How Measuring Blood Pressure in Hypertensive Patients - Assignment Example

Student Name: Student Number: Assignment 1 Template Part 1: ePBL Group Discussion (Word count: marked from the discussions) (10 marks) Word Count for all of Part 1: Included in the group discussion but not included in the overall Assignment 1 word count The marker will review your group discussion from the study desk Part 2: Asking a Clinical Question, Locating and Retrieving Evidence, Summarising and Synthesising Evidence (50 marks) Word Count for all of Part 2: 1,100 words Asking a Clinical Question 5 marks Can blood pressure in hypertensive patients (P) be measured more accurately using oscillometric technique (I) as compared to auscultatory technique (C) to obtain accurate blood pressure measurement without errors (O)? Locating and Retrieving Evidence 10 marks The evidence will be located by using search terms with key words in the PICO question. Therefore the search terms will be directly related to the PICO question and will include blood pressure measurement, oscillometric technique and auscultatory technique. The search process will retrieve a bibliography applicable to several studies and this will include titles and abstracts of potentially relevant studies. Inclusion/exclusion criteria will be applied to the titles and abstracts of the retrieved titles and abstracts. First, studies that will not meet one or more exclusion criteria will be eliminated and this will be done to all abstracts and titles that will not be having any relevance to the study topic (Meline, 2006). Next, full texts of the remaining studies (the titles and abstracts that met the exclusion and inclusion criteria) will be retrieved. The reliability of these studies will then be examined for inclusion and exclusion and the studies that will meet all inclusion criteria with no exclusion criteria will then be included in the study. These studies will then be evaluated further to ensure that all the included studies meet the inclusion criteria and studies that will have reasons to be excluded, for instance studies with inadequate statistics or studies with ambiguous and unclear results will be excluded. The remaining studies will then be accepted to be used as evidence for the study. The evidence will then be used in examining selected studies regarding research topic and identifying what is known and has been studied regarding research topic. The evidence will also identify questions that previous studies have not answered on the research topic (Aveyard, 2010). Examining the Literature 5 marks Nurses should seek out practice-relevant researches, primary research studies, examine different kind of literature during their practice and ensure that the literature used in up to date and synthesise all available knowledge and eventually translate the knowledge into action. This will include integrating the evidence into practice where the practice will be aligned to reflect the best evidence. Therefore, nurses should always ensure that they use the knowledge in literature in clinical decision making and seek out research evidence during their practice. Evidence based information is important in supporting clinical decision making because it provides an opportunity for nursing care to be more individualized, more effectual, rationalized, and dynamic, and to make best use of effects of clinical judgment. Using evidence based information will also ensure that the clinical decisions are made basing on the latest knowledge and technological developments (Aveyard, 2010). Summarising the Evidence 10 marks Assignment 1 – Task 4 (Summary Table) First Author (year) a 15 sources of evidence to be included Hierarchy of Evidence – Type of Evidence & Ranking b The Focus of the Study Key Variables Studies (Quantitative) Phenomena of interest (Qualitative) Type of Research Method (e.g. correlational, grounded theory) 1. Aarnes, T. (2012). Randomised controlled trials Accuracy of the oscillometric method for arterial blood pressure (ABP) monitoring Arterial blood pressure If accurate ABP monitoring can be attained using an oscillometric method Experimental 2. Acierno, M. (2014). Randomised controlled trials (RCT) Comparing direct and indirect blood pressure measurements Systolic and diastolic blood pressures Level of agreement between direct and indirect blood pressure measurement Correlational 3. Babbs, C. (2012). Randomised controlled trials (RCT) Measuring high blood pressure using an automatic oscillometric device with reliable algorithm to extract accurate systolic and diastolic pressures from cuff pressure oscillations Systolic and diastolic blood pressures Accurate blood pressure measurement Experimental 4. Bosiack AP. (2010). Randomised controlled trials (RCT) Comparing ultrasonic Doppler flow monitor, oscillometric, and direct arterial blood pressure measurements Systolic and diastolic blood pressures Accurate blood pressure measurement Correlational 5. Hubbell, J. (2014). Randomised controlled trials (RCT) Comparing oscillometric (O-NIBP) and an invasive method (IBP) to monitor arterial blood pressure (ABP) Systolic ABP and diastolic ABP Monitoring arterial BP using invasive metho Correlational 6. Joshua, S. (2012). Randomised controlled trials (RCT) Comparing simultaneous oscillometric and auscultatory BP measurements Auscusltatory measurement and Oscillometric measurement Repeated measurement is warranted in all blood pressure measurements Correlational 7. Kapse C.(2013) Meta-analysis Comparing an automated blood pressure measurement device against the traditional auscultatory technique of BP measurement in normotensive and hypertensive subjects Blood pressure values Accurate blood pressure measurement Correlational 8. Keavney, B. (2000). Randomised controlled trials (RCT) Ambulatory monitoring device capable of recording both by the Korotkoff-sound and oscillometric methods in a single cuff deflation Korotkoff sounds; oscillometric blood pressure measurements Ambulatory monitoring in auscultatory technique and oscillometric methods Correlational 9. Landgraf, J. (2010). Randomised controlled trials (RCT) Comparison of automated oscillometric versus auscultatory blood pressure measurement Blood pressure values Accurate blood pressure measurement Experimental 10. Miranda, J. (2008). Cohort Study Comparing oscillometric blood pressure devices with mercury sphygmomanometry Systolic and diastolic blood pressures Applicability of automated blood pressure measuring devices in children within resource-poor settings Correlational 11. Patel, K. (2001) Randomised controlled trials (RCT) Determine if the rapid method is as effective as the convectional oscillometric blood pressure measurement which can improve the accuracy of hypertension measurement Blood pressure values If during blood pressure measurement, venous engorgement that happens with too quick cuff re-inflation induces measurement errors Correlational 12. Ribezzo, S. (2014). Randomised controlled trials (RCT) Comparing invasive arterial blood pressure with noninvasive blood pressure measurements Arterial blood pressure, Diastolic blood pressure Correlational 13. Shau, D (2010). Cross-sectional survey Incorporating diastolic pressure in palpatory method of blood pressure measurement Arterial blood pressure, Diastolic blood pressure Descriptive 14. Sigridur, B. (2013). Randomised controlled trials (RCT) Investigating the difference in BP obtained using oscillometric and aneroid BP monitors Systolic blood pressure and Diastolic blood pressure Necessity of multiple measurements of blood pressure to obtain an accurate diagnosis of hypertension Correlational 15. Yasmen, G. (2008) Randomised controlled trials (RCT) Comparing auscultatory and oscillometric methods of ambulatory blood pressure measurements in patients with hypertension Values obtained by auscultatory and oscillometric blood pressure measurement methods Correlational Synthesising Evidence (approx. 500-700 words) 20 marks Currently, there are various methods used in measuring arterial systolic, diastolic and mean blood pressure which depend on the automatic oscillometric systems for indirect measurement of arterial blood pressure and auscultatory method for direct blood pressure measurement. In auscultatory technique, a cuff is placed around the upper arm, inflated over systolic pressure to occlude the brachial artery and then deflation occurs gradually (Bosiack, 2010). The restitution of blood flow is allied to the recognition of of Korotkoff sounds by a stethoscope over the artery. Studies indicate that auscultatory technique tends to produce lower systolic arterial pressure (SAP) values and higher diastolic arterial pressure (DAP) values in comparison to the real intra-arterial pressure (Bosiack, 2010). On the other hand, Oscillometric equipments record pressure in a sphygmomanometer cuff when it is deflating; the maximal sensed oscillation corresponds to mean arterial pressure (MAP), whereas the estimation of SAP and DAP is done in accordance with various manufacturer’s empirical algorithms. Babbs (2012) notes that the amplitude of the oscillations might be dependant of other aspects such as arteries’ stiffness as well as the measurement location since in more distal arteries systole arterial pressure tends to elevate and diastole arterial pressure reduce (Babbs, 2012). In addition, because deflation of cuffs occurs at a manufacturer-specific speed that presumes a regular pulse, oscillometric blood pressure is not reliable within arrhythmic patients (Babbs, 2012). Acierno (2014) conducted a study to compare both auscultatory method and oscillometric techniques and found out that even though the oscillometric method indicated a tendency of more elevated systolic and decreased diastolic measurement values in comparison to the auscultatory technique, both techniques are well analogous and the variations are below the level of physiological and clinical significance (Acierno, 2014). However, a results of the study conducted by Aarnes, (2012) indicated that even though auscultatory technique produced higher standard deviation systolic blood pressure values when compared to oscillometric technique, standard deviation values gotten using oscillometric technique were higher for diastolic blood pressure in comparison to auscultatory technique. Sigridur (2013) found out that the percentage of getting valid blood pressure measurements using the oscillometric technique utilized in ABPM equipment is higher in comparison to auscultatory technique and the results indicated that the oscillometric technique might be preferable over the auscultatory technique when examining arterial blood pressure measurements (Sigridur, 2013). The oscillometric technique is progressively utilized in blood pressure measurement because it is a simple and a reliable method due the oscillometric principle within automatic and semi-automatic non invasive blood pressure monitors. In addition, the aspect of automation in oscillometric technique provides an opportunity to avoid costly and constant training of healthcare practitioners in auscultation, which is required in order to decrease observer errors. The use of automatic oscillometric devices necessitates careful examination of the patients for nicotine or caffeine use, cuff size should be selected carefully and patients should be positioned properly to obtain accurate blood pressures (Yasmen, 2008). Kapse (2013) further explains that automatic oscillometric devices give times printouts of blood pressure and remove several sources of error allied to the convectional auscultatory method and hence enhance the overall accuracy of blood pressure measurement as long as they themselves are accurate. However, to validate the accuracy of the automated oscillometric devices, it is necessary to validate them against the established standards (Kapse, 2013). Part 3: Understanding the research process (10 marks) Word Count for all of Part 3: 400 words (200 words for each study) Add the DOI link for the qualitative study here (or full reference) Shau, D & Bhaskran, M. (2010). Palpatory Method of Measuring Diastolic Blood Pressure. J Anaesthesiol Clin Pharmacol. 26(4): 528–530. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3087253/ Add the DOI link for the quantitative study here (or full reference) here Ribezzo, S. (2014). Noninvasive Techniques for Blood Pressure Measurement Are Not a Reliable Alternative to Direct Measurement: A Randomized Crossover Trial in ICU. The Scientific World Journal. 14(9): 573-579. doi.org/10.1155/2014/353628 Add your outline of the research process used in the qualitative study below 5 marks Shau, D & Bhaskran, M. (2010). Palpatory Method of Measuring Diastolic Blood Pressure. J Anaesthesiol Clin Pharmacol. 26(4): 528–530. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3087253/ The aim of the study was to analyse palpatory method of blood pressure measurement method through systolic blood pressure and diastolic blood pressure as well The research involved 200 patients both males and females, during exercise in treadmill, preanaesthetic exmination and intraoperative period The research was conducted by measuring systolic and diastolic blood pressure with the new plapatory method and recorded and an independent blinded observer measured blood pressure using auscultatory method and recorded the values The data was collected by recording all blood pressure measurements and was analysed by comparing the values in terms of percentage and range The main finding were that 51% had systolic and diastolic blood pressure measured by palpatory method, within + 2 mmHg of auscutatory method, 20% patients had within + 4 mmHg, 52 (25 %) patients had same readings as with auscutatory method, and 0.5 % patients it could not be measured Implications of the research is that the new palpatory method can facilitate both systolic and diastolic blood measurement to be done without sphygmomanometer Limitations of the research is that very restrictive data was used since the data was collected from one source Opportunities for further research is validation of the study results Add your outline of the research process used in the quantitative study below 5 marks Ribezzo, S. (2014). Noninvasive Techniques for Blood Pressure Measurement Are Not a Reliable Alternative to Direct Measurement: A Randomized Crossover Trial in ICU. The Scientific World Journal. 14(9): 573-579. doi.org/10.1155/2014/353628 The aim of the study was toexamine the accuracy and reliability of aneroid (ABP) and oscillometric (OBP) devices compared to the invasive BP (IBP) monitoring The research involved 50 patients in the General ICU of the “Azienda Ospedaliero-Universitaria” Hospital of Trieste, Italy The research was conducted by measuring blood pressure following a standardized BP recording method The data was collected by filling four data collection forms for each patient The main findings were that blood pressure measurements with different devices produced significantly different results. Implication of the research is that the noninvasive techniques cannot be regarded as reliable alternative to direct measurements. Limitations of the research is that the study population suffered in regard to their main diagnosis, formula used in calculating the MAP with the auscultatory method may have been less accurate bradycardic or tachycardic patients, because of the length of the systole changing with the heart rate Study presents pportunities for further research in hypotensive and hypertensive patients Part 4: Critically Analysing the Evidence (30 marks) Word Count for all of Part 4: 500 words (250 for each critique – this excluded the table questions and headings) Add your qualitative critique table below Aspect Evidence Analysis Citation Shau, D & Bhaskran, M. (2010). Palpatory Method of Measuring Diastolic Blood Pressure. J Anaesthesiol Clin Pharmacol. 26(4): 528–530. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3087253/ Was the purpose and/ research question stated clearly? Yes. The aim of the study is clearly articulated and specific. The aim was to incorporate diastolic pressure in palpatory method of blood pressure measurement. However, the study aim is restrictive since the study outcome cannot be generalized to other related areas. Was relevant background literature reviewed? No. This is because the article does not discuss adequate literature regarding what is known about the study topic. Generally, there are numerous studies regarding the study topic and thus the article should have reviewed several previous literatures on the topic. Was a theoretical perspective identified? Yes. The article presented findings from an earlier grounded theory study of the Russian physician “Korotkoff” to explain the context of the study and also discussed the link to palpatory method of measuring blood pressure. The process of purposeful selection was described? Yes. In the study, 200 adult patients of both sexes, during exercise in treadmill, preanaesthetic examination and intraoperative period, were selected. Sampling was done until redundancy in data was reached? Yes. The sample size is adequate. The sample consisted of 200 patients which is relatively adequate and thus ensured validity of the study. Data collection strategies appropriate? No. There is no clear and vivid description of the important elements of the study such as the participants, and the site or setting. Process of analyzing the data was described adequately? No. The article does not describe how the data was analyzed and no data presentation was done which an aspect that should not miss in any study Ethical considerations The article does not show if there were any ethical considerations. This is inappropriate because the study involved collecting data from national nurses’ register and therefore the article should have indicated if permission to collect data from the register was sought from the relevant authority. Conclusions were appropriate given the study findings? Yes. Conclusions are consistent and congruent with the findings. The new palpatory method described has been shown to facilitate both systolic and diastolic blood measurement to be done without sphygmomanometer as per the study aim indicating congruency. The findings contributed to future practice? Yes. The study results support previous studies on this topic and hence the study results can be applied in practice. 15 marks Add your quantitative critique table below 15 marks Total word count of Assignment 1 Template: 294 words References Aarnes, T., Hubbell, J., Lerche, P & Bednarski. (2012). Comparison of invasive and oscillometric blood pressure measurement techniques in anesthetized camelids. Can Vet J. 53(8): 881–885. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3398528/ Acierno, M. (2014). Agreement between direct and indirect blood pressure measurements obtained from anesthetized Hispaniolan Amazon parrots. J Am Vet Med Assoc. 15; 233(10):1587-90. doi: 10.2460/javma.233.10.1587. Babbs, C. (2012). Oscillometric measurement of systolic and diastolic blood pressures validated in a physiologic mathematical model. Can Vet J. 53(8): 881–885. doi:10.1186/1475-925X-11-56. Bosiack AP, Mann FA, Dodam JR. Comparison of ultrasonic Doppler flow monitor, oscillometric, and direct arterial blood pressure measurements in ill dogs. J Vet Emerg Crit Care. 2010;20:207–215 doi: 10.1111/j.1476-4431.2010.00520.x. Hubbell, J. (2014). Comparison of invasive and oscillometric blood pressure measurement techniques in anesthetized sheep, goats, and cattle. Vet Anaesth Analg. 41(2):174-85. doi: 10.1111/vaa.12101. Joshua, S. (2012). Auscultatory versus oscillometric blood pressure measurements in teens. The Journal of Clinical Hypertension. 19-22 http://www.ashabstracts.com/abstract.asp?MeetingID=786&id=98855 Keavney, B. (2000). Measurement of blood pressure using the auscultatory and oscillometric methods in the same cuff deflation: validation and field trial of the A&D TM2421 monitor. Journal of Human Hypertension .14(9): 573-579. http://www.nature.com/jhh/journal/v14/n9/abs/1001100a.html Kapse C. & Patil B. (2013). Auscultatory and Oscillometric methods of Blood pressure Measurement. International Journal of Engineering Research and Applications. 3(2): 528-533. http://www.ijera.com/papers/Vol3_issue2/CI32528533.pdf Landgraf, J., Wishner, S & Kloner, R. (2010). Comparison of automated oscillometric versus auscultatory blood pressure measurement. Am J Cardiol. 106(3):386-388. doi: 10.1016/j.amjcard.2010.03.040. Miranda, J. (2008). Performance of oscillometric blood pressure devices in children in resource-poor settings. European Journal of Cardiovascular Prevention and Rehabilitation. 15(3). http://www.prisma.org.pe/wp-content/uploads/2012/03/Performance-of-oscillometric.pdf Patel, K, Yarows, S & Brook, R. (2001).Rapid oscillometric blood pressure measurement compared to conventional oscillometric measurement, Blood Pressure Monitoring. 6:145 – 147. http://www.medicalgroup.hu/download/ket_meres_kozti_ido_%28angol%29.pdf. Sigridur, B. (2013). Comparison of Aneroid and Oscillometric Blood Pressure Measurements in Children. The Journal of Clinical Hypertension. 15(11). DOI: 10.1111/jch.12196. Ribezzo, S. (2014). Noninvasive Techniques for Blood Pressure Measurement Are Not a Reliable Alternative to Direct Measurement: A Randomized Crossover Trial in ICU. The Scientific World Journal. 14(9): 573-579. doi.org/10.1155/2014/353628. Shau, D & Bhaskran, M. (2010). Palpatory Method of Measuring Diastolic Blood Pressure. J Anaesthesiol Clin Pharmacol. 26(4): 528–530. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3087253/ Yasmen, G., Sekip, A., Oguzhan, K, Erkan, A. (2008). Comparative study on auscultatory and oscillometric methods of ambulatory blood pressure measurements in adult patients. Blood Pressure Monitoring. 13(1):29-35. doi: 10.1097/MBP.0b013e3282f13f20 Marking Criteria Part 1: ePBL Group Discussion ePBL Activity 1 0 1 No evidence that student submitted a satisfactory introductory posting Student satisfactory submitted the ePBL Activity 1 into the ePBL group discussion forum. ePBL Activity 2 Student did not complete the activity to a satisfactory standard. 1 Minimum of 50 words of students own ideas. Responded to another student’s discussion. Evidence of links with course content. ePBL Activity 3 Student did not complete the activity to a satisfactory standard. 1 Minimum of 50 words of students own ideas. Responded to another student’s discussion. Evidence of links with course content. ePBL Activity 4 Student did not complete the activity to a satisfactory standard. 1 Minimum of 50 words of students own ideas. Responded to another student’s discussion. Evidence of links with course content. ePBL Activity 5 Student did not complete the activity to a satisfactory standard. 1 Minimum of 50 words of students own ideas. Responded to another student’s discussion. Evidence of links with course content. ePBL Activity 6 Student did not complete the activity to a satisfactory standard. 1 Minimum of 50 words of students own ideas. Responded to another student’s discussion. Evidence of links with course content. ePBL Activity 7 Student did not complete the activity to a satisfactory standard. 1 Minimum of 50 words of students own ideas. Responded to another student’s discussion. Evidence of links with course content. ePBL Bonus Marks 3 Comments by marker: Part 2: Asking a Clinical Question, Locating and Retrieving Evidence, Summarising and Synthesising Evidence Asking a Clinical Question using PICO 0 - 2 2.5-3 3.5 3.6-4 4-5 No or little evidence of using PICO as a framework to develop a clinical question Some attempt at applying PICO to a clinical question. Some elements correctly identified. Satisfactory attempt overall at using PICO to develop a clinical question. Good understanding and interpretation of PICO in relation to developing a clinical question. Excellent demonstration of using PICO to develop a clinical question. All elements correctly identified. Very good understanding of PICO. Locating and Retrieving Evidence 0 - 4.5 5 – 6.5 7- 7.4 7.5 – 8.4 8.5 - 10 Little or no discussion of the method of searching literature relevant to the PICO question. Some ability to discuss method of literature searching. A satisfactory ability to consider relevant and credible literature which helps to form the basis for helping to answer the PICO process. Some demonstration of ability to use electronic databases and catalogues. Some inclusion and exclusion criteria applied. Good understanding of using credible and professional evidence to help form the foundation of the PICO question. Ability to demonstrate a clear process of obtaining credible evidence. Good use of inclusion and exclusion criteria – good rationale provided. Student demonstrates an excellent understanding of the evidence useful to help answer the PICO question, including hierarchy of evidence. Excellent ability to utilise electronic databases and catalogues to help locate and retrieve information. Excellent choices of inclusion and exclusion criteria. Examining the Literature 0 - 2 2.5-3 3.5 3.6-4 4-5 Little or no discussion as to the purpose of reviewing the literature to support clinical decision-making. Student not able to identify any ways in which nurses should examine the literature. Limited discussion of a process of critically examining the literature. Some discussion of why examining evidence-based information is important for clinical decision-making. Sound rationale provided for examining the evidence for clinical decision-making. A sound level of understanding of how to examine the literature critically. A good level of understanding overall of the purpose of reviewing literature in relation to clinical decision-making. Student was able to articulate a variety of ways to examine the literature. May have used a framework. Student clearly able to demonstrate at a high level, an understanding of the importance of reviewing the literature broadly to answer clinical questions. Rationale supported with relevant literature. 0 – 4.5 5 – 6.5 7 – 7.4 7.5 – 8.4 8.5 - 10 Summarising Evidence Little or no evidence of summary table provided based on the example given. Summary table provided but only some information included. A satisfactory ability to not only develop a summary table, but relate this to neither the PICO question nor the eproblem 1. A good demonstrated ability to develop a summary table of published articles. Relevance to PICO question was evidence. Consideration of hierarchy of evidence. Student demonstrated an excellent ability to develop a summary table based on example. A total of 15 published articles included and were highly relevant to the PICO questions and demonstrated application of hierarchy of evidence. Synthesising Evidence 0-9 10-13 14-15.5 16-18 19-20 Little or no evidence of synthesis of evidence Some ability to synthesise evidence, however ideas often disjointed. Satisfactory ability to synthesise evidence. More analysis than synthesis evident. A good ability to synthesise the evidence, including conclusions of key findings. Relationships between ideas are being formed. An excellent ability to synthesise the evidence. Clear relationships between ideas are evident. Common findings between authors are apparent. Synthesis also extends to showing gaps in the evidence. Part 3: Understanding the Research Process (10 marks 0 -2 2.5-3 3.5 3.6-4 4-5 Qualitative Research Process Little or no evidence that student could identify elements of research process within each study. Student unable to identify the difference between a qualitative and quantitative study. Some ability to identify elements of research process inherent within each article. An overall satisfactory ability to identify key elements of the research process within the article. A good ability to identify key elements of the research process within the article. Student clearly demonstrated an ability to identify elements including information within the body of the article. An excellent ability to identify key elements of the research process within the article. Student clearly demonstrated an ability to identify elements including information within the body of the article. Quantitative Research Process Little or no evidence that student could identify elements of research process within each study. Student unable to identify the difference between a qualitative and quantitative study. Some ability to identify elements of research process inherent within each article. An overall satisfactory ability to identify key elements of the research process within the article. A good ability to identify key elements of the research process within the article. Student clearly demonstrated an ability to identify elements including information within the body of the article. An excellent ability to identify key elements of the research process within the article. Student clearly demonstrated an ability to identify elements including information within the body of the article. Part 4: Critically Analysing the Evidence (30 marks) 0-6.5 7-10.5 10.5-12 12-13.5 14-15 Qualitative critique Little or no evidence that student was able to use a set of critique criteria to appraise the identified study. Some ability to appraise and evaluate the article based on the criteria provided. Student has difficulty in identify key aspects of the studies. A satisfactory ability to appraise the study based on the criteria provided. A good ability overall to appraise and evaluate the studies. Student provided a high level of critical thinking in terms of the critical appraisal of the study. Responses are often well supported by relevant literature. 0-6.5 7-10.5 10.5-12 12-13.5 14-15 Quantitative critique Little or no evidence that student was able to use a set of critique criteria to appraise the identified study. Some ability to appraise and evaluate the article based on the criteria provided. Student has difficulty in identify key aspects of the studies. A satisfactory ability to appraise the study based on the criteria provided. A good ability overall to appraise and evaluate the studies. Student provided a high level of critical thinking in terms of the critical appraisal of the study. Responses are often well supported by relevant literature. THIS SECTION INDICATES THE MARKS DEDUCTED FOR REFERENCING, WORD LIMIT & SPELLING /GRAMMAR MINUS Over or under word limit by more than 10 % 4 – 5 3.5 2.5 – 3 0 Considerably over or under the word limit Moderately over or under word limit Slightly over or under word limit Adheres to correct word limit Evidence of research, use of suitable references and correct APA style referencing 7 – 10 4 – 6.5 1 – 3 0 Insufficient research/irrelevant research/limited use of evidence and / or absent referencing style Many errors with referencing style or insufficient or irrelevant use of research Minor referencing errors In depth investigation via use of relevant and comprehensive research and correct referencing style Spelling /grammar 4 – 5 3.5 1 – 3 0 Numerous spelling and or errors with grammar Moderate spelling and or grammatical errors Minimal spelling and or grammatical errors No spelling and or grammatical errors MARKS LOST FOR REFERENCING, WORD LIMIT & SPELLING /GRAMMAR MARKS LOST FOR LATE PENALTY (IF RELEVANT – 5 % per day) Part 1 Mark = Part 2 Mark = Part 3 Mark = Part 4 Mark = Deductions (If applicable) = Final Mark = / 100 Marker Feedback: Marker Name: Date: Read More