Critical Appraisal of a Qualitative Study in Nursing Research Module

This report provides a critical appraisal of a qualitative research paper focused on healthcare providers' experiences in caring for children with medical complexity (CMC). The appraisal evaluates the study's methodology, including the appropriateness of the qualitative approach, the clarity of the research question, and the sampling and recruitment strategies. It assesses the methods of data collection, such as interviews and focus groups, and analyzes the ethical considerations, including informed consent and confidentiality. The report also examines the presentation and relevance of the findings, the researchers' reflexivity, and the study's limitations. The student highlights strengths like the sample size and weaknesses such as the lack of audio recordings for individual interviews. The appraisal offers suggestions for improvement, such as verifying interview transcripts and field notes with respondents to enhance the research's rigor. The report references key literature and provides a comprehensive evaluation of the research paper's strengths and weaknesses.

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

1
NURSING
Answer 1
The qualitative methodology selected for this research is appropriate because the aim
of the research is to study the perceptions of the healthcare providers and their experience of
working together to care for children suffering from medical complexicity. Glesne (2016)
stated that the research that is initiated with an aim to study the lived experience of the
participants, qualitative methodology is considered to be appropriate. Qualitative research
undertaken interview helps to understand the underlying emotions of the interviewee and
thereby helping to improve the overall scope of the research. Neubauer, Witkop and Varpio
(2019) reported that qualitative research done with an interview perspective is regarded as a
power research medium in order to explore the challenging problems directed towards the
analysis of the lived experience of the participants. ALL THE PARTICIPANT NAMES
NEED TO BE MENTIONED IN THE ANSWER.
Answer 2
The goal of the research is to explore the experience of the healthcare providers who
are working in the Australian territory, secondary and primary healthcare system while giving
care to the children with medical complexcity (CMC). The conduction of research in this
particular domain is important because the Altman et al. (2018) stated that the healthcare
needs or the mental thought process of the family members of CMC have been studied
extensively. However, no significant study has been undertaken over the healthcare
professionals working in the Australian healthcare system. The relevance of the research is, it
would help to redesign the service of the healthcare and thus helping to improve the outcome
of the care of the children with medical complexity.

2
NURSING
Answer 3
Yes. The authors used purposeful sampling in order to recruit healthcare providers
from different healthcare services having differing experience in CMC. The authors described
in detailed about the characteristics of the participants recruited in the study. After purposeful
sampling, snowballing technique was used to selected further group of participants and the
sampling procedure was ceased when data saturation is achieved. In snowball sampling
research participants recruit other participants for the study (Etikan, Alkassim and Abubakar
2016). Palinkas et al. (2015) stated that purposeful sampling score high in the domain of
selection bias unlike non-probability sampling. Authors also gave valid examples behind the
selection of the inclusion criteria for the research. The authors recruited experienced
healthcare professionals in order to get a detailed perspective of their experiences in caring
for CMC. The recruitment strategy is appropriate to the research as the research entails
conduction of the review over the small group of participants.
Answer 4
The settings of the data collection were justified because it followed all the basic ethical
guidelines of qualitative interview research. The authors used semi-structure interview and
focus group interview format for the collection of the data. The semi structured and focus
group interview format is best suited for the collection of the lived experience of the
candidates (Neubauer, Witkop and Varpio 2019). The entire process of the interview was
audio-recorded. However, the authors failed to highlight the place for the condition of the
interview. The collection of the data occurred in two steps, first approach of the data
collection was focus group interview and the second approach of the data collection was
individual interview. Barnham (2015) stated that detailed illustrations of the process of data

3
NURSING
collection increase the probability of reciprocating identical research. The research how has
failed to justify the exact reason behind the selection of this methodology and this decreased
the overall strength of the research. The researcher highlighted the process through which the
interview was conducted including the time taken for the interview conduction. However,
there is no description of the topic guide that was used for the conduction of the interview.
Lack of topic guide for the conduction of the interview decreases the level of validity and
reliability of the research. The method has not modified during the conduction of the study
and audio-video recorder was used during the process. of conduction of the interview. This
helped to increase the validity of the research.
Answer 5
The researcher critically examined their own role along with potential bias that influenced the
process of data collection along with the formulations of the research questions. The research
question was focused on analysing the perception of the healthcare providers who are treating
children with medical complexcity. Triangulation among the coders with the help of the
consensus and feedbacks of themes to the participants were considered in order to ensure the
research rigour. Gardner et al. (2017) stated that the employment of the secondary coder is
important in order to reduce the chances of the observational bias and thus helping to increase
the validity and reliability of the research. There are no considerable changes in the research
design. There are no specific conflicts of interest in the research design as the themes that are
generated by the primary group of researchers were verified by the use of the participants in
order to avoid confusion and to increase the autonomy of the research. The relationship
between the researcher and the participants has not been considered adequately and this

4
NURSING
might lead to the generation of the biased selection of the candidates and biased evaluation of
the data.
Answer 6
The researchers have maintained a separate paragraph in order to illustrate the ethical
consideration of the research. The potential participants were contacted through integrated
care project manager and he only explained the purpose of the interview and the conduction
of the research. The issues about the informed consent and confidentiality of the study were
also described in details in the research. The approval has also been sorted from the ethical
committee. King, Horrocks and Brooks (2018) are of the opinion that the research involving
human subjects can only be conducted upon fetching the permission from the ethical
committee and proper maintenance of all the ethical standards help to increase the ethical
aspect of the research.
Answer 7
Yes, findings are explicit and are stated clearly in the research paper. The authors also
illustrated the process of theme generation from interviewee response and the characteristics
of the participants. There is also adequate discussion about the evidences that was used by the
authors. Proper used of references of previously published literatures help to increase the
overall strength of the research (Baillie 2015). The credibility of the research findings was
undertaken with the help of respondent validation. The initial themes, that were generated in
the research were further validated by the participants before the final selection of the themes.
Birt et al. (2016) stated that respondent validation occurs during the process of data collection

5
NURSING
when the overall feedback is obtained from the participants about the accuracy of the data
that has been collected and about the interpretation of the data by the researchers.
Answer 8
Yes researcher has clearly identified the rationale of the research even before the
initiation of the research followed by highlighting the implications of practice post result
section. The researcher however, failed to identify the future scope of practice however, ere
successful in identifying the gaps or limitations in their own research. The researcher also
failed to identify the process through which the findings can be transferred to the other
population. The research was conducted over the Australian healthcare practice settings and
thus further limiting the overall globalisation of the results or replication of the same results
under different practice settings (Glesne 2016). The findings are discussed in relation to the
original research questions and the main outcomes of the study were considered.
Answer 9
One of the principal limitations of the study is, although the stakeholder forums were audio-
recorded thoroughly and simultaneously transcribed, the individual interviews and the group-
based interview were recorded as filed notes by the project manager. In relation to these
different perceptions along might have come under the length leading to biased outcome
(Nyumba et al. 2018). One of the strength of the study is the sample size. The interview was
conducted over 103 participants and sample size of 100 is considered to the standard in
nursing research (Chow et al. 2017). The process of generation of themes from interview
transcripts was also mentioned in details under tabular format helping the readers to
understand the approach of inductive thematic analysis (Chow et al. 2017). Thus if I was
asked to conduct the study then I would verify the interview transcript that is transcript in the
written format from the audio-visual format by the respondents. This will be followed by the

6
NURSING
verification of the filed notes taken by the researcher by the respondents. This will help to
increase the overall research rigour through the process of respondent validation.

7
NURSING
References
Altman, L., Zurynski, Y., Breen, C., Hoffmann, T. and Woolfenden, S., 2018. A qualitative
study of health care providers’ perceptions and experiences of working together to care for
children with medical complexity (CMC). BMC health services research, 18(1), p.70.
Baillie, L., 2015. Promoting and evaluating scientific rigour in qualitative research. Nursing
Standard (2014+), 29(46), p.36.
Barnham, C., 2015. Quantitative and qualitative research: Perceptual
foundations. International Journal of Market Research, 57(6), pp.837-854.
Birt, L., Scott, S., Cavers, D., Campbell, C. and Walter, F., 2016. Member checking: a tool to
enhance trustworthiness or merely a nod to validation?. Qualitative health research, 26(13),
pp.1802-1811.
Chow, S.C., Shao, J., Wang, H. and Lokhnygina, Y., 2017. Sample size calculations in
clinical research. Chapman and Hall/CRC.
Etikan, I., Alkassim, R. and Abubakar, S., 2016. Comparision of snowball sampling and
sequential sampling technique. Biometrics & Biostatistics International Journal, 3(1), pp.1-2.
Gardner, A.K., Steffes, C.P., Nepomnayshy, D., Nicholas, C., Widmann, W.D., Fitzgibbons,
S.C., Dunkin, B.J., Jones, D.B. and Paige, J.T., 2017. Selection bias: examining the
feasibility, utility, and participant receptivity to incorporating simulation into the general
surgery residency selection process. The American Journal of Surgery, 213(6), pp.1171-1177.
Glesne, C., 2016. Becoming qualitative researchers: An introduction. Pearson. One Lake
Street, Upper Saddle River, New Jersey 07458. .

8
NURSING
King, N., Horrocks, C. and Brooks, J., 2018. Interviews in qualitative research. SAGE
Publications Limited.
Neubauer, B.E., Witkop, C.T. and Varpio, L., 2019. How phenomenology can help us learn
from the experiences of others. Perspectives on Medical Education, 8(2), pp.90-97.
O. Nyumba, T., Wilson, K., Derrick, C.J. and Mukherjee, N., 2018. The use of focus group
discussion methodology: Insights from two decades of application in conservation. Methods
in Ecology and evolution, 9(1), pp.20-32.
Palinkas, L.A., Horwitz, S.M., Green, C.A., Wisdom, J.P., Duan, N. and Hoagwood, K.,
2015. Purposeful sampling for qualitative data collection and analysis in mixed method
implementation research. Administration and policy in mental health and mental health
services research, 42(5), pp.533-544.