NURS 1547: Critical Appraisal of Data Collection in Nursing Research

This report critically appraises the data collection methods utilized in two nursing research studies examining the impact of smartphone use on nurses and midwives. The report focuses on the data collection aspect of the research methodology, specifically the use of questionnaires. It evaluates the questionnaires' reliability, validity, and credibility through a critical appraisal framework, considering factors such as the suitability of the method, personnel involved, advantages and disadvantages, ethical considerations, and accuracy. The analysis highlights the strengths and weaknesses of the chosen method, including its efficiency in collecting data from large samples, the expertise of the personnel involved, and the potential for bias. The report concludes by assessing the overall validity, credibility, and reliability of the data collection tools, offering insights into the trustworthiness of the research findings and their implications for evidence-based nursing practice. The report also discusses the importance of critical appraisal in determining the usefulness of research data.

Running head:NURS 1547
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Name of the Student
Name of the University
Author Note

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Introduction
The medical field is considered to be one of the hardest fields to work in, both for the
physical and emotional toll the job has on the person. The nurses, as well as midwives, work
closely with the patient and thus are considered to be a critical part of the healthcare industry.
They are expected to be role models towards the fellow nurses and the patients, inspiring
them to be healthy. However, like most of the public, they are prone to using current
technology such as smartphones which may affect their work. In the two studies conducted in
China and Australia, the researchers focus on the effect of smartphone use in registered
nurses and midwives, respectively (Wanget al. 2019 and Lewis et al. 2019). However,
conducting studies alone is not enough to determine the practicality of research data; it has to
be practically applicable and trustworthy. This report aims to focus on the Data Collection
aspect of the research methodology and critically appraise the selected area to determine its
reliability, validity and credibility of the method utilized, provide alternatives if required and
shed light on the importance of conducting a critical appraisal of obtained research data.
Main Body
Need for Research and Evidence in Nursing
The profession of nursing directly relates to providing healthcare to those who need
them. Thus they must know what they are doing and are completely aware of their actions
and the consequences. There is a steady flow of new information every day, and healthcare
professionals must be entirely up to date with the current research and findings. This enables
them to give the best care they can. Periodically taking a look at peer-reviewed articles can
increase understanding, and being informed about new ailments, diagnosis methods, as well
as treatments, can be critical in a healthcare setting (Northeastern State University Online,
2020). This can increase efficiency and thus have better outcomes. Nurses must base their

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work on current research findings that are unbiased and practically applicable. This involves
Evidence-Based Practice (EBP) which is vital in healthcare practice as it enables optimal
patient care. EBP is primarily based on research abilities. The nurses have a better
understanding of research in order to make use of peer-reviewed articles to the fullest extent.
It has been reported that many nurses do not have the necessary knowledge to successfully
find and utilize the data that will aid them in their work. The nurses who have a better
understanding of the research tools have a more positive attitude towards research and EBP,
thus having a clearer view of current medical status (Keib et al. 2017). Having a better
understanding of types of evidence is also crucial as it enables the healthcare professional to
avoid scenarios or procedures that may cause complications, as stated in the past. It informs
them about newfound side effects and ailments to be careful of.
Element of Choice (Data Collection)
The current report focuses on the element of Data Collection in both the studies where
observations were made on the impact of smartphone and social media use amongst nurses
and midwives. The data was collected via questionnaires in both cases. In the first study, the
questionnaire consisted of 41 questions (Wang et al. 2019) while in the second study, the
questionnaire consisted of four main questions (Lewis et al. 2019). Questionnaires were
chosen as they allow data collection with relative ease from a large sample size as in the first
study (Wang et al. 2019), where around the questionnaire was distributed among 1100
participants. The data can be collected simultaneously from many sources and they can be
carried out at a relatively low cost and thus is very practical (Ponto 2015).
Critical Appraisal of Data Collection Tool
The skill of critically appraising a study is essential as it sheds light on the credibility
of different studies and determines whether the results can be used to make an informed
decision or not. Tools used for critical appraisal promise to highlight the validity of a study

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and how reliable it is. This is important to assess the quality of a report or research
paper(Unisa.edu.au, 2020). Critical appraisal of a particular study depends on issues or
questions raised on different elements of the study (Dunemn, Roehrs and Wilson 2017). The
issues regarding the aspect of Data Collection was formulated per the Critical Appraisal
Framework by Pam Moule (Study.sagepub.com, 2020). They are as follows-
 Is the method suitable for use in the current sample and is it efficient?
 Was the data collected by suitable personnel?
 Did the paper mention the advantages and disadvantages of the method?
 Were the participants safe from any physical or emotional harm?
 Is the tool accurate or biased?
According to the first issue, this form is suitable for conducting a data collection
amongst a large sample size prone to have differing opinions. Using questionnaires is a good
idea to keep track of all those opinions in a quantitative manner. Especially in the case of the
first study, the data collection was done throughout eight conferences and one continuing
education program where 1100 questionnaires were distributed in total (Wang et al. 2019). In
a sample size as large as this, other procedures such as interviews would require extensive
time and would not be feasible. It is not feasible in the second case either (Lewis et al. 2019).
The significant advantage of this method in the context of the sample is the organization and
rapidity of surveys. The questionnaire is an excellent choice to use in the current scenario as
it does not need to credit anyone else. The researcher does not need any specialized training
to collect the data since by using a questionnaire. The clear advantage is that the
questionnaire is a relatively easy way to collect data. The effectiveness can be increased by
reviewing previous literature as done in both the cases and specifically in the second study
where the development of the questions was done from analyzing the previous work of the
author (Lewis et al. 2019). The disadvantage of this of the tool in this issue is that it is also

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harder to monitor, unlike an interview. As a result, some subjects may submit partially
answered questionnaires as happened in the first study, where only 658 people returned a
fully answered questionnaire out of the 1100 questionnaires that were initially distributed
(Wang et al. 2019). This resulted in a 60% answer rate.
Reflecting on the second issue, the data was collected via a questionnaire. Eight
registered nurses were in charge of coming up with suitable questions and surveying for the
first study (Wang et al. 2019). In the case of the second study (Lewis et al. 2019), five
qualified midwives were in charge of data collection. In addition, an observer was appointed
to keep notice of non-verbal cues of the attendees of the focus group and record the needful.
Thus it is safe to say that the person who conducted and took charge of the questionnaire and
survey were fully qualified and had sufficient expertise to conduct the research. The
advantages in this aspect are that all the personnel were experts in their respective fields
(nursing and midwifery) and thus could be trusted to come up with the proper questions to
efficiently collect the relevant data while keeping the questionnaire concise and organized.
They are capable of acquiring the required information without creating an overload with
background data. The potential disadvantage may be the possibility of missing out possible
points, even though the chances are slim.
In light of the third issue, the advantages of the method were not clearly stated in
either of the papers. The positive aspects of using a questionnaire could be guessed but not
explicitly mentioned in the papers. The disadvantages of the method were touched in the first
study but not explained in detail. The limitations were mentioned in aspect to the discrepancy
in reliability due to the use of self-administered methods such as the questionnaire. The risk
of bias was also highlighted (Wang et al. 2019). However, the second study did not mention
the disadvantages at all. This is a huge negative point as a study should always shed light on
the pros and cons of using the research methods they adopt.

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Considering the fourth issue, the first study clearly states that it gained approval from
the Biomedical Research Ethics Committee for conducting this research. It mentions that the
aspects of this research were clearly explained to the participants so that they could
understand the whole concept. It was mentioned that participation in the survey was
voluntary, and anyone can walk away at any point in the process. The questionnaire was
made fully anonymous to protect the identity and personal opinions of the participants and no
personal social media information was used. Only overall data was submitted rather than
individual data (Wang et al. 2019). In the second study, the clearance was obtained from the
Women and Newborn Ethics Committee. The survey was carried out at a tertiary care
hospital in Western Australia were the midwives who participated in the survey consented to
the conditions of the research verbally (Lewis et al. 2019). This vividly implies that all the
participants were a part of the research voluntarily and no one suffered any physical or
mental damage. The advantage of clearly stating these points is that it proves that the data
was given willingly without inflicting any harm on the participants and is morally sound. It
also shows that the responses are real and not coerced or fabricated.
In reference to the fifth issue, the aspect of using a questionnaire has its perks in
regards to accuracy. While it can not be promised that it is a perfect way, a questionnaire has
the advantage of being more informative in terms of accuracy. Expecting that the subjects
answered truthfully, the answers promise a pretty good idea of what the consensus is and thus
is effective. The advantage of this procedure in regards to accuracy that is it distributed
amongst a large sample and effectively organizes collected data. The disadvantage, however,
is that it has the risk of being biased as not everyone submitted the full response. There was
only a 60% response rate to the first study, as mentioned above. The accuracy of this method
is also under particular criticism because not everyone will submit an honest response.
Another risk is that they might discuss the contents of the questionnaire amongst themselves

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and their opinions might be swayed by their peers, causing a chance of biased responses. So
the responses may not represent the accurate data. It is also possible in the first study, only
the nurses who actively used social media were inclined to answer, as the topic interested
them rather than people who were not that familiar with social media.
Validity, Credibility and Reliability of Data Collection Tool
In light of the above issues, it is possible to make conclusions about the credibility,
validity, and reliability of the papers. In terms of data collection tools, validity is referred to
as the extent to which the tool measures what it aimed to measure. Credibility is defined a the
extent up to which the obtained result is believable and thus can be used as the basis of
clinical work. Reliability, on the other hand, is how much the research can be repeated to
produce similar results, that is the reproducibility of the said work. Higher the consistency,
the more reliable is the result.
There are a few types of validity that can be considered. In terms of research, the
focus is on content validity. The term content validity refers to how much the tool
successfully obtains the information that it is supposed to measure (Melnyk and Fineout-
Overholt 2011). In the first study, face validity was already determined by the registered
nurses involved in the process. The questionnaire collected data regarding the nurses
acquiring and sharing medical facts and practices on social media, as well as using it to
interact with their patients. (Wang et al. 2019). The questionnaire was detailed enough and
enabled the researchers to obtain the necessary information. In the case of the second study,
the questionnaire provided information on how using smartphones have affected the work of
the midwives, their relationship with the mothers in their care. It also sheds light on how
women using phones while in the labor ward can affect their delivery and the work of the
midwives. (Lewis et al. 2019). Overall, it covers the aspects on which this paper focuses on

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to a considerable degree. So in both cases, the content validity of the methodology seems to
be sound.
In terms of credibility, both studies were done in clinical settings. The first study takes
place in eight nursing conferences and one continuing education program The process of
convenience sampling was used to select nurses who were above 18 years. In the second
case, any willing nurses were selected from a tertiary care hospital in West Australia. The
questionnaire method in the first study was anonymous, which is considered to be more
credible as the participants are more likely to give honest answers when they know they
would not be crossed for any responses they give. So the methodology adopted in the first
paper appears to be credible (Wang et al. 2019). In the second paper, the midwives were
invited to participate via a poster, a newsletter, and word-of-mouth (Lewis et al. 2019). Since
the participants volunteered themselves, it is expected that they will provide honest
responses, thus making the methodology and, therefore, the data credible.
In terms of reliability, the first study conducted two rounds of data collection (Wang
et al. 2019). Apart from that, there is no information or indication of whether the data in
either of the papers is reproducible or not since there is an evident lack of such surveys
conducted among nurses as well as midwives.
The only alternative that could have been possible in such study methods is interview
instead of questionnaires, which would have been more personal and maybe more detailed.
However, considering the time required to conduct personal interviews and also the relatively
less anonymous nature of them, it can be believed that the authors chose the best tool for data
collection.

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Evidence-based Practice and Hierarchy of Evidence (HoE)
The term Evidence-based practice with respect to nursing can be described as taking a
clinical approach based on solid evidence, for example noticing a deterioration in condition
after doing a procedure in a certain manner and taking measures in order to avoid that setback
next time. According to some researchers, Florence Nightingale was one of the first people to
practically apply this concept. It is drawn from the fact that medical decisions should be taken
based on prior evidence (Mackey and Bassendowski 2017). In modern days, there are ample
resources available to draw evidence and learn from. In this context, it is also essential to
determine what is the strength of a particular type of paper. Different types of reports are
ranked differently, which signifies the hierarchy of evidence. Even though it has proved
important in determining the ranks of the papers, the hierarchy of evidence has been
criticized. It has been said that it does not clearly state the key terms in order to rank the
studies properly and also does not take into account the safety aspect of clinical studies. The
safety and ethical values of papers in the medical field are essential and cannot be measured
in terms of HoE.
Research Design and Position in HoE
In this report, both the studies were cross-sectional studies where observations were
made on a specific population to draw a conclusion on the topic in hand. The evidence
obtained is considered to be observational evidence. Evidence from cross-sectional studies is
often considered to be at one of the lowest levels in the hierarchy. The evidence is based on
handing out questionnaires and conducting effective surveys is collecting data but it is
difficult to determine how valid the data is (Health Knowledge, 2020). This type of data is
important to find a consensus but not very convincing in terms of evidence unless several
similar studies are conducted. Personally, it does not help in practice without enough
reproducibility.

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Findings of Selected Articles
In the first study, the results indicated that all the responders were active on social
media with 84.4% believing that it positively impacted their work. 93.5% of them used
WeChat, mostly to send and receive worktexts, reading the news and passing the time.
Around 56% of the subjects spend nearly three hours on social media. A majority of them
followed at least one medical account and reposted clinical facts. Around 67.2% of them talk
about work-related topics. Over half of them had the experience of a patient sending them a
friend request. Out of all the subjects, 7.6% responders admitted to posting patient
information online sometimes. However, a high 50.3% of subjects informed of seeing
inappropriate posts from coworkers (Wang et al. 2019).
In the second study, the use of phones by the women in the birth suite was discussed
by the midwives. The results were discussed in terms of consent, where the midwives
believed that they had the authority to instruct the women not to film or to turn it off. Next
was the point that if the woman was immersed in her phone, she was not entirely in the
moment and it also resulted in delaying care by the midwife. Another aspect was the women
keeping in contact with the close family members which, despite being helpful for the
women, may sometimes lead to unwanted opinions by members who are not there. It may
lead the woman being swayed by the opinion of others in decisions she must take herself
(Lewis et al. 2019).
Both of the above findings shed light on the impact of using mobile phones in a
clinical setting. This can help in coming up with necessary decisions about mobile phone
usage in a hospital setting, namely whether the nurses should post work-related content or
not, whether they should use social media during their shift hours or in front of patients and
whether they should be communicating with patients via social media. Similarly, there should
be a clear boundary on how a mother is allowed to use her phone during labor or not, based

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on whether the midwife is comfortable with being filmed and whether using the phone is
hindering care. It is a matter of pros and cons. Personally, I think using social media as a
nurse does have benefits, but it should be used with caution and there should be specific
guidelines regarding that. It is also important to highlight the harms of spreading false facts,
especially by a professional, so every information should be fact-checked before posting.
Conclusion
From the above essay, it can be concluded that critical appraisal is essential in the
medical field in order to successfully incorporate new knowledge into practice. The data
collection tool (questionnaire) was critically appraised for both the cases in order to
determine the validity, credibility, and reliability of the methodology with the help of the
Critical Appraisal Framework by Pam Moule. This essay also informs about the importance
of Evidence-Based Practice and the concept of the Hierarchy of Evidence. Both the studies
successfully conducted surveys on the selected demographic and arrived at plausible
conclusions regarding the use of social media and smartphones in a hospital setting,
elucidating on the advantages and disadvantages of it. So each clinical facility should assess
the pros and cons and come up with their own guidelines in order to optimize patient care.

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Reference
Dunemn, K.N., Roehrs, C.J. and Wilson, V.L., 2017. Critical appraisal and selection of data
collection instruments: A step-by-step guide. Journal of Nursing Education and
Practice, 7(3), pp.77-82.
Health Knowledge (2020). The hierarchy of research evidence - from well conducted meta-
analysis down to small case series. [online] Available at:
https://www.healthknowledge.org.uk/public-health-textbook/research-methods/1a-
epidemiology/hierarchy-research-evidence [Accessed 12 Feb. 2020].
Keib, C.N., Cailor, S.M., Kiersma, M.E. and Chen, A.M., 2017. Changes in nursing students'
perceptions of research and evidence-based practice after completing a research
course. Nurse education today, 54, pp.37-43.
Lewis, L., Barnes, C., Allan, J., Roberts, L., Lube, D. and Hauck, Y.L., 2019. Midwives’
perceptions of women’s mobile phone use and impact on care in birth suite. Midwifery, 76,
pp.142-147.
Mackey, A. and Bassendowski, S., 2017. The history of evidence-based practice in nursing
education and practice. Journal of Professional Nursing, 33(1), pp.51-55.
Melnyk, B.M. and Fineout-Overholt, E. eds., 2011. Evidence-based practice in nursing &
healthcare: A guide to best practice. Lippincott Williams & Wilkins.
Northeastern State University Online (2020). Why Do Nurses Need Research? | NSU Online.
[online] Available at: https://nursingonline.nsuok.edu/articles/rnbsn/why-nurses-need-
research.aspx [Accessed 11 Feb. 2020].
Ponto, J., 2015. Understanding and evaluating survey research. Journal of the advanced
practitioner in oncology, 6(2), p.168.

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Study.sagepub.com (2020). Critical appraisal framework | SAGE Companion. [online]
Available at: https://study.sagepub.com/moule6e/student-resources/additional-material-on-
critical-appraisal-and-literature-searching/critical-appraisal-framework [Accessed 11 Feb.
2020].
Unisa.edu.au (2020). Critical Appraisal Tools - Research - University of South Australia.
[online] Available at: https://www.unisa.edu.au/research/Health-Research/Research/Allied-
Health-Evidence/Resources/CAT/ [Accessed 11 Feb. 2020].
Wang, Z., Wang, S., Zhang, Y. and Jiang, X., 2019. Social media usage and online
professionalism among registered nurses: A cross-sectional survey. International journal of
nursing studies, 98, pp.19-26.