Description of the Study
The entire study is well organized and concise. The author uses various headings and subheadings to guide the reader. As such it is easy to skim through the article and evaluate if it has the information that the reader intends to acquire. The article is also devoid of grammar mistakes. The article has very limited use of nursing jargon and as such, it is easy to comprehend.
The title is clear and devoid of any ambiguity. At the same time, the title prepares the reader to understand the content of the article. The title does not employ the use of jargon. The author also keeps the title brief. The title arouses some level of curiosity which is important in making persons who have a glance at the article, create a desire to read the article and decipher the knowledge the author is trying to pass to the nursing profession.
The abstract that is provided by the author is clear and unambiguous. The author does not employ the use of jargon when writing the abstract and as such it is easy for readers to comprehend the message in the abstract. From the abstract the author sets the stage for the reader to know that the article is about midwifery. The author gives an introduction into the theoretical basis of the study as regards the work of midwives (Kinnane, 2009). The author has omitted a brief description of the study design and methods used in the study. As such the abstract is limiting to the readers in terms of evaluating the level of appropriateness of the study to their work without reading the entire research paper.
The author uses the introduction section to outline clearly the purpose of the study. From this section of the research, it is clear that the author will focus on the application of ethics in the practice of midwifery. The author also reviews the relevant literature to outline the reason the research is necessary. The author cites the reviewed literature to the extent of using direct quotations that express the views of the original authors more precisely. In order to introduce the research in a more appropriate manner, the author also gives a description of two scenarios that involve the experience of two different women during childbirth.
It is important to note that the author does not expressly mention the purpose of the article. The author instead leaves this information embedded in the introduction section of the research for the reader to decipher. When this is done in the article, there is a risk of having different readers understand the material differently and as such end up having different interpretations of the same study.
Participants
The article clearly identified the target population for the study. Kinnane (2009), states that the study participants included midwives from three different Australian hospitals located in southeast Queensland. The inclusion criterion is not expressly mentioned in the methodology section of the research. However, it is clear that the author only sort to include midwives who worked in the hospitals located in the region. As such the article excluded any nurse, who was not practicing as a midwife, as well as those practicing as midwives but were from a different geographical area.
The study participants constituted a group of fifteen midwives. Participant recruitment was done through contacting individual midwives as well as through advertisements placed at the institutional level. The author indicates that there were variations in the recruitment method based on hospital regulation on how to contact the staff for research. The author does not indicate whether a sampling method was utilized to recruit participants. However, the number of participants that was used was sufficient. In this type of study, the most important aspect is whether the participants identified have enough experience and if they have encountered enough issues related to ethics in their practice.
The article indicates clearly that consent was sought for the study to be carried out. All the participating midwives were informed about the research project. The article describes the process through which the consent from the participants was sought. The author indicates that the information provided in the study was mainly concerned with research on ethics in midwifery practice. The participants were given an opportunity to seek more clarification as well as have their questions answered by the researcher (Kinnane, 2009). The consent that was obtained was in both oral and written format. Given the nature of the study there was no need to provide any protection from harm as the study did not expose the participants to any harm.
Before engaging the participants, the author indicates that the necessary clearance was obtained from the different ethical committees that were concerned. The author also goes ahead to show that the necessary approval was obtained from the administration of the different hospital where the research was going to take place.
Research Question/Hypothesis
The author does not clearly state the hypothesis of the research nor does the author outline the objectives of the study. However looking at the introduction section of the article the reader can identify the hypothesis as advanced by the author. Ethics is an important part of midwifery practice. Midwives, however, do not have the advantage of the time to think about the application of ethics in their practice. Midwifery demands that the midwives should make ethical decisions as they continue with their fast paced work (Kinnane, 2009). This hypothesis reflects the information that is presented in the literature review.
The variables being studied in the research are not clearly outlined in the article. The author leaves out this information and allows the reader to try to identify the variables by reading the article. The independent variable is the use of ethics in the practice of midwifery. There is no shortcut to ethics, and they need to be applied without being altered for them to be able to play the vital role of protecting midwives, as well as the patients. The dependent variable is the practice of midwifery as it has always been done over the years based on the clinical guidelines that are provided.
Review Methods and Results
The article does not include any other review of literature apart from the one in the introduction. The entire article lacks a section where there is a considerable amount of literature featured. The author does not give an explanation for not including a literature review section. The author indicates clearly that over the recent years, other writers have extensively written or reviewed books on the ethical considerations in the practice of midwifery. The omission of an extensive literature review jeopardizes the work of the author as one cannot be able to ascertain whether the article does provide new knowledge.
The collection of data involved the use of unstructured interviews. The interviews were collected at the convenience of the study participants as regards to time and place. The article also outlines the interview questions that were posed to the participants. The interviews were done in a conversational manner by inviting the participants to give their experiences as midwives. According to Kinnane, (2009), tape recording was done to ensure that there was no loss of data collected during the interview. The use of a tape recorder is also important given that this allows the researcher enough time to listen and engage with the participants while at the same time limiting the loss of data.
The author omits information describing how the instrument of data collection was developed. The author does not indicate whether the instrument was also tested to evaluate its effectiveness and determine whether it elicits the required information. Using an instrument of data collection may end up yielding inadequate data as some of the interview questions may not be clear to the study participants. The testing of the data collection tool occurs in a pilot study. The author does not indicate if such an operation was carried out during the entire research process.
The researcher reviewed the narrative materials as provided by the participants. The understanding of the narratives from the participants drew from the narrative features described by Bruner (Kinnane, 2009). The author undertook multiple listening to the descriptions as provided by the study participants. The author went ahead to develop a thematic coding method that was aimed to enable the author to identify any repetitions that occurred in the interviews (Kinnane, 2009). The author also coded the ethical concepts as presented by the participants during the interviews so as to minimize repetition.
From the description of the data analysis process, as provided by the writer, it is clear that the data generated was significant. The author employed enough measures to limit repetitions in the study results and as such provide reliable data. The methods used to control for repetition were also appropriate for the study. Given that study was descriptive in nature, there was no statistical data that was required. The author obtains the cases from the participants and draws lessons from their experiences.
The author does not clearly express the limitations faced in the study. Instead, the author opts to focus on the limitations of the ethics in the practice of midwifery. A closer look at the article allows the reader to identify some of the limitations that the author could have faced when conducting the study. The first limitation was related to finding midwives who had practiced midwifery for a considerable number of years to have faced several ethical issues. Given that the study involved the provision of narratives from the participants, there is a likelihood that midwives who had worked together would provide similar narratives and hence result in repetition. The provision of a narrative was mainly from memory and as such there is a limitation in terms of how much information the participants would remember and provide the same information to the author.
Article Evaluation
The evidence provided in the article is first hand as the participants who were chosen are midwives who have had to deal with ethical issues in their practice. As such the evidence is directly linked to the hypothesis of the study. The evidence relates to how midwives have had to make ethical decisions as they care for patients in emergency situations. The author carries out a synthesis of the evidence and tries to make logical explanations. The author also links the evidence to the available literature so as to support it using theoretical basis. The author goes ahead to describe the limitations that midwives would face when they tried to apply the evidence as provided in the research.
The research focuses on the deontology aspect of nursing ethics. The author regards the application of nursing ethics in the practice of midwifery as being duty based. Midwives have the freedom to make an ethical, moral judgment as they care for their patients. According to the author, the moral actions of midwives are ends and not necessarily means to an end.
The author does not identify any areas that require further research. As such it is difficult to build on the knowledge since there seem to be no gaps. However, the author opens a debated as to how the application of nursing ethics should take place. For a long time nurses have been portrayed as if they have enough time to make decisions that are ethically beyond reproach (Kinnane, 2009). However, it is important for nursing research to consider how the nature of nursing practice influences the ability of the nurse to make ethical decisions. The area of making an ethical decision based on the nature of practice is a field of study toward which nursing research should focus.
Application in the Clinical Area
It is possible to apply the study results in the clinical area. The author identifies the level of facilitation that is required for nurses to be able to make decisions when they are on the run. The author argues that there is a need to provide the necessary equipments for practicing midwives to allow them to make ethical decisions on the run. The author also acknowledges that making ethical decisions on the run is not an easy task and as such the midwives need to be provided with the necessary support (Kinnane, 2009). From the recommendations that the author makes, it is clear that the outcomes are not only applicable to clinical practice but are also cost effective. The evidence is presented in a very clear and concise manner that is easy for the reader to comprehend and identify what they need to borrow for clinical practice.
The author also helps by identifying the nature of limitations that could occur when the evidence is applied in practice. The article states that at times the midwives might have to engage in some level of harm for the good effect to be obtained. The identification of the evidence limitations is essential as it prepares the nurse on what to expect when adopting the results of the study in clinical practice.
References
Kinnane, J. (2009). Ethics on-the-run. British Journal of Midwifery, 17(1), 30-35.