Worked Example

Review of: Evaluation of the basic life support CD-ROM: Its effectiveness as a learning tool and user experiences.

The following web address contains the paper 'Evaluation of the Basic Life Support CD-ROM: Its effectiveness as a learning tool and user experiences', as the last paper listed.

The following is a suggested critical appraisal of this paper.


The development of the CD-ROM is presented and its importance as a nursing tool within the nursing curriculum is given. The project aim clearly states that the effectiveness of the CD-ROM as a learning aid will be measured, along with the experiences of students and lecturers using the CD-ROM. The rationale for the research is set in the context of a tool to support learning of a compulsory skill, ie BLS, and also to enable development of IT skills. However, the need for this tool is not stated in the introductory paragraphs.


Literature Review
A brief review is included in the introduction. This concentrates on referencing previous pilot evaluation work and relates to the importance of developing BLS skills. It does not identify other literature relating to BLS skill development or e-learning. Some quite dated material is referred to in terms of IT skills. The literature leads to a specific research aim rather than a research question


There is a statement of the stages of data collection, but no formal discussion of research design or alternatives. Strengths and weaknesses are not presented.


The testing of BLS knowledge and skill attainment in the way conducted would seem to be a suitable way to gain information about the impact of the resource on BLS knowledge and skill attainment. Interviewing is a data collection method that is often used by researchers to ascertain individual experiences of events and would therefore be appropriate.

The sampling approach is clearly laid out, showing institutional and individual involvement. There was random selection of the research sites, although there is no explanation as to why only 2 of the potential 13 sites were chosen for testing. Some limitations relating to students' prior experience of BLS skills are noted. The researcher states that students self-selected themselves into the focus groups and the research groups, which may lead to potential bias, as identified in the study. It is not clear how lecturers were involved in the research. Given the focus of developing BLS skills in the nursing curriculum it would seem appropriate to use this sample group.

Data collection and analysis
The data was collected by a member of university staff, with listed related publications, showing they have research experience in the field. It is not clear what the status of the researcher is or whether they hold a researcher role.

Data analysis is clearly described, including measures taken to validate data entry. Data was assumed to be at ordinal level, but no justification was given for this. However, assuming this, the appropriate paired non-parametric test (Wilcoxon) was used. No mention is made of the level of significance used, but it is assumed that the researcher was working at the 5% level.

It is not clear how the 2 variables expired air respiration (EAR) and external chest compressions (ECC) were arrived at, but since they are given as percentages, it seems appropriate to carry out Pearson's correlation test. The linear relationship also required for this calculation is indicated in Figure 3 and 4. There is evidence of a statistician's input to the research, although there is no reference to any computer package used.

The researcher doesn't provide reflexive comment about her role in the research, though the approach to data preparation and analysis is clear. The researcher followed a recognised published approach to data reduction, display and verification, which on a positive note included independent researcher and respondent verification, thus improving trustworthiness of the data.

The researcher states ethical approval was gained from each institution and a protocol to maintain informed consent, confidentiality and anonymity was applied, though unfortunately no detail of this is given.


The tables and charts are clearly presented, although a table of results to include maximum, minimum and median values may have made comparisons between groups easier. However, this information is presented implicitly in the box-plots. 

There was no evidence of significant correlation between the variables EAR and ECC, with both probabilities being > 0.05. Indeed, one of the P-values is quoted as 1.738, which is clearly incorrect.

The discussion of the four emergent themes is supported by verbatim extracts from respondents across both sites, to include lecturers and students, though it is not clear which individual's views are being presented. This could mean that the views of only a limited number of the sample are being presented. The extracts clearly support the themes presented. A range of published literature supports the themes and builds on the initial brief literature review. The researcher does not explicitly relate the work to a framework for ensuring trustworthiness.

The final paragraphs identify the limitations of the research before stating the key findings and relates well back to the aims of the project. Key points for higher education providers to consider are identified. The research fails to identify further research issues/opportunities arising from the study.