Students are required to demonstrate their ability to critically appraise a piece of evidence (i.e. primary research study) provided, highlighting the strengths and weaknesses of the study, at a foundational level. In addition, students are required to discuss factors which may influence the use of this evidence in practice, within the context of a scenario.
Purpose and Rationale:
This assignment requires you to demonstrate critical appraisal of a published research study. This is a skill central to effective clinical practice and in many instances throughout your career, where you will be required to locate and apply best available evidence to support clinical decisions.
Part A: Part A solely focuses on review and appraisal of the research study.
Research Questions, aim or hypothesis
Results and limitation of the study
State two limitations of the study cited by the authors and discuss how these limitations may impact on the implementation of the research findings.
Part B: Part B requires you to read your selected scenario and clinical question; both of which were not required for Part A.
Enables and barriers
The acceptance of research study findings into clinical practice, can be influenced by factors that exist in an organisation, a local ward, or within the individual health care professional. These factors are referred to as enablers or barriers to the acceptance of research evidence into practice.
Reflecting on your scenario, describe two possible enablers and two potential barriers, that may impact on the adoption and use of the evidence (i.e. findings) in practice.23
There are rarely any studies focused on investigating mindfulness-based interventions for physiotherapy students. This paper focus on a critical analysis of a key primary research study related to the area of mindfulness as a key intervention to address the increasing level of psychological distress among university students studying physiotherapy. Here the analysis conducted using a set of questions focused on analyzing the strengths and weaknesses of some of the key sections like authorship, research question, research design, research methods and limitations and results. Furthermore, the paper presents a discussion about the enablers and barriers to the adopt of the results and recommendations of the study in relation to the stress experienced by physiotherapy students.
Part A- Critical appraisal
As discussed by Tarkang et al. (2017). authorship comes with several benefits but at the same time there are certain responsibilities of proper planning, conducting, analysis and reporting of research based on the knowledge and experience of the author.
The authorship of the study considered in this paper includes four authors qualified in the field of psychology and experienced in the area of medicine and education affiliated with universities making then appropriate to conduct a reliable study. The authorship is a major strength of the concerned research work citing their credentials, qualifications and affiliations. At the same time authors have given the details about no ‘conflict of interest’ that help in avoiding any issues related with merit of authorship, designation of senior or corresponding author and the determination of other authors (Davidoff et al., 2010).
Research question & Justification
This study (McConville et al., 2019) sought to explore “the lives experience of third-year physiotherapy students who participated in a six-week mindful stress-reduction (MSR) intervention” through two mindfulness interventions. Justification for the research given in ‘Introduction’ is a strength of the study talking of the need for exploring the possible interventions to reduce the higher levels of psychological distress among students. The discussion is supported with several studies published from 2015-2019 that is quite close to the date of the study’s publication of 2019. Moreover, the discussion justifies the literature gap about mindfulness-based interventions by citing studies ranging from 2002-2011 clarifying the lack of such research work. The discussion about limited intervention-based studies on mindfulness justifies a new study in this area acting as a key exploration to fill the literature gap of mindfulness-based interventions for physiotherapy students.
The authors stated that they used a qualitative analytic method to conduct the study, with thematic analysis as the design to identify, analyze and report patterns of meaning within the data set. Qualitative research aims to explore the knowledge grounded in human experience (Greenhalgh, 2019). There is no proper explanation of the research design here and authors fail to justify the selection of thematic analysis method making this section weak and creating possibilities of limited reliability of results. However, researchers’ selection of qualitative approach is appropriate as it is a flexible approach that can ensure exploring of experiences and feelings of participants that numbers cannot explain or reveal. This is coupled with thematic analysis approach appropriately to give flexibility to the study making it possible to provide a rich and detailed, yet complex account of data (Nowell et al., 2017).
The sample for the study was selected based on self-selection participation and students were randomly allocated to either an MSR or MMov group. Sampling remains a weakness of the study as a small number of students volunteered to participate in the study. It is unclear whether the program would have been successful if the complete cohort or a bigger sample of students had participated in the study leading to selection bias. However, a key strength is that the authors have reported an ethical approval as obtained from the Human Resources Ethics Committee of the university and ensured that all participants gave written informed consent. Also, authors have explained the data collection method of interview and themes to categories the collected data in a detailed manner. They justified the data collection tool as well as explained the proper method used to conduct the interview by a student enrolled in and Honors degree psychology program. These factors act as some of the key strengths of the study as it helps in avoiding personal interference and bias in data collection process (Hoffman et al., 2017).
However, presentation of collected data is a weakness of the paper, as the information is not presented in detailed form with illustrations and tables the presentation of results weak.
Results and Limitations
The authors found that increased mindfulness awareness is related with healthier choices like regular exercise and improved diet and sleep and reduced distractedness and increased study efficiency in both the MSR and MMov programmes.
The authors cite several limitations of the study including the self-selection of participants by volunteering. Also, the interventions MSR and MMov both had the same elements making it difficult to understand the relative contribution of meditation and movement practices on stress experienced by students.
Such limitations have a negative impact on implementation of the results, as a lack of proper sampling method may result in selection bias thereby making the results bias and limit the generalization of results of the study. (Smith et al., 2017)
Part B- Enablers and Barriers
The application of the study’s recommendations should be considered in relation to the physiotherapy colleges and training program organizers concerned about high level of stress experienced by students and use of mindfulness in addressing the issue. A major enabler is the easy use and implementation of interventions where mindfulness needs to be added as part of regular training program making it cost-effective and time saving for the university. There is no separate program, cost or time is required and students will be accustomed to it while studying other aspects of a physiotherapy course.
Another enabler is the healthier choices fostered by mindfulness leading to regular exercise and improved diet and sleep along with improved listening and communication. This will improve students’ relationship with patients and their family members once they practice professional physiotherapy. They will be able to take u bottom-up approach with collaborative working approach while developing an ability to understand individual needs.
Barriers at the university level may be incentives and approvals to include mindfulness training in physiotherapy training programmes. Another factor acting as a barrier will be the acceptance and usefulness of mindfulness-based programs as understood by the students themselves. In case students of physiotherapy courses do not consider such interventions useful in addressing the issues of stress leading to a positive impact on their personal and professional growth and wellbeing, there will be a barrier in implementing the results of the study efficiently.
The critical appraisal of the concerned research work concludes that McConcille et al. (2019) selected a les researched topic of experience of physiotherapy students about a mindful movement and a mindful stress-reduction intervention. Some of the weaknesses of the study like sampling bias and weak presentation of results were revealed, however the study has more of strengths like human ethics approval, authorship and declaration of conflict of interest, making it an appropriate study to be considered as the basis of future research work in the field of psychological stress experienced by students. There were certain limitations of the study related to sample selection and including same elements in the interventions that made the generalization of results difficult. The results can be taken forward to conduct more detailed studies with a better representative sample and explore the important topic of addressing stress among students using mindfulness-based interventions.