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Report NLM
ACTION RESEARCH
Action research – which is also known as Participatory Action Research (PAR), community-
based study, co-operative inquiry, action science and action learning – is an approach
commonly used for improving conditions and practices in a range of healthcare environments.
Action research is a form of applied research that tries to empower people through a process
that constructs and uses knowledge.
Seeks action to improve practices & study the effect of the action that was taken
It involves healthcare practitioners conducting systematic inquiries in order to help them improve
their own practices, which in turn can enhance their working environment and the working
environments of those who are part of it.
Purposes of Conducting Action Research
1. Action research is a method used for improving practice. It involves action,
evaluation, and critical reflection and – based on the evidence gathered – changes in
practice are then implemented.
2. Action research is participative and collaborative; it is undertaken by individuals with
a common purpose.
3. It is situation-based and context specific . It develops reflection based on
interpretations made by the participants. • Knowledge is created through action and
at the point of application.
4.  In action research findings will emerge as action develops, but these are not
conclusive or absolute.
Participatory Action Research
Participatory action research (PAR), one of several types of action research that originated in the
1940s with social psychologist Kurt Lewin, is based on a recognition that the production of
knowledge can be political and can be used to exert power.
Researchers in this approach typically work with groups or communities that are vulnerable to the
control or oppression of a dominant group or culture. Participatory action research is, as the name
implies, participatory. There is collaboration between researchers and study participants in the
definition of the problem, the selection of an approach and research methods, the analysis of the
data, and the use to which findings are put.
Aim of PAR
 The aim of PAR is to produce not only knowledge, but action and consciousness-
raising as well.
 Researchers specifically seek to empower people through the process of
constructing and using knowledge.
 The PAR tradition has as its starting point a concern for the powerlessness of the
group under study. Thus, a key objective is to produce an impetus that is directly
used to make improvements through education and sociopolitical action.
  It aims to find practical solutions to problems existing in the framework of an
organization. It increases understanding of how a change in an individual’s action or
practices can benefit an employee within an organization. Changes thus planned are
locally implemented in a selected organizational setup & therefore are not universally
applicable
What is involved in action research?
Research is about generating knowledge. Action research creates knowledge based on inquiries
conducted within specific and often practical contexts. As articulated earlier, the purpose of action
research is to learn through action that then leads on to personal or professional development.

The authors state that action research involves a spiral of self-reflective cycles of:
1. Planning a change.
2. Acting and observing the process and consequences of the change.
3. Reflecting on these processes and consequences and then replanning.
4. Acting and observing.

5. Reflecting.
What is Not Action Research?
 Action research does not usually come to mind when we hear the word “research.”
 Action research is not a library project where we learn more about a topic that
interests us.
  It is not problem-solving in the sense of trying to find out what is wrong, but rather a
quest for knowledge about how to improve.
 Action research is not about doing research on or about people, or finding all
available information on a topic looking for the correct answers. It involves people
working to improve their skills, techniques, and strategies.
 Action research is not about learning why we do certain things, but rather how we
can do things better. It is about how we can change our instruction to impact
students.
Similarities and Differences between Action Research and Formal Quantitative and
Qualitative Research
Action research Formal research

Systematic inquiry Systematic inquiry

Goal is to develop problems of local and test Goal is to develop and test theories and to
theories concern produce knowledge generalized to wide
population

Little formal training required to conduct such Considerable training required to conduct such
studies studies

Intent is to identify and correct problems of local Intent is to investigate larger issues
concern

Carried out by teacher or other local education Carried out by researcher who is not usually
professional involved in local situation

Less rigorous More rigorous

Usually value based Frequently value neutral

Purposive samples selective Random samples

Selective opinions of researcher often Selective opinions of researcher never

considered as data considered as data

Generalizability is very limited Generalizability often appropriate

Steps in action research 

1. Identification of problem area
 Identify a Problem Area There are several criteria to consider before investing the time and
effort in “researching” a problem. The question should:  
 be a higher-order question- not a yes/no  be stated in common language,
 avoiding jargon  
 be concise  
 be meaningful  
 not already have an answer
2. Collection and organization of data
The collection of data is an important step in deciding what action needs to be taken.
Multiple sources of data are used to better understand the scope of happenings.
3. Interpretation of data
Interpret Data Analyze and identify major themes. Depending upon the question. Some of
the data are quantifiable and can be analyzed without the use of statistics or technical
assistance.
4. Action based data
Using the information from the data collection and review of current literature, design a plan
of action that will allow you to make a change and to study that change. It is important that
only one variable be altered.
5. Reflection/ Evaluation of results
Assess intervention the effects of the to determine if improvement has occurred. If there is
improvement, does the data clearly provide the supporting evidence? If not, what changes
can be made to the actions to elicit better results?
identify additional questions raised by the data and plan for additional improvements, and
revisions
Application of Action Research
NURSING THEORY
The use of action research in knowledge development could increase nursing knowledge and
explains how change will lead to improved nursing practices.
The use of action research methodology to improve or enrich student learning in nursing education
ranged from the individual instructor to the class as a whole and from lecture content to facilitating
professional development. Research within the classroom involved student feedback that shifted the
focus of lectures from the instructor to the students; improved the structure and effectiveness of
cooperative learning activities; refocused course content from family health policy to clinical ethics;
incorporated artistic aspects of the humanities into two graduate-level nursing classes; and helped
deepen nursing students' understanding of the challenges of living in poverty. Also, a participatory
action research approach helped administrators better understand the needs of clinical facilitators
who supervise student nurses which led to increased feedback and mentoring among facilitators .
The diversity in approaches, settings, and areas of focus demonstrate how action research can bring
real and immediate improvements to nursing education courses.
As an example of how one article discusses the action research process, Smith-Stoner and Molle
sought to develop a systematic way of implementing cooperative learning in the nursing classroom
using action research to evaluate their efforts. They wanted to determine if cooperative learning
could improve learning outcomes. The authors cite several theoretical and action research definition
sources and note that classroom action research was used. Their research progressed through four
cycles of action followed by reflection, with student feedback serving as the data collected each step
of the way. Meeting every two weeks, faculty reflected on their successes, challenges, and student
reactions to the variation in instruction format. Limited dilemmas were reported and the action
portion of the research involved changes in classes that were articulated and instituted. The
reflection and discussion among the “actors” or co researchers also encouraged learning about
teaching. Implications for using cooperative learning with nursing students are identified.
NURSING PRACTICE
The use of action research is evident in addressing health disparities, leadership/organization
development, and nursing practice in general.
Research that included patients or the community allowed students to partner with parents who have
children with disabilities and to help a community prepare for a disaster. Other articles involved
working to improve communication between students and nurses in the clinical setting;developing a
new teaching strategy to improve therapeutic communication in nursing students; designing a new
clinical role to improve the theory/practice gap; exposing students to working in long-term care ;
developing interprofessional collaboration during simulation-based learning; and applying new
strategies for student evaluation. Some student evaluation strategies included a portfolio approach
and patient involvement in student evaluation. Such a variety of situations and problems addressed
by action research in the reviewed literature demonstrates how action research was used to
increase nursing outcome knowledge in clinical aspects of nursing education.
TYPES OF ACTION RESEARCH
1. Positivist approach to action research, also known as ‘classical action
research’ perceives research as a social experiment. Accordingly, action
research is accepted as a method to test hypotheses in a real world
environment.
2. Interpretive action research, also known as ‘contemporary action
research’ perceives business reality as socially constructed and focuses on
specifications of local and organizational factors when conducting the
action research.
3. Critical action research is a specific type of action research that adopts
critical approach towards business processes and aims for improvements.
BENEFITS OF ACTION RESEARCH
 New policies, procedures, and new ways of teaching can be formed
 Sharing of good practice
 Staff members may feel empowered to create their own action research project
 Action research results can be discussed in seminars and training days
Training Need
Analysis

What is a training needs analysis?

A training needs analysis (or TNA) always happens for a reason. Whether you are a learning
and development (L&D) professional, trainer, or consultant, a TNA always serves a specific
purpose.
Training needs analysis is the initial step in a cyclical process which contributes to the overall
training and educational strategy of staff in an organisation or a professional group. The cycle
commences with a systematic consultation to identify the learning needs of the population
considered, followed by course planning, delivery and evaluation. Although much has been
written about training needs analysis in relation to post-registration nursing education, there is
disagreement concerning its impact on the training cycle and its potential to influence service
delivery.
The need for such analysis usually arises due to an organizational problem. This can be a lower
than expected quarter for the sales team, changing technology threatening to impact the
continuity of train operators, or constantly low customer satisfaction scores forcing the product
team to work in a more agile and customer-focused way.
In all these instances, the problems can potentially be resolved through training. This is where
the training needs analysis comes in. The training needs analysis is a process in which the
gap between the actual and the desired knowledge, skills, and attitudes (KSAs) in a job
are identified.
This is not to say that every problem can be solved through a training needs analysis – on the
contrary! Most problems are caused by other organizational issues. Only when the problem is
caused by a lack of knowledge, skills or attitudes, can a training and the required training needs
analysis, be a viable solution.

This may mean that instead of a lack of knowledge, skills, or attitudes, our diagnosis may point
out that sales are low because of a mismatch between the work and the rewards. Or that
customer satisfaction is low because the top-down driven product strategy is not in line with
what customers are looking for. These problems cannot be solved through training (alone) but
require an organizational intervention.
Another example, is an assertiveness training that a large county hospital was looking to
purchase from a respected vendor. The problem was an increase in harassment incidents and
an increase in medical errors, caused by the fact that nurses did not speak up. The organization
was looking to train these nurses on assertiveness.
During the intake, the trainer realized that the organizational culture was highly hierarchical and
that it was not unusual for people who did speak up to be fired or otherwise punished. The
trainer refused to participate, explaining that the hospital first had to work on a culture where it
was safe to speak up before training its staff to actually do so. Doing it the other way around
could have devastating consequences for the nurses
Training needs analysis best practices
Before providing you with a training needs analysis template, we will first go over three best
practices that have impacted our recommendation for our training needs analysis template.
 1. Training effectiveness is difficult to assess. This has a number of reasons,
the most important one being its disconnect with organizational goals. A best
practice is therefore to start with the desired outcome and then work back to
which activities lead to these organizational outcomes, before identifying
training activities. This outcome can be an organizational or departmental goal
or an individual target that needs to be improved.
2. Managing expectations. Training and training needs analysis requires
advanced stakeholder management. Stakeholders include employees, service
users (the ultimate beneficiaries of care, often customers), educational
providers who design and deliver the program, and internal sponsors who pay
for the educational event. Ensuring that the training satisfies all groups is
crucial for its success. In other words, when a manager thinks that a
communication training session will solve all their internal problems, you need
to manage their expectations.
3. Integrated approach. Research shows that training programs that place new
skills in a broader job or organizational perspective and thus integrate it with
other organizational processes and activities are more successful. This does
not mean that you cannot focus your training on something specific, but you
will need to place what people learn into an organizational perspective.

Training needs analysis template

Step 1: Defining the organizational goals

When we talk about organizational goals or outcomes, we focus on measurements such as
financial performance, revenue, profit, Return on Equity, Return on Capital Employed, earning
growth, and share price, but also softer outcomes like customer satisfaction, customer loyalty,
and organizational culture. Organizational goals and outcomes are hard to influence as the
entire organization contributes to them and they are to a large extent subject to influences
outside of employee behavior. This means that it is hard to improve them through training.
Core competencies are competencies that are required for everyone in the organization. Most
organizations have defined these and have specified what good performance on these
competencies looks like. Everyone in the organization should have a basic proficiency level on
these competencies. As there is consensus on these core capabilities already, it is relatively
easy to define the relevant job behaviors for them

Step 2. Define relevant job behaviors

The next step is to define the relevant job behaviors that will build this competency.
These are the behavioral elements in the job that will be helpful in achieving the set
organizational goal.
For consultants to sell their services, they need to build relationships, be able to spot
and explore opportunities, provide solutions, and finally seal the deal commercially. If
we were to define these behaviors.

Step 3. Define the required knowledge & skills

To finalize this framework, it is advised to get input from people in the organization who
already have these skills and to go back to the assignment-giver. The former can help
to check if these behaviors, skills, and knowledge will help to achieve the goal the
organization is striving for and the latter can indicate to what degree the knowledge and
skills accurately reflect the core competencies the organization is looking for.

Step 4. Training
This is where the ADDIE model comes in. The ADDIE model is arguably the best-known model
about training design. ADDIE is an acronym for Analyze, Design, Develop, Implement, and
Evaluate. Good training design goes through all five stages.
The first stage, analyze, is where the training needs analysis comes in. In this stage,
instructional goals are defined and aligned with organizational goals; the target audience is
determined; behavioral outcomes are identified; and learning constraints are identified. All these
elements are addressed in the training needs analysis model you learned about in this article.
In the following stages, learning programs are designed, developed, implemented, and
effectiveness is evaluated. All these stages are much easier to do well once the training needs
analysis is completed in a thorough manner
EVALUATION STUDIES
What is Evaluation Study?
Evaluation study is defined as a form of disciplined and systematic inquiry that is carried out to
arrive at an assessment on appraisal of an object, program, practice, activity, or system with the
purpose of providing information that will be of use in decision making (Kellaghan, 2010).
According to Cambridge Dictionary (2022), evaluation is literally defined as “the process of
judging something’s quality, importance, value, or a report.” In nursing, it refers to the judgment
or assessment on the effectiveness of nursing care to meet client goals. Evaluation helps in
determining the effectiveness of the interventions by reviewing the predetermined outcome
criteria with the client’s responses toward the interventions.
Evaluations studies help in:
•Gaining insights about a project or program and sits operations
Evaluation study help in understanding what works and what doesn’t; find areas of improvement
and identify strengths. It helps in figuring out what do you need to focused more on.
•Improving practice
Evaluation study is an essential gauge to the past performances and understand what went
wrong in order to deliver better services or improve practice.
•Assessing the effects
oEvaluations lets you measure whether the intended goal or outcome criteria are achieved or
not.
Evaluation and Research
Evaluation studies need to obtain valid, reliable, and trustworthy data to draw convincing,
accurate, and defensible conclusions.
Evaluation studies, aforementioned above, uses systematic procedures to generate ideas. One
of the most common reasons why evaluation studies are conducted is to provide evidence
whether the initiative or program is proceeding according to expectations and to collect
information for use in formative way to develop capacity of the initiative to meet its objectives.
Types of Evaluation Studies
There is a range of approaches to evaluation, each asking different questions, employing
different methods, focusing on different aspects of the initiatives they investigate and being
undertaken with different ends in view. We listed three key variants in this report: summative,
illuminative, and formative evaluation.
Summative Evaluation
Summative evaluation is undertaken to determine whether the program or intervention achieved
its goals, objectives, or outcomes; how the program’s impact compares to different programs;
and to better understand the process of change, what works, what does not, and why.
Summative evaluation focuses on the results of a project, program, strategy or policy. It also
refers to the observed impact of the project on change in selected indicators (e.g. change in the
incidence of specific disease entities). Types of summative evaluation include:
A.Outcomes evaluation – investigates the causal relationship between the program, service or
product and outcomes in target population. It measures the success or failure of a project, how
a project or program achieved its objectives by measuring the results. For example, conduct of
final examination, oral revalida, or practical exams at the end of the semester in nursing
schools.
B.Impact evaluation – assesses the overall or net effects (intended or unintended) of a program,
service or product on the target population. It provides information about the impacts produced
by an intervention. It can be undertaken of a program or a policy, or upstream work. It answers
the question, “How much of the change observed in the target population occurred because of
the program or intervention?” For example, an impact evaluation of an initiative aimed at
preventing sexual assaults on women in town though infrastructural improvements such as
more visible walkways or lighting in comparison to other town to assess whether there is
reductions in number of assaults seen at the end of the program could be attributed to those
improvements made.
 Illuminative evaluation
In traditional experiments, the focus of attention is on specifying what is to be done and then
measuring the effects. Relatively little attention is given to monitoring the actual process of
implementation, since the procedures are presumed to be carried out as specified and any
effects are assumed to be attributable to known events. This approach, where the process of
implementation remains largely unexamined, has been called the "black box model of
evaluation. However, in a context like health care, where interventions to improve services are
often relatively complex and take place in an uncontrolled environment, such assumptions
cannot so easily be made.
In these circumstances, it may be unclear how or why results came about, or to what they may
be attributed. In recognition of these problems, there is increasing appreciation of the benefits of
tracking the implementation process in detail, checking whether what is supposed to happen at
each stage occurs and asking if so, why so, if not, why not, so that the eventual outcomes can
be better understood. This type of study is known as illuminative evaluation-it opens the black
box, casting light on how, why and in what circumstances particular outcomes are achieved.
Such studies help specify which elements in the process are essential to achieving success and
what contextual features in the environment may facilitate or obstruct progress
 Formative Evaluation
Elements of both the evaluative approaches outlined above are also frequently employed during
the development of an intervention or programme of work for a different purpose, which is not to
make judgements about its overall value or applicability for use elsewhere, but to improve and
refine the ongoing implementation process. This monitoring and scrutiny of progress is called
formative evaluation.
Its role is to inform those involved in delivering and developing the intervention about how things
are going and identify what aspects need to be tweaked or more fundamentally reconsidered.
While questions about the effectiveness of elements of the intervention may be asked, formal
experiments are unlikely to be undertaken in formative evaluation, since the objective is not to
determine whether something works in general, but how well it is working in the present case.
For such purposes, formative evaluation is more likely to make use of reflective cycles for
quality improvement such as plan-de-study-act. Methods used in illuminative evaluation, such
as, for example, asking participants to make notes on their experiences of particular events,
may be used in formative evaluation, to provide information and explanation about what took
place, and to identify problems.
Evaluation Studies in Nursing Leadership and Management
In Nursing Leadership and Management, evaluation studies can be applied during staffing
specifically in evaluating staff development, which is one of the nurse manager's functions.
Because staff development includes participation and involvement from many departments, it
may be very difficult to control the evaluation of staff development activities effectively. It would
be very easy for the personnel department, middle-level managers, and the education
department to "pass the buck" among one another for accountability regarding these activities
In addition, the evaluation of staff development must consist of more than merely having class
participants fill out an evaluation form at the end of the class session, signing an employee
handbook form, or assigning a preceptor for each new employee. Evaluation of staff
development should include the following four criteria:
 Learner's reaction. How did the learner perceive the orientation, the class, the
training, or the preceptor?
 Behavior changes. What behavior change occurred as a result of the learning?
Was the learning transferred? Testing someone at the end of a training or
educational program does not confirm that the learning changed behavior. There
needs to be some method of follow-up to observe if behavior change occurred
 Organizational impact. Although it is often difficult to measure how staff
development activities affect the organization, efforts should be made to measure
this criterion. Examples of measurements are assessing quality of care,
medication errors, accidents, quality of clinical judgment, turnover, and
productivity.
 Cost-effectiveness. All staff development activities should be quantified in some
manner. This is perhaps the most neglected aspect of accountability in staff
development. All staff development activities should be evaluated for quality
control, impact on the institution, and cost-effectiveness. This is true regardless
of whether the education and training activities are carried out by the manager,
the preceptor, the personnel department, or the education department.