Why Do Students Fail to Disclose Health Problems - Essay Example

Section/# “Why Do Fail to Disclose Health Problems An Analysis and Review The way that different shareholders within society view the importance of health and the need to disclose key information to medical professionals whose sole job it is to seek to care for the health concerns various groups may have is a primary determinant to the level of care that is given and received. In short, the quality of the medical care that is given is dependent, more than any other factor upon the means by which the receiving entity is able to expound upon their given needs, symptoms, questions, and health related problems. For this fact alone, studies that focus on the ways in which health care integrates with the stated or unstated needs of key communities is a primary concern. For purposes of this analysis, the following article, “Why do students fail to disclose health problems?” will be analyzed. As a means of doing this, the basic premises of the research will be reviewed, weighed, analyzed, and a level of inference drawn. Moreover, the author will seek to lay out the basic statements and findings and analyze them in such a way as to seek to agree or disagree with the findings that have been presented. To the piece’s credit, the title directly expresses to the reader the type of study which will therein be undertaken. Such a point may seem superficial; however, the fact of the matter is that a large number of studies will delve directly into the subject matter without taking the time to ensure that the potential reader has a firm explanation of the topic in a way that even a laymen would understand (Skinner 2011, p. 4). As such, the piece in question clearly and succinctly lays out the topic before moving on to describing the research which will be performed, measured, and interpreted. Likewise, the reader is introduced to the rational for performing such a study within the opening lines as well as within the abstract to the piece itself. This rational is based upon the fact that the given level of dishonesty is hurting the academic process itself and should sought to be understood as a means to better hone the process as well as determine to the extent that the dishonesty is currently taking place. In much the same way, the article begins by utilizing a well written abstract which details the way in which the measurements and the study will proceed (Ryan 2007, p. 740). This is of course done as a way to further provide the reader with a level of detail of specificity as well as clear aim with regards to the means whereby the study will be carried out, measured, and inferred upon (Marshal 2005, p. 56). Though this analysis of the piece will find fault with certain aspects of the study, the fact remains that with regards to the specificity of the abstract and/or the title, both have been done in a way that necessarily helps the reader/potential reader to understand the full scope of the work that is about to be engaged upon. In much the same way, the authors themselves are credible as they are professionals within the field and have provided a level of scholarship on other related topics in the past. This prior scholarship and publication helps to give the authors a degree of credibility when attempting to understand, analyze, and dissect the given piece in question. With respect to the methodology for the study that was presented within the case in question, it was both qualitative and quantitative. Due to the fact that respondents were tabulated and outcomes were drawn from this tabulation, the research took on a decidedly quantitative approach; however, at the same time, levels of expression were gleaned from the individual interviews which were also reported within the research. The combination of both forms of data helps to make the research more thoroughly grounded rather than simply exclusively reliant on one form or the other. With respect to the quantitative and qualitative data itself, the following brief paragraph will discuss the means by which it exhibits a series of weaknesses and strengths. Firstly, with respect to the level to which the data was defined and/or the philosophical background was laid out, the study went to adequate means to ensure that the framework of understanding for both qualitative and quantitative data was clearly defined. Furthermore, with respect to the hypothesis of the quantitative portion of the research being stated, the authors waste no time in stating that they expect to see a marked correlation between the level of dishonesty that is admitted to and the way in which the system has ultimately been manipulated and gamed. Further strengthening the study is the fact that the key variables, concepts, and populations upon which the research is ultimately performed are all clearly labeled, defined, and elaborated upon throughout the study. One portion of the study that could have used a significant amount of explanation is the reason why the wide data sets and given case study was determined as the best means to answer the given research question. Although the sampling method and the research itself was well described, a fundamental discussion of why such a wide sampling was twice completed was left up to the reader’s imagination. A strength of the methodology itself is the fact that the data which was collected is clearly able to be audited and inferred upon. Similarly, from the two wide samplings that were taken of the university population, both appeared to be, if by no other virtue than their overall breadth, indicative of the larger university population. As such, the method data analysis was both creditable and verifiable. As a function of ongoing requirements within the nursing field, it is required for prospective students within the affected program to disclose any and all health issues they may have. However, as the article notes, actually achieving this level of self identification of key health concerns is increasingly difficult due to the fact that many students do not want to self identify from an inherent fear that doing so will automatically flag them as somehow unfit. Although a litany of health factors are acceptable within the program, there are some that preclude further participation. However, due to the research that has been conducted within the piece that has been analyzed, it has become apparent that the fear that disclosure could hold the potential of negatively affecting further participation has led to the severe under-reporting of a litany of health related and pre-existing health issues that the students themselves face. As the article has noted, the mere existence of health related problem does not necessarily preclude one from the practice of nursing; rather, it is vital for students of the program to state any of the issues they may have as a means for the program to 1) see if the student is eligible to practice nursing and 2) work with the student for any and all health related issues they may have that do not preclude the student from practice of nursing (El-Adl 2010, p. 89). As such, the level to which denial of any existing health concern exists within the current field of nursing education is the primal motivating factor for the article’s publication (Ross 2006, p. 530). Delving directly into the first criticism that this analysis of the article consists of, the reader begins to first question the method of data collection due to the fact that the study itself is supposedly intended to measure under-reporting of key information; however, the first step that the study takes is to distribute an online survey to a large body of students via SurveyMonkey. Although this is beneficial in a small sense of the word due to the fact that it allows for a feature of anonymity, it begs the question of what level of participation and interaction the researchers hope to achieve given the very nature of the research question and the inherent problems involved (Knowles 2011, p. 391). Moreover, with respect to the results that the researchers hoped to achieve from such an approach, a further issue is brought to the mind of the reader. Rather than merely targeting the student body as a whole, it is highly likely that the study itself will simply be ignored by those students that have any type of desire to underreport (Ingram-Broomfield 2008, p. 105). Conversely, the study will likely be taken more seriously by those students that have no need or desire to underreport. Although there are few options for measuring under-reporting, seeking to have those students who initially under-reported answer such a question truthfully on the second iteration of questioning is highly shortsighted. Additionally, with regards to the means by which the study sought to deal with any and all ethical considerations, the most blatant oversight is of course with regards to the lack of consideration for the level of honesty that would be generated from the responses that were received. Obviously, such an ethical consideration is unique due to the fact that it is not an ethical consideration with regards to a decision, action, or behavior that the researchers are presenting to the affected group of respondents; rather, it is an ethical consideration that flows from the respondents to the researchers and works to affect the very foundation of believability with which the reader is able to integrate within the research. With respect to the literature review, this is another section of the research that found itself wanting. Rather than presenting the reader with a large volume of work that had been researched as a function of informing the research question and gaining valuable background onto the issues that were to be discussed, this section was compact, brief, and not highly informative. In such a way, the reader is left with a large question in their mind prior to delving into the research with regards to whether the work was done according to the informed amount of knowledge gleaned by an otherwise non-expansive literature review on the topic; which although it is up to date, leaves a series of doubts within the reader’s mind. Although it is beyond the scope of this research to seek to state whether this was done out of sheer laziness or a desire to skip such a step, the end result is that the structure and voracity of the study and its findings are called into question. Perhaps recognizing some of the drawbacks of seeking responses to an anonymous internet survey, the researchers of the article initiated a second phase of analysis whereby individual interviews were conducted as a means of hoping to gain a level of inference on the research question. Although this represents an attempt to gain more insights into the research question, the fact remains that it actually provides little improvement over the initial weaknesses that have been discussed above with relation to the online survey. Whereas the only survey had a response rate of approximately 27%, the individual requests for interview had a response rate of around 50%. The focus upon individual interviews is laudable; however, in all actuality, the reader should question as to whether individual interviews would have a higher likelihood of delivering legitimate and true results than did the surveys. This is not meant to question the honesty of the individuals that participated; rather the same drawbacks and shortcomings that were doubtless exhibited within responses to the anonymous survey will be exhibited to the same extent within the personal interviews (Sherrod et al 2010, p. 18). Individuals who purposefully had a degree of information to hide with regards to health disclosure are likely to behave in an evasive manner yet again. Even the results of the personal interviews underscore the fact that the students that participated fully understood the importance of reporting (Hewitt-Taylor 2012, p. 359). This helps to point to the fact that of those 50% of the students that agreed to participate in the study, these were likely representative of the individuals who at first answered entirely truthfully with regards to disclosure of medical issues. Although the results of the interviews as well as the anonymous surveys which have been discussed earlier denote that a number of respondents admit to lying within the context of the school’s initial inquiry as to their health history, the reader/researcher can safely assume that if a percentage of these respondents admitted to falsifying on this they would also do so within future responses (Dagget 2005, p. 255). As the preceding analysis has been highly critical of the ways in which the results for the study have been generated as well as the level of inference that the results that have been garnered actually give, this next section will be praiseworthy of the third section of analysis within the given case study (Elia 2011, p. 820). Within this third section, actually part of the personal interview process critiqued above, the students were asked what type of information they would like to see on a web-enabled resource which would be able to give key requirements for the different programs (Cleary 2006, p. 248). As a result of the responses that were garnered, the study was able to develop a more full and complete understanding of the needs of the student body as well gain a level of inference as to some of the reasons why such a high level of dishonesty had previously been experienced with relation to the responses that had initially been catalogued. Due to the fact that the students did not have a firm and comprehensive understanding of the different health concerns that would bar them from medical practice there was an increased incentive to lie regarding any and all maladies for fear that these may be exclusive as well (Russell et al 2012, p. 308). Notably missing from the analysis that the researchers performed was a definitive results section which could help to inform the future researcher with what to expect within the context of the research question and answer they have provided. This shortcoming is somewhat of a surprise due to the fact that the article itself has been published (Beck 2009, p. 545). A results section exists; however, the scope of the research is merely reiterated as a means of enforcing the research question which was originally set about to be uncovered (Dale 2005, p. 185). A better approach to the entire research plan will be briefly enumerated upon below. Due to the fact that the research article that has been published does not allow access to the questionnaire or interview questions that were asked it is difficult to determine the effective nature to which these questions were presented to the respondents; however, from a perspective of attempting to gain the most beneficial responses to the question of truthfulness within the context of self-reporting existing health problems, a far superior approach would have been to forego the surveymonkey questionnaire entirely (Coughlin et al 2012, p. 660). Although it had the benefit of being “anonymous” it is too easily ignored and highly likely that an individual would have little to no compunction with regards to outright fabricating responses. Furthermore, those individuals that took the time to complete the survey would likely have been the same individuals who answered truthfully on their applications; thereby diminishing the level of precision with which the results could have been indicative (Kaplan 2012, p. 10). Finally with respect to the analysis of the results of the study, it is the belief of this author that the results indicate the prior shortcomings which have been briefly discussed. Although the result findings are presented in a clear and concise way, the generalizable nature of the results falls into question as a result of the previous discussions regarding sampling flaws and ultimate transferability of the results. Moreover, due to the fact that the fundamental questions still exist with relation to the means by which the study itself was carried out, the level to which one can hope to draw inference on the results and use it to inform themselves with regards to tangentially related issues is severely limited. Finally, with regards to the conclusion, the authors are able to continue to build upon the information that they have gathered; however, the reader is unable to form a solid conclusion based upon the result as a function of the aforementioned methodological issues that plagued the research. As a means of improving the accuracy of responses to the research question, it would be the recommendation of this student to do away entirely with the online portion of the study and rely on the results that have been generated from the personal interview and the web-based site that experienced the high level of hits with reference to key requirements for nursing studies program (Hughes-Freeland 2012, p. 363). In such a context, the exclusion of the surveymonkey results would actually have little if any negative impact on the results that the study ultimately portend nor the level of response that was gleaned, as the personal interview recorded a higher response rate than the anonymous web survey distributed by email. Further, as has been indicated by the responses, the same key information was gleaned by the personal interview, with what one can only assume was a psychologically more difficult situation to lie in (Valle et al 2012, p. 13). As compared to the ease of fabricating ones past health history on a form, or via a web-enabled survey, dealing with a face to face interview is the form that bears the highest overall likelihood of gaining the truth. In this way, one inherently begins to question the true purpose behind the level of duplication that was exhibited within the survey due to the fact that if one was tempted to prevaricate upon the first iteration, the second iteration itself bears no particularly noticeable advantage with relation to seeking to gain a further level of honesty and introspection into the true nature of the level of disclosure that took place (Caldwell 2011, p. 3). As this analysis has indicated, the study under consideration bears a litany of drawbacks. Although the research question that is sought to be answered is legitimate and some of the means by which the researchers seek to gain a level of inference onto the research question are good, the ultimate combination of the technique by which the question is sought to be answered falls short of what one would hope to find from such a scholarly journal entry. As has been noted with regards to the key strengths that the analysis has enumerated upon, the original analysis could have benefited greatly from a more thoughtful approach to the subject matter; however, as it was, the main focus has been on duplication of the data without an appropriate level of interest devoted to the key biases that the results themselves contained. Naturally, producing a piece of scholarship that is devoid of bias would of course be impossible; however, as the analysis that has been produced herein has indicated, the key shortcomings that this piece offers have been to the point that a re-examination of the research question and the means by which the data was collected should be necessitated as a means to provide the reader/researcher with a more reliable and less biased result. References Beck, C 2009, 'Critiquing qualitative research', AORN Journal, 90, 4, pp. 543-554, CINAHL Plus with Full Text, EBSCOhost, viewed 27 January 2013. Caldwell, K, Henshaw, L, & Taylor, G 2011, 'Developing a framework for critiquing health research: an early evaluation', Nurse Education Today, 31, 8, pp. e1-e7, MEDLINE, EBSCOhost, viewed 27 January 2013. Cleary, M, Freeman, A, Hunt, G, & Siegfried, N 2006, 'Commentary. 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Sherrod, R, Ford, C, & Oliver, J 2010, 'Using data from the Internet to teach ethical principles for critiquing research studies', Nurse Educator, 35, 1, pp. 17-19, CINAHL Plus with Full Text, EBSCOhost, viewed 27 January 2013. Skinner, J 2011, 'Creating and critiquing knowledge', New Zealand College Of Midwives Journal, 44, p. 4, CINAHL Plus with Full Text, EBSCOhost, viewed 27 January 2013. Valle, J, & Connor, D 2012, 'Becoming Theatrical: Performing Narrative Research, Staging Visual Representation', International Journal Of Education & The Arts, 13, ERIC, EBSCOhost, viewed 27 January 2013. Read More