CUNY Nursing Research Methods Writing a Response to Two Papers

Running head: Critiquing A Qualitative Research Article Group 1: Critiquing A Qualitative Research Article The lived experience of new graduate nurses working in an acute care setting. 1 Running head: Critiquing A Qualitative Research Article Group 1: Article we are critiquing: Group 1: “The Lived Experience of New Graduate Nurses Working in an Acute Care Setting” (Qualitative Article). Table 4.2 From Textbook: Guide To A Focused Critique of Evidence

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Quality In A Qualitative Research Report Aspect of the Report Critiquing Questions Method (Research design and research tradition) 1. Is the identified research tradition (if any) congruent with the methods used to collect and analyze data? ● The identified research tradition was Descriptive Phenomenology. In a descriptive phenomenology study the researcher seeks to portray and depict “things” as people experience them. These “things” include hearing, seeing, believing, feeling, remembering, deciding, and evaluating. The research question was: What are the lived experiences of new graduate nurses in their first 12 months in the acute care clinical practice environment? The research tradition was congruent with the methods used to collect the data. The question that was asked seeked to examine the “things” the new nurses experience in their first months of working. 2. Was an adequate amount of time spent in the field or with study participants? ● The study was conducted over the first 12 months of the new nurses’ work in an acute care clinical practice environment. This is an adequate amount of time spent with the study participants as it seems like it is trying to capture the experience of “novice” nurses. According to Dr. Patricia Benner’s theory and book “From Novice To Expert”, the “novice” phase of a nurse takes place over the first year of working in a clinical setting. Benner, P. E. (1984). 3. Was there evidence of reflexivity in the design? ● According to Polit and Beck “the trustworthiness of the inquiry is enhanced if the report contains information about the researchers, including information about credentials. In addition, the report may need to make clear the personal 2 Running head: Critiquing A Qualitative Research Article connections the researchers had to the people, topic, or community under study. ● There was no evidence of reflexivity in the design as it made no connection to the researchers. The one of the researchers is an instructor at the Jersey College of Nursing in Tampa Florida. Throughout the research it only says that the participants are from a clinical setting in southwest Florida but it actually says which clinical setting it is and the connect of the researchers to that clinical setting. Sample and setting 1. Was the group or population of interest adequately described? Were the setting and sample described in sufficient detail? ● Yes, McCalla-Graham, & De Gagne, (2015) adequately describes the group included in the study, which inclusion criteria is nurses who are in practice in acute care clinical settings who have been employed and experienced in the area for 12 months. The exclusion criteria involved nurses who were licensed practical or vocational nurses, or those who were licensed via endorsement. McCalla-Graham, & De Gagne, (2015) describes the setting and sample, which included all participants who were located and employed in acute care environments within southwest Florida. 2. Was the best possible method of sampling used to enhance information richness? ● McCalla-Graham, & De Gagne, (2015) used purposeful sampling which entails deliberately choosing the types of participants who will best contribute to the study. The sampling is purposeful because McCalla-Graham, & De Gagne, (2015) simply selected people who experienced the phenomenon being investigated in the study. Purposeful sampling meant that the participants were the type of people who could best enhance the understanding of the phenomenon. 3. Was the sample size adequate? Was saturation achieved? ● Data saturation was achieved since McCallaGraham, & De Gagne, (2015) provided interview questions which ensured that all the aspects of the relevant phenomenon were covered. The sample 3 Running head: Critiquing A Qualitative Research Article size was sufficient based on the type of study, descriptive phenomenology, which tends to use a small sample of participants, only 10 or fewer. Data collection 1. Were the methods of gathering data appropriate? Were data gathered through two or more methods to achieve triangulation? ● The methods of gathering data was appropriate in that they selected a sample that would provide the information needed in the study. This was achieved using exclusion criteria. Anonymity was also maintained and nursing educators/experts developed the interview protocols and guidelines. In-depth interviews were conducted in a qualitative manner where open-ended questions were asked. The interviews were also tape recorded to ensure that all of the information was captured for a thorough analysis of the data. Data was collected and interpreted in multiple ways. 11 interview questions were asked and these questions enabled sub-questions to be answered. The phenomenological method of data analysis was used and information was collected and processed with the use of two software systems (CAQDAS and NVivo10). After the data was analyzed by the researchers, subjects were able to analyze their results and provide feedback. 2. Did the researcher ask the right questions or make the right observations? ● Researchers were able to ask the right questions in that they broke down their questions into 3 categories. The questions focused on the knowledge, skills and environments new graduate news experienced as they transition from nursing school and working as a nurse. Researchers observed a general census in the responses. 3. Was there a sufficient amount of data? Were they of sufficient depth and richness? ● In this study, there were sufficient amount of data collected where the researchers observed a general census in the responses. The open ended general questions also enabled sub-questions. Procedures 1. Do data collection and recording procedures appear 4 Running head: Critiquing A Qualitative Research Article appropriate? ● Descriptive phenomenology data was collected for this qualitative research report and was conducted appropriately. Phenomenology data consists of indepth interviews and other written forms. The data collected for new graduate nurses in acute care setting was done in such a way, that nurses in this study were all interviewed. The research study explained that it was studying nurses who had 12 months or less of experience prior to acute care. ● This form of recording was appropriate in this study because it allowed for an in-depth approach of why these graduate nurses felt that they would have benefited from more “worst case scenario” clinical rotations before entering the acute care field. 2. Were data collected in a manner that minimized bias? Were the people who collected data appropriately trained? ● The data collected was based off new graduate nurses in the acute care setting, in Southwest Florida. There was bias in this study since it was just based off one city in Florida. The study could have resulted in less bias if it included different cities. Also, all the nurses being interviewed, except one, all had a second career. ● The people who collected the data were appropriately trained. The approval of this study was conducted by the university’s institutional review board. The interviews were conducted privately for a time of 45-60 minutes each. The data was recorded and transferred to a computer-based program in order to provide appropriate analysis. The participants of the study were allowed to review the transcript and approve it. Enhancement of trustworthiness 1. Did the researchers use strategies to enhance the trustworthiness/integrity of the study, and were those strategies adequate? ● Integrity in a qualitative research study, the researcher must reflect and repeatedly check the validity of the data. In this case, the researcher reflected on the data provided by the graduate nurses and used their personal reflection. The nurses being allowed to review the data, makes the 5 Running head: Critiquing A Qualitative Research Article research study trustworthy. 2. Do the researchers’ clinical and methologic qualifications and experience enhance confidence in the findings and their interpretation? ● The researchers are both registered nurses with PhD level education, but they do not elaborate on their own reflection in the experience of working in an acute care setting. The researchers are aware that there is a gap between nursing school education and acute care bedside nursing. We don’t know if they were in that same situation post-graduation, however, their experience being nurses does enhance their confidence in their findings and interpretation. Results (Data analysis) 1. Was the data analysis strategy compatible with the research tradition and with the nature and type of data gathered? ● The identified research tradition was Descriptive Phenomenology which is meant to portray and depict the things people experience. The results were summarized according to the major topics of the interview: knowledge, skills, and environment related to working in an acute care setting as new graduate nurses. This is compatible with the research tradition because it captured key “things” that the new nurses experienced throughout their first 12 months of working. 2. Did the analysis yield an appropriate “product” (e.g., a theory, taxonomy, thematic pattern)? ● Yes, the analysis yield an appropriate “product”. The researchers study brought forth three themes: 1. Knowledge: The general consensus of the research participants indicated that nursing school provided basic knowledge for the neophyte nurses, but it did not actually prepare them to function effectively in their first 12 months in the acute care clinical learning setting. 2. Skills: Many of the participants expressed that they lacked practical skills to complete the assignment. 3. Environment: Several participants expressed that their transition from nursing school to 6 Running head: Critiquing A Qualitative Research Article the acute care clinical setting was problematic. 3. Did the analytic procedures suggest the possibility of biases? ● The analytic procedures did not suggest the possibility of biases. In the research it states that the written descriptions of the new graduate nurse experiences were broken down into “meaningful units derived through the identification of themes”. A software was used to facilitate the coding process. After all the data was coded it was brought back to the interviewees to so that they could read the transcriptions to validate the contents. “This process involved debriefings and discussions with study participants by providing them with the analyzed research data for a final validation step.” McCalla-Graham, & De Gagne, (2015) Findings 1. Were the findings effectively summarized, with good use of excerpts from the data and with strong supporting arguments? ● Findings provided in the discussion section are of high quality and well interpreted by the researchers. The findings are precise and all necessary information is given for the reader to fully understand the study. There are many previous studies included in the discussion section to relate the findings and prove them important in the aim to understanding good nursing care for patients in an ICU setting provided by the novice nurses.. The researchers have many interpretations that are well supported by other studies and some that contradict based on differing methods among studies. 2. Did the themes adequately capture the meaning of the data? Does it appear that the researcher satisfactorily conceptualized the themes or patterns in the data? ● The major 3 themes were well developed and described in the findings section and well related to the original research purpose of explaining the phenomena of high attrition among new graduate nurses in the acute care setting. The article goes into detail about the reasons for nurse’s concerns about bridging their knowledge gap with their previous education, the importance of practical skills in order to effectively function, and finally 7 Running head: Critiquing A Qualitative Research Article concern for nurses difficult transition from school to the acute care clinical setting to work as new graduate nurses. 3. Did the analysis yield an insightful, provocative, authentic, and meaningful picture of the phenomenon under investigation? ● The findings of the conducted analysis were relayed in very insightful, authentic and meaningful way. It captivated the attention of the reader and portrayed a well developed idea on the matter. Detailed description of the findings on researched phenomena revealed direct correlation between educational preparedness, amount of experience and performance by the novice nurses in the ICU settings. Summary assessment 1. Do the study findings appear to be trustworthy- do you have confidence in the truth values of the result? ● When analyzing the findings of the study, the truth values of the results is valid. McCalla-Graham, & De Gagne, (2015) offers an in depth analysis of the sample and the interview process offers great insight into the condition of nursing shortage in the United States. 2. Does the study contribute any meaningful evidence that can be used in nursing practice or that is useful to the nursing discipline? ● This study does contribute meaningful evidence, McCalla-Graham, & De Gagne, (2015) offers insight into what can be done to curb the attrition of nurses. They suggest that measures (from employment organizations) should be put into place to retain graduate nurses to decrease the issue of high turnover rates in acute care settings and that efforts should be made to assist in the transition from nursing school to the workforce to keep people in the profession. The findings of the research are transferable and have practical application. 8 Running head: Critiquing A Qualitative Research Article 9 References: Benner, P. E. (1984). From novice to expert: Excellence and power in clinical nursing practice. Menlo Park, Calif.: Addison-Wesley Pub. Co., Nursing Division. McCalla-Graham, J. A., & De Gagne, J. C. (2015). The lived experience of new graduate nurses working in an acute care setting. The Journal of Continuing Education in Nursing, 46(3), 122-128. Polit, D. F., & Beck, C. T. (2018). Essentials of nursing research: Appraising evidence for nursing practice (9th edition.). Philadelphia: Wolters Kluwer Health /Lippincott Williams & Wilkins. Article Critique Quantitative Assignment Group 2 Emotion and Coping in the Aftermath of Medical Error: A Cross Country Exploration. Method • Was the most rigorous possible design used, given the purpose of the research? The purpose of this research was to,” investigate the following the professional or personal disruption experienced after making an error, b) the emotional response and coping strategies used, c) the relationship between emotions and coping strategy selection, d) influential factors in clinicians’ responses, and e) perceptions of organizational support.” A cross sectional, cross country survey of 265 medical professionals was conducted in order to research and evaluate how medical errors influence and effect medical professionals. A cross sectional study, “is an observational type of study that analyzes data and variables collected at one given point of time across a sample population”. I think a cross sectional study was the most rigorous possible design used because the study purpose is to to describe the overall picture of a situational problem by asking a cross-section of a given population at one specified moment in time. • Were appropriate comparisons made to enhance interpretability of the findings? A number of variables, such as level of emotions or type of emotions, were placed in comparison to facilitate easy interpretation of the data. • Was the number of data collection points appropriate? I believe the data collection process was appropriate because the study was able to gather and measure information on topic of interest. The data collection was organized and efficient which enabled the researchers to test hypotheses, and evaluate outcomes. • Did the design minimize biases and threats to the validity of the study? The design minimized biases because they kept the data confidential and distributed on multiple platforms. “Participants were presented with the study information sheet and consent form and completed an online or paper survey. No identifiable information was gathered, surveys were completed confidentially, and paper copies were returned using freepost envelopes.” Population and Sample • Was the population identified and described? Was the sample described in sufficient detail? Yes, the population and sample were described in sufficient detail. The population was 265 physicians and nurses in 2 large teaching hospitals in the United Kingdom and the United States. The sample size was described as the following, “A responder sample was used, and a cross-section of health professionals was recruited in this way, but only data from the physicians and nurses were included because the sample sizes of the other health professions, despite being proportional, were too small to draw statistical comparisons.” • Was the best possible sampling design used to enhance the sample’s representativeness? Were sample biases minimized? The responses received through responder sampling are commonly biased towards the given topic. As a responder the person usually chooses to volunteer for the survey because they might have strong opinion towards the subject. • Was the sample size adequate? Was a power analysis used to estimate sample size needs? The sample size was adequate and fit into the appropriate demographics for the given study. The study never stated if a power analysis was used to estimate the sample size needs. Data Collection and Measurement • Were key variable operationalized using the best possible method? (Interviews, observations, and so on?) Yes, the researchers used the Health Professional Experience of Error Questionnaire (HPEEQ) to assess the emotional and coping strategies of the healthcare professionals who made medical errors. This tool was developed from past data describing different levels of error. • Are the specific instruments adequately described, and were they good choices, given the study population? The study population consisted of nurses and physicians in two teaching hospitals. The instruments used for the study included descriptive statistics, surveys, and the questionnaire. The questionnaire was highly described including what each section was composed of and what is was measuring. The authors of the study explained the self-reported measures were the best option due to the nature of the study: medical errors and emotion regarding the medical errors. • Did the report provide evidence that the data collection methods yielded data that were high on reliability and validity? No, but the results were taken directly from the study itself. The authors did not report the validity of the study. They stated that it was difficult to assess the assessment tool because it is a relatively new area of research. They also stated that since it is a new area of research, there is not much to compare the study against. Procedures • If there was an intervention, was it adequately described, and was it properly implemented? Did most participants allocated to the intervention group actually receive it? The study was conducted to see how healthcare professionals cope with the aftermath or medical errors. The researches speak of the emotional and mental strain that these errors cause physicians and nurses. The study used surveys to collect data from the healthcare teams to see what resources are available after errors have occurred. The study confirmed that there are resources available for healthcare professionals after medical errors are made. • Were the data collected in a manner that minimized bias? Were the staff who collected data appropriately trained? The study was a cross sectional cross-country study that invited all healthcare professional to participate. They used newsletter, paper copies at trainings and emails to get the surveys data collection. In the end the data only included physicians and nurses because there was an inadequate number of other participants. Data Analysis • Were appropriate statistical methods used? Yes, descriptive statistics were used in this study. The researchers provided percentages of describe the population study (125 physicans and 145 nurses (N=265), UK sample included 61 physicians and 65 nurses, etc.) • Was the most powerful analytic method used? (eg., did the analysis control for confounding variables?) The researchers used a multivariate analysis of variance (MANOVA) to analyze for different variables. Initially they assumed location of the subjects would make a difference in results and later found out that it played a smaller role than they thought. • Were Type I and Type II errors avoided or minimized? Type I and II errors were avoided because this study was just based on finding the amount of disruption after a medical error, the emotional response and the subsequent coping strategies, the factors influencing the response and the population’s perception of support. The study did not have a strong hypothesis. Findings and Interpretation • Was information about statistical significance presented? Statistical significant is very important information. If the researchers report that the findings are statistically significant, it means that the results are true and able to be copied and reproduced exactly with a new sample. The researchers also report the significant level, the significant level it is an index of how probable it is that the results are reliable and represented by the latter p . In our article “Emotion and Coping in the Aftermath of Medical Error: A CrossCountry Exploration” in the result section the researches discuss statistical significant in the parts.” • Was information about effect size and precision of estimates presented? Confidence interval (CI) the range of values with in which a population parameter is estimated to lie at specified probability. CI it is as a range of possible values for the population mean. In our article ” Emotion and Coping in the Aftermath of Medical Error: A Cross-Country table 1 we can see that our CI is 95 percent confidence level has a 95 percent chance of capturing the population mean. That means if the experiment were repeated many times, 95 percent of the CIs would contain the true population mean. • Was clinical significance of the findings discussed? Clinical significant is the practical important of researchers results in terms of whether they have actually, noticeable effect on the daily lives of patients. “Apply the resource to two different hospitals The Brigham and Women’s Hospital that support the program that was develops and continue to improve based on growing and understanding of how best to help clinicians how to manage with unfortunate events. “ Summary Assessment • Limitations of this study included recall of events and social desirability. Some of the participants may have not answered truthfully because of fear of what others might think of their behaviors. • “Participants were asked to recall emotion and coping responses relating to previous error, but the ability to retrieve this episodic information regarding a discrete event declines quickly over time, rendering these reports subject to inaccuracies, particularly in the detail (Armitage, et al, 2015).” • It is hard to say that this study is valid because of the many factors that affect people’s emotions and there is no true way to know whether they are answering truthfully. • This study does contribute meaningful evidence that can be used in nursing practice. • Errors need to be reported and noticed so that changes can be implemented to reduce errors from happening. • Nurses need to have a program where they can deal with the emotional effects of making medical errors. • In the study they mentioned peer programs where the nurses can talk about their feelings with trained peer supporters. If nurses had more emotional support, they might be more open to discussing these medical errors. • “An extrapolation from this and many other studies would suggest that helping support clinicians after adverse events might, in addition to preventing further errors and individual burnout, facilitate more transparent and compassionate disclosure (Armitage, et al, 2015).” • If nurses were able to disclose information regarding the error and be provided with ways to cope and prevent further errors from happening it would benefit both the patient and the nurse. Bibliography Armitage, G., Gardner, P., Harrison, R., et al, Emotion and Coping in the Aftermath of Medical Error: A Cross Country Exploration. Journal of Patient Safety. 2015;11:28-35. Running head: CRITIQUING QUANTITATIVE RESEARCH ARTICLE 1 Group 4 Critiquing Quantitative Research article: “ Bullying among nursing staff: Relationship with psychological/ behavioral responses of nurses and medical errors” CRITIQUING QUANTITATIVE RESEARCH ARTICLE 2 Method: Research Design Was the most rigorous possible design used, given the purpose of the research? Wright and Khari (2015) probe how bullying among the nursing staff affects them physiologically, and how it leads to psychological/behavioral responses. The study is a nonexperimental quantitative research. This design is suitable for such a review since it does not require experimental data, owing to its large sample size over a short period. Wright and Kari (2015) opted to use a non-experimental study design, meaning that no intervention was needed at the time of research. There was no indication for including experimental designs, which warrants a response. Were appropriate comparisons made to enhance the interpretability of the findings? The comparison employed in the study was useful in showing the critical relationship between the variables as demonstrated by the results, which outlined a positive correlation between bullying, behaviors, and medical errors. The study used a temporal relationship between bullying and its effect as part of inferring causality. Although there was a positive temporal relationship between person-related and work-related bullying and their impacts. Physical intimidation was significantly compromised, as it showed no positive relationship with either outcome (Wright & Khari, 2015). Additionally, this study was a descriptive, cross-sectional study and used a prospective correlation design. The design was not appropriate. Was the number of data collection points appropriate? The number of participants was necessary, though a 23% response rate lowered the credibility of the findings. The timing was also suitable for the type of study. However, it would be better if an experimental design was employed, using a control group to ascertain the best CRITIQUING QUANTITATIVE RESEARCH ARTICLE 3 relationship. Polit and Beck (2018) explain the significance of an empirical study in associating a strong correlation between placebo and actual intervention. Did the design minimize biases and threats to the validity of the study? The procedures were not sufficient; more ways like randomization and matching would be suitable, only if the study design would be a different one. Wright and Kari (2015) controlled the confounding effects by restricting their research to nurses across three primary facilities. The significant drawbacks of the model used include exposure to biases, which the researchers never sought to control through randomization although data analysis was done using NAQ-R method. The external validity of the study was not adequately addressed as there was no inclusion of literature review from comparative studies. Population and Sample Was the population identified and described? Was the sample described in sufficient details? The population identified in Wright and Kari (2015) are registered and licensed practical nurses. The participants were to come from an unidentified university hospital system in the Midwest. Age and work experiences were described after examining the participating nurses. Correct sampling during research is an essential factor in the validity of a study (Bacchieri, 2014). The eligibility and exclusion criteria were not identified. Was the best possible sampling design used to enhance the sample’s representativeness? Were sample biases minimized? The sampling design used is a non-probability type, specifically purposive sampling. The sampling population is the nursing profession, both licensed and registered nurses. This sampling plan is not suitable for yielding a representative sample. One setback on non-probability CRITIQUING QUANTITATIVE RESEARCH ARTICLE 4 sampling method is the likelihood of producing a non-representative sample and high chances of bias (Solvik & Struksnes, 2018). Was the sample size adequate? Was a power analysis used to estimate sample size needs? Potential study participants were 1,078. The survey opted to interview all of them, but only 23% actively participated. Out of the 248 of the returned questionnaires, only 241 were completed. The sample size was, thus, affected as there was no accurate representation of the sample population. The study concluded that there was a positive correlation between bullying and physiological responses and medical error. Due to a large number of the non-respondents, the non-probability method of sampling, and the likelihood of biases in the research, the statistical validity of the study conclusion is not justified. The demographics and critical characteristics of participants were adequately addressed in the first part of the survey. The ages and sex were both analyzed in terms of mean and percentage, thus, giving a broad overview of the population sample (Wright & Kari, 2015). The study can be generalized to nurses in the hospital setting, although a better sample might give a different result. The relationship sought affects those nurses in clinical areas, who actively interact with patients and other cadres. Data Collection and Measurement Were key variables operationalized using the best possible method? The general feeling is that the researchers used the best method to capture the study phenomenon through the use of online surveys. Bacchieri (2014) talks of the significance of a well-outlined data collection plans for both quantitative and qualitative research. Online CRITIQUING QUANTITATIVE RESEARCH ARTICLE 5 questionnaires are essential in a situation where participants are many, and the study needs to be conducted within a short time. There was no triangulation of methods. Only online surveys were employed, which reduced the validity of the data. Respondents used self-reports, hence, making the researchers not prudent in their choice of soliciting information. Internet questionnaires are not reliable due to difficulty in following up the respondents. It is difficult to know which respondents have begun filling the surveys, those that are halfway, and those that are done but have not submitted. Composite scales are used to approach data collection, and such was employed in the study. For example, the Likert scale was used to assess different variables of the study. Are the specific instruments adequately described, and were they good choices, given the study purpose and study population? The research report provided only information about the data collection procedures and methods, thus, not adequate. It only described how demographic data was gathered and the use of Negative Acts Questionnaire-Revised (NAQ-R) in defining the frequency of the variables. Observational bias was never addressed due to the difficulty in assessing how self-administered online surveys were done. No biophysiological measures were employed in the study. There was no information about a well-outlined data collection procedure and also no insight on the training of data collectors. This is because the primary method was through online surveys (Wright & Kari, 2015). Did the report provide evidence that the data collection methods yielded data that were high on reliability and validity? CRITIQUING QUANTITATIVE RESEARCH ARTICLE 6 It is difficult to talk about whether the report gave evidence of the reliability of measures as this cannot be assessed. As a result, it is right to conclude that the quality of data in the research was not satisfactory. A high number of biases were witnessed from the method of data collection, that is the use of unmonitored online surveys. The researchers need to improve future data collection methods. Procedures: If there was an intervention, was it adequately described, and was it properly implemented? Did most participants allocated to the intervention group actually receive it? This study sought to explore the relationship between several types of bullying among nurses: person-related, work-related, and physically intimidating with the resultant psychological/behavioral responses from the victims, along with the commission of medical errors. In essence, the study attempted to demonstrate a relationship between bullying and responses of the victimized nurses which indirectly impacted the level of productivity, delivery of care, turnover rates and other financial costs imposed on the organization. This was about establishing a correlation between bullying and nurses psychological/behavioral responses (Polit et al; chapter 9). No intervention was introduced or utilized in this article. It is a correlational research study and it is non-experimental Were data collected in a manner that minimized bias? Were the staff who collected data appropriately trained? Care was not taken to ensure the validity and credibility of the sampling due to the fact that, questionnaires were forwarded to nurse managers whom were expected to distribute them to their staff. It was indicated in the article that, some participants might not have received the questionnaires because of the way in which they were distributed due to some nurse managers biases and bad intentions. It was believed that some supervisors that are engaged in the bullying CRITIQUING QUANTITATIVE RESEARCH ARTICLE 7 would be motivated to keep the questionnaires away from participants in order to keep victims from revealing their unfortunate experiences. The process by which questionnaires were disseminated, as aforementioned significantly lowered the amount of participants in the study. Also, the article indicated that, questionnaires were forwarded to the same organization’s employees in three different facilities. There were a number of individuals floating throughout those facilities, which definitely affects the amount of individuals sampled and might have resulted in the same individuals responding to the same study questions. Data collection was limited to this specific organization not a swath of nurses across several organizations or regions. In this regard, the study is very limited because it is not representative of a large swath of practitioners. The data that were collected were measured with scientific methods, there are no observable signs of biases during this stage Were appropriate statistical methods used? Yes, The Negative Acts Questionnaire – Revised (NAQ-R; Einarsen et al., 2009) is a proven and effective measuring tool. It is a credible and valid tool in measuring bullying across the work-place. The Researcher in this study identified three categories of bullying behaviors: work-related, person-related, and physical intimidation (Wright & Kari, 2015). Another appropriate measuring tool that was utilized in this study is the “Rosenstein & O’Daniel assessment tool. This instrument has been used in several studies to determine the impact of work-place tensions, conflicts and strife on behavioral responses of the victims of bullying Was the most powerful analytic method used? (e.g., did the analysis control for confounding variables)? The confounding variables in the article were age, gender and the facilities. The study sought to analyze the impact of these covariates by evaluating their impacts on the overall CRITIQUING QUANTITATIVE RESEARCH ARTICLE 8 outcome. The impact of the “facilities” variable was insignificant to the outcome due to the fact that the leadership and individuals that work within them are essentially the same individuals. However, the impact of the “age and gender,” variables were significant. The study found that person related bullying (which is a form of informal bullying such as ridiculing, gossip, hazing), is higher among younger and less experienced nurses and that men experienced more workrelated bullying. (Whitney et al., 2015). All the aforementioned variables were accounted for, in the synthesization of the overall outcome. In its final analysis, the study underlines that a relationship exists between bullying and behavioral/psychological responses of those victimized, irrespective of those other variables described Were Type I and Type II errors avoided or minimized? Type I error is when a null hypothesis that is true is rejected by the researcher. Type I error can be minimized by choosing the smaller level of significance, alpha level. In the research, alpha level is .001. P value is smaller than alpha level ( p
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