Evidence Based Healthcare Management Practicum Assignment
The purpose of this document is to provide guidance on the rapid review of evidence assignment for the Evidence-Based Healthcare Management Practicum module. A rapid review of evidence is a form of knowledge synthesis that follows the systematic review process, but components of the process are simplified (or omitted) to allow the review to be undertaken in a shortened time span to that required for a full systematic review (Khangura 2012).
Chapter 1: Introduction and Background
Section 1: Introduction. 200
This should be an introduction to the whole assignment and should provide a map setting out all the sections to come in the evidence review.
Section 2: Problem/Issue Background: 500
The issue that you chose for review should be related to an area of your own recent practice. Set out your topic by discussing the background to the issue – what is the specific issue of concern? For whom or why is it a problem or issue. You might want to consider if this issue or problem affects the quality of patient care, patient or healthcare outcomes, safe and effective practice or quality of life. Describe the issue or problem in detail, considering: definitions; incidences; prevalence; key stakeholders affected by this issue or problem and effects on patient care or outcomes.
Chapter 2: Methodology
Section 1: Introduce Rapid Review Methodology: 200
Referring to the literature, set out an explanatory overview of the rapid review of evidence process, including its strengths and limitations. Evidence Based Healthcare Management Practicum Assignment
Section 2: Clinical Question and Search Strategy:300
Please use the PICOT Template and the Search Strategy Template provided on Moodle. The PICOT Template allows you to consider the key words in your question in the PICOT format. It also allows you to set out alternative words that may represent the key words. A sample PICOT Template, together with a blank POCOT template are provided for you on Moodle. To complete this part of the assignment, you may need to do a preliminary search to retrieve some articles and consider the language and words used to describe the topic. In addition, it may be useful to look up some subject heading terms or MeSH terms for your topic. Provide an account of the PICOT development process within the assignment and support this by including your PICOT Template as an appendix.
As part of the search strategy you will also need to consider other issues related to the search such as the most relevant databases for your topic and where on the evidence hierarchy the studies for this topic are likely to be positioned. Consider, based on your PICOT, what inclusion and exclusion criteria you will use in constructing the search strategy and later when selecting the studies to include in the review. For example, you may decide to set age limits on your population or to only review RTCs if this is appropriate to your question. You should discuss the rationale (appropriateness, strength, limitations) around the inclusion and exclusion criteria used. Support your discussion of your search strategy by including your Search Strategy Template as an appendix. A sample search strategy template and a blank search strategy template are available on Moodle.
Section 3: Searching the Databases: 250
You are required to run your search on three databases: CINAHL and PUBMED and you may select a third based of relevance to your topic. So, if the evidence for your topic is likely to be found in RTCs then Cochrane Trial database could be selected. If your topic is related to mental health, then PsycINFO may be a more relevant database; or if your topic is related to a drug intervention then EMBASE may be appropriate. Discuss your choice of databases and give an overview of your search process in this section. Include a printout/copy of each search history as an appendix in the assignment – therefore there will be three appendices to include related to your search. Please see Moodle for a sample search history. You are advised to use the referencing software Mendeley to keep a record of all the relevant citations retrieved. When citations are exported to Mendeley, there may be some duplicate references and you are required to remove all duplicate reference before proceeding to the next stage of work.
Section 4: Selecting Studies for Inclusion: 300
In general, a search will yield many studies and a judgement will have to be made as to the relevancy of each study and whether it will be included in the final selection of studies included in the review (also known as ‘keeper studies’). Therefore, all abstracts must be screened to see if they meet the inclusion and exclusion criteria. For it to be a systematic screening, this stage will be conducted by two people, who review each abstract independently. You are therefore asked to pair with another student in your class to undertake the screen process
You are required to use a software programme called Rayyan QCRI to undertake this screening process. This web-based application allows both reviewers to access the retrieved literature, facilitating an independent decision to be made as to whether to include or exclude each study. Please log into Rayyan QCRI review web application available at https://rayyan.qcri.org/welcome (also available as a mobile app) and create an account. You then must invite your second reviewer to the screening process and this allows him/her access to your retrieved literature. You are advised to move the retrieved citations from Mendeley to Rayyan (ensure you have removed all duplicate reference first), as not all searching databases load directly to Rayyan.
The outcome of the screening process will result in studies that both reviewers agree to include; studies that both reviewers agree to exclude and a third group, where there is a discrepancy between reviewers and therefore these abstracts will need to be discussed by both reviewers before a final decision is made. If there is still disagreement following discussion, then your supervisor makes the final decision. Before you undertake the screening process please discuss the inclusion and exclusion criteria for your review with your screening partner, so that you are both clear about what should be included and excluded. When excluding a study, you will be presented with a drop-down menu asking you to select a reason for excluding the study, please select the first available appropriate reason. If you scroll past the first available appropriate reason to a later option and you partner choses a different option, it will log that study as one that you both need to discuss for agreement.
A synopsis of the above process and its outcome should be presented in the review and this process should also be supported by the inclusion of a PRISMA Flow Diagram in the appendix of your review. Please see Moodle for a PRISMA Flow Diagram sample and a blank template.
Section 5: Appraising the Evidence: 500
You will then need to critically appraise all the included studies using an appraisal tool from the CLASP suite of study appraisal tools. You are required to include as an appendix the full appraisal of one study included in the review. Please see Moodle for CASP appraisal tools. You supervisor will review your appraisal of two other studies.
A CASP Quality Assessment Table must be completed that includes the critical appraisal outcomes for all studies appraised in the review and this must also be presented as an appendix in the review. Depending on the tool used, included studies should be graded for quality based on a score range representing high, moderate or low quality. Please see a sample completed CASP Quality Assessment Table on Moodle. A synopsis of how you undertook the above process and its outcomes should be presented in the review. Evidence Based Healthcare Management Practicum Assignment
Chapter 3: Evidence Synthesis Findings: 2500
Section 1: Introduction to Evidence Synthesis Findings
Section 2: Evidence Synthesis:
To limit the extent of this review and to ensure that it can be completed in the specified timeframe, you are asked to select the 12 highest quality studies to complete the next stage of the review (evidence synthesis). You will now need to complete a Characteristics of Included Studies Table of each of the studies included in the review and include this as an appendix in the review. Please provide a synopsis of this process within the review. Please see Moodle for a sample Characteristics of Included Studies Table.
Using an appropriate data extraction form, extract the relevant data from the studies selected. Please provide as an appendix a sample of one completed data extraction form. Please see Moodle for qualitative and quantitative data extraction forms. Your supervisor will ask to review one other completed data extraction form.
In the synthesis you are seeking to combine the separate findings into a coherent summary of the evidence that answers your clinical focused question and draw conclusions. As part of the synthesis you should seek to discuss the comprehensiveness and methodological quality of the overall evidence base and what the evidence indicates in relation to the clinical question posed. Your narrative synthesis should include discussion of the research designs used in included studies, the variables that were studied, the outcomes that were measured and details of the contexts in which the studies took place.
In addition the narrative synthesis should say something in relation to the consistency of the evidence (similar or divergent conclusions); contested evidence (some studies directly refute or contest the findings of other studies) and mixed evidence (where studies have a variety of designs, undertaken in a wide variety of contexts, producing wide variance in findings and perhaps showing that the issue is still not well understood (Barends et al 2017).
An evidence synthesis in not a tallying up of numbers for and against a position, rather it is a synthesis of the evidence involving careful consideration of the commonalities and differences across studies, put together with a weighing-up of results by their methodological soundness (Dobbins 2017).
In relation to presenting main findings, it is useful to create a summary of findings table that shows or maps the main findings from each study. The parameters for this table will be determined by the types of studies included in the review. So, for quantitative work you may want to construct a table mapping the main outcome that were measured and the associated statistical results. For qualitative synthesis you may want to map the main individual study themes and show how these merged into the final synthesis themes presented in the review. For qualitative synthesis we recommend that student follow process documented by Thomas and Harding (2008). Present this finding table or map as an appendix in you review.
Section 3: Review Conclusions and Recommendations: 500
The review should finish by reiterating some of the key finding from the review and making concluding statement regarding the state of the evidence for the clinical question posed. Recommendations as appropriate can then be made for policy, practice, education or research as appropriate. If recommendations are being made they should be done so in bullet points and be concise and action focused. Evidence Based Healthcare Management Practicum Assignment