Critical Review Of Article Cook, Braine, And Troutin In Relation To Nursing Practice Assessment Answer

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Question :

You are required to critically appraise one of the research articles from the list provided to you. You are required to use a systematic approach to objectively review a piece of research and highlight the strengths and weaknesses of the research study. You must also reference your work using APA 6th referencing style.

The critical evaluation should follow to the following structure, and use relevant sub-headings:
a. Title.
b. Abstract.
c. Introduction.
d. Literature Review.

e. Methodology/ sample/ethics.
f. Data collection strategies.
g. Data analysis/ results/ findings.
h. Discussion/ limitation/ conclusion
A minimum of ten (10) credible, current (less than 7 years) and scholarly sources should be used to support your work.
This assessment task will assess the following learning outcome/s:
• be able to evaluate the relationships between research, theory and evidence-based practice for nursing.
• be able to describe the research process and explain its components be able to critically evaluate research articles and their applicability to nursing practice

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Answer :



The aim of this assignment is presenting a critical review of a selected research article in relation to nursing practice. This assignment has reviewed the research work of Cook, Braine & Trout (2019). Each subsection of the articles, especially the methodologies used and all the key components of the article has been critically reviewed and evaluated by identifying the strengths and limitations of each component. Findings of the review suggested that the research article in question involves many strengths that outweigh the very few limitations making the conclusions and recommendation drawn ready to be used in nursing practice.


This article reviews the research work of Cook, Braine, & Trout (2019). Their research was focused on exploring the understanding and experience of the nursing professionals with regard to the application of painful stimuli when assessing components of the Glasgow Coma Scale. The article was published in 2019 in the Journal of clinical nursing. Considering the publication date and the journal where the study had been published, the research can be viewed as credible and recent.

The introduction section of the article starts off by establishing the relevance and context of the study, where the authors have presented the reasons for choosing the research topic. With respect to establishing the significance of the research study, the authors detailed that the Glasgow Coma Scale (GCS) which is a universally accepted method for undertaking the neurological assessment of patients in the unconscious state requires professional skill and knowledge that nurses must have in order to perform the tests appropriately. However, as per the authors, previous research has identified inadequate education and training of the assessor which in this case are the nurses can potentially impact on the degree of accuracy, confidence and understanding of the GCSnegatively which underlines the relevance and importance of the research. Followed by this reasoning, the authors dictated the aim of the study as "evaluating the application, understanding and experience of nurses with respect to applying painful stimuli when assessing components of the Glasgow Coma Scale.” The aim is clear and concise and expertly conveys what the study aims to achieve through undertaking this research. Furthermore, the introduction section further includes the strength of underlying that the contribution of this research to the wider global clinical community presenting the global significance of the study. Therefore, the introduction section of the paper is adequately written and design with a lucid introduction that builds interest of readers (DePoy&Gitlin, 2015). 


In order to set the background of the research, the authors have conducted a descriptive literature review of previous research conducted on a similar study area. The literature review (LR) section involved reviewing approximately 40 different research articles to set the background context of the study. The authors as systematically arranged the LR section into individual themes which helped in easy understanding of the background context of the study. The authors in reference to the painful stimulus that is used for GCS scale have explored the theoretical concepts in relation to the location of the noxious stimuli, the time duration for which it is acceptable to apply noxious stimuli and the current status of the knowledge of nurses. This section of the articles involves various strengths. The LR section is well constructed and involved the review of approximately 40 research articles ranging for a long period of time which presented the scenario of nursing knowledge and painful stimulus for a significant period. The LR section being segmented under individual themes have also presented a clear analysis of the research background. However, the LR section also has some limitations. According to Christmals, & Gross, (2017), a literature review of research studies should be presented in a way that helps in identifying the literature gap which sets the context of the study. On the other hand, LR should inform the methodology of a research study as well. However, in this research, neither any literature gap has been clearly identified, nor any details of methodologies used in the articles reviewed were presented. This suggests that the authors in this study refrained from undertaking any systemic literature review method.


The methodology section of research is a highly important part as it determines the validity and relevance of the data presented in the findings section in relation to the research aims and objectives. As per the views of Dannels, (2018), research methodology section of a research paper should clearly detail the methods of data collection, the sample population of the study, the methods of data analysis and the ethical consideration associated to the methods applied for the study. A well-constructed research methodology section details each of these individual sections clearly while refraining from using unnecessary jargons constructing the understanding of the readers. Moreover, according to Creswell & Creswell (2017), a clearly communicated methodology helps in linking the findings with analysis and corresponding conclusions.

 With respect to the current research article, the authors have sub-sectioned the methodology chapter of the research into five subheadings, namely, research design, data collection, sample, data analysis and ethical considerations. This contributed as strength as the article followed a well-structured flow for this section (Kelly et al. 2018). With respect to the research design, the authors had used descriptive research design while presenting justifications for choosing the design. The authors are further detailed that the study has used a survey as a research method and conducted both qualitative and quantitative study design for data analysis. Each choice of the methodology has been backed-up by a justification for choosing that particular method which is a great strength of this paper. Considering the research topic and aim, the choice of descriptive design using survey and mixed method of data analysis has been an appropriate choice which is clearly detailed through the justification of the choice of methodology (Avella, 2016). 

In reference to the data samples, the study detailed the choice of using a nonprobability, purposive sampling technique where the sample participants were recruited into the study based upon specific criteria, and convenience sampling. This is because the research topic directed using conducting the study on neuroscience nurses who are currently practising nursing. The target number of the sample population was determined using g a sample size calculator and 365 nurses were targeted for conducting the study referring to a large population of sample for data collection and analysis. 

The paper also highlighted that the research conducted following the ethical paradigms of primary research involving human participants. The authors detailed that ethical approval for conducting the research was gained form "Research and Governance Ethics Committee" of all three Higher Education Institutes where the researchers are employed. Approvals have been gained from six hospitals as well, and informed consent has been obtained from all the research participants. This has also strengthened the research in terms of following proper research ethics paradigms.  


In this research, the authors had developed a questionnaire based on the variables drawn from LR and data was collected through a self‐report online questionnaire survey. The authors have identified the need for establishing content validity and in the article they have detailed that this was achieved through distribution of the questionnaire to a consensus panel of 10 expert nurses working in the area of neuroscience division each of them having the experience at least 15 years’ experience in the area of using GCS for neurological examination. As detailed by Fain (2017), data collection strategies should suit the research scopes. As the research included the scope of exploring a large data source population use of online survey provided the benefits of saving time and costs of the study. 


For this research, the authors have used Descriptive statistics for analysing the data which involved methods like mean, standard deviation calculation for quantitative data. On the other hand, the researchers had chosen to use content analysis for qualitative data using Newell and Burnard's (2006) six‐stage approach. Braine & Cook (2015) had also used this approach in the qualitative analysis of neuroscience data. This details the significance of this method. 

Results were presented using different subheadings such as duration of painful stimuli, determining the eye‐opening response, determining motor response etc. quantitative data was further presented using tables. These aspects of the study made the study highly detailed, clear and concise (Zhang et al. 2017). However, the limitation of this format of data representation was that while findings represented the statistical results, there were not interpreted clearly.


The discussion section of this study involved detailing the identified themes associated with concerns of applying the painful stimulus. These themes have been represented in a concise manner using a diagrammatic representation which aids the author in understanding the themes with ease. The discussion section has been linked to a literature review of secondary data sources, thus validating the research outcomes. The article has clearly detailed the limitations of the study clearly contributing to the strengths of the article. The limitations identified included problems with sampling, biased population characteristics of non-responders and the possibility of having differing views. The clear detailing of limitations in any study as per Scott, Murphy &Warshawsky (2016) makes the study more acceptable. 

Research conclusions have been presented clearly and briefly without restating the results followed by recommendations relating to improving the guidelines for conducting the GCS test. The article also detailed the relevance of this research in clinical practice, also contributing to the strengths. Moreover, the use of APA 6th referencing style as informed the study with relevant citations. These aspects make the conclusions and recommendations ready to be used in nursing practice.

The overall review findings of the article suggested that the strengths of this particular research article outweigh the very few limitations. This suggests the study being conclusive and appropriate for global acceptance.