Critical appraisal of qualitative studies determines different aspects that should be observed in carrying out research. It touches on the aims of the research, the appropriateness of the use of qualitative methodology, the research design, the recruitment strategy, and data collection, among other elements as highlighted in this paper.
Aims of the research
The research paper had a clear statement of aims. The paper sought to establish how primary care clinicians arrive at different evidence-based decisions, whether individually or collectively (Gabbay & May 2004). The research objective was thought equally important because evidence-based healthcare had elicited numerous dilemmas over the previous decade. The key dilemma was how healthcare practitioners incorporate information from the existing literature in evidence-based care. The research objective is of relevance as it has the potential to solve the dilemmas that have surrounded evidence-based research.
The appropriateness of qualitative methodology
The researchers sought to shed light on some of the underlying explanations to the highlighted dilemmas by seeking the experiences of the participants. Qualitative research was the best methodology as it captured the participants’ experiences, which were critical to the objective of the study (Gabbay & May 2004). The qualitative study gives a clear picture of participants’ experiences as it captures firsthand information through methods like interviews, which then leaves little or no room for data manipulation (Jeanfreau & Jack, 2010). The open nature of the interview allows the respondents to be at ease, and thus they are likely to provide unbiased information (Jeanfreau & Jack, 2010)
The appropriateness of research design
The research design was appropriate as the researchers discussed how they decided the method to use. The researchers chose ethnography data collection, analysis, and interpretation, which allowed them to interact with the participants and obtain relevant information using structured and unstructured participant and/or non-participant strategies. The participant strategies let the respondents give the required information via formal and informal interviews and reviews of practice protocols. Non-participant strategies involve the researchers observing interactions between the participants and their work environment (Mulhalla 2003). Therefore, the researchers were clear on the research design chosen as they explained how they used different methods like semi-structured formal and informal interviews, together with observation and notes taking throughout the study.
The appropriateness of the recruitment strategy
The recruitment strategy was appropriate for the aims of the research. The researchers noted that they selected the participants from local and urban learning institutions with different ethnographic characteristics. The researchers chose nine doctors from different areas of specialisation to get inclusive responses. However, the researchers did not discuss any issues surrounding recruitment or indicate whether if the selected participants opted out of the study. In addition, the researchers did not explain why the selected participants were the most appropriate to provide access to the type of knowledge sought in the study, but the target was primary care health givers, which explains why doctors were the most suited participants.
The setting for data collection was not justified, but the researchers mentioned that they used two different locations in disparate environments. One location was in rural areas while the other one was in the urban area, but they did not justify why they chose such places. The researchers made it clear that they used both the semi-structured formal and informal interviews. They also used unstructured non-participant observation to study the interactions between the participants and fellow participants or with other workers in the study setting. The interviews had been initially audiotaped and later transcribed. Other data collection methods included taking field notes. The researchers made the method explicit by noting that interviews were carried in person with recordings on the same. The methods were modified during the study as the researchers realised that verbatim transcription was expensive, and thus they used tape recordings and took field notes. The researchers did not use data saturation as it is used in cases where data is predetermined (Jeanfreau & Jack 2010; Streubert-Speziale & Carpenter 2007), but in this case, the study was based on novel experiences from the participants.
The relationship between researchers and participants
The relationship between the researcher and participants has not been considered. The researchers did not mention if they examined their own role, potential bias, and influence on the formulation of the research questions or data collection. During the research, the researchers were involved directly as they conducted the interviews and observations made they did not indicate their role, which might have determined some outcomes and responses. In addition, they did not consider the implication of any changes in the research design during the study.
Consideration of ethical issues
The researchers did not indicate whether they sought informed consent from the participants. There is no mention of if the participants were informed of the research. In addition, there is no mention of whether approval was sought from the ethics committee. Conventionally, the researchers should have sought approval from an ethics committee.
The sufficiency of data analysis
The researchers provided an in-depth description of the analysis process by giving step-by-step on how they had analysed the data. The analysis was entirely based on interviews and observations. They also applied thematic analysis, and they explain how themes were derived. In addition, there is sufficient data to support the findings, and the researchers were present so they might have influenced the outcome, but that aspect was not explored. The researchers used several theoretical frameworks as opposed to applying a simple, grounded theory approach. For instance, they investigated the role of social and organisational setups in the making and application of knowledge.
Statement of findings
A clear statement on the findings was given, and the discussion adequately addresses points for and against researchers’ arguments. The researchers discussed the credibility of their findings and in relation to the original question. The findings were congruent with the issues highlighted in the research question as the researchers hypothesised that contemporary primary healthcare providers had digressed from the conventional protocols of applying evidence-based decision making in health practice and the hypothesis was confirmed in the findings.
The value of the research
The researchers admitted that further research was needed in a bid to determine whether their findings could be transferred to the other centres. The researchers discussed the contribution of this study to the existing understanding of the subject of evidence-based decision making amongst clinicians. They noted that as hypothesised in the introductory section, primary healthcare givers had abandoned the protocols followed in applying evidence-based decision making in health practice.
Contribution to Knowledge
The paper has added crucial information on the current understanding of the topic of evidence-based practise amongst primary health caregivers. The researchers realised that contemporary primary healthcare providers deviated from the conventional linear-rational model associated with evidence-based healthcare provision (McCaughey & Bruning 2010; Dobrow, Goel & Upshur 2004). Conventionally, health practitioners are required to use guidelines whilst applying evidence-based decision-making (Munroe, Duffy & Fisher 2008). However, the participants admitted that they only consulted such materials occasionally when necessary. It became clear that health providers, especially, nurses, only use these guidelines when faced with novel situations. In addition, instead of relying on the conventional guidelines pinned on the wall, the participants would use the Internet to download such guidelines. These approaches digress from the conventional way of handling evidence-based practices amongst primary healthcare providers (Ferguson & Day 2007; Kania-Lachance et al. 2006).
In addition, they abandoned the conventional way of gaining evidence-based information, which emphasised on books and journals (Majid 2011; McKenna, Ashton & Keeney 2004). On the contrary, they relied on networks with experienced colleagues who monthly mailed magazines to get evidence. Those who could not access such networks relied on colleagues to get the needed information. In essence, it became clear that clinicians abandoned the conventional way of gaining information for research. The researchers supported earlier theory by Choo (1998), Davenport and Prusak (1998), and Nonaka and Takeuchi (1995) that clinicians normally apply knowledge in practice as opposed to using denotative codified knowledge. Therefore, the practice should be changed to entail the use of research and experiential evidence to be in line with proven protocols set for evidence-based practice (Nagy, Lumby, & McKinley 2001; Titler, Cullen, & Ardery 2002; Scott-Findlay & Golden-Biddle 2005).
As indicated in this essay, the research study by Gabbay and May followed the majority of the different elements needed when carrying out a qualitative study. They stated the research objectives clearly and explained the appropriateness of their data collection methods, among other aspects, as indicated in this paper. The research adds value to the existent literature available on the subject of evidence-based decision making amongst primary healthcare providers.
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