A critical appraisal for nursing and medical students is what an article reviews or critiques in other subjects or fields of study.
Nurses and other healthcare professionals leverage research to answer questions about the practice, improve healthcare quality and patient satisfaction levels, generate new research questions, and shape the direction of healthcare policy.
To confront questions relating to policy and practice, nurses need robust, high-quality, valid, reliable, and evidence-based research.
Although research articles published in peer-reviewed nursing and medical journals undergo a rigorous review process to ensure they meet the strict scholarly standards, the fact that standards vary among journals and reviewers mandates independent critical appraisals, critiques, or reviews of the research articles.
Therefore, nurses and medical students need to gain critical appraisal skills as it helps to systematically read and critique research articles, which is the foundation for translating evidence into practice or policy.
In this guide, we take you through the step-by-step process of reviewing a nursing or medical journal so that you can inform your practice or facilitate an evidence-based research process culminating into a systematic review, change/quality improvement proposal, dissertation, or capstone project.
Critical appraisal otherwise referred to as critique or a critical review, is a systematic process that entails assessing the strengths and weaknesses of a specific research study to determine its usefulness and whether the findings are trustworthy, reliable, relevant, and applicable to a specific clinical decision or can be part of a research process.
Critical appraisal of health-related literature and journal articles by healthcare professionals and students is rather a multistep approach that has the following functions:
The process is arduous, given that you must undergo specific steps to critically review a research paper that supports clinical decision-making and evidence-based practice.
Let us assume that you have been assigned to write a critical article review of a journal article or a critical appraisal, and you do not know where to begin. Well, you are not alone.
A critical appraisal, critique, or review of a nursing journal article is not the same as an annotated bibliography.
Most nursing and medical students find the process of appraising nursing journal articles tedious. And they are right. But with the steps below, you can ace the nursing assignment and slay what in the beginning seems like a giant.
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Otherwise, here are the seven steps to get you started on the assignment.
The most obvious step when writing a critical appraisal is to read the assignment instructions. Your professor or instructor will share their expectations, the word count or the number of pages, and the specific aspects to focus on.
Your instructions or prompt might be accompanied by a rubric specifying how the assignment will be assessed and graded. As you read the instructions, take notes to comprehensively critique the research article to the standards expected by your professor or instructor.
You will also know if you have been assigned to critique a specific journal article or if you can select one based on your interests.
Usually, a critical appraisal or a journal article critique is part of a series of nursing or medical school assignments that lead to your final project or a capstone.
If no article has been given, you must narrow your focus to a specific clinical or medical issue, topic, or practice area.
Ensure that you select a topic, issue, or practice area that meets the criteria outlined in the instruction file.
On rare occasions, you will be required to develop a hypothesis, formulate a research question, or come up with a PICOT before critiquing a research article identified based on the same.
You should be very keen to choose the hypothesis, research question, or PICOT question/statement that rhymes with the topic, issue, or practice area you had identified earlier in the previous step.
Ensure that the choice is not influenced by ease but by your comprehension and interest in the issue. Besides, choose something relevant to your career prospects and interest. If possible, you can focus on the most current issues in your area of specialization or practice. Most instructors will require you to share with them your PICOT, research questions, or hypotheses before proceeding to the next step. If there is a need for approval, ensure that you seek the necessary approvals before proceeding to the next step. If there is feedback and you need to tweak anything, ensure that you make the necessary changes and get feedback before you proceed.
If everything is smooth thus far, you need to either use the peer-reviewed scholarly article provided or suggested by your instructor and proceed to the 6th step or do a proper database search for a relevant article.
Remember, a critical appraisal will look at a research article's value, validity, credibility, and applicability to evidence-based practice or clinical decision-making. Therefore, select a journal from a nursing journal or database with a list of A-Z journals.
Set the specific search parameters in the search window, including date range (preferably articles published in the last five years), keywords, your topic or research question, and whether you want articles with abstracts or those in full text.
Your search will yield many articles, and you must use the levels of evidence to determine the article you want based on your instructions.
As you search for the article, please take note of filtered sources of information such as the Cochrane Database of Systematic Reviews, Joanna Briggs Institute, National Guideline Clearinghouse, and AHRQ Evidence Summaries to reduce the time it takes to choose and appraise studies as you make critical clinical decisions. These sources can yield Systematic Reviews, Evidence Summaries, Structured Abstracts, and evidence-based clinical practice guidelines that experts have written in the field who have critically appraised studies and summarized the results.
Also, look for unfiltered sources such as PubMed and CINAHL for primary studies such as RCTs, quantitative, and cohort studies. You can also check landmark studies that significantly influence nursing, allied health, or medicine.
Some specific nursing article databases you can focus on include ProQuest Nursing and Allied Health Source, PubMed, CINAHL with Full Text, BMJ, Cochrane Library, Rational Clinical Exam, Turning Research into Practice (TRIP), and Embase.
Using exclusion and inclusion criteria, you should be able to narrow down to a specific number of articles and then peruse through each to determine if it fits the presented criteria. You can use the levels of evidence and the types of studies to determine the right article that suits your research needs.
If an article meets the criteria set in the instructions, do a full APA or Harvard Citation, download it, and share it with your professor or instructor for approval before moving to the next step.
Perform a critical appraisal of the journal article using the critical appraisal tools we have included as part of this guide.
Critical appraisal entails the systematic identification of the strengths and weaknesses of an article so that you can predict the validity and usefulness of its findings in informing decision-making or good practice.
You must be very careful with how you present the different aspects of the critique. If anything, ensure that your written piece is critical, clear, concise, and logical. The arguments, analyses, and evaluations should portray higher critical thinking, creativity, and logical reasoning levels.
When reviewing the article, here are specific aspects to focus on.
Determine whether the study addressed a clearly focused issue:
Identify the study population
Interpret the results
Assess for Bias
Determine the applicability of the study to practice
After writing your critical review paper, you must take a break from writing. The break is intended to take your mind off the monotony of writing and researching. You will also have enough time to have an objective mindset to help you spot mistakes, omissions, and errors.
After the break, go through the paper from top to bottom, reading it aloud to yourself to spot errors and mistakes. Ensure that you pay close attention to the flow, punctuation, choice of words, tenses, and organization/structure.
You can then use editing and proofreading software such as Ginger, Grammarly, or Hemmingway Editor to address grammatical, punctuation, and stylistic errors and mistakes.
Nursing or medical students must possess high precision, and your instructor expects a spotless paper, to say the least. Therefore, ensure that before you hit the submit button, the format, style, and structure of the paper meet the required standards. If it is double-spaced, ensure that everything is double-spaced in Times New Roman or Arial font size 12 and that the titles and subtitles are well-represented.
Now that you know how to read and critique a nursing research paper let us delve into the structure of a critical appraisal paper.
You will be critiquing qualitative and quantitative studies. Even though the structure will differ depending on the appraisal tool you choose, certain things remain standard and must feature in the critique.
Does the article have a clear and concise introduction?
A hypothesis is a clear statement of what the investigators expect to find and is critical to any research as it states the research question in the form of what can be tested and refuted.
Interpretations of the Findings
To determine if a study applies to practice, you need to:
Implications and Recommendations
Before undertaking a critical analysis, you must be very clear on the types of studies that can generate clinical evidence and how the data analyzed can provide standardized outcomes measurements.
Please note that case reports, case series, case control studies, randomized control studies, meta-analyses, and systematic reviews are examples of quantitative studies as they generate numerical data that can be converted into numbers. Other examples include cross-sectional surveys, decision analysis, and economic analysis.
Several user-friendly tools are available online to assist with developing critical appraisal skills for nursing and medical students. Below is a summary of the tool with links to specific websites that have checklists and guides on critical appraisal. We have categorized the tools based on the type of studies for more straightforward navigation.
Critical Appraisal Skills Programme (CASP) cohort tool
Randomized control trials
Centre for Evidence-Based Medicine (CEBM)
Crowe Critical Appraisal Tool (CCAT)
If you are critically appraising a clinical practice guideline, use the AGREE II tool. You can also confirm with your instructor what specific tools to critique a clinical research article.
Related: How to write a student nurse resume.
Writing an article critique should not be that challenging after defining it, reading the steps, and looking into the structure, template, and breakdown of every other aspect to factor into the journal article critique. As a nursing student, you can use the tools we have explored to make meaningful assessments and write an outstanding paper.
But even with the best advice, you will most likely find the process tedious, engaging, and time-consuming. And if you have shifts or part-time work and studies to balance with your life, you might get overwhelmed. Do not worry, though, because that is where we come in. Our Nursing Paper writers can help you ace or slay your nursing papers. They are experts in writing various papers.
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