Reflection on Learning

1. Write a brief 1–2 paragraph weekly reflection(one reflection per each week 1,2,3,4,5,6,7) addressing the questions posed in the Reflect section of each week. Edit your Reflection to include each weekly reflection. Presents information using clear and concise language in an organized manner (Free of errors in English grammar, spelling, syntax, and punctuation).
2. Include the following sections in your Reflection:

1. Week 1
   • Provide one specific example of how you achieved the weekly objectives. ( This week I appraising and determining the Level of Evidence and Grade of Quality for a qualitative study, summarize my findings using the Johns Hopkins Research Evidence Appraisal Tool and the Johns Hopkins Individual Evidence Summary Tool.)
   • What did you learn about your capacity to read and appraise original qualitative research? What changed, if anything, following the week’s activities?
   • How will this skill improve your effectiveness as a practice scholar?   

 [This week’s objectives as per professor: Compare and contrast differences and similarities of qualitative, quantitative, and mixed-method designs. we discovered that, more and more, nurses are using qualitative data to provide a holistic understanding of a phenomenon. As a practice scholar, you’ll use qualitative inquiry and data to enrich your understanding of a practice problem. Good qualitative research uses a systematic and rigorous approach that aims to answer questions that address what something is like (such as a patient experience), what people think or feel about something that has occurred, or why something has happened. Different from numbers, qualitative data often takes the form of words or text and images. Nurses with advanced education are called to transform the health of our nation. I have no doubt that you’ll answer the call by translating best evidence to gain new insights on needed change.]

1. Week 2
   • Provide one specific example of how you achieved the weekly objectives.
   • What did you learn about your capacity to read and appraise original quantitative research? What changed, if anything, following the week’s activities?
   • How will this skill improve your effectiveness as a practice scholar?

 [Profesor comments about week objectives: This week you have Appraising Quantitative Research the Johns Hopkins Research Evidence Appraisal Tool and the Johns Hopkins Individual Evidence Summary Tool. Let’s recap what you learned this week. We continued our dialogue about research designs by examining quantitative inquiry and data. You appraised a quantitative research study with my guidance, and reflected on how quantitative methods differ from qualitative methods. You continued building an evidence summary table, adding two quantitative research studies. That’s a lot of progress! I know you gained an understanding of how the research question drives the selection and appraisal of the design. What’s more, you explored how the roles of quantitative inquiry and data can be used by the practice scholar to influence patient outcomes.]

1. Week 3
   • Provide one specific example of how you achieved the weekly objectives.
   • What did you learn about your capacity to read and appraise summaries of research evidence? What changed, if anything, following the week’s activities?
   • How will this skill improve your effectiveness as a practice scholar?

[Profesor comet about week objectives: Hello, and welcome to Week 3! Last week, you explored quantitative inquiry and data. This week, we’ll take that knowledge a step further—you’ll have the opportunity to investigate summaries of multiple research studies, including systematic reviews. In the hierarchy of evidence quality, systematic reviews of randomized controlled trials are considered the gold standard of evidence. During this week’s leg of the journey, you’ll learn how to appraise systematic reviews and other summaries of multiple studies using the Johns Hopkins Nursing Evidence-Based Practice Research Evidence Appraisal Tool. I bet you’re getting familiar with this tool after applying it in Weeks 1 and 2. Using this industry standard provides a systematic process of appraisal and assists you in locating high-quality evidence. Besides systematic reviews, we’ll examine other summaries of multiple studies, including an integrative review, meta-analysis, and meta-synthesis. How does an integrative review, meta-analysis, systematic review, and meta-synthesis differ? I’m sure you’re ready to find answers to these questions, so let’s get started!  This week’s focus was summaries of multiple studies. You examined how the integrative review, meta-analysis, systematic review, and meta-synthesis differ and how they are similar. More importantly, you learned the value and importance these research summaries play in informing practice change. Research is a critical component in solving practice problems. As a DNP-prepared nurse, your critical appraisal of research study articles includes reviewing research to locate high-quality evidence. After just three weeks, look how far you’ve come already! Let’s move on to Week 4.]

1. Week 4 
   • Provide one specific example of how you achieved the weekly objectives.
   • How has the course information influenced your understanding of descriptive statistics?
   • How can you bring this information of statistical analysis to practice?

[Profesor comet about week objectives: Week 4 marks the midpoint of your journey in NR714! You’re making tremendous progress in learning analytic methods! This leg of the journey involves the exploration of data analysis. If you’re at all like me, you might feel anxious about analyzing qualitative and quantitative data. Don’t worry! You’ll have lots of support from me and your course faculty. Most likely, you’re already familiar with some aspects of data analysis, and this week, we’ll explore some of the most widely recognized statistical procedures. I think you’ll enjoy exploring the learning activity about descriptive statistics, where you’ll analyze data from a real scenario to see how statistics inform practice change. As you review weekly content, consider how to research study data management and statistical analysis directly influence the conclusions made by researchers. In a scientific study, the concepts in which a researcher is interested are referred to as variables. One distinction relates to independent and dependent variables. Another distinction that has relevance for statistical analysis concerns discrete and continuous variables. This week we learn about that.

 A power analysis is a statistical procedure needed to determine an effective sample size to make a reasonable conclusion.

Power Analyses (Ali & Bhaskar, 206; Polit & Beck, 2017)

• Helps to decide how large a sample is needed to make sure judgments about statistical findings are accurate and reliable.
• Prevent the recruitment of too many or too few numbers of subjects.
• Must be used to determine sample size before the study begins

Chi-Square is powerful for what it is intended to do – determine if variables are associated in any way. Chi-Square Analysis (Ali & Bhaskar, 206; Polit & Beck, 2017)

• Is a type of inferential statistic.
• Evaluates if two categorical variables (e.g., gender, educational level, race, etc.) are related (correlated) in any way.
• Appropriate for discrete variables (nominal, ordinal).
• Does not work with continuous variables (interval, ratio).

The null hypothesis states that there is no relationship between variables. As such, if the null is accepted, you are agreeing that there is no relationship between variables.

Null Hypothesis Testing (Polit & Beck, 2017)

• The beginning point for statistical significance testing.
• A formal approach to deciding between two interpretations of a statistical relationship in a sample.

Null Hypothesis – suggests there is no relationship between variables, populations, etc. meaning there was an error in sampling.

Alternative Hypothesis – suggests there is a relationship between variables, populations, etc.

Rejecting the Null Hypothesis – suggests being in support of the Alternative Hypothesis.

 Week 4’s concepts certainly offered some great information! Let’s take some time to go over everything you learned this week. This part of your journey focused on analyzing qualitative and quantitative data. You’ve probably realized that as you explored some of the most commonly used descriptive statistics, you’re already familiar with several of these procedures. But did you know that the Chi-Square Test determines whether two variables are independent or related? You do now! By using the knowledge of this and other descriptive statistical tests, you’ll be able to select high-quality evidence to lead successful change in practice. And with that understanding under your belt, you’re ready to move forward to Week 5! ]

1. Week 5
   • Provide one specific example of how you achieved the weekly objectives.
   • In what ways did course information influence your understanding of parametric statistics?
   • What goals will you set in accordance with what you have learned this week?

• [Profesor comet about week objectives: This week on your journey, we’ll explore how translating best available evidence to a practice problem requires knowledge specific to the critical appraisal of research studies. Of course, critical appraisal involves data analysis, so this week we’ll spend more time learning and applying statistical tests, specifically, parametric statistical tests. Parametric statistics can be used to examine relationships, make predictions, and examine causality. While you’ll likely use technology to calculate statistics, you do need to know which test aligns with the data and is best suited to answer the practice problem. We learn that one approach to judging the appropriateness of an analysis technique for a critique is to use a flowchart, which directs you by gradually narrowing the number of appropriate statistical procedures as you make judgments about the nature of the study and the data.   How does the practice scholar determine the appropriate statistical method? Let’s find out!  
• OBJETIVES Informing Practice Change Through Parametric Statistics

1. Select the appropriate statistical test to answer the research question.
2. Compare and contrast the use of parametric and nonparametric statistical tests.
3. Critique the statistical tests used to answer the research question.
4. Appraise the quality of data generated from selected statistical tests to guide practice.
5. Select appropriate literature to answer research question.

 let’s review everything you learned in Week 5. You now know that data analysis plays an essential role in your ability to translate best available evidence to a practice problem. After many years of chaotic attempts at progress, nurses have come to realize that, to be useful, evidence from data analysis must be carefully examined, organized, and given meaning. Evaluating the meaning of the study results and forecasting the usefulness of the findings to unique practice settings is the hallmark of the practice scholar. Now that you’re here, you understand not only the importance of data analysis, but also the skill needed to determine whether to use evidence in practice. This knowledge is vital to your role as a practice scholar! I can tell that you’re ready to move onward. See you in Week 6! ]

1. Week 6
   • Provide one specific example of how you achieved the weekly objectives.
   • What was the most rewarding learning experience you had this week?
   • How could you amplify the effectiveness of your skill in evidence synthesis and translation science?

• [Profesor comet about week objectives: Welcome to Week 6! This week, as you continue on your journey, we’ll explore evidence synthesis and its role in the translation of evidence to a practice problem. Over the past weeks, you’ve gained the knowledge and skills needed to read, review, and critically appraise published research. It’s time for the next step! A practice scholar takes what is learned from research studies and synthesizes it to highlight similarities, differences, and connections. Together, we’ll explore strategies for writing an evidence synthesis. I have no doubt that you’ll find this week’s content to be foundational to writing a practice problem statement that conveys the significance, relevance, and prevalence of a practice problem. In fact, you’ll integrate many of these important concepts into your assessment.  When a practice scholar synthesizes successfully, they present new ideas based on interpretations of published research evidence. Conceptually, it can be helpful to think about synthesis existing at both the local (or paragraph) level and the global (or paper) level. Synthesis is all about collecting information from different sources and putting it together as one piece of content.
• WEEK OBJECTIVES

1. Differentiate evidence synthesis from a literature summary.
2. Select appropriate literature to answer the research question.
3. Formulate an evidence synthesis utilizing quality research.

 Evidence synthesis plays a critical role in translation science. Many nurses confuse the evidence synthesis with an evidence summary. You now know an important difference. An evidence synthesis brings together information from different sources of information in order to interpret existing knowledge, identify knowledge gaps, and inform decision making. ]

1. Week 7
   • Provide one specific example of how you achieved the weekly objectives.
   • How has course information changed your ways of knowing?
   •  How does the knowledge gained advance your professional formation as a practice scholar?

• [Profesor comet about week objectives: Are you familiar with PICOT formulation? I thought I was when I started this course. Although I knew this important mnemonic, I came to realize that I wasn’t skilled at writing a focused, answerable practice question. It looks easier than it is! But with practice, I learned to be proficient in writing answerable questions. You will too! You’ll have lots of opportunities to develop and evaluate PICOT-formatted questions this week.  

 Week objetives

1. Develop a PICOT question using key search terms.
2. Construct a focused answerable question.

PICOT is a mnemonic for a formatting tool that serves two purposes. Each purpose is of equal importance to the practice scholar as the practice change project is designed.

• Assists with writing a clear, concise, one-sentence practice question.
• Assists with searching and retrieving relevant evidence in the robust scientific search engines. The formatting tool PICOT lends itself to the identification of keywords from each segment of the practice question. The ability to break a practice question into keywords is what makes searching for evidence.

ElementDescription

P      Patient/PopulationThe practice scholar states the relevant patients/individuals. What does the research literature say about the age, gender, specific characteristics, social  that would be important in this practice problem? The concise articulation of the population is supported by a synthesis of research evidence.

I        InterventionThe practice scholar states the research-evidence based intervention to be translated to practice. The research-evidence  based intervention is supported by research evidence. The practice scholar translates/transfers the research-evidence  based intervention as it was tested and empirically proven across research studies. Note: The practice scholar does not alter the research-evidence  based intervention. Implementation fidelity requires no changes be made to the empirically proven research intervention.

C         ComparisonThe practice scholar describes current practice. In a practice change project, the comparison is practice as usual.

O          Outcome

The practice scholar’s intention is to learn if the translation of a research-evidence based intervention influences local practice outcomes. Practice change projects are not intended to design or test an intervention, therefore, a prediction is not made as outcomes are identified.

The practice outcome may be singular or several stated outcomes. The practice scholar returns to research studies where the research-evidence based intervention was tested. These studies describe how study outcomes were measured. The practice scholar confirms that identified outcomes in the practice change project are numerical and are captured using reliable and valid measures.

Reliability in statistics and psychometrics is the overall consistency of a measure. A measure is said to have a high reliability if it produces similar results under consistent conditions. For example, measurements of people’s height and weight are often extremely reliable.

Validity in statistics and psychometrics refers to the extent to which an assessment accurately measures what it is intended to measure.

T      TimeframeThe timeframe for the DNP Practice Change Project is 8–10 weeks.