order to assist data entry for computer reading and analysis; an inappropriate layout may obstruct data entry and subsequent analysis by computer.
Statistical Considerations / Parametric vs. Non-Parametric
The planning of data analysis needs to be considered: What needs to be done with the data when they have been collected, how will they be processed and analyzed? How will the results of the analysis be verified, cross-checked and validated? Decisions will need to be taken with regard to the statistical tests that will be used in data analysis as this will affect the layout of research items (for example in a questionnaire), and the computer packages that are available for processing quantitative and qualitative data, e.g. SPSS and NUD.IST respectively.
For statistical processing the researcher will need to ascertain the level of data being processed nominally, ordinal, interval or ratio. Nominal and ordinal scales yield nonparametric data, i.e. data from populations, where few or no assumptions are made about the distribution of the population or the characteristics of that population; the parameters of the population are unknown.
Interval and ratio scales yield parametric data, on the basis of which assumptions are made about the characteristics and distribution of the wider population, i.e. the parameters of the population are known, and usually assume a normal, Gaussian curve of distribution, as in reading scores, for example.
Non-parametric data are often derived from questionnaires and surveys whilst parametric data tend to be derived from experiments and tests. The choice of which statistics to employ is not arbitrary and sets out the commonly used statistics for data types (Siegel, 1956; Cohen and Holliday, 1996; Hopkins, Hopkins and Glass, 1996). For qualitative data analysis the researchers have at their disposal a range of techniques, for example (Hammersley, 1979):
- coding of field notes (Miles and Huberman, 1984).
- content analysis of field notes or qualitative data
- cognitive mapping (Jones, 1987; Morrison, 1993).
- seeking patterning of responses.
- looking for causal pathways and connections (Miles and Huberman, 1984).
- presenting cross-site analysis (ibid.).
- case studies.
- personal constructs.
- narrative accounts.
- action research analysis;
- analytic induction (Denzin, 1970).
- constant comparison (Glaser and Strauss, 1967).
- grounded theory (Glaser and Strauss, 1967).
- discourse analysis (Stillar, 1998).
- biographies and life histories (Atkinson, 1998).
The criteria for deciding which forms of data analysis to undertake are governed both by fitness for purpose and legitimacy—the form of data analysis must be appropriate for the kinds of data gathered. For example, it would be inappropriate to use certain statistics with certain kinds of numerical data (e.g. using means on nominal data), or to use causal pathways on unrelated cross-site analysis
Reporting and Implementation
The results as with the stage of planning data analysis, the prepared researcher will need to consider the form of the reporting of the research and its results, giving due attention to the needs of different audiences (for example, an academic audience may require different contents from a wider professional audience and, a fortiori, from a lay audience). Decisions here will need to be considered:
How to write up and report the research?
When to write up and report the research (e.g. ongoing or summative)?
How to present the results in tabular and/or write ten-out form?
How to present the results in non-verbal forms?
To whom to report (the necessary and possible audiences of the research)?
How frequently do you report?
Nursing Research Planning Matrix
In planning a piece of research, the range of questions to be addressed can be set into a matrix. It provides such a matrix, in the left-hand column of which are the questions which figure in the four main areas set out so far:
(i) orienting decisions
(ii) research design and methodology
(iii) data analysis
(iv) presenting and reporting the results.
Questions 1–10 are the orienting decisions, questions 11–22 concern the research design and methodology, questions 23–4 cover data analysis, and questions 25–30 deal with presenting and reporting the results. Within each of the 30 questions there are several sub-questions which research planners may need to address. For example, within question 5 (What are the purposes of the research?’) the researcher would have to differentiate major and minor purposes, explicit and maybe implicit purposes, whose purposes are being served by the research, and whose interests are being served by the research.
An example of these sub-issues and problems is contained in the second column. At this point the planner is still at the diver gent phase of the research planning, dealing with planned possibilities (Morrison, 1993:19), and opening the research to all facets and interpretations.
Coherence and Practicability Assessment
In the column headed ‘decisions’ the research planner is moving towards a convergent phase, where planned possibilities become visible within the terms of constraints available to the researcher. To do this the researcher has to move down the column marked ‘decisions’ to see how well the decision which is taken regarding one issue/question fits in with the decisions in regard to other issues/questions.
Four-Stage Model for Research Management
For one decision to fit with another, four factors must be present:
1 All of the cells in the ‘decisions’ column must be coherent; they must not contradict each other.
2 All of the cells in the ‘decisions’ column must be mutually supporting.
3 All of the cells in the ‘decisions’ column must be practicable when taken separately.
4 All of the cells in the ‘decisions’ column must be practicable when taken together.
Not all of the planned possibilities might be practicable when these four criteria are applied. It would be of very little use if the methods of data collection listed in the ‘decisions’ column of question 21 (‘How will the data be gathered?’) offered little opportunity to fulfill the needs of acquiring information to answer question 7 (‘What must be the focus in order to answer the research questions?’), or if the methods of data collection were impracticable within the time scales available in question 4.
In the matrix the cells have been completed in a deliberately content-free way, i.e. the matrix as presented here does not deal with the specific, actual points which might emerge in a particular research proposal. If the matrix were to be used for planning an actual piece of research, then, instead of couching the wording of each cell in generalized terms, it would be more useful if specific, concrete responses were given which addressed issues and concerns in the research proposal in question.
Many of these questions concern rights, responsibilities and the political uses (and abuses) of the research. This underlines the view that research is an inherently political and moral activity; it is not politically or morally neutral. The researcher must be concerned with the uses as well as the conduct of the research.
Managing Complexity and Contingencies
The preceding discussion has revealed the complexity of planning a piece of research, yet it should not be assumed that research will always go according to plan! For example, the mortality of the sample might be a feature (participants leaving during the research), or a poor response rate to questionnaires might been countered, rendering subsequent analysis, reporting and generalization problematically; administrative support might not be forthcoming, or there might be serious slippage in the timing.
This is not to say that a plan for the research should not be made; rather it is to suggest that it is dangerous to put absolute faith in it! To manage the complexity in planning outlined above a simple four-stage model can be proposed: Stage 1 Identify the purposes of the research. Stage 2 Identify and give priority to the constraints under which the research will take place. Stage 3 Plan the possibilities for research within these constraints. Stage 4 Decide the research design. Each stage contains several operations
Matrix Planning Coverage
It may be useful for research planners to consider which instruments will be used at which stage of the research and with which sectors of the sample population. Sets out a matrix of these for planning (see also Morrison, 1993:109), for example, of a small-scale piece of research. A matrix approach such as this enables research planners to see immediately their coverage of the sample and of the instruments used at points in time, making omissions clear, and promoting such questions as:
Why are certain instruments used at certain times and not at others?
Why are certain instruments used with certain people and not with others?
Why do certain times in the research use more instruments than other times?
Why is there such a heavy concentration of instruments at the end of the study?
Why are certain groups involved in more instruments than other groups?
Why are some groups apparently neglected (e.g. parents), e.g. is there a political dimension to the research?
Why are questionnaires the main kinds of instrument to be used?
Why are some instruments (e.g. observation, testing) not used at all?
What makes the five stages separate?
Are documents only held by certain parties (and, if so, might one suspect an ‘institutional line’ to be revealed in them)?
Are some parties more difficult to contact than others (e.g. University teacher educators)?
Are some parties more important to the research than others (e.g. the principals)?
Why are some parties excluded from the sample (e.g. school governors, policy-makers, teachers’ associations and unions)?
What is the difference between the three groups of teachers?
Matrix planning is useful for exposing key features of the planning of research.
Further matrices might be constructed to indicate other features of the research, for example:
- the timing of the identification of the sample.
- the timing of the release of interim reports.
- the timing of the release of the final report.
- the timing of pretests and post-tests (in an experimental style of research).
- the timing of intensive necessary resource support (e.g. reprographics).
- the timing of meetings of interested parties.
These examples cover timings only; other matrices might be developed to cover other combinations, for example: reporting by audiences; research team meetings by reporting; instrumentation by participants etc. They are useful summary devices.
Research as Political and Moral Activity
This post has suggested how a research plan can be formulated and operationalized, moving from general areas of interest, questions and purposes to very specific research questions which can be answered using appropriate sampling procedures, methodologies and instruments, and with the gathering of relevant data. The message from this post is that, while research may not always unfold according to plan, it is important to have thought out the several stages and elements of research so that coherence and practicability have been addressed within an ethically defensible context.
Such planning can be usefully informed by models of research, and, indeed, these are addressed in several posts on the webpage. The planning of research begins with the identification of purposes and constraints. With these in mind, the researcher can now decide on a research design and strategy that will provide him or her with answers to specific research questions. These in turn will serve more general research purposes and aims.
Both the novice and experienced researcher alike must confront the necessity of having a clear plan of action if the research is to have momentum and purpose. The notion of ‘fitness for purpose’ reigns here; the research plan must suit the purposes of the research. If the reader is left feeling, at the end of this post, that the task of research is complex, then that is an important message, for rigor and thoughtful, thorough planning are necessary if the research is to be worthwhile and effective.
Read More:
https://nurseseducator.com/didactic-and-dialectic-teaching-rationale-for-team-based-learning/
https://nurseseducator.com/high-fidelity-simulation-use-in-nursing-education/
First NCLEX Exam Center In Pakistan From Lahore (Mall of Lahore) to the Global Nursing
Categories of Journals: W, X, Y and Z Category Journal In Nursing Education
AI in Healthcare Content Creation: A Double-Edged Sword and Scary
Social Links:
https://www.facebook.com/nurseseducator/
https://www.instagram.com/nurseseducator/
https://www.pinterest.com/NursesEducator/
https://www.linkedin.com/in/nurseseducator/
https://www.researchgate.net/profile/Afza-Lal-Din
https://scholar.google.com/citations?hl=en&user=F0XY9vQAAAAJ