NR 532 Fall 2020 Assignments

A major objective of the course is to learn how to search and appraise the research literature in
order to guide clinical practice. To do so, a series of 3 Assignments are provided to help you
formulate a question about an area of clinical interest to Primary Care APRNs, search the
research literature to find studies on your topic, and create a table of evidence that summarizes
your findings. All assignments should be written as though you were speaking to an
administrator at your agency. No Direct Quotes. Every assignment has a separate Title and
Reference page and follows APA. All students submit assignments on D2L.

Late Submissions: Two points will be deducted for all late submissions

Assignment 1: PICOT Question with Problem Statement of Significance/Reference (50

points)
For this assignment, you will develop a PICOT question based on a primary care APRN clinical
problem and be within the scope of practice of an APRN in primary care.

1. Describe a primary care APRN clinical problem. Provide the reader with some context
or background to situate the problem you will be investigating. Describe the problem,
clearly. What is not working? This is the foundation of your PICOT.
2. Include a reference that states “this is a significant problem”, e.g. high costs, increased
mortality. Focus on engaging your audience to care about this problem.
3. Use the template found in the 3rd AJN article to write a PICOT question that addresses
your problem. If possible, write an intervention level question.
4. List 5 search terms that you plan to use to begin your search of the research literature to
help you identify published studies that address the problem posed in your PICOT
question.
5. This is a short paper—Title page, narrative (1 page) and Reference page—that is focused
on the problem, not the intervention. State the significance and why this is a problem.
Make the reader care about this problem.

(Remember, the measure (and definition) of a “Good” PICOT question is one that is both
searchable and answerable. That is, researchers have studied the interventions posed in your
question, but it is not yet implemented consistently in practice).

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Assignment 2: Search (50 points)

For this assignment, you are required to systematically search a minimum of 3 databases. The 4th
AJN article provides very detailed information on searching. The box on p. 42 elaborates the
steps to searching to address a clinical question or problem (this is not exactly the same as
searching with a research question). Use the following steps-- Search each key word and MeSH
term alone; then combine. The only limiters permitted for this assignment are “published dates”,
“English” and in CINAHL “Research”. Do not use “full text” as a limiter. The expectation is
that you will be able to collect a minimum of 5 original research articles that address the “I” and
“C” and “O” of your PICOT Question. Use your PICOT question as the title of the paper.
Provide the following information in a figure (sample figure posted to D2L):

 Pick 3 databases
 Include answerable (but not implemented), APRN primary care PICOT question guiding
your search. The PICOT question should serve as the title of the Figure and the title of
the paper. PICOT question should be an intervention question and follow the template
for intervention questions from the AJN 3 article.
 Use the sample search figure uploaded under the content in D2L as an example. The
sample is labeled “A2 Sample Search Figure”. Please review the following instructions
as you input information into the search figure:
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o Instructions: Delete content in the sample search figure and insert your content
in its place.

o Databases searched: List all databases searched

o Keywords: List most productive search words. Remember the search history
should reflect your use of single key words first before combining terms.

o MeSH terms: List Medical Subject Headings (MeSH) related to the topic. MeSH
are controlled vocabulary terms used in Medline and PubMed to describe article
content using standardized language.

o Database limiters: If needed, you can limit to past 5 years, English, Research
(CINAHL).

o Number of potential articles identified: Look at your best search result list in
each database and add the total results together. For example: best search in
CINAHL had 47 results, best Medline had 3 results, best PubMed had 4 results =
54 articles identified.

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o Inclusion and Exclusion criteria: List explicit reasons why some studies and
articles were selected while others were not.

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o Number of studies selected: Minimum of 5 research studies. Must equal the

number of studies listed in References.

 Choose one search history from one database that gives a good picture of how the
search was conducted to retrieve studies that answer the PICOT question. Cut and paste
this search history into a Word document or print and scan as a pdf and submit. The
search history does not need to be part of the paper or in APA format and can be
uploaded separately into the Dropbox. No pictures of the search history will be accepted.
 Reference page has the studies that answer your question (final number in your figure
with a minimum of 5 studies). The intent of this assignment is to demonstrate how to
systematically search different databases to answer a PICOT question.
 Studies answer your PICOT—compare 2 interventions or one intervention and one
control group. Studies should include the same outcome.

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Assignment 3: Evaluation Table of Evidence/ Summary and Recommendation (50 points)

For this assignment, you will develop an evaluation table that identifies your “best” two original
research studies that respond to your PICOT question. Follow the example provided on p. 50 of
AJN 5 for what content to include. Make sure to include your PICOT question as well as a list
of references (in APA format) in your work. You will not use all the headings in the example on
p. 50. Use only the following headings:

1. Author, year of publication, evidence hierarchy level, theory

If the theory is not stated, then list NR— (not reported)
2. Purpose of the study
3. Sample/Setting – number of participants in each group, age range, criteria, inpatient/
outpatient, if outside the US, any pertinent characteristics of the sample
4. Interventions/Variables—this is your “I” from your PICOT question; describe
intervention, what was done and for how long? If LOE I, II, III, you will list intervention
(IV, DV, and O)….If LOE IV, V, VI….you will list variables (I and O).
5. Conclusions/Outcomes/Results—this is your “O” from PICOT question, include
significance levels and confidence intervals if available. Only list those outcomes that
relate to your PICOT question.

This information is presented in abbreviations and short phrases, not sentences. This paper
should be done in Word, set up as a table with the headings across the top, (follow APA for
tables). The goal is a concise table summary of your 2 studies. If possible, have only 1 page for
both studies. Submit the 2 study articles with table on D2L (not a link, but the actual articles).

Narrative: After the table of evidence, write a short narrative. Include the following:

Summary of evidence do not include your opinions here, only the findings from your 2 original
studies and the context that these findings apply to. Summarize the studies together (compare
and contrast) rather than “Study 1 says…Study 2 says…”. This section needs citation!

Recommendation for practice based upon your evidence only. Do not exceed the
findings/outcome from your table. This is a recommendation for practice, not “further research is
needed”. Include the population and context that the intervention applies. Any limitations to the
recommendation? Would you recommend the intervention to a certain population or in a
particular setting? Avoid writing in first person.

Quizzes: There will be four, 10-question, multiple-choice quizzes, two on APA and two on
statistics and research methods. Each is worth 10 points. Quizzes are to be taken individually.
Failure to do so will result in a 0.

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