Posted: June 4th, 2015
ALLH12006 Evidence-Based Practice for Allied Health
In this assessment you will present a synthesised and critical evaluation of three original research articles in an attempt to answer a clinical question. In doing this you will also need to present and explain your clinical question, describe how you performed an information search, and justify how and why you narrowed your search down to three articles.
This assessments aligns with course outcomes 1, 2, 3, and 4
You are permitted, indeed encouraged, to complete this assessment as a follow-up to what you did in Assessment 1. In other words, you can base this assessment around the same clinical question and search strategy. However, you are expected to have refined your PICO question and search as necessary following feedback received in Assessment 1. When this assessment is being marked, it will be marked as a standalone piece, and the marker will not refer back to your submission for Assessment 1.
However, you may base this assessment on a completely different PICO question to that which you used in Assessment 1 if you wish to do so. If you are continuing your topic area from Assessment 1, you need to be wary about your wording to avoid self-plagiarism, i.e. you cannot simply cut and paste wording from Assessment 1 into this assessment.
This assessment task essentially breaks down into three sections
Section 1 Background and Clinical question
This section is essentially your introduction which should provide the reader with sufficient background to understand the clinical significance of your proposed PICO question.
You should ensure that you define and describe any key terms and concepts and provide examples as necessary. You should also be sure to emphasise the real-life clinical need for addressing your question in the context of current allied health care. It should be clear that the question is relevant to current
practice and is not simply a question for the sake of asking a question for a piece of academic assessment (i.e. one for where there is already a well-established answer easily accessible in the literature).
If it helps, you may imagine that you are attempting to answer the question as a clinician in a real-life service delivery scenario, e.g. you may imagine that you are a clinician working in a rural rehabilitation centre, or whatever, if this helps you to build a better-rounded introduction section.
It is up to you whether you present your PICO question first followed by your background that justifies the question, or whether you present your introduction first which then leads to your PICO question. Either way can work well. You do not need to present your PICO question in tabulated form as was required in Assessment 1 – just the written question itself is sufficient.
This section would be expected to be in the region of 200 -300 words.
Section 2 Search strategy
You should include a paragraph describing your search strategy that has informed the following evaluative discussion in Section 3. You should do this concisely by mentioning the databases/sources you have searched to find information, any particular text and index terms you have used and any particular limits you have used on your search (e.g. date range, language of articles etc.). You should then describe the process for reviewing the results of your search in order to come down to your final selection of three. You are expected to present a process whereby you have systematically selected literature that presents as high a level of evidence as possible in relation to your type of question, and not simply selected the first three articles you come across that appear relevant to your question.
To get an idea of how to do this concisely, you may wish to refer to some published systematic reviews to see how they describe their search methodology.
You should conclude this section by identifying the articles that you have selected and will thus form the basis of your critical evaluation. In doing this you are not required to provide full bibliographic information (as you will do this in the reference list). You may do this as you would normally incorporate in-text citations, e.g.
“Following the review process, three articles were identified as being relevant to address the clinical question and as being of relatively high levels of evidence. These articles were Smith (2010), Jones (2011), and Adams (2012).
Ideally your final three articles will represent original research (inclusive of systematic reviews) and should not be Clinical Practice Guidelines. If you must use Clinical Practice Guidelines as one of you three articles (e.g. due to lack of original research addressing your question), you need to explain why you are using it and you must demonstrate that you have appraised the
quality of these Guidelines. Regardless of what your final three articles are, you are more than welcome to refer to Clinical Practice Guidelines in your background section and when you consider the clinical significance of the results of the three articles (see Section 3).
This section would be expected to be in the region of 200 -250 words.
Section 3 Evaluative review of evidence
This is by far the largest and most important section of this assessment piece as this is where you demonstrate your ability to synthesise information with the aim of answering your clinical question.
Firstly, you should aim to give brief summaries of each of the individual articles that you have selected. You should aim to include information about their research questions/focus, their research methodology, the participants, the main results and conclusions. In doing this, you should be as concise as possible.
Following the brief summaries of the individual articles you should then begin to present your synthesised evaluation that attempts to discuss how these three articles help address your clinical question. In doing so you may consider
? The level of evidence provided by each article in the context of the your overall information search (e.g. is the literature available on the topic of interest conducive to selecting high levels of evidence, or is the highest evidence available ‘only’ single case study research, etc.?)
? The quality of the evidence provided by the three articles selected. This is where you will need to demonstrate you ability to critically appraise the articles individually and come to a conclusion regarding
o Was the research well-focused?
o Were the methods appropriate?
o Could the results be trusted?
? The nature of the results provided by the three articles and how these results contribute to answering your clinical question
o Are the results in agreement?
o Is there inconsistency? What may lead to this inconsistency?
? The clinical significance of the results provided by the three articles
o Even if the results are positive, are they clinically significant?
o Do the results suggest a change in clinical practice? Or even a continuation of current practice?
o If a change of practice is indicated, are there any potential barriers to implementing these changes? Or what other issues may need to be considered for successful implementation to take place?
? An overall conclusion that summarises the previous discussion and answers your clinical question.
o There is no expectation that in order to do well, you need to answer your question positively (e.g. ‘the evidence presented highlights that treatment x is amazingly effective’)
o If the research you have reviewed raises further questions that warrant consideration, you may highlight these
o If the answer to your question is dependent on factors you had not previously considered, or if there are certain caveats, you can highlight these (e.g. the effectiveness may depend on the type of stroke someone has had therefore this may be worthy of implementing into inclusion/exclusion criteria in subsequent reviews of literature).
You will most likely not have sufficient words available to address all of the above points to a good level of detail. Therefore it is up to you to be concise, and judicious in terms of what you decide to discuss.
If you are unsure of what I mean by ‘synthesised’, I mean that you should demonstrate that you are bringing together information across all three articles and not simply defaulting to a structure such as ‘article one says … Meanwhile article two says … whereas article three says …’. A more critical writing approach may be something more like
‘positive results to support the use of … in people with … was observed in Smith (2012) and Jones (2011) although the results of Adams (2013) did not show any additional beneficial effects compared to people receiving normal care. Therefore, given that all three articles present good quality evidence, overall there appears sufficient evidence to conclude that … is worthy of implementation as a treatment method although its effectiveness may be dependent on … as discussed by Adams (2013)’
Within this section, you may also find it useful to describe the process of critical appraisal, e.g. by identifying the critical appraisal tools that you have used to review each of the individual articles. If you do this, it would work well at the beginning of the section.
While this section will be focused on discussing the three articles you have selected, you may also refer to other sources of information where relevant. For example, it may help to refer to authoritative information when interpreting the clinical significance of the results of the study. Similarly, it may help to refer to current clinical practice guidelines or other organizational documentation when interpreting whether a change to current practice is indicated.
Across this piece of assessment, you should be aiming to demonstrate how you have attempted to incorporate perspectives from each of the four domains of evidence-based practice. While ‘Research evidence’ is the strong
focus, you should consider this in relation to Clinical experience, Client-related factors, and also Service delivery factors as well. This should be integrated into your discussion rather than explicitly represented (e.g. you should not need headings for each of the four EBP domains with subsequent discussion).
This section would be expected to be in the region of 700-850 words.
Basic structure of piece
? Cover page
? Section 1 Background and clinical question
? Section 2 Search strategy
? Section 3 Evaluative review of evidence
? Reference list (this should contain full (APA) bibliographic information for the three articles that form the basis of your review and any additional sources you have cited. It is expected that you will need to cite more than just the three primary articles you are appraising.
You are encouraged to use headings and sub-headings to aid the structure of your writing. You may use the headings above or reasonable alternatives.
The word limit for this assessment piece is 1,250 words maximum. There is no +10% leeway on this. A 1,250 word maximum means that this is the absolute maximum. You should state your word count on your cover page. If you do exceed to word limit, the marker will not read any word over the 1,250th word.
Words included in word count
Words not included in word count
The body of your text
Heading and sub-headings
Word in tables and figures
You should not need to include appendices with this assessment. While you are expected to have used some formal method to critically appraise of the three articles that make up your evaluation, you are not required to include completed critical appraisal tools.
You will only be penalized if you exceed the maximum word limit for the assessment as a whole (1,250). However, if you exceed the suggested word limits for an individual section, this may impact on your ability to effectively complete other sections. Similarly, you will not be penalized for going significantly under the 1,250 word limit, although this may also impact on your ability to effectively complete the assessment piece.
Style and formatting
Cover pages should be plain and non-distracting (i.e. no colours or fancy borders) and should present all necessary information as per usual.
You do not need to include a contents page.
All in-text citations and reference lists should be consistent with current APA styles of formatting and style.
You should use a standard font (e.g. Times New Roman, Arial) and this should be 12pt. You may use single, 1.5 or double line spacing. Page margins should be no smaller than 2.5cm all around.
If including tables, these should be introduced in the text and/or have a title so that the reader understands the purpose of the table.
You should save your final submission as a Microsoft Word document, not pdf, and you should give this a filename according to the following formula:
Your surname, Your first name, Course code, Assessment 3.docx (or .doc)
Plant, Chris, ALLH12006, Assessment 3.docx
Mark Background and clinical question 15 – 11.5 11 – 9.5 9 – 7.5 7 – 0
? A well-phrased PICO question Is presented
? Definitions and examples are provided to explain key terms/concepts
? Sufficient background information is provided that draws from relevant sources of information to allow appreciation of the clinical relevance and significance of the PICO question.
? The PICO question is clear but may require minor modification
? Most key terms/concepts are defined and explained sufficiently
? A good background section that allows appreciation of the clinical relevance and significance of the PICO question although would benefit from further support from external sources of information.
? The PICO question may require some modifications to one or more elements.
? Some key terms/concepts would benefit from further explanation
? The background presents a basic discussion that may lack adequate support from external sources of information. However, it allows a general appreciation of the clinical relevance of the PICO question.
? The PICO questions requires major modification
? No key term or concept is defined or explained adequately
? Background section is extremely limited and does not allow the reader to appreciate the clinical relevance of the PICO question.
/15 Search strategy 15 – 11.5 11 – 9.5 9 – 7.5 7 – 0
? An appropriate search strategy is described concisely and reassures the reader that a thorough and efficient search has been performed.
? The process of identifying three original research articles is logical and is described comprehensively and is fully justified.
? An appropriate search strategy is described although this may have benefitted from minor modifications.
? The process of identifying three original research articles appears mostly logical although could be described in more detail or with greater justification
? A basic, although mostly appropriate search strategy is described.
? The process of identifying three original research articles requires greater elaboration although some justification is presented
? A poor search strategy is described or the description is not adequate to appreciate how an information search has been performed.
? There is very limited or no description of the process of identifying three original research articles or the process appears inappropriate or illogical.
Review and evaluation 50 – 37.5 37 – 32.5 32 – 25 24.5 – 0
? Each article is summarized concisely with regards to its aims, methods, and findings and it is clear how each article relates to the clinical question.
? Individual articles are appraised and evaluated in terms of their quality and all comments are well justified.
? Key issues from the three individual articles are synthesised in a coherent manner in a way that is relevant the clinical question.
? A logical answer for the clinical question is proposed alongside any relevant caveats
? Each article is summarized well although some minor information is not included or there may slight lack of clarity with how one or two articles related to clinical question
? Individual articles are generally appraised well although some points may not be fully justified
? Key issues from the three articles are identified but may require more effective integration into a coherent discussion addressing relating to the clinical question.
? A logical answer to the clinical question is proposed which may require further elaboration
? Each article is summarised from a basic perspective and it may be unclear as to how articles relate to the clinical question
? Appraisal of individual articles is superficial although some good points are identified
? There is a lack of effective integration of information across the articles when addressing the clinical question although some points have merit.
? An answer to the clinical question is proposed although it may be unclear how this is informed by the information that has been appraised.
? Summaries of individual articles lack depth and there is no clear link to the clinical question
? There is no evidence of an effective appraisal process
? There is no, or a very poor attempt to integrate information across individual articles when addressing the clinical question
? No answer to the clinical question is proposed or an answer is unsupported by information presented (or due to a lack of information presented).
/50 Academic writing 20 – 15 14.5 – 12.5 12 – 10 9.5 – 0
? Writing is well-structured and flows logically
? Writing style is clear and concise
? No, or very few, spelling and grammar errors
? APA format applied faultlessly or with only minor errors (same error repeatedly)
? Writing is well-structured and flows logically with minor exceptions
? Writing is mostly clear and concise with minor exceptions
? Occasional minor spelling and grammar errors (maybe same error repeatedly)
? Some minor but varied errors of applying APA formatting
? Writing occasionally lacks structure but overall flows logically
? Writing style is sometimes unclear and/or overly wordy
? Noticeable errors in spelling and grammar
? Frequent and varied errors in applying APA formatting
? Writing lacks structure and does not present information logically
? Writing is unclear and difficult to read
? Frequent and varied errors in spelling and grammar
? No citations used
? Frequent errors and great inconsistency in attempting to apply APA formatting
Total ( /100)
1. Marker may award whole point marks or 0.5 point marks in any criterion
2. Final mark /100 will contribute towards 40% of overall course grade. So if you achieve exactly 50/100 you have achieved 20% of your overall course grade via this assessment piece.
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