Claire Sharifi, MLIS
Reference Librarian, Liaison to the School of Nursing and Health Professions
Gleeson Library
University of San Francisco

Robin Buccheri, PhD, RN, NP, FAAN
Professor Emerita
School of Nursing & Health Professions
University of San Francisco

Introduction

Critical appraisal tools and reporting guidelines are two important tools in an evidence-based practice (EBP) toolbox. Critical appraisal tools guide a consumer of evidence through an objective, analytical, evaluation process and aid in the assessment of evidence for validity, reliability, and applicability to clinical practice. Essentially, critical appraisal is the process that allows nurses and other healthcare practitioners to identify evidence that comes from rigorous, reliable literature. Reporting guidelines increase the likelihood that research and other types of evidence are reported upon completely and with transparency. Adherence to reporting guidelines in the medical literature has been found to be low (Samaan et al. 2013), and the incorporation of reporting guidelines into nursing education can help registered and advanced practice nurses achieve EBP competencies related to evidence dissemination (Melnyk, Gallagher-Ford, & Fineout-Overholt, 2017).

Background

Despite the fact that these tools are intended to facilitate evidence-based practice, we found that the doctoral nursing students we work with struggled with identifying and selecting an appropriate critical appraisal tool, understanding the difference between critical appraisal tools and reporting guidelines, and envisioning how each might be used in a report or publication. When tasked with critically appraising an article, our students often turned to a familiar critical appraisal tool, even if it was not the most appropriate tool for the methodology at hand, and they had trouble selecting the best tool from the large number of tools available. This phenomenon is not specific to our students or our institution, and is widely discussed in the literature (Katrak, Bialocerkowski, Massy-Westropp, Kumar, & Grimmer, 2004).

Methodology

In order to help students not only understand what critical appraisal tools and reporting guidelines are, but also select the best tool for the task at hand, we created a resource that attempts to clarify this sometimes confusing topic. A comprehensive search of PubMed, CINAHL, and Scopus was undertaken in order to identify critical appraisal tools and reporting guidelines commonly used by nurses. Critical appraisal tools and reporting guidelines found through this literature review search were combined with tools identified by one author during her career spent teaching EBP at the doctoral level, attending EBP conferences, reviewing EBP textbooks, and networking with other EBP nurse educators. Nine critical appraisal tools and eight reporting guidelines relevant to nursing and frequently used in nursing EBP were selected. Each tool was reviewed thoroughly and a summary and tables were created to facilitate the use of critical appraisal tools and reporting guidelines.

A Guide to Critical Appraisal Tools and Reporting Guidelines

The resource, in article form (published in Worldviews on Evidence-Based Nursing, volume 14 issue 6, page 463-472) includes a clear, plain language definition of both critical appraisal tools and reporting guidelines. It enables users to understand the scope of critical appraisal tools and reporting guidelines and to differentiate between the two. It also includes: a brief, one-paragraph overview of each of the selected critical appraisal tools and reporting guidelines; a table that facilitates the selection of an appropriate critical appraisal tool or reporting guideline based on the methodology of the article, report, or manuscript; a table that provides instructions on how to access the full text of included critical appraisal tools and reporting guidelines; and citations to articles that used the critical appraisal tools and reporting guidelines so the reader can see the tools in use.

Conclusion

Although critical appraisal tools and reporting guidelines are useful tools that have the potential to improve scholarship and EBP, identifying and selecting the appropriate tool is a potentially challenging and frustrating experience for both novice and expert consumers and reporters of evidence. By providing clear descriptions of each tool, as well as tables that provide an easy reference for matching the type of tool with an article's methodology, this resource lessens that challenge and minimizes frustration.

References

Buccheri, R., & Sharifi, C. (2017). Critical Appraisal Tools and Reporting Guidelines for Evidence-Based Practice. Worldviews On Evidence-Based Nursing, 14(6), 463-472. doi:10.1111/wvn.12258

Katrak, P., Bialocerkowski, A. E., Massy-Westropp, N., Kumar, V. S., & Grimmer, K. A. (2004). A systematic review of the content of critical appraisal tools. BMC Medical Research Methodology, 4(22), e1–11. https://doi.org/10.1186/1471-2288-4-22

Melnyk, B. M., Gallagher-Ford, L., & Fineout-Overholt, E. (2017). Implementing the evidence-based practice (EBP) competencies in healthcare. Indianapolis, IN: Sigma Theta Tau International.

Samaan, Z., Mbuagbaw, L., Kosa, S., Borg Debono, V., Dillenburg, R., Zhang, S., et al. (2013). A systematic scoping review of adherence to reporting guidelines in health care literature. Journal of Multidisciplinary Healthcare, 2013(6), 169–188. https://doi.org/10.2147/JMDH.S43952