I want to test a wound treatment or educational program in my clinical setting with patient
groups that are convenient or that already exist, How do I do it?
Implementing & evaluating wound research conducted using quasi-experimental designs AAWC WocSpec Research Committee, Barbara M. Bates-Jensen, PhD, RN 5. Statistical Regression: occurs when groups have ABSTRACT QUASI-EXPERIMENTAL Nonequivalent Before-after been selected based on extreme scores. PURPOSE: To provide information on how to evaluate and improve METHODS Designs Use a control group and randomization . Select methodology of wound research conducted using quasi-experimental designs. groups that are not at the extreme of characteristics. BACKGROUND: Research methodology is concerned with how a study’s The purpose of quasi-experimental research is to Treatment Group 1 O1 X O2 design is implemented and how the research is conducted. Methodology approximate the conditions of the true experiment in 6. Selection: biases resulting from the differential determines the quality of the data generated by the study and specifies: when Treatment Group 2 O1 X O2 selection of subjects. a setting which does not allow the control and/or and how often data are collected, construction of data collection measures, who data is collected from, how data is analyzed, and how findings are presented. manipulation of all relevant variables. Quasi- O1 = Pre observation measurement or Pretest Use of randomization procedures and pretesting can Study design is a part of research methodology but not the only part. X = Wound Treatment or Educational Program help by determining the presence or knowledge that METHODS: Quasi-experimental studies include: pretest posttest nonequivalent experimental research designs: exist before the treatment. group design, time series design, and non-equivalent before-after design. The answer questions using as much of an O2 = Post observation measurement or Posttest purpose of quasi-experimental research is to approximate the conditions of the experimental approach as possible in a clinical Two groups with known differences before the study 7. Experimental Mortality: the differential loss of true experiment in a setting which does not allow the control and/or subjects from the comparison groups. manipulation of all relevant variables. The researcher must clearly understand setting begins are tested and compared. what compromises exist in the internal and external validity of the design and follow basic experimental steps but do not The same treatment is done for both groups and Use pretesting as subjects can be removed from the proceed within these limitations. We use quasi-experimental designs in the entire comparison by removing their pretest. clinical setting when control of all variables is not possible. Quasi-experimental include randomization and may not control other differences in posttests are assumed to be related to the designs are better than pre-experimental studies in that they use a method of variables; uses existing or convenient groups difference in the two groups. 8. Selection-Maturation Interaction: interaction effects comparing groups. They are limited in that they fail to randomize the groups. between the selection and maturation which can be This research is characterized by methods of partial control based on a careful Quasi-experimental research designs include: identification of factors influencing both internal and external validity. Methods of 1. Pretest posttest nonequivalent group design Improving Quasi-experimental mistaken for the effects of the experimental variable. increasing the strength of quasi-experimental wound studies are outlined. Use a control group and randomization CONCLUSIONS: Quasi-experimental designs follow true experimental steps 2. Time series design studies: Internal Validity but typically do not control all variables and do not include randomization. The aim of quasi-experimental design is to evaluate the influence of a variable on 3. Non-equivalent before-after design Internal Validity asks the question: did, in fact, the Quasi-experimental studies: one group and not on another. Limitations relate to the researcher’s attention to internal and external validity. Methods to improve the quality of wound research Pretest Posttest Nonequivalent experimental treatments make a difference in this specific External Validity using quasi-experimental designs include attending to internal validity or did the instance? treatment make the difference in this specific instance rather than other factors? And external validity or to what populations, settings, or treatment variables can Group Designs • 8 classes of extraneous variables which, if not External Validity asks the question: to what this observed effect be generalized? populations, settings, treatment, and measurement Treatment Group O1 X O2 controlled, may produce effects that can be confused with variables can this effect be generalized? BACKGROUND Control Group O1 O2 the effects of the experimental treatment: • Just like internal validity, 4 classes of variables which, if 1. History: Did something happen between the first and Research methodology determines the quality of O1 = Pre observation measurement or Pretest second measurements in addition to the treatment not controlled, may produce effects that can only be the data collected in a study, it concerns how the X = Wound Treatment or Educational Program attributed to the specific sample, setting, and procedures which might affect the measurement? in the current study. Thus, there is no way to use the design is implemented and specifies: O2 = Post observation measurement or Posttest Use a control group. when and how often data are collected A strong and widely used quasi-experimental design. 2. Maturation: the process of growing, developing, findings with other groups. development of data collection measures & Differs from true experiments because there is no aging or maturing which takes place in the individual 1. Interaction effects of Selection and the experimental instruments randomization, the groups are not equal. variable. Subjects selected from a small group or one during the study period. with particular characteristics can’t be generalized to who data is collected from (the sample) Comparing pretest results can show the level of Use a control group. how data are analyzed equivalence between the groups. 3. Pre-testing: the effect created on the second any larger group. how findings are presented. Time Series Designs measurement by having a measurement before the 2. Reactive or Interaction effect of Pretesting- the Whether or not study results are really the result of experiment (the pre-test). pretesting modifies the subjects in such a way that the variable on the group under investigation in the Treatment Group O1 O2 O3 X O4 O5 O6 they respond to the experimental treatment differently Use additional groups that do not receive the than will un-pretested persons making them study (internal validity) and not some other variable pretest or experimental treatment. These groups Control Group O1 O2 O3 O4 O5 O6 unrepresentative of the population. AND are in addition to the regular control group. Whether or not the study results can be expected O1 –O3= Pre observation measurements or Pretests 4. Instrumentation: changes in measurement due to 3. Reactive effects of experimental procedures arising to be the same with other groups of people X = Wound Treatment or Educational Program from the experimental setting which will not occur in O4 –O6 = Post observation measurement s or Posttests changes in instrumentation calibration or changes in non-experimental settings. (external validity) are issues that are addressed by methodology. To determine the influence of a variable introduced the observers. 4. Multiple-Treatment Interference effects due to Use a control group. Use quality control monitoring Research design is an important part of after a series of initial observations multiple treatments applied to the same subjects so methodology. Study design is a part of research Differs from true experiments because there is no during the study to help detect/control changes in the findings can only be generalized to persons randomization, the groups are not equal. instrument use/measurement. Include reliability exposed to the same treatments in the same order of methodology but not the only part. Comparing pretest results can show the level of testing throughout the study, include instrument presentation. equivalence between the groups. calibration and adequate training.