Critical Analysis of Research for Patient Treatment Decisions

Author

Suzanne Hopper, RDH, MAEd

Oregon Institute of Technology

Citation

Hopper, S. (2015). Critical analysis of research for patient treatment decisions. Oregon Institute of Technology.

Description

Teams of three to four students are assigned patient clinical scenarios in which they identify the patient problem, conduct computerized searches to find valid and reliable research to answer the clinical question, summarize the results, and determine how the answer will affect their patient treatment decisions.

Background and Context

The main DQP Proficiency this assignment addresses is “Applied and Collaborative Learning”, and to a lesser extent “Intellectual Skills”.

The assignment is used in the course Research Methods II, which is the second course in a two-course sequence. Students are seniors in our dental hygiene program. Teams of three to four students are assigned patient clinical scenarios in which they identify the patient problem, conduct computerized searches to find three research articles that answer the question, summarize the results, and determine how the answer will affect their patient treatment decisions. As students critically analyze the research, they address issues of validity, reliability, bias, and clinical/practical significance. The assignment is repeated three weeks in a row several weeks into the course. The goal of repeating the assignment is to develop research and analysis skills to help students determine treatment decisions for their patients in the school clinical setting and in their future work setting.

Evidence-based decision making (EBDM) is the cornerstone for making treatment decisions in the medical and dental fields. EBDM not only involves finding valid and reliable research studies that answer the clinical question, but also takes into account the clinician’s experiences and expertise, collaborating with other professionals, and the patient’s preferences.

Although the assignment could be completed individually, I believe the value of the learning experience comes from students working collaboratively in small groups. The process of determining best methods for treating patients relies on intra-professional and inter-professional collaboration. While working in teams students exchange resources, discuss and analyze information, and determine validity and reliability of research. But more importantly they work together to determine the practical and clinical significance of their conclusions and determine a final treatment outcome for the patient scenario. Future healthcare professionals need the skills and knowledge of this type of EBDM process to effectively treat their patients.

Alignment and Scaffolding

In Research Methods I emphasis is placed on understanding the importance of EBDM, identifying patient/clinical treatment problems, developing Problem, Intervention, Comparison, and Outcome (PICO) questions, distinguishing between levels of evidence in research studies, conducting searches for appropriate articles, and introducing students to analysis of research.

This assignment occurs several weeks into the subsequent course – Research Methods II. At the beginning of the course we review information learned in Research Methods I and then dive more in-depth to critical analysis of research.

After working in small groups repeating this assignment three times with three different clinical scenarios, the students transition to working individually over the next couple of weeks in the course. Instead of assigning a patient problem/clinical scenario, the student chooses a patient problem from their own patient pool in their school clinic. The student will repeat this activity two times, using two different patient scenarios.

The ultimate goal is for students to have the EBDM knowledge and skills needed to make treatment decisions for their patients in their future clinical work settings.

This assignment would be useful for any students in any healthcare professional program (i.e. nursing, respiratory therapy, medical imaging, etc.). Instructors could assign case scenarios and/or have students determine their own case scenario from one of their patient experiences. I also believe the assignment could be adapted and used in any major that requires students to research, critically analyze, and summarize information to solve problems (i.e. psychology).

Reflections

I teach this course online to dental hygiene students at two different campuses. This assignment easily works for the on-campus or online environment. I’ve used this assignment for three years and have enjoyed seeing it evolve. During the first week before the assignment is due almost all teams email me with questions to make sure they are on track. I find the most valuable aspects of their learning experiences come from working in small teams and asking me for guidance and feedback as they work on the first assignment. The second week students continue to ask for feedback, but they need less from me. By the third week almost all teams produce high quality work without guidance from me. I enjoy watching them become very discerning and critical when reviewing research and almost always agree with their conclusions.

The main struggle students face is finding free, full-text articles. After attending a workshop in which this assignment was peer-reviewed, I will implement a new strategy as I move forward with this course. It came to my attention that not all of the articles need to be full-text. Although I believe there is value in reading full-text research articles, in the busyness of the working-world professionals often rely on reading abstracts only. I’m going to change the requirement from “three full-text articles” to allowing students to use one abstract in place of one of the full-text articles if they have difficulty finding three full-text articles that address their PICO question.


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