A CRITIQUE OF THE PDA RESEARCH ARTICLE. Kylie Bouphaphanh, Marilyn Butler. Ferris State University

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1 Running head: PDA ARTICLE CRITIQUE

A CRITIQUE OF THE PDA RESEARCH ARTICLE Kylie Bouphaphanh, Marilyn Butler Ferris State University

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Abstract The text book, Nieswiadomy taught the students how to critique nursing research information. Critiquing was done by providing evidence, support, and analysis of each section of the research article (Nieswiadomy, 2008). This paper critiques the PDA article, “The Use of Personal Digital Assistants at the Point of Care in an Undergraduate Nursing Program, (Goldsworthy, 2006). The research study in this article, involved undergraduate BSN students by using the Solomon-Four Group Design (Nieswiadomy, 2008, p. 155).

Keywords: PDA=personal digital assistants, Critique= to assess the strengths, and weaknesses of a study, Self-efficacy=is the belief in one’s capabilities to organize and execute the sources of action required to manage a prospective situation. Solomon-Four Group Design= Two groups as control groups and two groups as experimental groups. Evidence, support, and analysis.

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A Critique of the PDA Research Article As nursing students we are learning how to critique a research study by using Nieswiadomy as the reference. In the article we are critiquing, “The Use of Personal Digital Assistants at the Point of Care in an Undergraduate Nursing Program” (Goldsworthy, 2006). The research study in this article used undergraduate BSN students; the researchers provided two groups of nine students with a PDA as the experimental groups, and two groups of nine students as the control group, which used the standard paper resources available to them in the clinical settings. This paper will analyze the strengths, and weaknesses, in their research study techniques. Nieswiadomy states, “There are five important questions the researcher should ask in the process of collecting data. What, how, who, where and when the data will be collected.” (Nieswiadomy, 2008, p. 214). This paper will attempt to critique the researchers documented findings based on Nieswiadomys’ guidelines (Nieswiadomy, 2008, p. 379-387). Purpose and Problem Evidence The Use of Personal Digital Assistants at the Point of Care in an Undergraduate Nursing Program research article was the tool used for our research article critique paper. There was a section titled “Research Questions” (Goldsworthy, 2006, p. 139). We believe that this was where their problem statement was found, and it was not a single declarative statement, as it was not a single statement declaring what their research purpose was. We believe that it was an interrogatory sentence, as it does ask some direct questions.

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Evidence In the problem statement they acknowledged some variables, and found gaps in other PDA nursing research, but it did not list what the gaps were. Some of the questions that they had identified, would not be explored because of limited availability of the needed PDA types, this was another variable. They did identify their research population to be second year BSN students working in a medical surgical area (Goldsworthy, 2006). We did not find any indication of what empirical data would be identified; they did not explain what scientific method they used to get their knowledge in the problem area. The article did state that due to unavailability of specialized PDA tools, they would limit their research. This was part of their evaluation of how feasible it would be to address all of the questions that they had identified. The significance to nursing was identified in this section by the use of the PDA to improve the students’ preparation and giving of medications using the PDA devices, but it did not explain what the students’ self-efficacy was, but stated a goal to enhance it (Goldsworthy, 2006). Support We support the above statements with the knowledge we gained from (Nieswiadomy, 2008, p. 80-84). “A problem statement must include four things to be complete.” First it must be written in an interrogative sentence form. This article did post the information in question form. Second it must include the population; it did identify the student nurses as their population. Third the problem should include what the variables are, they did include some variables. The fourth

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and last, was the empirical data testable? This section of their paper did not address this issue (Nieswiadomy, 2008). Analysis We believe that the problem section of this article was not complete as it did not have all of the information needed to make it complete. We have stated specific information in the evidence section related to this. Review of Literature Evidence The researchers in this study of the PDAs did indicate the information needed for this experiment. They presented the purpose of the information that was appropriate for the study. The authors referred to their reference list in this research article. The information incorporated in the use of PDAs were time savings, ease of use and portability; replacing traditional note taking, paper files, and hunting for a text, or up-to-date information. It also indicated that an earlier comparative study compared handheld computers with traditional methods of documentation and found that “PDAs saved time and reduced errors” (Goldsworthy, 2006, p.139). At the end of the literature review, there was not a heading pertaining to self-efficacy, only a definition was provided. Support The references the articles listed were from 2001 through 2005. The articles used for this research were listed as the primary source. The information cited in the article was listed as part of the reference.

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Analysis The literature review section of this article it had a good flow for the reader to follow. However, not enough information was presented for a comparison to validate the study. The research articles were mainly from the primary sources. Some of the articles were noted to be from 2001-2005. Quantitative research requires that it is important to “obtain information from the articles within the last five years” (Nieswiadomy, 2008, p.100). The references used in the literature review were older than five years. The supporting information for the use of the PDA was presented, but the data lacks opposing information. The guidelines from Nieswiadomy were partially followed; the article showed direct quotes and paraphrase in the content. Theoretical/ Conceptual Model Evidence This article did not explain the role of the model they chose being self-efficacy, and there was not a heading specific to the nursing role model chosen. They did not explain why this theory was the best one for this study. They also expected that all readers would know what the self-efficacy model was and how it applied to this research study. When the research results were summarized they mentioned the word self-efficacy but did not explain how the study applied to this model (Goldsworthy, 2006). Support The theoretical framework needs to be a basic explanation of how the research concept and the single chosen theory work together (Nieswiadomy, 2008, p.111). In the book, in chapter

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seven the only mention of the theory of self-efficacy is found on page 117, but it does not explain what the theory is or how it functions (Nieswiadomy, 2008).

As readers of this article we do not know what their theory was, or how it applied to the PDA research (Nieswiadomy, 2008). This article did in the literature review section give a definition of what self-efficacy is, but did not have a separate heading related to the nursing theory and the research study component. Analysis The article was poorly written, and confusing as information was not placed in the proper heading areas, and important information was not explained appropriately. Hypothesis and Research questions Evidence The hypothesis needed to be written before the research began, it should not have been changed. A hypothesis is usually used in research to present the answer to the question. It would give an explanation, between the independent and the dependent variables (Nieswiadomy, 2008, p. 126). In the PDA article the researchers did not state the type of hypothesis being used or define the two variables that were being tested. The researchers listed two questions, but only concentrated on one question using only parts 1a and 1b (Goldsworthy, 2006). The hypothesis did not give a proper problem prediction as there was no hypothesis. (Nieswiadomy, 2008). Support We believe that this research article did not include the type of hypothesis being examined in this article. The self-efficacy empirical data, t-(test) sample provided the mean results of the two groups, but it was not stated in the problem questions. Or was it predicted as an

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outcome in the problem statement. Therefore, the errors of the empirical data results of the research may be significantly high.

Support “The level of significance for rejecting the statistical null hypothesis should always be stated before data are collected. In nursing, as in many other disciplines, the level of significance is usually set at .05. A significance level of .05 means that the researcher is willing to risk being wrong 5% of the time or 5% out of 100% when rejecting null hypothesis” (Nieswiadomy, 2008, p. 130). Analysis The hypothesis section of this article was weak, because they did not properly state their problem statement and was absent Research (Study) Design Evidence In this article the design that the authors used was an experimental design. In the text “the experimental design,” the researcher have control over the group; however the convenient use of the students for this experiment, (Nieswiadomy 2008, p. 155) makes it a quasi experimental design because it does not randomly select the subjects. So this increased the chance of bias and decreased the control of the study by using the convenient students. This decreased the study’s internal and external validity, and weakens our trust in the results. Support The experimental group was divided into four groups, two groups of nine were the nonPDA (control groups) and the other two groups of nine each were the PDA user groups. Out of

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36 second year baccalaureate nursing students, all were randomly assigned. According to (Nieswiadomy 2008, p.153) the random assignment of the subjects eliminate bias, and the threat to internal validity. Therefore, we support that the experiment was a quasi-experimental design, because there was no previous study to make a comparison to the research. Analysis The researchers indicated that the study was an experimental design, but there was not any evidence of a previous study to make a comparison. The article indicated there was a pilot study but did not make further correlation to this study. The analysis in the experiment indicated the self-efficacy pretest and post-test results of the students with a use of the PDA and non-PDA groups. The results provided the mean score for the post test of the PDA with an increase from 32.539 on the pretest to 36.308 on the posttest. The mean differences equaled 3.77 which indicated a significant increase. In addition, the results of non-PDA posttest mean score was .667 which was significantly lower than the PDA students. The article was weak because there was no hypothesis to guide the study; therefore it lacked a clear direction. Sample and Sampling Methods Evidence The target population was thirty six second year BSN student nurses. The study took place in two Ontario community acute care hospitals. The article does not provide the name of the hospitals (Goldsworthy, 2006). Evidence The students were chosen to be in four different groups with nine students in each. There were two professors; each one had two groups of nine. One group was a control group that had

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written information but no PDA’s, the other group had the PDA’s with the information available in them (Goldsworthy, 2006 p. 140). The probability sampling was used for this study, it was an example of “Convenience Sampling” where people who are convenient, and available were used for the study (Nieswiadomy, 2008 p.197). The article did not mention the name or describe the sampling method used. It did describe who they used and how the groups would be supervised, as well as the breakdown of the control and study PDA groups. We thought using the nursing students in a clinical setting was appropriate for this study. We also thought it would have been a truer study if they had used a larger number of students to do this research. Thirty six nursing students was a very small representation for the benefit or lack of benefit of using PDA’s to save time in the nursing role. The article did not tell of any biases, but the students were being supervised by the instructor who was going to give them a grade, which would decrease the truth of the study. The students would not feel free to use the PDA’s the way they really might have under different circumstances. In the charts there were missing student results (Goldsworthy, 2006, p.140-141), but the article did not list why or what happened to that student’s research. This limits the validity of the research (Nieswiadomy, 2008). Nieswiadomy gives guidelines for listing data in charts or graphs (p.215). Placing a dash for missing data in a chart is correct, but there should have been an explanation for the missing data in the article, but there was not.

Support The use of nursing students was appropriate for a study of PDA use in the clinical setting, this was an example of a convenience sample, “using readily available subjects in a study”

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(Nieswiadomy, 2008 p. 197). The use of the PDA to improve the nurses’ time in a hospital setting verses the written methods that were used, was the purpose of the study. The students worked with patients in the hospital, half used written methods and the other half used the PDA’s. This research was important because nursing is always changing, and with changes we need to find better, quicker, and more accurate methods to help with patient care delivery. Analysis The article did not present the hypothesis or the framework of how the research was to be conducted. Therefore, this research study failed to have a clear direction of how the research was to be conducted. It did not provide the expected outcome of the research. The article was not .complete in all of the information stated in it. The lack of explanation of what happened with the missing student data, takes away some of the validity of the study. Also the small size of the number of students in the study is a poor representation of how well the use of PDA’s would improve a nurse’s delivery of care, so it also limits the validity of the benefit of PDA use. Discussion/ Communication of the Research Findings Evidence and Support The presentation of the findings was presented in both the narrative form, and in figures (tables). This was found in the “Results” section of the article (Goldsworthy, 2006 p.141). Our book tells us that there should be a presentation of data and discussion in a research study article (Nieswiadomy, 2008 p.321). Evidence and Support The discussion of the study was presented as a subjective interpretation of the study’s findings. The article used the “Discussion” heading to document this (Goldsworthy, 2006 p.142).

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The book said that the discussion area was a subjective researcher’s interpretation of the study’s data findings not the actual listing of the data in this section (Nieswiadomy, 2008 p.323). Analysis The evidence in the article was weak because in the tables, there were several blanks without any reason given for the loss of data. The sections were poorly written, and the data results were weak. The article did not document how the communication of their findings was done. But the article was a published article. "The preparation of an article for a journal is a service to the profession as well as a means of obtaining recognition for the author or authors" (Nieswiadomy, 2008, p.342). So by just doing the research and the publication of their findings, it was a service to the nursing profession, even though it may have been poorly written, or lacking in data, it still was a nursing research project and was published. Data Collection Methods Evidence and Support The book states that there are five important questions that should be asked in relationship to data collection, they are “What, How, Who, Where, and When” (Nieswiadomy, 2008, p.214)? The “what” was the collection of data related to the students PDA use, compared to the same number of students that do not use the PDA devices? The “how” was written that they gave a pre test and post test to the 36 students. There was no example of the self-efficacy tool, or did the article describe the tool, so how valid was it? Evidence and Support Listed in the article but not in the “Methods” section, the researchers mentioned that they reviewed other journal articles about PDA’s, but they did not cite them. They did not provide any journal information to show any validity (Goldsworthy, 2006, p.140). The text book said that

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researchers can use preexisting data, such as professional journals (Niewsiadomy, 2008, p.255256). The “who” were the 36 baccalaureate nursing students. There were two professors who each had two groups of nine students, one group with PDA’s, the other group without PDA’s. The “where” was in an acute care hospital, where the students were doing clinical for their nursing training. The “when” was not given to us, we know the article was printed in the CIN May/June 2006, but we do not know when the study was actually done. Analysis Due to the lack of knowledge of the data collection tools and methods, the validity of the data comes into question. Instrument Evidence and Support The article told us that they chose the Hewlett Packard iPAQ, PDA. They did not tell us why this one was chosen. This allows questions about instrument validity. They did not mention if other studies using this device had been done in research. They chose the Elsevier Products software, the researchers stated that they “reviewed several resources” but they do not tell us which ones. The researchers did tell us that this software was capable of providing lab, diagnostic, med book, and reference information. They also told us that it also had medical surgical procedures available to the students. Evidence and Support When they evaluated the data, the researchers said, they could not monitor the PDA med error reduction rates. They wrote that due to the fast clinical pace and only one instructor being available for the eighteen students that this important original objective to the study could not be measured (Goldsworthy, 2006, p.142).

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The article provided the names of the instruments used, as well as telling us that the researchers gave the students a pre and post self-efficacy test. The article documented that journal articles about PDA’s were reviewed (Goldsworthy, 2006, p.139). Analysis This article did not give us enough information about the tools and instruments used to determine if these were the best tools to use, or determine how valid their use was. The article was not complete in all of the information stated in it. The lack of explanation of what happened with the missing student data, takes away some of the validity of the study. Data Analysis (Descriptive and Inferential Statistics) Evidence In the PDA article, (Goldsworthy, 2009) they used the Solomon Four-Group Design which controls for the pre and post test. The pre-post test control group design, controls for all threats to the internal validity (Nieswiadomy, 2008, p. 153). The researchers divided the 36 students into four groups; two groups with PDAs, the experimental group, and two control groups without PDAs, the findings were done by comparing two experimental groups to two control groups. The students were conveniently chosen as sample, this weakens the design. Although, the design for this study indicated the use of a Solomon four group design, this method requires a large sample, and statistical analysis of the data (Nieswiadomy, 2008, p. 155). Therefore, the design used for this study had strong evidence as being a quasi experimental design. Evidence

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A quasi experimental design is one that there is either no comparison group or subjects that are not randomly assigned to groups (Nieswiamdomy, 2008, p. 155). Thus, this indicated the only strength of the study. Support The researchers in this study lacked evidence of the inferential statistics. “Inferential statistics are used to determine the likelihood that the sample chosen for a study is actually representative of the population” (Nieswiadomy, 2008, p. 269). The article did not state the alpha/probability, but provided the results of the research to have a t-test probability of non-PDA student P=0.002 and PDA students of P