Tag Archives: research

Trial Balloons & Pilot Studies

A pilot study is to research what a trial balloon is to politics

In politics, a trial balloon is communicating a law or policy idea via media to see how the intended audience reacts to it.  A trial balloon does not answer the question, “Would this policy (or law) work?” Instead a trial balloon answers questions like “Which people hate the idea of the policy/law–even if it would work?” or “What problems might enacting it create?” In other words, a trial balloon answers questions that a politician wants to know BEFORE implementing a policy so that the policy or law can be tweaked to be successfully put in place.

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In research, a pilot study is sort of like a trial balloon. It is “a small-scale test of the methods and procedures” of a planned full-scale study (Porta, Dictionary of Epidemiology, 5th edition, 2008). A pilot study answers questions that we want to know BEFORE doing a larger study, so that we can tweak the study plan and have a successful full-scale research project. A pilot study does NOT answer research questions or hypotheses, such as “Does this intervention work?”  Instead a pilot study answers the question “Are these research procedures workable?”

A pilot study asks & answers:Can I recruit my target population? Can the treatments be delivered per protocol? Are study conditions acceptable to participants?” and so on.   A pilot study should have specific measurable benchmarks for feasibility testing. For example if the pilot is finding out whether subjects will adhere to the study, then adherence might be defined as  “70 percent of participants in each [group] will attend at least 8 of 12 scheduled group sessions.”  Sample size is based on practical criteria such as  budget, participant flow, and the number needed to answer feasibility questions (ie. questions about whether the study is workable).

A pilot study does NOT Test hypotheses (even preliminarily); Use inferential statistics; Assess safety of a treatment; Estimate effect size; Demonstrate safety of an intervention.

A pilot study is not just a small study.

Next blog: Why this matters!!

For more info read the source of all quotes in this blog: Pilot Studies: Common Uses and Misuses @ https://nccih.nih.gov/grants/whatnccihfunds/pilot_studies

Easy to read. Hard to write.

Musings:  For me the most difficult to write sections of a research report are the Intro/Background and Discussion.  And yet,  those are apparently the easiest to read for many.   My students at least tend to read only those sections and skip the rest.

Why? For the author, Intro/Background and Discussion require hard, critical thinking about what is already known about the topic (Intro/Background) and then what one’s findings mean in light of that (Discussion).  For research consumers, the language used in these sections is more familiar, ordinary sounding words.  On the other hand, writing the technical nature of other sections (Methods, Instruments, Results) is pretty straightforward with scientifically standardized vocabulary and structure.  But, for readers, those same sections contain potentially unfamiliar research terminology that is not part of everyday conversation– i.e., scientific vocabulary.  Quantitative studies often create more reader difficulty.

My solution for myself as a writer? To spend time making sure that the first sentence of every paragraph in Intro/Background and Discussion makes a step-by-step argument supported by the rest of the paragraph. Follow standardized structure for the rest.  Keep  language  precise  yet  simple  as  possible.

Solution for research readers? Read the whole article understanding what you can and keep a research glossary handy (e.g., https://sites.google.com/site/nursingresearchaid/week-1. Even if practice doesn’t make you perfect, it works in learning a new language–whether it is  a ‘foreign’ language or a scientific one.

Critical Thinking:  Test out your reading skills with this article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6503597/   .  Do the authors make systematic arguments in Intro/Background & Discussion? What makes this article hard or easy to read?

Happy Summer! -Dr.H

Part 2: It’s a jungle out there! Flaky academic conferences

Flaky conferences can taken advantage of your time, money and energy.  My own publications in bona fide journals have triggered an onslaught of emails from probably predatory conferences–World Congresses of this and that (global health, nursing, education, etc.).  The cartoon below totally resonates!  Thanks PHD Comics.

http://phdcomics.com/comics.php?f=1704

 

2019: It is…….

I’m not a New Year’s resolution person.  I used to be and then I realized that I wanted to hit the restart button more often than every 365 days.  So…my aim for this blog remains pretty much unchanged:   Make research processes and ideas understandable for every RN.

DifficultToBeSimpleAlthough “to be simple is difficult,” that’s my goalLjourneyet me know what’s difficult for you in research, because it probably is for others as well.  Let’s work on the difficult together so that you can use the BEST Evidence in your practice.

The 2019 journey begins today, and tomorrow, and the tomorrows after that!

FOR MORE: Go to PubMed. Search for a topic of interest. Send me the article & we’ll critique together.

DNP vs. PhD: If the shoe fits….

For RNs wanting to pursue a doctorate, it is important to pick a degree that Glass slipperbest matches your anticipated  career path.   The shortest simplest explanation of the difference in these degrees is probably:

  1. PhD If you want to be a nurse scientist & teach in a university & conduct  nursing research. 
  2. DNP – If you want to be an advanced practice nurse, who primarily uses research in leadership, QI, patient care, etc. along with measuring project outcomes.

An excellent, free full-text, critique can be found at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4547057/  

Of course, some DNPs teach in universities, particularly in DNP programs.  PhDs may otherwise be better prepared for faculty roles.  I encourage you to look carefully at the curriculum at the school where you hope to study and expectations of a university where you hope to teach.  Speak with faculty,  & choose wisely.

It’s Up to you: Accept the Status Quo or Challenge it

Yes.  Change can be painful.question

Yes. It is easier to do things the way we’ve always done them (and been seemingly successful).

Yet, most of us want to work more efficiently or improve our own or patients’ health.Tension

 So, there you have the problem: a tension between status quo and change. Perhaps taking the easy status quo is why ‘everyday nurses’ don’t read research.

Ralph (2017) writes encountering 3 common mindsets that keep nurses stuck in the rut of refusing to examine new research:

  1. I’m not a researcher.
  2. I don’t value research.
  3. I don’t have time to read research.

But, he argues, you have a choice: you can go with the status quo or challenge it (Ralph).  And (admit it), haven’t we all found that the status quo sometimes doesn’t work well so that we end up

  • choosing a “work around,” or
  • ignoring/avoiding the problem or
  • leaving the problem for someone else or
  • ….[well….,you pick an action.]

TensionHow to begin solving the problem of not reading research? Think of a super-interesting topic to you and make a quick trip to PubMed.com. Check out a few relevant abstracts and ask your librarian to get the articles for you. Read them in the nurses’ lounge so others can, too.

Let me know how your challenge to the status quo works out.

Bibliography: Fulltext available for download through https://www.researchgate.net/ of  Ralph, N. (2017 April). Editorial: Engaging with research & evidence is a nursing priority so why are ‘everyday’ nurses not reading the literature, ACORN 30(3):3-5. doi: 10.26550/303/3.5

More? Not always better! Check out NNT.

EBPPractice based in evidence (EBP) means that you must critique/synthesize evidence and then apply it to particular setting and populations using your best judgement.  This means that you must discriminate about when (and when NOT) to apply the research.  Be sure to use best professional judgment to particularize your actions to the situation!

Add to your repertoire of EBP tools,  ratiothe Number Needed to Treat (NNT).   This is not mumbo -jumbo.   NNT explained here–short & sweet: http://www.thennt.com/thennt-explained/ 

FindingsCRITICAL THINKING:   Check out this or other analyses at the site.  How does the info on antihypertensives for mild hypertension answer the question of whether more is better?  Are there patients in whom you SHOULD treat mild HTN?  (“We report, you decide.”)   http://www.thennt.com/nnt/anti-hypertensives-for-cardiovascular-prevention-in-mild-hypertension/

MORE INFO:  Check out what the data say about other risk/benefit treatments at http://www.thennt.com/