The Role Transition Of Nurses

Published Date: 02 Nov 2017

WARNING: This Essay Has No Title!

Qualitative Research Critique

The research article named "The Role Transition of Nurses in a University Teaching Hospital in Pakistan". The purpose of this paper is to provide critical appraisal of the research process. According to Burns & Grove (2007) "nursing research is… systemic process that validates and refines existing knowledge and generates new knowledge that directly and indirectly influences nursing practices". To judge limitations, significance, strength and weakness of a study or research, one should review all the aspects of that study comprehensively.

and Abstract:

The title is depicting the study content. Only the phrase "experiences of nurses in teaching hospital" have made it more focused and informative. Moreover, authors are doing qualitative study, by taking nurses perceptions on the basis of their experience. However, by adding the city name Karachi Pakistan would have specified the study setting. It is simple for the reader to decide about the topic by reading the name of the article. This title has 12 words which defines the setting that where the study has been conducted. According to Pilot & Beck (2006), "research reports begin with a title that succinctly conveys (typically in 15 or fewer words)…. In qualitative studies, the title normally includes the central phenomenon and group under investigation". Research report usually includes abstract which gives readers an idea about the entire article. According to Polite and Beck (2008), some journals have moved from traditional abstract which single paragraph is summarizing the main features of the study to a structured abstract by giving specific headings.

Although, the abstract of the study is not presented in a traditional format, no headings are mentioned but given a quick brief overview of the study. According to Burns & Grove, (2007), abstract should be the limited to 100-250 word and should give the gist of the study which is maintained by the researcher. Whereas, in this article it’s about 65 words but it has explained the overall reflection of the article. It includes significance of the problem studied, purpose, methodology (grounded theory), and outcome of the study (substantive theory) and highlighted the major themes. Key words are not mentioned, which is often necessary to include as it would help future nurses to locate the study.

The Problem:

The research problem is highly significant to nurses because it is growing concern among nurses in both developing and developed countries, as new nursing graduates are facing difficulties to adjust in their new professional life, even after intense clinical trainings and educational preparation during their school life. The researchers have given the justification for the selection of the phenomenon of interest under the heading of aim. The researchers has not explicitly stated that the study requires the qualitative approach, under the heading of methodology but has not explained anywhere in the article that why this study requires a qualitative format. According to Burns and Grove (2007), in a study, the research problem identifies an area of concern, significance of problem, provides background and outlines need for further study. Similarly, in this article, the researcher has addressed the research problem part. Even though it is not in a form of problem statement but it is explained in whole paragraph under the introduction part where she has mentioned the aims and objectives and strategies how to facilitate smooth transition. But how this study will impact is not mentioned.

In a qualitative study, the specific philosophical orientation of each approach directs the research method. The philosophical approach is primarily an attempt to understand empirical matters from the perspectives of those being studied which serve as the rationale behind the efforts to understand individuals by entering into their field of perception. In this article, although the philosophical underpinning has clearly described however, the researcher is trying to explore the experiences of newly graduates, facing various conflicts during their job roles, directs us for an assumption that the author might be referring to the social and psychological context as stated in the paragraph under the heading of core category.

The limitation of the study is mentioned in the limitation paragraph. There is no separate heading given. Limitation of the study included that there is a possibility that transitional experiences might have overcome or forgotten or participants may felt constraints to provide socially acceptable answer due to researchers influenced, which is strength of the article as researcher has identified her area of improvement. The inclusion and exclusion criteria for recruiting study participants are given under the heading of methodology

Review of Literature:

Researchers not mention about review of literature as a separate heading, but the references which were given are clear complete and interconnected with the content in the study.

According to Polite &Beck (2008), in grounded theory studies, the literature review can be defer and done after data collection and analysis, as the grounded theory begins to take a shape so that the information in the literature may not affect the interpretation of researchers’ findings.

In this article, total of 12 references were used with volume and page number given. These references are relevant, extracted from year 1974- 2005 which consist of both old and new literature. The researchers have used adequate literature which was paraphrased instead of any direct quotes. On source of the literature, Burns & Grove (2007) mentioned that "Current sources are those publicized within five years". In my opinion in this article the researchers have used both primary and secondary sources, but ratio of current and old articles is not balanced may be researchers trying to emphasized that related study has not been done before in Pakistani context. Researcher might be looking for classic ones. The opinions and views facilitated the study to be well-built and assist reader to understand the problem in a wider perspective, and relation to the previous study is obvious and researchers used it nicely in the study. A Tabular form of transition process with various themes and sub categories is mentioned which was self-explanatory. Online data base search strategy for literature is missing. Conceptual definition is also provided in the article where needed (Jamat Khana). Researcher also recommend for future exploration on spiritual care due to nature of the nursing job spiritual distress cause further distress in transitional phase.

Theoretical Frame Work:

In grounded theory researchers integrate sociological values of the individuals, means theories are derived directly from the data, which is grounded in the experience of the participants. As grounded theory is an inductive process makes research more meaningful and generalizable in nursing practice. In this article researcher explicitly illustrate interrelated relationship of conceptual and theoretical framework, through emergent data finding and came up with core categories and sub categories, shows strong relationship of transitional process and its effects on nurse’s personal and professional lives. By Symbolizing sailing forward.

It is mentioned under the heading of methodology that study was conducted in the naturalistic settings (hospital).

Population and Sampling:

Polite and Beck (2008), Grounded theory research is done by using theoretical Sampling. The purpose is to select informant who can contribute to the evolving theory. However, in this article researcher has not adequately described the type of sampling approach used, it’s seems to be a purposive sampling which is an appropriate method for qualitative study design. In this article researcher has provided the sample size 6 of the seven staff nurses but she has neither stated rational for this small sample size nor has she discussed about the sample being a focus group or has been interviewed individually. In the contrast, for grounded theory appropriate sample size is 20 to 60 participants (Creswell, 2008). During Selection of the participants researcher considered the principle of achieving saturation, which is the guiding principle in qualitative study. According to Burns & Grove (2007), Qualitative study design does not require large sample size but if the saturation is obtained then the researcher should stop gathering the data. Saturation is discussed under the heading of methodology.

Lack of variation is observed in the study, I couldn’t differentiate with the verbatim whether the participants are females only or males only. Gender, ethnicity, time frame took to complete the study are not mentioned. Few characteristics of the participants are very well defined like 6 to 12 month experience, diploma graduates from different areas working in the private tertiary care hospital. There was no negative or discrepant case mentioned in the study.

Research Design:

The researcher has used grounded theory qualitative design which is explicable from the title of the study and also mentioned under the heading of methodology. This design is appropriate for the study as researcher were exploring experiences of the nurses in their natural settings. The purpose of using this design is explicitly discussed in the objectives of the study. That she wanted to elicit the process of transition from new nursing graduate to a staff nurse role. She has mentioned the research problem but has not given any research question. Moreover, study could be replicable. But I infer, due to ethnic constraints we cannot generalized the study and author has not given permission for replication.

Data Collection:

The collected data was completely based on human experiences as it’s visible through many responses in the study. The researcher used formal unstructured interview used for the data collection. Unstructured means in depth interview were used to elicit information what people believe and think about the particular topic. The researchers have mentioned other methods of data collection tape recorder, separate notes on non verbal behaviors were also mentioned. However, number of sittings not clearly mentioned which keeps the data gap to find the saturation level of data. However, researcher have not mentioned what language were used (native or foreign) and rational for using these methods. The time for the interview is appropriate (50 to 90 mins). During data collection researchers maintained the confidentiality, remove personal identifiers.

Protection of Human Rights:

For any study design researchers need ethical approval from the ethical committee which is not mentioned in the article. One of the strategies a researcher has used to protect study participants is to conduct risk and benefit assessment. Risk and benefit was very nicely provided to the participants. But it seems that study used, helped the participants to ventilate their feelings to some extent. Therefore, they include voluntary participant in their study, Informed consent taken from each participant prior to interview. Anonymity, confidentiality was very well maintained, discuss under the heading of methodology. There is no evidence found for deception and intimidation.

Data Analysis:

In grounded theory constant comparative method used for data analysis. According to Strauss and Corbin (1998), three types of coding methods are open, axial, and selective coding. An open coding data is a process, broken down into parts to compare for similarities and differences which they were grouped into a category to generate the initial concepts. In axial coding analyst develop systematic categories and link them up with the sub category. This helps them to identify the linking of concepts into conceptual family paradigm. Selective coding is a course of action by which findings are integrated into theoretical concepts. The strategy which was used in analysis of this study was compatible with the purpose of the study, the findings are describe in a well manner within the context and under the heading of methodology and the three categories which was the result of the study were described very explicitly. The findings are presented using the participants’ quotes and the reader is able to understand the essence of the experiences as reported in the findings Fittingness of the research refers to how well the findings fit outside of the study situation. Researcher have followed the all the steps of analysis and maintained the coherence. Raw data well developed and supported with theoretical concepts in the light of literature.

Rigor:

In qualitative study, researchers use different criteria of enhancing the trustworthiness of the study, comprises of credibility, and audibility, dependability is used as rigor. This results criterion helps researchers to derived result from the characteristics of the participants and the study context, not from the researcher biases. (Polite & Beck 2008).The creditability of the data with the focus of the research and refers how the data was well processed, addressed and gained the focus of the readers. In audibility researcher used tapes and transcribed verbatim which was listened and sorted into sub- categories and later into categories which help to maintain consistency and come up with underlying meaning as a theme. As far as, transferability is concerned, researcher is not clearly mentioned, whether the findings are applicable outside the study situation. It appears that it could be replicable, where there is competency based orientation program organized by nursing education services. I assumed primary researcher herself has taken all the interviews, but have not reflected her personal biasness about the topic.

Conclusion and Recommendation:

In conclusion authors have mainly highlighted the future recommendations and challenges facing by the nurses in their personal and professional life. The recommendations which were given by the researchers were relevant to the study and need for future research was also incorporated in the discussion and conclusion. In my opinion, these recommendations are not easy to follow due to shortages of nurses globally. Providing mentorship and preceptor ship for newly graduates, it seems senior nurses are over burden with their own task, so in my point of view, it is very challenging for the experience nurses to give their true mentorship to these novice nurses to get a smooth transition. As I mentioned earlier, the study is transferable but there is a limitation seems in the study in spiritual context which was focused to only one community.

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