What is the difference between background and foreground search questions. This is the ask module video 1. The following slides will advance on their own. But feel free to pause or rewind as many times as you need you can also mute the sound if you prefer in video 1 we will look at the difference between background and foreground search questions we are step 1 of the 7 step evidence-based nursing practice process in this video we will learn about search questions versus clinical scenarios and research questions as well as continuous quality improvement projects. We will look at background versus foreground questions with some examples. And we'll look at. What are the best research studies to answer. Each type of foreground question. Search questions are not the same as research questions. A patient scenario also known as a clinical practice scenario may include several questions a research topic may also include several search questions this is also true for continuous quality improvement or CQI and implementation projects. Each search question should be performed separately as each will include different key concepts and lead to a different search. We will talk about key concepts in video 2 for this video we will work from a clinical practice scenario like the ones you may use in class or practice. Please take a moment to read this practice scenario we will be using it. Throughout the videos. As our example we will use search questions contained within the clinical practice scenario. We just saw you may wish to print out a copy of the scenario to follow along with. Let's begin. There are two types of questions background questions and foreground questions. Background questions are above general knowledge and can best be answered using textbooks for narrative. Reviews up to date can also be used to answer background questions. You can ask a background question. Looking for general information about an illness disease or condition a process or a thing such as a piece of equipment when thinking about background questions.

You might ask who what where when how or why here are some examples of background questions. What is a fever. What is a urinary tract infection what is mrs a what is the relationship between Mr SA and complications related to antibiotics. What is the connection between urinary tract infection and fever. How common are you. T is in women as mentioned before a good place to search for background. Information would be textbooks. Narrative reviews up-to-date. But you may like to start with your course textbooks. Of course you can find more in the library catalog either from the library homepage or from the nursing subject guide or specific course guides on those guides. You would go to step two. Finding background information. Foreground questions on the other hand are more specific and relate to patient care or research usually foreground questions relate to a specific patient or population. There are several types of foreground question and each is best answered by a different type of research. Study design. Here are the types of foreground questions prevention therapy diagnosis which has two types differential and diagnostic tests etiology or harm prognosis economics meaning or implementation and there are many types of study designs you have systematic reviews of various study types randomized control trials or RCTs prospective studies comparative studies diagnostic validation studies cohort studies case control studies cost-effectiveness studies case studies ethnographic studies grounded. Theory studies phenomenological studies. Evaluation studies and participatory action research. And the list continues to grow if you would like to read more about study designs. Follow the link below. Once you've find a study you need to decide whether the study is relevant for your patient population or setting you need to ask yourself is the patient population or settings similar enough to your own for the results to be applicable to assess the quality of a study.

It's important to determine how well the researchers follow the particular study design or methodology. It's also important to assess studies for quality and relevance but it is sometimes difficult to know exactly what type of study you are looking at when writing about their studies. Researchers will use a variety of ways to describe what they did and the databases you use to find. The studies do not always provide information about study design very clearly look for clues in how the author describes what they did. A good study will have a method section and in that section describe what was done clearly this way other researchers can replicate it and hopefully get similar results consider whether a study that does not describe itself clearly is a good source of evidence however we saw earlier that there are many types of study design so keep in mind that there may be ones you are an unfamiliar with that are still valid and well described it's important to consider your own level of expertise when making judgments about study design. The more you learn the better able you will be to make these judgments about study. Quality is called critical appraisal you can see the appraise module to learn the basics of assessing study quality using the crap test. One of the things you'll want to know is the difference between quantitative and qualitative research to determine whether a study is qualitative or quantitative look at what kind of data is being analyzed and presented if the data being presented is statistical mathematical or computational in nature. It's probably a quantitative study on the other hand if the study is presenting non numerical data and techniques such as interviews and observations it's probably a qualitative study in some cases. You might find that a study presents. Both statistical mathematical or computational data and techniques and non numerical data and techniques such as interviews and observations.

This means this is a mixed method study now. Let's look at some examples of each type of foreground question and what type of study best answers. Each prevention questions. Our questions have put. The effectiveness of interventions to prevent disease or harms for example is cranberry juice effective for urinary tract infection prevention in women the best study designs to answer prevention questions are quantitative such as systematic reviews of randomized control. Trials randomized control trials or prospective studies therapy questions are questions about the effectiveness of treatments or other interventions to improve patient outcomes for example in recurrent urinary tract infections are probiotics and effective treatment similarly to prevention questions. The best study designs to answer therapy questions are quantitative such as systematic reviews of randomized control. Trials randomized control trials or prospective studies. We mentioned earlier that there are two types of diagnosis questions. Differential diagnosis questions are questions about a possible diagnosis. Given a patient's signs or symptoms for example if a female patient has a fever and complains of urinary frequency and urgency. What is the possible diagnosis. The best study designs to answer. Differential diagnosis questions are also quantitative. Prospective studies comparison to gold standard studies diagnostic validation studies. The second type of diagnosis question is about diagnostic tests. These are questions about specific diagnostic tests and how well they work for. Example is using dipstick urinalysis as effective as laboratory analysis for urinary tract infection diagnosis. The best study designs to answer diagnostic test. Questions are quantitative comparison to gold standard studies or diagnostic validation studies. Etiology or harm questions are questions. About a harmful effect or exposure for example what are the potential harms of untreated urinary tract infections the best study designs to answer etiology or harm questions are quantitative either systematic reviews of observational studies or observational studies cohort or case-control prognosis studies are questions about how likely it is for a patient to develop a disease or condition or side effect or the probable course of a disease for example does having a mother with a history of UTIs increase the risk of UTIs the best designs to answer prognosis questions are quantitative such as systematic reviews of observational studies or observational studies such as cohort or case control economics questions are questions about the cost of health care for example his level phlox's seen as cost effective as SCI prophylaxis seen as a urinary tract infection treatment the best study designs to answer economics questions are quantitative cost effectiveness studies questions about meaning are about patients were populations such as nurses experiences and concerns for example what are public attitudes towards taking antibiotics the best study designs to answer meaning questions are qualitative or mixed methods such as case studies ech ethnography grounded theory or phenomenological approaches etc and finally implementation questions are about barriers or facilitators - and methods for implementing research in practice for example what are some effective strategies to reduce inappropriate antibiotic use in clinical practice the best study designs to answer implementation questions are quantitative or mixed methods many of the above types of study methodologies that we mentioned earlier can be used in implementation research but about additional types of studies such as evaluation studies and participatory action research studies and others can also be used you can use the interactive concept map to see how question formulation connects to type of question and best type of evidence or best study design.

This is what the interactive concept map looks like and you start up here with your research question or your clinical scenario and as you can see you may have more than one search question and each one might have a different outcome.

The type of outcome leads you to determine what kind of question you're asking and from there you can follow along until you discover. What is the best evidence to answer your question. The reason this map is interactive is that you can actually click at each point here and it will take you to a list of McGill databases where you can find this type of evidence as well you can just go directly to the evidence pyramid and click on the level that matches. What you're looking for you'll learn more about this pyramid in a different module and we're gonna learn a little bit about this part of this map also in another module because the way you formulate your question will determine what key ideas you end up searching for when you are using the various databases and tools. You'll find a link to the interactive concept map on the ask module under readings and resources. There you go. That's what you need to click on and you'll get to the interactive map. The best place to look for foreground information is in online bibliographic search engines or databases or what we call point-of-care tools. You're probably used to googling for information but here are some good places to start searching more effectively for research evidence. We had mentioned up-to-date earlier as a place where you can answer background questions. But you can also use it to find evidence summaries and we consider this a point-of-care tool you can also search a database called. Scopus to find research studies. This is a multidisciplinary bibliographic database and you can also search. Google Scholar to find research studies. And this is also a multidisciplinary search engine in the search modules. We're gonna look at some more specific tools that you can use better databases for finding answers to nursing questions in search module basic.

You'll learn how to search the resources. I just showed you in the previous slide. If you need more help you can register for a library clinic or book an appointment with your liaison librarian. That's me. Francesca you can do both from the nursing subject guide or your specific course guide but don't forget to watch all the modules before you come see me because many of your questions will be answered in the modules. Of course it's always important to cite your sources and for this video. I looked at a video created by another library so I am putting the citation.