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Nursing Practice Keywords: Clinical research/Education/

Research question/Topic
Discussion
●This article has been double-blind
Clinical research peer reviewed

Successful clinical research depends on a properly constructed research question on

a topic that is relevant for study. Discover the best process of developing one

Identifying and defining

research questions
In this article... 5 key
 ow to choose the subject of your research
H
points
Deciding on a relevant research question 1 Students must
complete an
independent
Generating applicable search terms and key words
learning project as
part of their
Author Raouf Khodabux is senior lecturer, However, perhaps the biggest challenge nursing degree
module leader for Approaches to Health
and Social Care Research, Middlesex
University, London
is the fact that this is an independent
module in which a lot depends on students’
motivation and willingness – they have to
2 Before
conducting
research, students
Abstract Khodabux R (2015) Identifying determine the focus and direction of their must have some
and defining research questions. Nursing work. This is usually carried out on an indi- knowledge of
Times; 112: 3/4, 16-19 vidual basis, although some tutor support, research process
Research is vital to improving nursing supervision and direction is provided. and methodologies
practice and patient outcomes, and
therefore a key aspect of nursing degree
programmes. All student nurses must
The module is also demanding because
there is typically a substantial research
component to the project requiring pri-
3 Many issues
encountered in
clinical practice
show they can undertake an independent mary data to be collected and secondary or form the basis of
learning project before they can graduate existing data to be analysed. Furthermore, research projects
and become registered nurses. This article
outlines processes that can be followed to
select a research area and narrow it down
students are expected to have a more pro-
longed engagement with the chosen sub-
ject than they do with standard course-
4 Once a broad
topic has been
selected, it should
to generate a specific research question. work, such as essays or reports; the work is be narrowed down
Methodologies and models can then be consequently required to be more in-depth until a specific
used to compile a list of search terms that than students are accustomed to (Todd et research question
can be used to get the research underway. al, 2004). has been framed

5
I
Many students struggle to start their Research
n 2011, pre-registration education in project because they simply do not know models can
England became an all-degree pro- where to begin. The most critical question help generate
gramme (Nursing and Midwifery for many is “What should I study?” relevant search
Council, 2010), so student nurses in Deciding between a research project and a terms from a
their final year must carry out an inde- literature review depends on the type of research question
pendent learning project. In addition, degree course being undertaken. However,
many qualified nurses are returning to for most undergraduate nursing courses,
university to do their dissertation and students are required to carry out a litera-
complete their degree (Aveyard, 2014). ture review.
These projects vary in scope and nature, Pole and Lampard (2002) stated that
from literature reviews or extended essays curiosity is, or at least should be, the
to small research projects. driving force behind the conduct of any
For many students, the dissertation is a research. Research questions are an
“nightmare” they have to endure to gain a attempt to “tame” curiosity, so they are not
degree (Lundgren and Halvarsson, 2009). asked in a haphazard manner but in rela-
This module can be challenging for a tion to what is already known about the
number of reasons such as: topic of interest (White 2013). The process
» The requirement to be on placement; of framing, developing and refining these
» Long days and/or night duty; questions allows researchers to make con-
» Working part-time to make ends meet; nections with existing theories and pre- Many nursing students do not know where
Alamy

» Family commitments. vious empirical findings; this helps avoid to begin with their research project

16 Nursing Times 27.01.16 / Vol 112 No 3/4 / www.nursingtimes.net

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Box 1. Conducting a Ionesco (1969) stated that it is not the the literature on a particular topic, you
literature review answer that enlightens, but the question. may find new ideas are recommended for
According to Graziano and Raulin (2004): further investigation. For example, there
There are seven steps to follow when “Questions are everywhere; all you have to may be observational studies that explain
conducting a literature review: do is observe and be curious”. what is happening but not necessarily why.
1. F
 ormulate a research question To carry out a literature review, it is nec- When reading the literature it is useful to
2. Identify a term/terms that will be essary to: bear in mind that:
used to search the literature » Have a basic knowledge of research pro- » I t is possible to replicate a study – this
3. C reate robust inclusion and exclusion cesses and methodologies; not only ensures its reliability but also
criteria to select the most appropriate » Understand the origins of the evidence, provides additional information;
literature primary and secondary sources; » A ny recommendations made at the end
4. Select the most relevant databases » Understand the terminology used; of research articles may be followed up
to interrogate the literature » Know how the various types of litera- with another investigation;
5. Search the literature from a global ture reviews vary (Conner, 2014). » S ometimes there may be flaws in
perspective It is well documented that student the original method used in a study,
6. Analyse, synthesise and critique the nurses tend to disengage with the research and the same question can be asked in a
research articles module (Ax and Kincade, 2001). Under- different way – this may then rein-
7. Present the findings graduates find research boring, and may force or challenge the findings of the
RCE: Wakefield (2015) have difficulty understanding the lan- earlier study.
guage and experience cognitive shutdown
(Porter et al, 2006); this may come back to Theories
unnecessary repetition of, or overlap with, haunt them in the final year when they Theoretical concepts that may be tested in
previous work (White, 2009). In the final attempt the literature review for their dis- practice are the second major source of
analysis, a researchable question is an sertation. Since the literature review is an research questions. Theories such as the
uncertainty about a problem that can be integral part of the research process, it is promotion of continence and self-care as a
challenged, examined and analysed to pro- crucial for students to engage with the framework for nursing or mentorship, and
vide useful information (Ellis, 2013). A research module. student nurses’ performance, can be tested
clearly defined research problem is the fuel in practice. An example of a theory is: “Pro-
that drives the scientific process, and is the Choosing a research topic motion of continence will result in better
foundation of any research method and The starting point for any research project quality of life for patients”. Like many
experimental design, from true experi- begins with the choice of topic. This other theories in nursing, this can be inves-
ment to case study (Shuttleworth 2008). should be a subject the student finds inter- tigated inductively or deductively. A quan-
esting, stimulating and worthwhile, as titative experimental design uses deductive
Framework for a literature review this will make the process more enjoyable reasoning to arrive at a testable hypothesis.
Formulation of a research-focused ques- and, ultimately, more rewarding. While According to Coates (2011), this approach
tion underpins any type of literature the initial topic selected may be broad, it focuses on replicability, objectivity, predic-
review, whether it is for a: must be narrowed down to a focused ques- tion and control; the distinguishing fea-
» Dissertation for a systematic or tradi- tion (Playle, 2000). ture is a collection of numerical data that
tional/narrative review; The topic should already have been can be subjected to statistical analysis.
» Primary research project; researched by others so it is possible to Qualitative research designs use inductive
» Research proposal. search for relevant literature to review. The reasoning to propose a research statement
A literature review is an account of most interesting topic in the world will not about how people interpret and structure
what has been published on a topic by create a successful literature review if their lives. This kind of research is used to
accredited scholars and researchers. It is nothing has previously been written about explore, understand and interpret experi-
an objective, thorough summary and crit- it. Sometimes it is a good idea to come up ences, feelings and beliefs (Gelling, 2015).
ical analysis of the relevant available with a few alternative ideas and carry out
research and non-research literature on some preliminary research on each – that Experience
the topic being studied (Hart 2012). way, if there has only been limited explora- Research ideas can also stem from experi-
Conducting a literature review can be a tion of the first choice, there is an alterna- ence in clinical areas where nurses observe
daunting and confusing prospect. Wake- tive to fall back on. practice that may be a source of concern or
field (2015) identifies seven steps in the Most research projects start with an simply “interest”. The research question
process (Box 1), at the top of which is for- idea that arises from clinical practice (Gel- need not be about something that is
mulating a research question. Aveyard ling, 2015). However, it is generally agreed “wrong” but something that could be done
(2010) argued that in order to write a robust that research topics narrowed into focused better or has not been thought about
evaluative literature review, it is essential questions arise from three basic sources: before. Student nurses are taught critical
to start with a sound research question. » The literature; analysis to encourage them to ask:
Even in the context of the research process, » A theory; » W hy is this being done in this particular
Gelling (2015) identified the development » Experience (Springett and Campbell, way?
of a research question as the first stage, 2006). » W hat will happen if this is done differ-
while Offredy and Vickers (2010) said the ently?
first step in writing a research proposal is Using the literature These are important ways to explore
to choose a topic and then to develop Sometimes studies raise far more ques- more about nursing inductively as they
research questions. tions than they answer so, when reading stem from the real world of nursing.

www.nursingtimes.net / Vol 112 No 3/4 / Nursing Times 27.01.16 17

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Nursing Practice
Discussion

Table 1 research question types

Broad topic area Narrow topic area Focus Research question
Older people’s health Older people and Older people and Is there a link between duration of stay in hospital and
malnutrition malnutrition in hospital malnutrition in older people?
Women’s health Women and mental Women, mental health What are the psychological effects of miscarriage among
health and miscarriage 35-40-year-old women?
Drug errors Drug errors and Drug error, nurses and What is the association between poor mathematical skills
nurses mathematical skills and drug errors among newly qualified nurses?
Teenagers’ health Teenagers and Teenagers, modelling What role does modelling play in the development of
bulimia and bulimia bulimia among teenagers?

From a clinical practice perspective, as an aide memoire, and helps keep the student. Hanson (2006) argued that there
when a research question is carefully com- researcher focused on the specific area of are three important phases of developing a
posed it aims to close the gaps between enquiry, which is particularly helpful when study question destined for success:
what is known and what needs to be known searching the literature (Lahlafi, 2007). » D efining the research question(s);
about nursing care, and resolve the dis- Blaikie (2007) argued that the use of » R efining the research question(s);
crepancy between the way things are and research questions in the design and con- » C onverting the research question(s)
how they ought to be to result in better duct of research is often neglected. The key into a specific aim(s).
patient care. However, research does not to defining a research question is focus. If Similarly, Lipowski (2008) proposed
always lead to definitive answers. it is too broad (for example, “Does regular three steps in the formulation of a great
exercise prevent heart disease in adult research question:
Composing the research question men?”), the search strategy will become » A sk interesting questions;
Deciding on the research question is chal- unstructured and many important articles » S elect the best question for research;
lenging, but is one of the most critical may be overlooked (Wakefield, 2015). The » T ransform the research question
aspects of the research process. A carefully end product should be a specific query that into a testable hypothesis.
constructed research question helps to is explicit in what it is looking for. How- There are three types of research
guide the project to hit its scholarly target. ever, Denney and Tewksbury (2013) have question:
Research is only as good as the question also argued against having a research » D escriptive: describing something,
and plan on which it is based; this is rele- question that is too narrow (for example, using a descriptive approach that
vant to healthcare research because new “Do daily 30-minute exercise sessions can simply be an observation of
knowledge comes from having asked reduce the incidence of myocardial infarc- something, with the researcher
answerable questions (Haynes, 2006). tion in 40-60-year-old Asian men?”) as it taking the role of the “witness” and
Beitz (2006) defined research questions can limit the search strategy. An appro- answering the basic question of
as: priate question on the topic in the exam- “what happened?”;
“An explicit query about a problem or issue ples above might be, “Does daily exercise » R elational: a relational or correla-
that can be challenged, examined and reduce the incidence of myocardial infarc- tional study exploring relationships
analysed, and that will yield useful new tion in men over 40 years of age?” between two or more variables using
information.” statistical analysis, and asking the
Framing the research question question: “how are these linked?”;
The question is the fundamental core The development of the research question » C ausal: exploring cause and effect to
of a research project, study or literature is important as it sets the parameters of determine whether one or more vari-
review. It focuses the study, determines the the research. It provides opportunities for ables causes or affects one or more
methodology and guides all stages of a wide range of research methodologies as outcomes using an experimental
inquiry, analysis and reporting. It also acts well as a structure and direction for the approach (Trochim, 2006).

FIG 1. GENERATING SEARCH TERMS FROM A RESEarch question

Question: “Does patient-controlled analgesia provide better pain relief than
injection-administered analgesia by nurses following major surgery?

P = Patient/ I = Intervention C = Comparison O = Outcome

population
Patient-controlled Injection of analgesia Pain relief
Surgical patient (and) analgesia (PCA) (and) given by nurses (and) or
or or or Management of pain
Patient with major Self-pain management Nurse-controlled
operation analgesia
or
Surgery

18 Nursing Times 27.01.16 / Vol 112 No 3/4 / www.nursingtimes.net

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Generating search terms Methods: A Process of Inquiry.

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