final exam Flashcards
(151 cards)
1
Q
t-test
A
the difference between means of either
1. 2 diff groups like male vs female
2. 2 groups in one concept like pre-surgery and post surgery patients
2
Q
Confidence Interval
A
it’s basically standard deviation but between homogenous groups
eg) 3 groups of LPNs. You have a CI of probability that it would apply to all the groups so you can generalize it to all LPNs
3
Q
Inferential statistics demonstrates what?
A
a relationship between variables
draw conclusions
makes predictions
4
Q
descriptive statistics describes what?
A
certain elements in the population
DOES not demonstrate relationships between variables
5
Q
what does standard deviation measure?
A
variability
6
Q
What is included in measures of central tendancy?
A
Mean
median
mode (frequency distribution)
7
Q
What are the key elements of a Quantitative research study?
A
- hypothesis
- theoretical framework
- literature review
- Problem statement (the question)
- Design
8
Q
Which research design for quantitative does not have a hypothesis?
A
descriptive design (non-experimental)
just needs a good research question
9
Q
Which research design for quantitative typically has a hypothesis?
A
experimental design
10
Q
point of descriptive design
A
describe
explore
compare variables
11
Q
what sampling is used for descriptive design?
A
non-probable/no randomized
12
Q
advantage/disadvantage of descriptive design?
A
Lots of data, accurate, economical/but it’s superficial & there’s almost too much
13
Q
advantages/disadvantages of correlational design
A
good for complex relationships between variables
- application to clinical situations
-*foundation for experimental research
cannot manipulate variables. can’t determine casual relationships
14
Q
what non-experimental design is foundational to experimental research?
A
correlational
15
Q
What does correlational design not do?
A
comparison between variables
16
Q
Which design is considered gold standard for quantitative?
A
Experimental - randomized control groups
17
Q
What are the advantages & disadvantages of experimental design?
A
DETERMINE cause and effect
does not account for some confounding variables like social determinents of health
18
Q
What is the point of quasi-experimental?
A
TEST not prove - cause and effect
19
Q
what does Quasiexperimental typically not have?
A
Randomization
Control group
20
Q
What are the advantages/disadvantages of quasi?
A
more practical and feasible than experimental (RCT)
EVALUATE the effect of the independent variable
can’t establish clear cause and effect, only TEST it
21
Q
What is the difference between systematic review and meta-analysis?
A
meta analysis - combine and focus on statistical results of numerous studies
22
Q
Heirarchy of evidence is ranked according to possibility of what?
A
Possibility of bias
23
Q
Are clinical protocols general or specific to the setting?
A
setting specific
24
Q
What is hypothesis in research
A
relationship between two or more variables related to the research purpose
25
What is the goal of qualitative research?
find meaning of social or human issues within a particular context
26
What are the 5 steps of qualitative research?
1. determine focus/aim/goal/purpose
2. develop research question
3. identify data and sources and ethics
4. data collection and analysis
5. synthesis and writing
27
What is a good definition of EIP?
ongoing process
incorporates evidence from: research, clinical expertise, client preferences and other resources
goal: make nursing decisions with clients
28
What is the order of Hierarchy of Evidence?
Clinical practice guidelines
case reports/case studies
RCTs
Cohort studies
Meta-analysis/systematic reviews
top - clinical practice guidelines
- Meta-analysis/systematic reviews
- RCTs
- Cohort studies
- case reports/case studies
29
What are the medical data bases?
CINAHL - nursing/allied health
PubMED/Mediline
30
What is the systematic review database in nursing?
Joanna Briggs Institute
31
What does PICo stand for ? (qualitative)
Population
Interest (phenomenon)
Context
32
What does PICOT stand for? (quantitative)
Population
Intervention/issue
comparison intervention
outcomes
timing
setting (sometimes added)
33
What are the 5 phases of quantitative study?
1. conceptual
2. design and planning
3. empirical
4. analytic
5. dissemination
34
What are the 4 non-experimental designs?
1. descriptive (observational)
2. Exploratory
3. comparative
4 .Correlational
35
What are 3 correlational research designs?
1. retrospective (past)
2. crosssectional (present)
3. prospective (future)
36
What are the 3 main types of quantitative research designs?
1. non experimental
2. Quasi-experimental
3. Experimental
37
How is homogenity determined in descriptive (observational ) design?
inclusion & exclusion criteria
38
What type of data collection method does descriptive (observational) design use?
surveys & questionnaires
39
in correlational design, how are examined variables chosen and management of extraneous variables?
inclusion and exclusion criteria
40
What are disadvantages to correlational design?
can't manipulate variables of interest
decreased generalizability
can't determine causal relationship
41
What research method is gold standard for cause and effect relationships?
Experimental design
42
What 3 properties does Experimental design have that quasi may not include (quasi always has 1 of the 3 though)?
1. randomization
2. control
3. Manipulation
43
How does experimental design account for confounding and extraneous variables?
Sampling
randomization
44
What is the control in experimental design?
the comparison/control group (the constant) - we do not give the intervention we are testing to this group. They just get the normal/usual care so we can compare them to the group with the intervention
45
What is manipulation in experimental design?
administration of the intervention. It is the independent variable that acts on dependent variable
46
Which property is almost always missing in quasi-experimental design?
usually randomization
often control is not possible or practical (no control group)
47
Which design evaluates the effect of the independent variable?
quasi-experimental
48
In quantitative research what 2 things make up rigor?
validity
reliability
49
What are the 5 threats to internal validity?
Temporal ambiguity
selection
history
maturation
mortality/attrition
50
Is internal validity qualitative or quantitative?
Quantitative
51
What is temporal ambiguity?
- order in which variables influence each other
52
what is "selection" as a threat to internal validity?
preexisting differences between groups (you want homogeneity )
53
how does history affect internal validity?
concurrent events happening during the study
54
What is maturation?
changes that occur with time such as fatigue
55
What is mortality/attrition?
loss of subjects
56
what affects validity?
Temporal ambiguity
selection
history
maturation
mortality/attrition
Bias:
Selection bias
Attrition bias
Measurement bias
Performance bias
Reporting bias
Sampling bias
Biased survey questions
non-response bias
57
What are the 8 types of bias in qualitative research?
Selection bias
Attrition bias
Measurement bias
Performance bias
Reporting bias
Sampling bias
biased survey questions
non-response bias
58
What is selection bias?
people are chosen in a way that is not proper and allows for too much bias or not enough randomness to be able to generalize to the population
59
What is attrition bias?
When people are lost from a study it could be because of differences between them and others who were not lost (remember we want homogeneity )
60
What is measurement bias?
How data was collected
we thought it would measure one thing but it picked up something else
61
What is performance bias?
Hawthorne effect - saying what you think the researcher wants
62
What is reporting bias?
what authors and journals present
63
What is sampling bias?
sample is not representative of the population
64
What is biophysiological measurements?
Anything to do with the body physically, labs, temp, vitals, etc.
65
What is psychometric measurements (assessments)
perceptions/thoughts/feelings
66
What is psychometrics ?
theory and development of measurement instruments
67
What are 2 types of quantitative data measurment strategies?
1. biophysiological measures : in vivo, in vitro
2. Psychometric measures:
- Direct observation
- Structured self-reported data
68
What is in vivo data?
what is directly on the body :
weight, BP, etc
69
What is in vitro data?
What you take from the body:
blood work, tissue samples
70
What is a mix of biophysiological measures and psychometric measures called?
Existing data - ie) medical records
71
What questions are typically used in psychometric (self-reported) tools?
Closed-ended questions
72
What are the 5 closed-ended questions typically used in psychometric tools?
1. Dichotomous (yes/no)
2. Rating (0-10)
3. Likert scale (strongly agree to strongly disagree)
4. M/C
5. Forced choice (must pick a statement)
73
Why is expertise, testing and refinement over time needed when developing psychometric tools?
ensure validity and reliability
73
What are the 3 types of reliability when it comes to measurement tools?
Test-retest reliability
Interrater reliability
Internal consistency
74
What are the 4 types of validity when it comes to measurement tools?
Face validity
Content validity
Criterion validity
construct validity
75
What type of reliability is pre/post test after an intervention?
test-retest reliability
76
Consistency of results when the same test is independently conducted by two diff people is what type of reliability?
Interrater reliability
77
consistency within the tool itself (wording, etc) is considered what type of reliability?
Internal consistency
78
What is non probability samping?
choose by nonrandom methods
79
What research designs typically use non probability sampling?
Descriptive (observational)
Correlational
quasi-experimental
qualitative
80
What is probability samping?
random selection
81
What type of designs use probability sampling?
experimental *required*
quasi-experimental (sometimes)
82
What are the 5 types of non probability sampling?
1. specifying inclusion/exclusion criteria
2. purposive sampling
3. convenience sampling
4. consecutive sampling
5. snowball sampling
83
What is a key word/concept when determining if a study is descriptive (observational) design?
How- gathering more info about something
"How does attending a “student-infused” pulmonary rehabilitation program impact adults in the Saint John area with COPD in management of their health condition?"
84
What is a key word/concept when determining if a study is correlational design?
Influence - how variables interplay- relationships
"What physiological dimensions of adults with COPD are influenced when attending an 8-week student infused pulmonary rehabilitation program
85
What are the 4 types of probability sampling ?
1. random
2. stratified random - i divide them
3. cluster - already divided
4. systematic - every kth
86
What is a key word/concept when determining if a study is quasi-experimental design?
What is the impact of ... - it's about testing
What is the impact of attending an 8-week “student-infused”
pulmonary rehabilitation program on the quality of life of
adults living with COPD?
87
What are the 7 aspects of decriptive statistics in quantitative research?
Measures of Central tendency
frequency distribution
levels of significance
standard deviation
confidence interval
t-Test
p-value
88
What are measures of central tendency?
mean
median
mode
frequency distribution
89
What are the 2 measures of variability?
S.D
variance (how flat or tall the bell curve is)
-low variability is better because then the population is more homogeneous
90
what are the 3 inferential statistics? (ie) generalizability
confidence interval
t-Test
p-value
91
What are 4 reasons statistical analysis is used in quantitataive research?
1. make sense of numeric info
2. describe sample (n) characteristics
3. test hypothesis - p-value (0.05)
4. provide evidence of measurement properties of quantified variables
92
What are the 4 levels of measurment?
Nominal - lowest - categorize - numbers - 1= gender, 2= prof. role etc
Ordinal- 1-5- agree/disagree
Interval - no absolute zero- IQ scale, temp
Ratio- highest - meaningful zero - cases of H1N1
93
Of the 4 levels of measurement, which can we do inferrential statistics with?
Ordinal
Interval
Ratio
*not Nominal*
94
Is there more variability with homogeneity or heterogeneity?
heterogeneity
95
What is a parameter in confidence intervals?
the characteristic of a population (eg) age
96
What are threats to external validity?
inadequate sample size
inability to generalize
97
What are the three hallmarks of critical appraisal of quantitative research?
1. credibility
2. clinical significance
3. applicability
98
In qualitative research, what affects rigor?
The researcher - trustworthiness
99
What about the researcher influences rigor in qual?
philisophical orientations
paradigms
personal values
100
What comes first, the research question or the methodological approach?
The research question
so you know what approach to pick
101
in qual how do we decide what the best methodological approach is?
Ask if there are basic gaps of knowledge in what is already out there
102
If i don't know what want to look at (study), what qual methodological approach would I pick?
Qualitative descriptive
103
What design includes elements of grounded theory, ethnography and phenomenology?
Interpretative description
104
If I want to focus on someone's lived experience, what methodological approach do i choose?
Phenomonology
105
If i want to look at "culture" what methodological approach would i choose?
ethnography
106
If I want to look at a specific phenomenon, like a program, event, experience, what methodological approach would I choose?
Case study (can include quant data)
107
If I want to focus on psychosocial process what methodological approach would I choose?
Grounded theory
108
What is the end goal of grounded theory?
development of a theory
109
What are the 3 types of grounded theory?
1. glassarian - classic
2. straussian - qual analysis
3. charmaz- constructivist
110
What are the seven ethical principles for research and EIP?
Social or scientific value.
Scientific validity.
Fair subject selection.
Favorable risk-benefit ratio.
Independent review.
Respect for potential and enrolled subjects (participants).
Informed consent.
111
What is Social or scientific value in ethics?
human subject research should have both scientific and social merit.
if not then it is unjustifiable
112
What is scientific validity in ethics?
how well a scientific test or piece of research actually measures what it sets out to, or how well it reflects the reality it claims to represent.
113
what is fair subject selection in ethics?
vulnerable people receive special protections and perhaps also be excluded from participation
114
What is favorable risk-benefit ratio?
Everything should be done to minimize the risks and inconvenience to research participants to maximize the potential benefits, and to determine that the potential benefits are proportionate to, or outweigh, the risks
115
what is independent review with ethics?
This occurs before any research activities involving human subjects, including recruitment, are allowed to begin.
116
What are four distinct categories of reasons why research has a poor reputation amongst Indigenous, Inuit, and Métis peoples?
1. Reason for research /goal of research - Indigenous is self- determination. Western vary between knowledge creation to policy development
2. Data management and data ownership - lack of respect for past research participants equals distrust .
3. Views on knowledge. Ideas are accepted or rejected based on usefulness - not so much on methodical research methods . Ways of knowing are different
4. Disrespectful research methods of the past need to go and make room for Indigenous methodology.
116
What is respect for potential and enrolled subjects in ethics?
Individuals should be treated with respect from the time they are approached for possible participation — even if they refuse enrollment in a study — throughout their participation and after their participation ends. This includes: Respecting their privacy and keeping their private information confidential
117
What are the implications of the Five “Rs” of Higher Education for Indigenous, Inuit, and Métis peoples as it relates to research
1. Respect – egalitarian relationships – the researcher adapts to participants, express humility and honour, and acknowledge contributions (Justice/Autonomy)
2. Relevance – research should be relevant to the community – ideally initiated by the community (beneficence)
3. Reciprocity – research should serve a purpose to the community, ideally improve the community, the community chooses the researcher (non-maleficence)
4. Responsibility – as a human being in relationship with others, network of family and community to ensure research is done in a good way; ensure research is not misused or used in a way that causes harm. (both beneficience and non-maleficence)
5. Relationships – foundation of research. Relationship with knowledge, researcher, participants, land, ancestors, future generations . (both beneficience and non-maleficence)
118
What are four common tenets (principles) when considering research involving Indigenous peoples?
1. Ownership- the community/groups owns their information
2.Control- they control all aspects of research
3. Access – access to info about themselves and their communities. They manage the right to access their collective information
4. Possession – the physical control of data. Possession is how ownership is asserted and protected.
119
What is the philosophy behind “Two-Eyed Seeing” and its application to research methodology?
“refers to learning to see from one eye with the strengths of Indigenous knowledge and way of knowing and from the other eye with the strengths of western knowledges and use both these eyes together for the benefit of all.”
They wanted to weave together Western and Indigenous knowledges and ways of knowing.
120
What are the seven issues that Indigenous communities have had with wester research(ers) ?
Misrepresentation
inhumane
lack of consent
maleficence
lack of autonomy
lack of cultural safety
121
in qual, why is adequate demographic info important?
so the person knows if the info is transferable (transferability)
to show credibility of sources
122
What are 4 data sources in Qual?
Interviews
observation - emic/etic
Textual info
Literature - existing evidence
123
What is emic perspective?
Insiders perspective
124
What is etic perspective?
Outsiders perspective
125
What is content or initial coding?
basic first level of coding where the researcher identifies codes what they “see” in the data
126
Which element(s) would you assess as part of quality for a primary research article, systematic review, and clinical practice guideline?
Credibility - useful for both qual and quant
demographic info - should be present in all
fidelity of process - yes for all
127
What is thematic coding?
Thematic coding involves grouping content or initial codes into categories or themes.
128
What is constant comparison?
grounded theory method used in analysis. It involves constantly comparing data across and within levels of coding.
128
What element would we not assess as part of quality for primary resarch articles, systematic reviews and clinical practice guidelines?
internal validity - because that's only quant
129
in quant we say rigor, in qual we say what?
trustworthiness - measuring tools & statistics & researcher
130
in quant we say validity (external/internal). in qual we say what?
credibility (external/internal) - researchers
131
what are the 3 factors that make up trustworthiness in Qual?
1. credibility
2. Fittingness
3. Auditability
132
What is PRISMA?
a checklist - not a methodological approach to conducting a systematic review
133
What helps us decide what we might use from the CPG?
1. Feasibility and practicality – does this work for my population
2. Context – can you do the recommendations at home instead?
3. Population- are people interested?
4. Age of the CPG- always takes time to get published
5. New information that comes up
134
What is similar between clinical expertise, clinical judgement and clinical wisdom?
1. Knowledge
2. Time sequence
3. Novice to expert
135
What is clinical expertise?
combination of competency with multiple observations of patients and phenomenon (e.g., reaction to interventions).
136
What is clinical judgement?
- An interpretation or conclusion about a patient’s needs, concerns or health problems
- The decision to take action (or not)
- Decision to use or modify standard approaches or improvise new ones
- Appropriateness is based on patient’s response
- A requirement for clinicians to discern what is good/appropriate in a particular situation
137
What is clinical wisdom?
the ability to determine and apply appropriate evidence to a situation in conjunction with ones own expertise, experience, and judgement
138
What is a brief overview of the 7 phases of JBI model for implementing EBP?
Phase 1 - find the problem
Phase 2 - Find the agents of change
Phase 3 - Are peeps ready to change and is the change appropriate for context
Phase 4- compare the practice with evidence based criteria
Phase 5- implement changes – getting research into practice
Phase 6- reassess
Phase 7 - need sustainability
139
What is Lewin’s Force Field Analysis ?
driving forces of change - facilitators
restraining forces - barriers to change
140
What are lewins driving forces of change?
1. willingness
2. backing of leadership
3. identify the need
4. have the evidence
141
What are lewins barriers to change?
1. entrenched views
2. assumptions made
3. cost
4. technology
142
What are Clinical decision supports (CDS) ?
clinical decision making tools
- they must always be adapted to the patient thought!
143
Why do we want to implement change in a clinical setting?
1. keep care up to date
2. want better outcomes for people
3. stop cycle of readmittance
4. risk management & patient safety
144
what 2 things do we look at to determine if EIP is working?
1. Outcomes - decide what they are and need tools to measure them
2. Process - what is the benefit(s)
145
what are the biggest challenges to promoting EIP in clinical setting?
1.Time
2.Concrete thinkers – some people just don’t get it
3.Culture of the unit – do they support EIP?
4.Attitude – this doesn’t apply to me. I just want to do my job
146
What makes something Quasi-experimental?
it has an intervention (manipulation) but no randomization.
- cuz you're doing it to test (not prove) cause and effect
146
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