Nurse 440 Issues and Trends in Nursing

Professor question:

Describe quantitative research designs that are used to support changes in nursing practice. Choose one and explain why you chose it. Give an example of how this research design is used to drive change in nursing practices.

1 Gustavo:

The quantitative designs are important because it shows the relationship between experimental and non-experimental data (p.150).  Experimental designs show the causality of the item being examined, and nonexperimental designs are used to describe phenomena in detail, explaining the differences among variables, and having a prediction among variables (p.150).  There seems that a combination of these two designs are used in a lot of research to that eventually becomes evidence-based practice.  The one that is the biggest driver of this research is the nonexperimental design. 

The nonexperimental design has the most use in nursing practice due to how well a study can utilize this design.  In the study by Solvik & Struksnes the nonexperimental design is used to show the experience nursing students have before and after clinical practice.  The study compares the student’s degree of satisfaction with the learning taking place, the relevance of it before and after practice among other things (p.2).  This is a good example of nonexperimental designs due to the comparisons of the students before and after clinicals. 

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2 Kristopher

Nursing is a dynamic practice that necessitates changes to improve the quality service that clients and patients receive. Qualitative research designs are applied in diverse ways to support changes in nursing practice. Some of the qualitative research designs that are used to support changes in the nursing practice include grounded theory, phenomenology, narrative inquiry, and ethnography (Stiensta, 2015). I will discuss phenomenology in this discussion as an essential qualitative research design that can be used to support the changes in nursing practice.

Phenomenology qualitative research design is applicable in specific situations when formulating and implementing changes in the nursing practice. According to Chesnay (2015), phenomenology research design is a methodology that attempts to explore people’s experiences, sensory perception, and understanding. Nursing practitioners need to understand their patients from different perspectives. In turn, they can use the research design to use the information they gather to make the necessary changes that would prove to be more effective to the patients and in the overall delivery of quality services. Phenomenology also helps in observing persons that are considered unusual in one way or another (Stiensta, 2015). For example, phenomenology research design can be used to find out a specific health problem that faces patients; as a result, an effective strategy may be formulated and implemented to save the situation or mitigate a certain health care problem. All necessary changes in the nursing practice have to be made objectively and strategically. 

In conclusion, phenomenology qualitative research design is essential to understand patients. All patients visit health care centers expecting quality services. Nurses have to rely on empirical and evidence-based researches to understand some health care problems and challenges and address them properly by initiating the necessary changes.

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Professor question

What is the difference between statistical significance and clinical significance? Explain why statistically significant results in a study do not always mean that the study is clinically significant. Provide an example.

1 Kimberly

Statistical significance is when "critical values fall in the tails of normal distributions; when findings did not happen by chance alone"  (Schmidt, 2017, p. 355.) Also, a value of <5% "P0" is to be considered statistically significant since it entails that it did not happen by chance  which makes the study reliable (Ranganathan, 2015.) Whereas, clinical significance  refers to the "magnitude of the actual treatment effect (i.e., the difference between the intervention and control groups, also known as the "treatment effect size"), which will determine whether the results of the trial are likely to impact current medical practice"  (Ranganathan, 2015.) One example is a study conducted to patients with advanced pancreatic cancer. They were randomly picked whoever would receive erlotinib plus gemcitabine medication versus gemcitabine medication alone. In the study, patients taking the combination medication has a prolonged survival rate of 3.8% which equates to 10 days, hence making it statistical significant since the cut off is 5%. And the clinical significance would be, the treatment, having a positive effect and improvement in survival rate. But the findings in this study did not make the cut to be too relevant to impact current medical practice hence, making it just statistically significant but not clinically significant. (Ranganathan, 2015.)

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2 Hannie

Clinical significance is referred to as practical significance.  Clinical significance targets how beneficial and meaningful are the results to the patient.  Clinical significance is more concerned about how the data are used to promote a positive patient outcome.  Statistical significance is a function of the size of the sample or group. The larger the sample group will decrease random error.  It is important to remember that the larger the sample group the more costly the study. If a research result is considered to be true, then it is identified by researchers with a p value.  A predetermined p-value set at let’s say p< 0.001 indicates that statistically there is false result due to chance that is less than 1 in 1000.  Statistical significance is based on probability. Statistical significance culls out matter of chance and determines the real effect of the intervention. Clinical significance is subjective, and the results are based on treatments that are beneficial to the patient (Thompson, 2017).  Research ought to be viewed beyond just statistics.  Clinical research is more patient focused.  It tells how meaningful or effective the research will be to the patients.

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