Nursing professionals should be able to gather and critically assess the available evidence that can be helpful in their practice. The aim of this paper is to analyze the process of critical appraisal of the literature review and its organization. The paper will also discuss the hierarchy of evidence and how it informs clinical practice.
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Critical Appraisal of the Literature Review
Literature reviews in nursing studies are needed to provide the background for problems under discussion; therefore, it is necessary to ensure that they are conducted with a sufficient degree of academic rigor. Reasons for the appraisal of literature are two-pronged. On the one hand, it is necessary to evaluate the quality of sources used by a researcher. On the other hand, one has to assess the breadth of the review and the quality of synthesis (Grove, Burns, & Gray, 2014). According to Machi and McEvoy (2016), specific areas of a topic under discussion have to be explored from different perspectives. It follows that another reason for the critical appraisal of the literature review is to assess the diversity of scholarly opinions in research and how they are presented by a researcher.
Critical Appraisal Process
The purpose of the critical appraisal is to expand the analytical skillset, better understand a study and its research process steps as well as evaluate the credibility of its findings. It has to be borne in mind, however, that approaches to critical appraisals of quantitative and qualitative studies are somewhat different. Nonetheless, the appraisal process presupposes the following basic phases: identification of research components/steps, evaluation of strengths and weaknesses of a study, and assessment of the credibility of a study’s findings and conclusions drawn by a researcher (Grove et al., 2014). By following these phases, it is possible to ensure the quality of studies underpinning clinical practice.
The Hierarchy of Evidence
An article by Costantino, Montano, and Casazza (2015) on the hierarchy of evidence is indispensable for improving one’s understanding of the relevancy of academic literature for research purposes. Modern nursing requires external validation, which lies at the basis of evidence-based practice. Therefore, to arrive at reliable sources of evidence, it is necessary to evaluate the ranking of studies. The student has learned from the article that randomized clinical trials (RCT) are the best types of studies to be used for assessing the efficacy of clinical interventions. When it comes to diagnosis, it is recommended to use studies with a cross-sectional design. Systematic reviews are studies with the highest level of evidence (Costantino et al., 2015).
Absence of Evidence
The practice of evidence-based medicine (EBM) presupposes the “judicious use of current best evidence in making decisions about the care of individual patients” (Fontelo, Liu, & Uy, 2015, p. 157). Therefore, nursing practitioners are befuddled by situations in which necessary evidence is not available. It should be remembered that a clinical intervention taken without solid evidential support is more likely to harm a patient that it is to help them. Taking into consideration the fact that approximately 19 000 RCTs are published annually, it can be argued that the paucity of evidence can be attributed to the lack of research skills (Tunis, 2013). It follows that in the absence of evidence, it is necessary to reconsider one’s approaches to research and make the best use of the existing evidentiary base.
The paper has discussed the process of critical appraisal of literature reviews and their application to clinical practice. It has been argued that nursing practitioners should be able to understand the key steps of both quantitative and qualitative studies as well as to discern their depth and breadth.
Costantino, G., Montano, N., & Casazza, G. (2015). When should we change our clinical practice based on the results of a clinical study? The hierarchy of evidence. Internal and Emergency Medicine, 10(6), 745-747.
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Fontelo, P., Liu, F., & Uy, R. C. (2015). How does evidence affect clinical decision-making? Evidence-Based Medicine, 20(5), 156-161.
Grove, S. K., Burns, N., & Gray, J. (2014). Understanding nursing research: Building an evidence-based practice. Frankfurt, Germany: Elsevier Health Sciences.
Machi, L. A., & McEvoy, B. T. (2016). The literature review: Six steps to success (3rd ed.). Teller, Canada: Corwin.
Tunis, S. R. (2013). Lack of evidence for clinical and health policy decisions. BMJ, 347, 1-12.