Nursing Research And Evidence-Based Practice: A Critical Appraisal On The Use Of Stimulants To Improve Academic Performance

Importance of Nursing Research and Evidence-Based Practice

Question:

Discuss about the Critical Evaluation of Evidence for Health Professionals.

Health professionals should be well-informed with current knowledge to allow them to deliver effective care and remain professionally pertinent. Also, it is vital for care providers to investigate the quality of new evidence before application in practice. Nursing research allows nurses to embrace best practice and evidence-based practice (EBP). The primary role of EBP is to deliver the most effective care that is available, with the aim of promoting patient outcome. This role is buttressed by the fact that clients expect to receive the best care based on the present evidence. EBP promotes a culture of inquiry in healthcare professional. It also promotes patient safety, improves clinical outcomes and minimises variation in patient outcomes (Boswell & Cannon, 2015). Nurses thus require critical appraisal skills as well as tools to advance their practice. Critical evaluation skills help users to determine which evidence is authoritative for use in practice. This assignment will evaluate the evidence presented in two articles on the use of stimulants to improve academic performance. Part B will discuss the barriers to the application of evidence in practice and how closely the articles adhere to the PICO elements.

Hildt, E., Lieb, K., & Franke, A. G. (2014). Life context of pharmacological academic performance enhancement among university students – a qualitative approach. BMC Medical Ethics, 15(1), 23-23. doi:10.1186/1472-6939-15-23

The authors are better placed to explore this topic due to their qualification and experience of working in the university. Hildt is an expert in philosophy and heads neuroethics research groups. Besides, her focus and interest is neurophilosophy, neuroethics and human genetics (Illes & Sahakian, 2013). Her knowledge in this area allows a better understanding of the human brain, principles of thoughts and conscience (Rabadan, 2015). Hildt is affiliated to the Johannes Gutenberg University of Mainz. Lieb and Franke are experts in psychiatry and psychotherapy. Based on their expertise, these authors understand mental illnesses and prescriptions. Both authors are affiliated to University Medical Centre where they work in the department of psychiatry and psychotherapy. The three authors declared that they have no competing interest in relation to the topic of study.

The study aimed to investigate the student’s experience and the effects of the use of prescription and illicit stimulants such as methylphenidate and amphetamines. Their research questions were: Why are stimulants used in academic contexts either by students and other persons? What are the impacts? Does the usage of stimulants in academic contexts offer benefits? How are students’ life affected? What are the side-effects encountered? (Hildt, Lieb, & Franke, 2014).The authors noted that there was lack of evidence-based data about the circumstantial factors as well as the real world impacts of academic performance enhancement through the use of stimulant drugs. This argument was used to justify the need for study.

Evaluation of Two Research Articles on the Use of Stimulants to Improve Academic Performance

The study used a sampling methodology, whereby 18 university students were involved. Only the participants who reported non-medical intake of illicit and prescription stimulants to improve academic performance were included in the study. A face-to-face interview was then conducted with a focus on the research questions. In a population, random sampling ensures that a subset (n) of the target population (N) is recruited. This method was appropriate for this study because the findings can be generalized (Bornstein, Jager & Putnick, 2013). Also, the researchers can tailor the questions based on sociodemographic factors.

The findings answered the aim and research questions comprehensively. Based on the conclusion, students consider stimulants as beneficial for enhancing academic performance and leading an active life. Students indicated that they use stimulants to maximise time, enhance motivation and help in memorizing (Hildt, Lieb, & Franke, 2014). On the effects of stimulants, the conclusion notes that there is inconsistency in the use of stimulants and academic performance.

The primary strength of the study is the use of randomised sampling, which allows for the generalisation of results (Greenhalgh, Bidewell, Crisp, Lambros, & Warland, 2017). Also, the right population was selected for this study. The major weakness of the research is coercion and undue influence over the student participating in the study. Students can offer informed consent in research; however, in a student-tutor relationship, it might be challenging to determine whether consent was sought.

Munro, B. A., Weyandt, L. L., Marraccini, M. E., & Oster, D. R. (2017). The relationship between nonmedical use of prescription stimulants, executive functioning and academic outcomes. Addictive Behaviors, 65, 250-257. doi:https://ift.tt/2fDSHfZ

The authors have expertise in diverse fields and can articulate the issue of the use of stimulants effectively. They integrated interdisciplinary knowledge to examine the topic. Both Munro and Weyandt are engaged in interdisciplinary neuroscience program and are affiliated with the University of Rhode Island. Marraccini, on the other hand, has expertise in medicine and is affiliated with several institutions including the University of Rhode Island. Oster specialises in psychology enabling them to understand the human brain and its functions. Oster is also affiliated with the University of Rhode Island. All the authors indicated that they did not have interests to disclose in relation to the study (Munro, Weyandt, Marraccini, & Oster, 2017).

The aim of their study was to analyse the relationship between nonmedical use of prescription stimulants (NMUPS) and executive functioning (EF) among college students. The authors hypothesised that students who have EF problems are likely to use NMUPS to enhance academic performance. Additionally, they hypothesised that NMUPS would facilitate the association between academic performance and EF (Munro, Weyandt, Marraccini, & Oster, 2017). The authors justified the study by arguing that previous studies had not focused on the link between EF and NMUPS among college students.

Barriers to the Application of Evidence in Practice

In this research, a convenience sample was selected from the eligible participants. Specifically, participants were recruited through email and Facebook web pages. A secure and encrypted site was used to allow the students deliver their feedback. The student demographic information was collected through questionnaires. A stimulant survey questionnaire (SSQ) was then used to quantify the extent of NMUPS (Munro, Weyandt, Marraccini, & Oster, 2017). The SSQ was appropriate for the study because it consists of a self-reported part, which allows students to answer yes or no. In addition, BDEFS for adults was also used to evaluate the misuse of stimulants among the selected population. The BDEFS was effective because it is inexpensive and offers useful information on a facet of EF in everyday activities (Barkley, 2011).

The findings of this study supported only one hypothesis. Based on the results, students who had EF problems had higher chances of NMUPS than those without EF problems. Nevertheless, the findings failed to support the hypothesis that there is a positive relationship between NMUPS and academic performance (Munro, Weyandt, Marraccini, & Oster, 2017).

The strength of this article is the focus on the relationship between EF and NMUPS only. This focus led to a comprehensive study that answers the hypothesis succinctly. The main weakness of the study was the use of a convenience sample, which limits the generalisation of the results.

Several factors act as barriers to the implementation of research findings. The lack of enough time for searching and reading articles is a key barrier (Al-Kubaisi, Al-Dahnaim & Salama, 2010). In one study, it was found that only 4.8 percent of nurses had read scientific articles weekly. This study also found that about 17.5 percent of all the nurses did not read scientific articles entirely (Oh, 2008). Based on the fact that clinical science databases are updated constantly, and illnesses, drugs and treatment techniques are constantly changing, failure to read scientific works is a serious thing. Another barrier is the lack of adequate time to execute new ideas. Nurses require enough time for research and implementation of clinical findings (Bahadori, Raadabadi, Ravangard, & Mahaki, 2016). However, most nurses feel that their workload does not leave adequate time as well as energy to execute new ideas. This belief causes most nurses not to apply the evidence of research in practice. Time management is thus an important barrier since implementing research evidence is time-consuming (Tacia, Biskupski, Pheley & Lehto, 2015). The lack of enough facilities and equipment to apply new evidence is a barrier. Some healthcare institutions fail to provide the needed facilities to facilitate the application of findings. This factor leaves nurses with no proper setting to use the evidence drawn from their research.

Alignment of the Articles with the PICO Elements

The lack of interest in research causes nurses fail to embrace empirical evidence in practice. Some nurses have a negative attitude towards research and thus do not appreciate new evidence. Additionally, nurses might lack the authority to change the techniques and patterns of care. These barriers are mainly individual factors although institutional factors play a fundamental role in the application of evidence in practice (Shifaza, Evans & Bradley, 2014).

PICO is an acronym for population, intervention, comparison and outcome, a tool that is often used for inquiry search in health (Richardson-Tench, Taylor, Kermode, & Roberts, 2016). In the PICO question, the population (P) is university performance, intervention (I) is stimulants and outcome (O) is academic performance. To determine how closely the research articles align with the PICO elements, there is a need to analyse their methods and methodology. The closeness of the article to the PICO is determined by the participants included in the study and interventions used.

In the first article, Hildt and colleagues seem to deviate a bit from the PICO elements. The selected population in the study was right since only university students were included.  Also, the intervention was right based on the PICO question because the authors focused on the use of stimulants only. However, the authors did not measure academic performance as the sole outcome. Instead, they focused on other outcomes such as general effects. The second article by Munro and colleagues was closely related to the PICO elements. The researchers did not seem to deviate from the PICO elements in the recruitment of participants and measuring of outcomes. In this research, Munro and colleagues recruited university students, focused on the use of stimulants and measured academic achievement as the only outcome.

Conclusion

As discussed in this assignment, the authors of the two articles strived to investigate the use of stimulants to improve academic performance. The articles seem to agree that university students use stimulants often. However, there is no evidence that stimulants improve academic performance. The two studies note that stimulants might improve awareness, memorisation and motivation, but may not improve direct academic performance. Wasim can use this evidence to determine if stimulants are related to high academic performance for university students. The student would realise that the use of smart drugs does not improve objective performance. The evidence provided by the two articles is authoritative since the authors know how the human brain functions. They are also affiliated with reputable universities and used primary data from university students who have been using stimulants.  The other area of focus for this assignment was the barriers to the implementation of evidence in practice. Most of the barriers arise from personal factors and can be addressed. Nurses require more knowledge on how to use scientific databases and time management skills for application of evidence in practice.

References

Al-Kubaisi, N.J., Al-Dahnaim, L. A. & Salama, R. E. (2010). Knowledge, attitudes and practice of primary health care physicians towards evidence-based medicine in Doha, Qatar. East Mediterr Health J.16(11), 1189-1197. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21218744

Bahadori, M., Raadabadi, M., Ravangard, R., & Mahaki, B. (2016). The barriers to the application of the research findings from the nurses’ perspective: A case study in a teaching hospital. Journal of education and health promotion, 5(1) 14. doi:  10.4103/2277-9531.184553

Barkley, R, A. (2011). The Barkley deficits in executive functioning scale. New York, NY: Guilford Press.

Bornstein, M. H., Jager, J., & Putnick, D. L. (2013). Sampling in developmental science: Situations, shortcomings, solutions, and standards. Developmental Review, 33(4), 357-370. doi:  10.1016/j.dr.2013.08.003

Boswell, C., & Cannon, S. (2015). Introduction to nursing research. Jones & Bartlett Publishers. 

Greenhalgh, T.M., Bidewell, J., Crisp, E., Lambros, A., & Warland, J. (2017). Understanding research methods for evidence-based practice in health 1e Wileyplus learning space Wiley e-text powered by Vitalsource. Wiley. Retrieved from https://ift.tt/2xjnxVh 1ACU&search_scope=61ACU_All&tab=61acu_all&lang=en_US

Hildt, E., Lieb, K., & Franke, A. G. (2014). Life context of pharmacological academic performance enhancement among university students – a qualitative approach. BMC Medical Ethics, 15(1), 23-23. doi:10.1186/1472-6939-15-23

Illes, J., & Sahakian, B. J. (Eds.). (2013). Oxford handbook of neuroethics. Oxford University Press.

Munro, B. A., Weyandt, L. L., Marraccini, M. E., & Oster, D. R. (2017). The relationship between nonmedical use of prescription stimulants, executive functioning and academic outcomes. Addictive Behaviors, 65, 250-257. doi:https://ift.tt/2fDSHfZ

Oh, E. G. (2008). Research activities and perceptions of barriers to research utilization among critical care nurses in Korea. Intensive and Critical Care Nursing, 24(5), 314-322. doi: 10.1016/j.iccn.2007.12.001

Rabadán, A. T. (2015). Neuroethics scope at a glance. Surgical neurology international, 6, 183. doi:  10.4103/2152-7806.171249

Richardson-Tench, M., Taylor, B., Kermode, S., & Roberts, K. (2016). Inquiry in health care (5th [ACU] ed.). South Melbourne, Australia: Cengage Learning.

Shifaza, F., Evans, D., & Bradley, H. (2014). Nurses’ Perceptions of Barriers and Facilitators to Implement EBP in Maldives. Advances in Nursing, 2014. https://dx.doi.org/10.1155/2014/698604

Tacia, L., Biskupski, K., Pheley, A., & Lehto, R. H. (2015). Identifying barriers to evidence-based practice adoption: A focus group study. Clinical Nursing Studies, 3(2), 90-96. doi 10.5430/cns.v3n2p90