Statement of the Problem
The problem statement is stated clearly, and it is easy to identify. In Sweden, one of the biggest problems in nursing education is passing exams, and this statement is stated unambiguously. This problem is significant in nursing because students are expected to pass certain exams before they can join the profession. Additionally, the statement of problem has built a persuasive argument for the study by discussing the gaps in the subject, and thus the need to have the research. Moreover, there is a good match between the research problem and the methods used because the quantitative approach employed is appropriate for the study.
Hypotheses or Research Questions
The research questions and hypotheses are not stated explicitly. However, their absence is justified because throughout the introduction, the reader can understand the issues that the study seeks to address. Additionally, the aim of the study is stated clearly, and it specifies the key variables and the study population.
The literature review has a mixture of old and up-to-date references, but most of them are primary sources. The oldest reference material is a study published in 1993. On the other hand, the latest source was published in 2015. The review has provided exhaustive synthesis of evidence on the problems being addressed in the study. Additionally, the literature review has given a strong basis for the new study by highlighting areas that have not been addressed in previous studies.
Conceptual. Theoretical Framework
The key concepts are adequately defined. The researchers synthesized the available literature to explain the issue of nursing students’ attendance at learning activities. The theoretical framework is articulated clearly by using different theories related to the research question, which sets the stage for the presentation of the problems being addressed. The research questions, which can be deduced from the introduction, are consistent with the theoretical framework used for this study.
Protection of Human Rights
The researchers acted appropriately to safeguard the rights of the study participants. The participating students were informed orally about the study’s details and its voluntary nature. Formal written consent was not obtained. However, the participants were presumed to have agreed to take part in the study after choosing to mark their attendance at the beginning of every teaching activity. Additionally, the study was reviewed and approved by the ethical board of University West in Sweden. Similarly, it followed guidelines provided in the Declaration of Helsinki. The nature of this study did not have any risks to the participants, and thus the design maximized benefits to the involved individuals.
The most rigorous design was used considering the aims of the study. The researchers sought to establish the effects of nursing students attending non-mandatory learning activities on the overall performance. Therefore, the most rigorous design would be to study the students’ patterns in attending such courses and the subsequent performance. Appropriate comparisons were made, thus enhancing the interpretability of the findings. For instance, data was compared within and between the two courses selected for the study. One data collection point was used, and it was appropriate, as students were only required to sign the lesson attendance list. To minimize bias and threats to validity, the researchers did not influence the participation of the students, and thus participation was voluntary and random.
Population and Sample
The population was identified as nursing students taking non-mandatory courses. The sample was described sufficiently. 361 students participated, and they were evenly distributed across the four classes that were chosen for the study. Allowing all the students to participate voluntarily enhanced the sample’s representativeness. Therefore, the data collected would be indicative of a natural class attendance setting with students of different ages and sex together with other demographics, and thus sampling bias was minimized. The sample size was not based on a power analysis, but it was adequate for the study.
Data Collection and Measurement
The operational and conceptual definitions were congruent. The key variables were class attendance and performance, and their definitions were not changed throughout the study. Additionally, the key variables were measured sufficiently using document reviews, which is an appropriate method for this form of study. The specific instruments used were described adequately, and they were good choices considering the variables and population being studied. Similarly, there was evidence that the data collection methods would yield valid, reliable, and responsive data, because the information obtained could not be manipulated.
The intervention for the study was adequately described. Additionally, it was developed and implemented rigorously. The study population was divided in six groups based on the class attendance. Ultimately, the number of attendances was analyzed against performance, and thus it can be concluded that most participants received the intervention. Similarly, the intervention fidelity came naturally because the data could not be manipulated. The data collection method employed, viz. document reviews, had minimal chances for bias, and there was no need to give the staff members who collected the data any form of special training for the task.
Enhancement of Trustworthiness
In quantitative studies, trustworthiness can be enhanced through validity and reliability of the chosen instrument (Polit & Beck, 2008). In this case, data validity and reliability were enhanced by not interfering with the students’ choice to participate in the study. Additionally, it was made clear that the information would be handled confidentially, and the data used for analysis were de-identified to protect the participants’ identity.
Data analyses were conducted to address the research questions that emerged in the introduction. The statistical method used for analysis was appropriate given the level of measurement of the variables. Logistic regression was used in “the analysis of the relationship between examination outcome and potential explanatory variables expressed with odds ratios” (Rejnö, Nordin, Forsgren, Sundell, & Rudolfsson, 2017, p. 38). Additionally, to control confounding variables, two-sided statistical tests were used. There was no mention of avoidance or minimization of type I and type II errors. Given the nature of intervention used in this study, an intention-to-treat analysis was not performed, and the issue of missing values was not mentioned or addressed.
Reliability and Validity
Information about statistical significance was presented. It is stated that the number of students passing exams due to high attendance rates had statistically significant differences compared to those that fail occasioned by non-attendance. Similarly, information about confidence intervals was stated clearly. The findings were summarized adequately using tables, figures, and graphs. Additionally, the reliability of the data was ensured by allowing the chosen instrument to measure the intended variables consistently. To ensure validity, the selected instrument measured the needed variables to the highest degree possible. As such, the results from the study sample can be generalized, which underscores the external validity of the data.
Interpretation of Findings
All the major findings were interpreted and discussed within the context of prior research and the study’s conceptual framework. An in-depth interpretation was carried out to show the correlation between class attendance and performance. Different demographics were also considered including age and sex. Casual inferences were not mentioned or justified. The issue addressed here is significant to nursing as it explains one of the major problems causing exam failures among nursing students in Sweden. The study’s limitations were not stated, and the generalizability of the findings was not addressed.
The researchers discussed the implications of the study in nursing education. It was observed that nursing students’ performance is highly dependent on the attendance of non-mandatory learning activities. Additionally, the researchers pointed out the need for further studies to enlighten their findings. While the researchers established a strong link between class attendance and performance, they acknowledged that further studies were required to address factors influencing that relationship. The implications and recommendations given were complete and reasonable.
The report was well-written, organized, and sufficiently detailed for critical analysis. The authors organized the report in a way that the reader can follow the flow of information from the introduction to conclusion. In the discussion part, each section of the report, such as results and methods, was explored separately, thus facilitating coherence and organization. Charts, graphs, and figures were used extensively to clearly present the obtained data. Given the nature of the intervention measures used in this study, a consort flowchart was not provided, and it was not necessary. The report was written in a manner that makes the findings accessible to nursing students. From the study, it is clear that nursing students can improve their performances by attending classes for non-mandatory learning activities.
The researchers’ clinical and substantive qualifications and experience enhance confidence in the findings and their interpretations. Four of the researchers work at the Department of Health Sciences at University West, while one of them is a member of the Skaraborg Institute for Research and Development. Another one belongs to the Faculty of Professional Studies in Nord University. Additionally, one of the researchers works at Skaraborg Hospital in the stroke unit. Therefore, the researchers have combined experience and qualifications to enhance the findings’ confidence and interpretation.
Even though the researchers have not indicated the study’s limitations, and despite the presence of the same, the findings appear valid and I have confidence in the truth-value of the results. Similarly, the study contributes meaningful evidence that is useful in the nursing education discipline. Given that nursing students are required to pass certain exams before joining the profession, the findings play an important role by revealing one of the main causes of exam failures. As such, students can use the findings to improve their learning performance.
Statement of the Problem
The statement problem has been stated unambiguously, and it easy to identify. At the beginning of the introduction, the researchers clarified that the issue of how teachers’ empathy towards learners affects students’ professional development has not been addressed sufficiently and directly. Therefore, the current study sought to fill this gap. The problem statement has built a cogent and persuasive argument for the new study by exploring what is already known and the need to have this research. The problem is significant for nursing because it addresses a life-long issue on nursing professional development. The qualitative approach is appropriate, as there is a good match between the research problem and the methods used.
Hypotheses or Research Questions
Two research questions were explicitly stated. The first one is “How does the empathy of nursing teachers’ influence students and their learning?” (Mikkonen, Kyngäs, & Kääriäinen, 2015, p. 671). The second one is “How does experiencing empathy from teachers prepare students to become a nurse?” (Mikkonen et al., 2015, p. 671). The questions are consistent with the study’s philosophical basis, which problematizes the issue of teachers’ empathy towards their students, and how the same prepares leaners for the nursing profession.
The report adequately summarized the existing body of knowledge related to the problem of interest. The researchers explored the available literature on the issue of teachers’ empathy towards students to highlight what is already known about the subject. The existing body of literature indicates that teachers’ empathy towards students influences the learning experience. However, the available studies address this subject indirectly. Therefore, this study sought to examine the direct impact of the teachers’ empathy on the students’ learning and professional development, thus providing a strong basis for the new study.
The key issues were adequately defined conceptually. The researchers addressed the concept of empathy and how it has been theorized in nursing education. The philosophical basis, underlying tradition, and conceptual framework were made explicit, and they were appropriate for the problem. For instance, according to the researchers, different studies have criticized nursing education for producing nurses with proper technical skills, but poor in creativity, critical thinking, caring philosophy, and communication skills. This problem points to an inherent problem in how nursing is taught, and the teachers’ empathy towards students has been pointed as one of the causes. Therefore, the underlying concepts and traditions were stated clearly in the study.
Protection of Participants’ Rights
Appropriate procedures were used to safeguard the rights of study participants. The participants gave informed consent before being enrolled for the study. Additionally, they were given full freedom to participate or opt out of the interviews. The participants were guaranteed that the information obtained from the interviews would only be used for the study purposes only, and it could only be accessed by the researchers. The study was subject to external review by an IRB/ethics review board as approval was obtained from the administrator of the university where the research was conducted. The study was designed to minimize risks and maximize benefits to participants by keeping the data anonymous and confidential.
Research Design and Research Tradition
There was no identification of any research tradition. Adequate time was spent with the study participants. Every interview lasted for about 40 minutes, thus allowing the researchers to interact with the participants sufficiently. The design unfolded during data collection, thus giving researchers the opportunity to capitalize on early understanding. For instance, the sampling and coding process was discontinued in cases where additional data showed replication of information. There was adequate number of contacts with the study participants from the time they were invited for the study to the day the interviews were conducted.
Sample and Setting
The population of interest was adequately described, and only nursing students studying degree programs taught in the English language were considered for the study. Ultimately, 12 participants met the inclusion criteria, and they were recruited for the study. The setting and sample were described in sufficient detail. The inclusion criteria required participants to have completed their first year of learning, enrolled in a nursing course taught in English, and in a position to communicate fluently in English. The approach used to recruit participants was appropriate because language was a key component for this study to avoid the misinterpretation of the word “empathy”. The best possible sampling method was used to enhance information richness and address the needs of the study. However, the sample size was not adequate even though saturation was achieved.
Data was gathered using face-to-face interviews, and this method was appropriate as researchers had enough time and opportunity to collect rich data by asking relevant questions. However, data was gathered through one method, and thus triangulation was not achieved. The researchers asked the right questions and they were recorded appropriately. The interview questions were pretested using one of the volunteer students to ensure the relevance to the study. Enough amounts of data were gathered from the participants, and it was sufficient in depth and richness.
The data collection and recording procedures were adequately described, and they appear appropriate. Face-to-face interviews were used and data was recorded in audio tapes and notes, which were appropriate for this kind of study. To avoid bias, the participants were asked to define the concept of empathy before starting the interviews. The researchers were satisfied with the definitions given by the participants, and thus data was collected in a manner that minimized bias. The staff member who collected data was an experienced teacher in health sciences, and thus he had appropriate training.
Enhancement of Trustworthiness
The researchers used effective strategies to enhance the integrity of the study, and there was a good description of those strategies. Confirmability, dependability, and credibility were ensured in accordance with the framework of trustworthiness. For instance, credibility was ensured by using the obtained data without any form of manipulation. The researchers documented research procedures and decision processes sufficiently that findings are auditable and confirmable. There was evidence of researcher reflexivity because he was a qualified teacher with no professional ties with the participants or the institution. There was “thick description” of the context, participants, and findings, and it was at a sufficient level to support transferability.
The data management and analysis methods were adequately described. Qualitative content analysis was used to identify main categories and patterns among the responses, thus making it inductive in nature. The data analysis strategy was compatible with the research tradition, nature, and type of data gathered. As such, the formation of subcategories was shaped by meanings and connections that emerged within the interview answers. The analysis yielded an appropriate “product” through the formation of thematic patterns. Similarly, the analytic procedures suggested the possibility of biases given that the participants were multi-culturally grounded.
The emerging patterns were logically connected to each other to form a convincing and integrated whole. The interview responses had a pattern to suggest that the teachers’ empathy towards students promotes constructive learning experience. The common themes included improved motivation for students, positive learning outcomes, and the encouragement to learn among students. Figures were used effectively to summarize conceptualizations. Moreover, the patterns for the conceptual framework linked cogently.
Interpretation of Findings
The findings were interpreted within an appropriate social context of nursing students. Similarly, the major findings were interpreted and discussed within the context of prior studies. The researchers translated their findings against information gathered from the existing body of literature. Additionally, the interpretations were consistent with the study’s limitations. The researchers acknowledged the presence of study limitations, and thus when making conclusions, they highlighted what can be done to strengthen the findings in future studies.
The researchers discussed the implications of the study for nursing education and the need for further research. Based on the findings, it emerged that the teachers’ empathy towards students enhances the learning experience and affects the way learners are prepared to become nurses. As such, the researchers noted the need for improvement of empathy among teachers together with role modeling in nursing education. Such improvements would ensure that on top of having technical skills, nurses can communicate effectively, be creative and critical thinkers, and promote the caring philosophy. The implications stated in the study were reasonable and complete.
The report is well-written, organized, and sufficiently detailed for critical analysis. Right from the beginning, the researchers organized ideas logically in a way that the reader can follow the flow of what is being said. Additionally, the description of the methods, findings, and interpretations was sufficiently rich and vivid. From the conclusions made, it is clear that the study’s objectives were met sufficiently.
The researchers’ clinical and substantive qualifications and experience enhanced confidence in the findings and their interpretations. Two of the researchers are members of the Faculty of Medicine at the Institute of Health Sciences, University of Oulu, Finland. The other one is a qualified health science teacher. The combined experience and qualifications of the three researchers make their findings and interpretations credible.
The study findings appear to be trustworthy and I have confidence in the truth-value of the results. Moreover, the study contributes meaningful evidence that can be used in the nursing discipline. Nurses should possess different qualities apart from having technical skills. Teachers’ empathy towards nursing students produces nurses with desirable qualities like a caring philosophy, critical thinking, good communication skills, and creativity. Therefore, the study’s findings can play an important role in changing the way students are prepared to be nurses.
Mikkonen, K., Kyngäs, H., & Kääriäinen, M. (2015). Nursing students’ experiences of the empathy of their teachers: A qualitative study. Advances in Health Sciences Education, 20(3), 669-682.
Polit, D. F., & Beck, C. T. (2008). Nursing Research: Generating and Assessing Evidence for Nursing Practice (8th ed.). New York, NY: Wolters Kluwer/Lippincott Williams & Wilkins.
Rejnö, Å., Nordin, P., Forsgren, S., Sundell, Y., & Rudolfsson, G. (2017). Nursing students’ attendance at learning activities in relation to attainment and passing courses: A prospective quantitative study. Nurse Education Today, 50, 36-41.