What Is Critical Appraisal? How To Critically Appraise The Study?

Critical appraisal is a method to critically examine research, its value, relevance, and reliability. It is an essential skill in evidence-based clinical, or medical studies. The purpose of this evaluation is to guide the nursing professional in terms of vital clinical decision making. Other essential things regarding critical appraisal include the following aspects;

• Continuing Professional Development (CPD).
• Conducting research on the clinically relevant academic nursing papers.
• Combat information overload.

Apart from all this, critical appraisal is an opportunity for clinicians to check the reliability, or efficiency of the research resources. All of us would like to have the best health facilities. But this wish can never come true in the absence of reliable information. Hence, reliable information about what may help, or harm a person while taking health care decisions means a lot.

Further, the biggest hurdle in the path of improving clinical practices is biased, and untrue results’ presentation. Although research includes data gathering, analysis, or representation for providing a meaningful scientific story, some researchers fail to solve a scientific problem. Most of them hire nursing dissertation writing services. At the same time, others lag in maintaining the quality of research.

In either case, they use unfair tricks, or detract the audience from the path of achieving better healthcare/nursing facilities. Eliminating biasness and encouraging honest practices within all researches is next to impossible. But through critical appraisal, we can judge the reliability, or validity of research before taking any medical/nursing decision. The aspect of critical appraisal can help nursing students in getting answers to the following questions;

• Whether the information represented in a research paper, or report is trustworthy, or not?
• Is conclusion drawn within the research valid, or contradictory?
• Is a research paper’s information trustworthy enough to take medical decisions based on it?
• Do the decisions made on certain pieces of information ensure practical sustainability, or not?

For critical appraisal, nursing students can address the following questions one by one;

• Are research questions well-formulated?
• Which research design does a researcher opt for to solve a scientific problem?
• Is the sample size well-suited for exploring the underlying facts?
• How does the research’s design test stated hypotheses?
• What are the associated factors with regards to a medical procedure?
• What possible connection these factors might have with one another, or an overall medical process?
• What statistical methods are used?
• Is the applied statistical method justifying reported results?
• Is any other study having evidence of a similar phenomenon, or not?
• Are ethical considerations of nursing research followed within a study, or not?

Critical appraisal, in another way, is a process of identifying biased studies. It is equally useful in identifying the following;

• Performance biasness
• Selection biasness
• Detection biasness
• Attrition biasness

No study is free from biasness. Similarly, no study can be labelled as perfect either. Rather, the studies may differ in degree of biasness. In short, critical appraisal looks at the researcher’s efforts for minimising biasness. It also monitors whether biasness is too large to affect the quality of the research, or not. In addition, if a study is free from all kinds of bias, we will say that it has internal validity. Internal validity is the key to selecting a research for making vital medical/nursing healthcare decisions. In current settings, for critical appraisal, there are many tools available that a nursing student can use.

Critical Appraisal Tools:

Critical assessment can be done in a non-structured way, where you can read it critically, or in a structured way using a critical assessment tool (CAT). CAT is a structured checklist that evaluates the quality of a research’s method following a set of rules. One advantage of using CAT is that you can apply consistency while reviewing a series of researches to get ideas for dissertation topics. In contrast, a potential disadvantage here is that CAT does not question the origin of bias that may be important in the specific research questions asked. Below are the two most important CATs that nursing students use;

CASP- Critical Appraisal Skill Programmes Tool

CASP is a generic tool that aims to appraise the strengths, and weaknesses of a research’s methodology. CASP contains ten questions that are sufficient for exploring the quality standards of a research methodology. It is one of the best, and user-friendly options for gauging the quality of qualitative researches. Beside this, CASP is especially designed for assessing the health care researches as well. Yet CASP does not clearly classify the quality of a research into three distinguish scales of low, medium, and high. Hence, nursing students can use CASP tool before taking any medical decision. But for assessing a mixed approach study’s quality other critical appraisal tools can be used.

MMAT- Mixed Method Appraisal Tool

As the name suggests, MMAT is a quality appraisal tool for mixed-method studies. It can help nurses in appraisal stages for checking the quality of research like;

• Qualitative reviews
• Quantitative review
• Mixed methods studies

It offers to access the research methods, or designs’ quality that falls under these five categories;

• Quantitative descriptive studies
• Qualitative research
• Non-randomised studies
• Randomised controlled trials
• Mixed method studies.

Uses of MMAT:

As it is a tool designed for mixed studies, it is best suited for empirical studies. These studies include observations, experiments, or simulations. This tool has very little, or no practical application in non-empirical research papers’ appraisal. And since nurses’ research paper includes empirical studies, it can help them in getting the maximum benefits from it.

How Can Nurses Get Benefits from MMAT?

In general, MMAT has two sections. The first one contains a checklist whereas the other one explains the appraisal criteria;

• First, answer whether your study is empirical or not. If it is, you can use MMAT, but in the case that it’s not, you can search for another CAT.
• After that, the next task is choosing appropriate criteria for your studies from the MMAT rules.
• The last step is rating quality of the study by following the chosen criteria rules.