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NUR 6020 (Advanced Nursing Research)

Resources for NUR 6020 students

Assessing Results 

Once you have identified relevant literature, the next step is to assess whether the evidence aligns with your research question and meets the criteria for quality and relevance. A key part of this process is determining what type of study design would best answer your specific clinical or research question. For example, randomized controlled trials (RCTs) are often considered the gold standard for evaluating treatment effectiveness, while qualitative studies may provide richer insight into patient experiences or behaviors.

Most academic databases offer filtering options to help you narrow your results to particular types of studies, such as systematic reviews, cohort studies, or case-control studies. Using these filters strategically can save time and improve the quality of evidence you incorporate into your work. It’s important to critically evaluate each study by examining aspects such as methodology, sample size, potential biases, and the applicability of findings to your patient population or research focus.

In the following section, you will find an overview of common study designs and their strengths and limitations to help guide your appraisal of the literature.

Types of Studies

A Systematic Review is a rigorous, structured review of all relevant studies on a specific clinical question, using pre-defined criteria to identify, appraise, and synthesize evidence.
Strengths: Provides a comprehensive summary of high-quality evidence; reduces bias through transparent methodology; supports evidence-based practice.
Limitations: Time-consuming to conduct; quality depends on included studies; may not reflect emerging research or niche populations.
A meta-analysis is a specialized form of systematic review that uses statistical techniques to combine and analyze the quantitative results of multiple independent studies. By synthesizing findings across studies, it calculates an overall effect size and can provide a more precise estimate of an intervention's impact.
Strengths: Enhances statistical power and precision when individual studies are too small to draw firm conclusions; assesses consistency of effects across diverse populations and settings; helps resolve conflicting findings and may reveal new patterns or generate hypotheses.
Limitations: Quality depends on the rigor and comparability of included studies; results can be skewed by publication bias or heterogeneity in study designs; inappropriate pooling can lead to misleading conclusions.
An RCT is a clinical study design that evaluates the effectiveness of an intervention by randomly assigning participants to either an intervention group or a control (comparator) group. This randomization helps minimize bias and allows for a clear comparison of outcomes between treatments, procedures or care models.
Strengths: Considered the gold standard for evaluating treatment effectiveness; minimizes bias through random assignment; allows for strong causal inferences; highly relevant to nursing practice where intervention-based questions are common.
Limitations: May be costly and time-consuming; ethical concerns can arise when withholding treatment; strict inclusion criteria can limit applicability; may not account for the complexities of patient-centered care in diverse clinical settings.
A cohort study is a type of longitudinal research that follows a group of individuals who share a common characteristic, such as age or exposure status, over a period of time to observe health outcomes. These studies are particularly valuable in nursing and epidemiology for identifying associations between risk factors and the development of disease. Cohort studies can be categorized as either prospective or retrospective, depending on when the data collection begins in relation to the outcome being studied.
Strengths: Useful for exploring causal relationships; can measure multiple outcomes from a single exposure; often more ethical than experimental designs when studying harmful exposures.
Limitations: Resource-intensive; risk of loss to follow-up; not randomized making it more susceptible to confounding variables; large sample sized and long timelines can complicate analysis and interpretation.
A Prospective cohort study follows participants from the present into the future, tracking exposures and outcomes over time. Researchers collect data at regular intervals usign tools like surveys, clinical assessments, or lab tests.
Strengths: Clear exposure-outcome timeline; good for studying incidence. Useful for exploring causal relationships and long-term effects; often more ethical than experimental design when studying harmful exposures.
Limitations: Long duration; expensive; participant dropout is common. Large sample sizes and long timelines can complicate analysis and interpretation.
A retrospective cohort study looks back at existing data- such as electronic health records or medical databases to study outcomes in a group that was previously exposed to a certain factor. Both the exposure and outcome have already occurred at the time of the study begins.
Strengths: Time-efficient; cost-effective; useful when long-term data already exists; no need to recruit new participants.
Limitations: Limited control over data quality; missing or inconsistent data may affect reliability; not all variables may have been recorded for research purposes.
Observes a population at a single point in time to assess prevalence and relationships between variables.
Strengths: Quick amd cost-effective; good for surveys and prevalence estimates; good for generating hypotheses for further research.
Limitations: Cannot establish temporal relationships or causality; susceptible to recall and selection bias; not ideal for studying rare diseases or long-term outcomes.
A study that starts with the identification of persons with a specific condition then compared with a control group who do not have the condition. The relationship of an attribute to the disease is examined by comparing often relying on medical records of and patient recall for data collection. Documenting the frequency or levels of the attribute in each group.
Strengths: Efficient for rare or new conditions; requires fewer participants; helpful when RCTs are not feasible.
Limitations: Prone to recall and selection bias; less reliable in proving causality; can be difficult to match controls properly.
Case reports and case series are descriptive studies that document observations from one patient (case report) or a small group of patients (case series) with similar conditions or treatments. These studies are often used to highlight rare diseases, unusual presentations of common illnesses, unexpected responses to treatments, or novel therapeutic approaches.
Strengths: Useful for identifying rare or new conditions; can provide detailed clinical insight; often the first step in recognizing patterns or adverse events; quick and inexpensive to publish.
Limitations: No control group or randomization; findings are anecdotal and not generalizable; cannot establish causality; prone to publication bias (unusual or successful cases are more likely to be reported).

Qualitive VS Quantitative

As you assess the research literature, it’s important to consider not only the study design but also the research approach: qualitative or quantitative.

Qualitative Research:

Uses words to describe human behaviors. It answers a wide variety of questions related to human responses to actual or potential health problems. The purpose of qualitative research is to describe, explore and explain the health-related phenomena being studied.

Quantitative Research:

Uses numbers to obtain precise measurements that can later be statistically analyzed.  Many quantitative studies test hypotheses.  It follows a systematic, subjective approach to examine the relationship between variables with the primary goal being to analyze and represent that relationship mathematically through statistical analysis.  This is the type of research approach most commonly used in scientific research problems.

Appraise Levels of Evidence

When reading articles and determining which studies to use, appraise the strength and quality of the research studies using the John Hopkins Nursing Evidence-Based Practices which evaluate the validity and reliability thru various levels of evidence. See appendix C for full list. 

Source: Dearholt, S. L., & Dang, D. (2014). Johns Hopkins Evidence-Based Practice Model and Guidelines, second edition : Models and guidelines. Sigma Theta Tau International.

Below you will find tools from Johns Hopkins University, that would help you critically asses studies: