Critical Thinking/Research

Critical Thinking/Research

Module 3 Assignment Critical Thinking, Part 3 Please READ ALL of the following instructions BEFORE providing your answers and responses to the question/items of the Part 3 Worksheet. First, fill out your identification information, as below.

Critical Thinking/Research

Name of Group Member (indicate in parenthesis after the name- what specific question(s) each member was responsible to initially address): 1-Mehrnoosh Ejlali (I worked on whole assignment and answered all questions, then we sent each other the work we did, review it, and submitted the best answers)

2- Kamran Vastani (He did the same thing and worked on whole assignment and answered all questions, then we sent each other the work we did, review it, and submitted the best answers)

Date: 7/10/2019


Did all group members participate in the assignment as outlined by the group and adhering to your Team Charter Agreement? Yes_______No______

If your group responded “no” or individually and you have concerns about a member’s work quality and/or timeliness/ and/or contributions to the group and would like your faculty to intervene; please send an e-mail correspondence to your faculty as soon as possible. In your e-mail correspondence, please indicate if you are giving faculty permission to contact the identified student with your group/individual concerns.

Instructions: Critical Thinking/Research

· Group members will need access to the approved article , and course texts and APA manual as a minimum to complete this assignment.

· Recall: you will earn a group grade for this assignment.

· Record responses to each question in the “grey” space provided for each question. The grey box will expand as you type.

· Your responses should be your own words and written in complete sentences. “Yes” or “no” answers will not be accepted and will result in point(s) deduction. N/A responses require justification of why that criteria/question does not pertain to your article.

· Minimize use of direct quotes except where specifically requested.

· Requests for tables must include columns and rows if needed. It is not appropriate to use spacing for a table. If you are unfamiliar with how to make a table in a Word document, please to the “Resources” tab in Blackboard and scroll to:”How to Make a Table in a Word Document”. Failure to include a table when asked will result in point deduction for that specific question.

· Review the “Hints” placed throughout the worksheet prior to responding to the question.

· Be sure you understand what the questions are asking and verify that you have addressed all questions within a specific question set. Do not respond until you know what is being asked.

· Contact your faculty if clarification is needed.

· Read through your responses when completed for accuracy of responses, and correct APA format, spelling, and grammar.

· Hint: Lo-Biondo-Wood: Chapters 14, 15, 16 and 18 may be helpful in addressing these questions).

INSERT the full reference citation for your APPROVED article in the grey space below (NOTE: Use correct APA. Your faculty is aware of indentation challenges and will not deduct points for incorrect indentation).
Wells, R., Ejem, D., Dionne-Odom, J. N., Bagcivan, G., Keebler, K., Frost, J., Azuera, A., Kono, A., Swetz, M.K., Bakitas, M. (2018). Protocol driven palliative care consultation: Outcomes of the ENABLE CHF-PC pilot study. Heart & Lung, 47(6), 533-538. doi:10.1016/j.hrtlng.2018.06.012

PROVIDE YOUR COMPLETE ANSWERS to each of the following items within this Part 3 Worksheet.

11. Collecting Data
11a. Identify the research design for your selected study. Discuss how the data collection method is appropriate (fits or is consistent) with the research design. (You may want to review your response to question 9a-Module 2 Worksheet)

(Hint: This is a question that frequently perplexes past students. It is important for you to understand the concept of design. Basically, what is being asked is the way the researcher(s) collected the data consistent/fits/congruent with the study design. For example, if I was doing an experimental study using human subjects, and I collected data from observing mice- this would not fit with an experimental study involving patients- right?! I might suggest that you refer to Resource on the course menu list and review the Quantitative Research Designs Figure in addition to your text-chapter 9).

The parent study (the one that had interventions) is a longitudinal outcome-based study that was preceded by this two site, single-arm pilot feasibility study which is evidently outlined in the method section as follows: “From April 1, 2014 to December 31, 2015, we enrolled 61 patients diagnosed with advanced HF and 48 family caregivers in a two-site, single-arm pilot study to determine the feasibility of ENABLE CHF-PC (Educate, Nurture, Before Life Ends: Comprehensive Heart care for Patients and Caregivers), an intervention to deliver early concurrent PC” (Wells et al., 2018).

The two selected sites were cardiology clinics. The data collected, the methodology and research findings can be applied carrying out larger scale studies (Wells et al., 2018).image2.png

11b: What specific data/information did the researchers collect? How did this information/data address the research question? Under what specific heading in your article did you find the answer to these questions? Identify the page number(s).
The objective for this study was to describe evaluation practices and treatment recommendations made during protocol-driven OPCCs for advanced HF (Wells et al., 2018, p. 534). The inadequacy of information regarding protocol-driven outpatient palliative care consultation for advanced heart failure (HF) got addressed through the findings that this research established (Wells et al., 2018 p. 533)

The study found that HF patients had weighty burdens of symptoms and unmet goals of care. Other findings showed that protocol-driven consultations for HF clients was motivated by the symptoms and social issues (Wells et al., 2018 p. 533).

The title of the article is ‘Protocol image3.pngdrove palliative care consultation: Outcomes of the ENABLE CHF-PC pilot study’ The title has addressed the research question in that it outlines what the study was about – that is, Protocol driven palliative care consultation (Wells et al., 2018, p. 533)

11c: Discuss how the researcher collected the data.

Were specific instruments used to collect the data? If yes, what was the name(s) of the instrument(s)? (Identify the page number you found this information. Make a two-column table; place the exact name of the specific instrument(s) to collect the data (if the researcher developed the instrument and did not name the tool, then state researcher developed tool) and in the second column the page number where you found this information.Make sure you do this for each specific instrument used in this study.

(Hint: Interchangeable terms for “instrument(s) may be tools/survey/questionnaire/measurements/surveys/ test, etc. However, also know that it is possible that the researcher(s) did not use a paper and pencil type tool to collect the data. How data is collected dependent on the research method).

Instrument used

Page No.


The researchers designed the survey as evidenced on page 535

“….Investigator designed survey of recent hospital days…”

(Wells et al., 2018, p. 535)

Telephone Interviews

The telephone sessions were based on previewing the Charting Your Course curriculum (Wells et al., 2018, p. 535).The curriculum was based on Chronic Care Model that promotes patient self-management and the decision to foster, activate and have ensure the patient are informed about their health outcomes (Wagner et al., 2001).

Content analysis of OPCC notes

The researchers designed the instrument page 535 under ‘data collection’ section (Wells et al., 2018, p. 535).

In-person consultations.

AHF patients were slated to go for one OPCC at palliative care outpatient clinic in UAB or DHMC (Wells et al., 2018, p. 535).

Baseline questionnaires.

The information about the instrument is found ‘data collection’ in page 535 (Wells et al., 2018, p. 535)

11d: If an instrument was used, what was the type and format of the instrument? (Likert scale (pages 273; 284-85), open-ended question(s), physiologic measure (for example, a blood pressure reading), risk assessment tool, etc.). Make a table and in the first column identify the instrument by name and in the second column identify the type and format of the instrument. Do this for each specific instrument used in this study.

(Hint: You may need to Google the specific name of the instrument and see if you can review the instrument if this information is not provided within your selected article).

Instrument used

Type and Format of the Instrument


Patient-reported healthcare utilization (utilization measure). This has been outlined in page 535 of the article (Wells et al., 2018 p. 535).

OPCC notes

Content analysis of OPCC notes (Wells et al., 2018 p. 535)

Baseline questionnaires.

On page 536 under Table 2.

The answers to the questions show that the answers are measure of central tendency.

The questions are close-ended, which makes it a quantitative instrument (Wells et al., 2018, p. 536).

In-person consultations.

AHF patients were slated to go for one OPCC at palliative care outpatient clinic in UAB or DHMC (Wells et al., 2018, p. 535).

Telephone Interviews

The parent-study was composed of in-person OPCC and six weekly telephone sessions during the early palliative care HF intervention, conducted at sites in the Northeast and Southeast. (Wells et al., 2018, p. 535).

The Chronic Care Model used in coming up with Charting Your Course curriculum was adopted from Wagner et al. (2001)’s study.

11e: How did the participants in the study obtain/receive or gain access to the instruments/tools/survey/questionnaire/physiological measures, etc. in order for the researchers to obtain the data?
Baseline questionnaires were filled in as part of a parent study. During the ENABLE: CHF-PC intervention, the participants gained access the instruments and survey through in-person OPCC and six telephone sessions conducted on weekly basis, to review their progresses.

The single in-person outpatient palliative consultation occurred at either DHMC or UAB.

Patients initially gained access to these instruments by being approached by study coordinators and recruiters for this study.

(Wells et al., 2018).

11f: Discuss who specifically collected the data. Discuss if the person(s) collecting the data were trained in data collection procedures. (If yes, state page number(s) where you found this information). If this information is not provided in your article-state “Information Not Provided”.
The article points out that all the staff members were trained on page 535. This is stated in the second paragraph of the section ‘Data analysis (Wells et al., 2018).

Also, under the section sample, the article indicates that the identification of study subjects was done by study coordinators and recruitment staff who approached and checked the eligibility of patients if they qualified to be included in this research (Wells et al., 2018, p. 535).

The parent study was conducted by nurses with special training in palliative care (Wells et al., 2018, p. 535), under section ‘ENABLE: CHF-PC intervention’.

Data collection from the patient with AHF took place as personal OPCC basis and six weekly telephone sessions to review the Charting Your Course curriculum (Wells et al., 2018).

11g: If an instrument/tool/survey/questionnaire etc. was developed/written specifically for the study by the researcher(s), was the reader informed who and how the instrument/tool was developed?
1. A curriculum on Charting Your Course was developed based on Chronic Care Model (Wagner et al., 2012).

2. In-person OPCC were modeled from guidelines of the National Consensus Project (Wells et al., 2018, p. 535).

3. Survey was designed by the investigators as it is outlined under data collection section (Wells et al., 2018).

11h: Discuss how the authors presented evidence or discussed the reliability of the instruments/tools/survey/measurements. What page number(s) did your find this information? Did the researchers present the Cronbach’s Alpha or the test-retest reliability related to the instrument? If yes, how would you interpret this statistic related to reliability? If no information was presented in the article on reliability of an instrument, discuss how an instrument would be determined reliable?

(Hint: Review Chapter 15 to address question 11h).

Information has not been provided about reliability.

Reliability looks at the ability of the instrument to measure consistently (Wells et al., 2018).

11i: Discuss how the researcher(s) presented evidence or discussed the validity of the instruments/tools/survey/measurements. What type of validity did they implement regarding the instruments/tools/survey/measurements? How did they specifically determine validity? What page number(s) did you find this information? If no information was presented in the article on validity discuss how an instrument would establish validity? Be specific as to type of validity you would expect. image4.png

(Hint: Review Chapter 15 to address question 11i).

Validity is the extent to which an instrument precisely measures what it is expected to measure (LoBiondo-Wood & Haber, 2018).

There was no information provided in this article on validity, however, based on the information provided, content validity could be achieved measuring the knowledge of content domain of which it was fashioned to measures (Wells et al., 2018).

12. Statistical Analysis
12a: How is the data analyzed? What is the name of the method/test provided? State the page number where the data analysis method is identified. Discuss how the analysis fits the research question. For this response, make a table and in column 1 identify the data approach of inferential or descriptive (see Chapter 16 in Lo-Biondo-Wood and Haber) used, in column 2-identify the specific statistic(s) used in your study as it relates to the data approach and the page number where the data analysis method was identified. Lastly, in column 3 provide the rationale for using the specific statistical test as it relates to your selected study. How does this statistical data analysis fit the research question?

(Hint: For example, if the researcher wanted to know the average pulse rate of patients who followed a specific protocol-what would be the appropriate statistic? If you said t-test, you would be asked to think again but if you said mean-you would be congratulated.To address this question, you will need to know the purpose of the identified statistical data analysis method.

Data Approach

Specific Statistic(s)

The rationale for using the specific statistical test



T-test is useful in testing and possibly reject a null hypothesis. (Liobondo-Wood & Haber, 2018).

Two sample T-test was used to test differences in demographic means (Wells et al., 2018).



Inferential statistics are useful in making inferences or predictions about a population based on available data.

Chi-square is crucial in determining how probable it is for an event to occur due to chance. (Wells et al., 2018, p. 535)

Demographic characteristics were measured using Chi-square (Wells et al., 2018).

Descriptive Statistics


OPCC’s codes and patient demographics were computed by descriptive statistics.

Descriptive statistics, in this case, are useful as one can use them to describe, summaries, and present data. (Wells et al., 2018, p. 534)image5.png

12b: What level of measurement is used to measure each of the major research variables? (See pages 282-85). Justify your answer with an example from your study if this information is provided. (State page number where you found this information). To answer this question, you are to make a table: label one column: Research Variable(s); another column: LOM (level of measurement); and the 3rd column: explaining how you knew that was the level of measurement.

(Hint: You may need to use your statistics class notes to address this question, and Google level of measurement and/or text chapter 16 and/or scroll to the “level of measurement” at

(Hint 2: Review your CT 2 and identify what independent and dependent variables you correctly identified in question 5d-this is very important in addressing select questions in this section. ).

Research Variables

LOM (level of measurement)


Patient Assessment of Chronic Illness Care (PACIC)


Has an absolute zero

Hospital Anxiety and Depression Scale (HADS)


Has an absolute zero

Global physical health T score

Ratio scale

The measurements global physical health have of an absolute zero.

Days in ICU


Has an absolute zero

Decision making preferences


Decision making preferences entails following an order of the choices at hand, settling on what a client best fits him or her.

An intervention to deliver early concurrent PC

Nominal Scale

Attend religious service


AHF patients had either attended or never attended religious services.

These are mutually exclusive events

Do-not-resuscitate Order


Either a yes or a no.

These are mutually exclusive events

Smoking habits


AHF patients either has ever smoked or has never smoked

These are mutually exclusive events



One is either disabled or not disabled.

These are mutually exclusive outcomes

Early concurrent PC


The participant either had early concurrent PC or did not.

Source: (Wells et al., 2018, p. 535)

12c: Identify the statistical test(s) used for varying level of measurements found in your study. Did researchers use an appropriate type of statistic for the level of measurement associated with each variable? Now, copy the table you provided in answering questions 12b. Add a column, indicating the specific statistical test for the level of measurement and another column indicating if the statistical analysis was appropriate, answering yes or no and then your rationale for your answer.

(Hint: Sometimes students find this specific question as challenging. It is important for you to understand that the appropriate type of statistical analysis will be based on selection and use of the correct statistical test(s), which depends on the level of measurement of the research variables. For additional guidance, you also may need to refer to the text from your prerequisite statistical course, or you might check resources available via the internet; images about the flow of statistical decisions can be found by searching the internet for “flowchart of decision tree for choosing a statistical test.” Relevant information also is available at the following website, , where learning modules called “reusable learning objects” (RLO) are available. For additional help, see the “RLO entitled, “Descriptive statistics for interval and ratio scale data” AND the RLO: “Probability associated with inferential statistics.” Other resources also may be helpful, such as the following source:

Introduction to SAS. (2007, November). UCLA: Statistical Consulting Group. Retrieved from

Study did not specify which statistical test was used, only stating descriptive statistics or “Chi Squared, T-test, or Fishers exact tests as appropriate” (Wells et al., 2018).

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