Critical Appraisal of Scholarly Study - Research Proposal Example

Critical Appraisal of Scholarly Study 2009 Critical Appraisal of Scholarly Study Bissel, P., Blenkinsopp, A., Short, D., and Mason, L. 2008, ‘Patients experiences of a community pharmacy-led medicines management service’, Health and Social Care in the Community, 16(4), pp. 363-369 The article under review focuses on a specific issue related to community health services, namely community pharmacist-led medicines management services. The authors clearly identify two main goals of their research: to describe patients’ views and experiences of being involved in a community pharmacy-led medicines management services delivered in England to interpret the revealed patients’ views and experiences in the context of studies available in this field. The introductory section includes a brief, but very solid and appropriate literature review describing credible research in the field. The review links potential findings of the study to a wider framework of theoretical knowledge in the area of community health services and helps the reader identify gaps in the existing body of knowledge and justify the need for their study. Such synthesis of relevant information relating to the previous research provides adequate background to the study. Specific nature of the formulated research purposes raised a set of specific requirements to be addressed within a certain methodological framework. The context of study undertaken by Bissel and colleagues suggests that the choice of qualitative approach is the most appropriate alternative in this case. Such choice of methodology and research design is absolutely justified by the formulated research purposes and obtained results: the researchers explicitly express an interest in understanding the experiences perceived by the participants of their study and strongly emphasize the context in which the perceptions take place. the study involves in-depth exploration of the issue with the authors requiring from the participants comprehensive information. the nature of results obtained by Bissel and colleagues suggests that the researchers have sought for both understanding and meaning. the type of reasoning utilised by Bissel and colleagues is apparently inductive: the authors do not formulate any specific hypothesis or suggest a theory to be tested. Instead, they offer several research objectives to be fulfilled. Data gathering techniques chosen by the authors within the qualitative methodology are congruent with the purposes of their study. The authors prefer semi-structured interview is the instrument of data collection. Semi-structured interview is one of the most popular types of interviewing due to several reasons. Firstly, semi-structured interviewing allow for focused two-way communication. Secondly, while the questionnaire framework implies formulation of detailed questions, a semi-structured interview starts with more general topic or questions, identified ahead of time, and makes it possible for the interviewer to seek for relationships between the questions/topic and variety of relevant issues. The answers given by the interviewee serve as the basis for more specific questions formulated during the interview. And finally, semi-structured interviewing is not as time-consuming and costly as other qualitative methods, while the data is valid, diverse and reliable enough to ensure in-depth exploration of the issue being studied (Glesne and Peshkin, 1992). The method of interviewing has the same set of drawbacks the other qualitative methods do. Thus, data obtained during interviewing is believed to be subjective and descriptive (Murphy et al, 1998). Probably the main drawback of this method is related to the language-imposed constraints: the researcher’s questions asked verbally during the interview are believed to frame responses of the participant being interviewed (Hancock, 2002). However, the method of interviewing seems to be an absolutely appropriate and justified choice for the study design type. The advantages of interviewing overweigh the drawbacks of this method considering the objectives set by the authors in the introductory section. Observing the lack of qualitative studies exploring the area patients’ perspectives of medicines management services the study design is absolutely justified: only qualitative methodology is capable of generating data related to in-depth experiences and understanding. As far as the ethical aspect is concerned, the study is absolutely flawless. Firstly, the research was fully explained to participants during the sample recruitment stage. Secondly, all activities relating to data collection were carried out only with the patient’s permission, and the authors thoroughly maintained confidentiality of collected information (for example, only numbers of participants are referenced in the quotes. And thirdly, formal ethical approval was received from MREC Scotland to confirm that the authors properly observed all applicable ethical norms and standard. The sampling strategy used by the researchers adds credibility to their choice of this method and ensures highly relevant and well-reasoned selection of participants. The initial phase of sampling involved a randomized controlled trial “…comparing patients with coronary heart disease (CHD), who received the community pharmacy medicines management service, with control CHD patients, who received usual general-practice-based care” (Bissel et al, 2007, p.364-365). Data obtained the survey allowed the authors to recruit a valid sample taking into consideration such parameters as range of population, general practice and community pharmacy characteristics. Such selection of the study sample ensured participants’ representativeness of the total population of CHD patients in the latter stages of the research (interviews). The sampling strategy is comprehensively described and soundly related to the purposes of the study. Only six male patients from the initial sample of 55 did not participate in the interviews: they were either too ill to take part or the researchers could not contact them. The final sample of 49 participants included 30 male patients and 19 female patients (aged from 57 to 72), which suggests certain underrepresentation of female population. The process of data collection is described in detail. Areas covered by Bissel and colleagues during the interview included the patient’s knowledge of CHD, understanding of medicines including perceived benefits and concerns, relationship with the general practice, feedback on the consultation with the pharmacist including the perceived value of the consultation, ‘likes’ and ‘dislikes’, perceptions of the pharmacist’s skills and the suitability of the setting for the meeting (Bissel et al. 2007, p.365). The authors provided a synthesis of their findings revealed during the interview using a lot of quotes so that the reader could have a sense of personal involvement in the issue being studied. The quotes highlight the most essential elements of the research and strongly support the overall argument of the article. The total of 49 interviews carried out by Bissel and colleagues provided rich information on the issues being studied. Interpretative analysis of collected data allowed Bissel and colleagues make associations between responses of different participants and refer them to similar themes. Three major themes were identified during analysis, namely: patients’ views about the medicines management service, experiences of consulting the pharmacist, and patients’ views about pharmacists making recommendations about treatment. Although the authors do not provide a clear description of shortcomings and limitations of the research, they do, however, present an explanation of how the method is used and how data obtained via the interviews is treated, analysed and interpreted. Thus, each interview was tapped, transcribed, carefully read several times and discussed within the evaluation team. As a result, initial findings/themes identified by one researcher were thoroughly verified by other professionals. Different disciplinary background of the principal authors (medical sociology, pharmacy, health services research and medical geography) contributed to high reliability of both the themes and corresponding data. At the same time, no description of data analysis procedures or the coding schemes used by the authors was included in the article. Similarly, no description of potential biases and influences is provided in the article and no information is included to demonstrate how the researcher responded to events during the study and whether they considered the implications of any changes in the research design. However, the study design is rather simple and no specifically designed methods were employed by the authors. Probably, such description might be considered irrelevant by the authors whose professional background and experience seems to be more than sufficient to overcome the traditional well-known shortcomings and biases associated with the qualitative methodology in general and semi-structured interviewing in particular. The concluding section of the study provides strong synthesis of the research findings. The authors draw several major points that are fully consistent with the main findings and reflect the objectives set in the introductory chapter. From the reader’s point of view, the conclusions of the study are formulated clearly and are very helpful for proper understanding of the meaning of their specific findings (CHD patients) within a wider framework of medicines management services provided by community pharmacists. What is especially helpful is that the authors establish a link between their study and recent academic debates about the issue; also various approaches to medicines management service are discussed in light of the study findings as well as implications of the study for various practice situations are also mapped in the concluding chapter. Overall, sufficient information is provided to understand the contribution the study makes to existing knowledge in the field where lack of credible qualitative studies is apparent up to now. However, what should be noted in this regard is that the concluding section is rather brief: granted that the research in the field of community-led pharmacy and medicines management is still developing, it might have been appropriate to extend this chapter to create a more meaningful and understandable picture for the reader. References Bissel, P., Blenkinsopp, A., Short, D., and Mason, L. 2008, ‘Patients experiences of a community pharmacy-led medicines management service’, Health and Social Care in the Community, 16(4): 363-369. Glesne, C. & Peshkin, P. 1992, Becoming qualitative researches: An introduction, New York, NY: Longman. Hancock, B. 2002, An Introduction to Qualitative Research, Trent Focus Group. Murphy, E., Dingwall, R., Greatbatch, D., Parker, S. & Watson, P. 1998, “Qualitative research methods in health technology assessment: a review of the literature”, Health Technology Assessment, 2(16), pp.141-165. Read More