How to read a research article.

Scientific Inquiry provides a forum to facilitate the ongoing process of questioning and evaluating practice, presents informed practice based on available data, and innovates new practices through research and experimental learning.     

Authorship Order in Medical Education Publications: In Search of Practical Guidance for the Community

Phenomenon: With scholarly collaborations come questions about the order of authorship. Authorship order is an important consideration because it often used as an indicator of seniority, expertise, leadership, and scholarly productivity. As a result, authorship order factors into decisions about hiring, salary, resource allocation, and professional advancement. This study describes principles commonly applied to authorship order decisions within the medical education community and educators’ opinions about the significance of authorship order. Approach: A questionnaire was developed to ascertain current practices related to authorship decisions. Sixteen items were rated in terms of frequency of actual use and the desirability of the practice using a 4-point rating scale: 1 (never), 2 (sometimes), 3 (often), and 4 (always). Additional questions addressed the perceived significance of authorship order. The last set of questions provided information about respondents’ personal and career characteristics. The survey was delivered via e-mail to a random sample of 391 subscribers from the DR-ED listserv. Findings: Fifty-four e-mail addresses were returned as undeliverable; of the remaining 337 mailed surveys, 109 responses (32.3%) were received. Five of the current practices for determining authorship order were rated as both frequent and desirable; 4 items had low ratings suggesting that these practices were both infrequent and undesirable. For 7 items, there was a significant gap between the ratings of practice frequency and desirability. When asked about preferred authorship order strategies, most respondents (94%) endorsed listing authors by descending order based on contribution but were split in identifying the last author (47%) or second author (46%) as the next best placement after first author. Respondents supported the practice of many journals requiring authors to disclose their contributions, agreeing (69%) that it provides useful information for promotion and tenure committees; however, 43% were uncertain about how disclosed contributions were reflected in authorship order. Insights: Respondents strongly endorsed the importance of listing authors in order of decreasing contribution, although the meaning of second versus last author lacks consensus. This finding, together the other strategies that received strong endorsement and those that were not strongly endorsed, provides a starting point to develop guidance for medical educators about how to determine authorship order. Clear guidance for authors would promote fairness and accountability within the medical education community as well as provide more consistent interpretation for those who consider authorship order for career- and resource-related decisions.     

Approaches used to implement research findings into nursing practice: Report of a study tour to Australia and New Zealand

The focus of the study tour to several research and nursing units in Australia and New Zealand (NZ) was to investigate what has influenced the way nurses implement research into practice. The key areas examined were strategic policy influences, activities within leading academic units and responses in practice areas. The main themes to emerge were that the strategies developed by health policy makers in Australia and New Zealand have been profoundly influenced by the global clinical effectiveness and evidence-based practice movements. Nursing needs to position itself firmly in the centre of such developments and leading nursing initiatives need to be mainstreamed into the wider evidence-based movement. While activity around clinical/practice guideline development moves on, more work needs to be done to understand how best to actually implement research in practice. Issues of organizational context, ownership, practice, culture and identifying local champions are emerging as key challenges for the next stage of implementation. Much can be learnt from ongoing dialogue.     

Developing a theory-based taxonomy of methods for implementing change in practice

AIM: In this paper we present a theory-based taxonomy of the methods used to implement change in practice. BACKGROUND: Implementation research is characterized by inconsistent terminology for the methods employed and inattention to differences in the relevance of methods across different disciplines. Studies of the effectiveness of implementation have yielded mixed results. Positive effects shown have been small. The limited success of many efforts to implement change in practice may be due, in part, to the absence of a framework to guide the use of implementation methods. METHOD: A provisional taxonomy of implementation methods, derived from theory and existing taxonomies, was used to content analyse a convenience sample of 43 reports of empirical studies of the implementation of one or more research-based practice changes involving nurses that had been published between 1995 and 2005. This taxonomy was revised throughout the course of analysis to capture more completely the information in each report. FINDINGS: Following the analysis, nine of the 11 methods in the provisional taxonomy were retained, two were removed and five new methods were identified. The final taxonomy includes 14 implementation methods organized into five categories: (a) increasing coordination; (b) raising awareness; (c) persuasion via interpersonal channels; (d) persuasion via reinforcing belief that behaviour will lead to desirable results and (e) increasing behavioural control. CONCLUSIONS: The taxonomy presented here differs from prior taxonomies by focusing on nursing and by providing a clear and mutually exclusive guide to implementation methods. By deriving the initial coding strategy from theory, the taxonomy links the methods to theoretical constructs that may inform the selection of methods across different practice changes and settings.     

Linking Practice With Research: The Role of the Unit Research Coordinator

Scientific Inquiry provides a forum to facilitate the ongoing process of questioning and evaluating practice, presents informed practice based on available data, and innovates new practices through research and experimental learning.     

Using research for practice: a UK experience of the BARRIERS Scale

It is generally recognized that the majority of health care has been largely based upon opinion rather than research evidence of clinical effectiveness. Attempts to rectify this have been initiated by increasing emphasis on the dissemination of findings. For example, in the UK this had been supported via the Cochran Collaboration and the Centre for Dissemination and Reviews. Dissemination does not, however, guarantee implementation. The complex nature of research utilization has been studied and obstacles identified that can influence the uptake of research by practising nurses. Sandra Funk and colleagues developed the BARRIERS Scale using this research and literature on research utilization. The scale may be helpful for identifying and measuring the barriers to research utilization perceived by nurses working within the UK and has formed the basis of the present study. A convenience sample of 316 comprising a broad spectrum of nurses working in the UK provided the data. Comparison is made with North American nurses from the studies used in the scale's development. The results suggest there are items which are consistently perceived as either strong or negligible barriers by both groups of nurses. Differences, however, did emerge between nurses from the UK and North America on several items. These included the confindence in evaluating research and the perception of the nurse's authority to change patient procedures. Psychometric evaluation was also done. These findings are presented and discussed.     

以临床实践为基础的护理科研管理模式探讨

目的:探讨以临床实践为基础的护理科研管理模式,建立完善的护理科研管理制度以及搭建良好的护理科研交流平台的方法。方法:比较建立以临床实践为基础的护理科研管理模式前后各5年内获得的科研成果数量。结果:2005-2009年度与2000-2004年度比较,科研成果数量明显增加。结论:建立以临床实践为基础的护理科研管理模式有助于科研工作的开展,提高护理科研水平。     

Building Communities of Practice: The Research Nurse Round Table

This paper shares the experience of establishing a research nurse forum aimed at knowledge sharing, problem solving, and community building from the perspective of a group of clinical research nurses at Massachusetts General Hospital (MGH), a tertiary care center in Boston, ­Massachusetts. We report on a sequence of developmental steps taken to create this forum as an example of best practice for research nurses. Logistical considerations, mission and goals, as well as outcomes and implications for practice are described, with the intent that others interested in building similar forums can replicate aspects of this model within their own practice settings. Clin Trans Sci 2012; Volume 5: 428–431     

Pre- and post-test evaluation of a project to facilitate research development in practice in a hospital setting

BACKGROUND: This paper describes a project designed to facilitate the use of research in nursing practice in one acute hospital. A university team worked in collaboration with staff from the hospital to develop and evaluate the impact of development work designed to enhance knowledge and use of research in practice. DESIGN/METHODS: A research utilization questionnaire was administered as a pre-test (stage 1); a development phase was implemented (stage 2) and a post-test survey (stage 3) was administered to evaluate the impact of the development work. In stage 1, the total population of nursing and midwifery staff in the hospital (n=473) were targeted and 235 returned the questionnaire, giving a response rate of 50%. Data from the pre-test and focus group discussions with staff were used to plan stage 2 of the project. The development stage involved an educational strand in which open learning research materials were made available to staff, who were also offered tutorial support in their learning. A second strand supported the development of clinical research projects and funds were identified for clinical staff to apply for project development awards to enable them to develop skills in research and development activity under the supervision of a research fellow. Stage 3 involved a post-test survey of staff who had completed the questionnaire in stage 1 (n=81). FINDINGS: There were no significant differences in findings between the pre-test and post-test. Qualitative data from those involved in the clinical projects in stage 2 indicated factors impacting on the feasibility of undertaking research in practice.     

The development of evidence-based nursing

This paper argues that the current conception of evidence-based medicine has its limitations in the promotion of research which effects the quality of service in any health care system. It also poses something of a difficulty for the development of evidence-based nursing in particular. This paper advocates the more broad based concept of evidence-based practice and discusses its potential for addressing theory/practice problems and the uptake of nursing research. The broader conceptualization of evidence-based practice focuses on the integration of available evidence and the tacit knowledge of the investigator. An evidence-based practice project undertaken in Hong Kong is outlined as this provided the basis of many of the conclusions made in this paper. Three vignettes are given in order to demonstrate the nature of the evidence-based practice projects which have been conducted. The critical elements of evidence-based practice projects are outlined. Finally issues concerning the process of generating evidence, the relationship to continuous quality improvement and the cost effectiveness of evidence-based practice are discussed in more detail.     

The view of evidence-based medicine from the trenches: liberating or authoritarian?

Evidence-based medicine at first promised to be a popularistic movement, bringing the fruits of research to all practising physicians. Instead it has created its own religion and dogma, further codifying daily practice.     

A Model for Change to Evidence-Based Practice

To describe a model that guides nurses and other healthcare professionals through a systematic process for the change to evidence-based practice. The tremendous increases in clinical research and accessibility to research findings have prepared the way for the paradigm shift from traditional and intuition-driven practice to evidence-based practice. Although several models have emerged to guide practitioners in research utilization, practitioners continue to have difficulty synthesizing empirical and contextual evidence and integrating evidence-based changes into practice.

Organizing Framework:

The model is based on theoretical and research literature related to evidence-based practice, research utilization, standardized language, and change theory. In this model, practitioners are guided through the entire process of developing and integrating an evidence-based practice change. The model supports evidence-based practice changes derived from a combination of quantitative and qualitative data, clinical expertise, and contextual evidence.

Methods:

The model was developed using sources identified on searches of Medline, CINAHL, and systematic reviews available on the Internet. Review topics were focused on evidence-based medicine and nursing, research utilization, and change process. Other sources included clinical expertise and quality-improvement information.

Conclusions:

Practitioners need skills and resources to appraise, synthesize, and diffuse the best evidence into practice. Patient outcomes must reflect discipline-specific and interdisciplinary accountabilities. Collaboration between researchers and practitioners within and among disciplines will enhance the diffusion of evidence-based practice innovations.     

Research awareness: managerial challenges for nurses in the Republic of Ireland

timmins f., McCabe c. & McSherry r. (2012) Journal of Nursing Management 20, 224–235
Research awareness: managerial challenges for nurses in the Republic of Ireland Background In spite of the growing body of literature, the reality of getting research into practice remains problematic. Objective The present study aimed to establish contemporary levels of research awareness among nurses in Ireland. Population, sample, setting A random sample of 234 registered nurses (RNs). Methods A self-report survey Research Awareness Questionnaire (RAQ) was used to collect data in March 2005. Results Most agreed (92%) that research can improve patient care and 93% agreed that it is the way forward to change clinical practice. Most nurses’ perceived research as being integral to their role. However, 71% of the nurses within the present study indicated that they had insufficient support and encouragement from peers and professionals. Similarly, 69.2% indicated insufficient support from management. Conclusions Consistent with other countries, nurses in Ireland have a positive attitude towards evidence-based nursing but face many obstacles which include a lack of time, support, knowledge and confidence. Implications for nursing management Nurse managers have a vital role in the use and dissemination of research among staff. It is imperative that nurse managers have clinical expertise, research awareness training, and awareness to promote research-based practice and attempt to provide positive role modelling in addition to protected time for research efforts.