Article critique and analysis methods

¶ … Measure Interdisciplinary Critical Incident Verbal Reports by Jacqueline Guhde

The research article, "An Evaluation Tool to Measure Interdisciplinary Critical Incident Verbal Reports" by Jacqueline Guhde (2014) discussed and explored the use of an evaluation tool in assessing the communication effectiveness of nurses when relaying patient problem information to physicians in the hospital setting. In the research article, Guhde discussed the relevance of such an evaluation tool in improving effectiveness of communication between nurses and physicians. Further, the author also explained the rigor in analyses applied in the development of the evaluation tool, particularly on the reliability of scoring among assessors, which ultimately determines if effective communication was achieved or not.

The evaluation tool was developed based on a mix of simulation through tape-recorded cases and actual practices and assessed through content validity and inter-rater reliability (IRR) tests. The study's design is appropriate especially for the intended audience or users of the evaluation, the healthcare professionals. Through simulations in the form of assessments of tape-recorded cases and practice scenarios, the study was able to make the graduate students internalize the importance of the study's importance to their practice: that effective communication is a critical component to ensuring that patient problems and conditions are responded to appropriately and correctly.

Supporting these simulation exercises are the statistical tests conducted to determine if the results generated from simulation/practice tests can be used in a general sense -- that is, across all health practitioners. The author even suggested the use of an evaluation tool across other disciplines as well, as the objective and framework from which the tool was anchored by is not unique to the hospital setting, but can be also applied to other workplace settings as well (180). Thus, the evaluation tool is useful and important not only to nursing practice, but to all other work practices wherein effective communication is critical, e.g., emergency response and crisis management situations.

The core of the evaluation tool comes from the SBAR tool, which follows the following protocol and order of verbally reporting a patient problem or condition: situation, background, assessment, and recommendation (180). However, what has evolved in the evaluation tool is that additional "categories" were included, specifically: providing a "situationer" to the physician, providing information in an "orderly sequence," and determining which information could be considered pertinent for the physician to use (180). What resulted is an evaluation tool based on the ISBARR (SBAR with additional categories). These protocols or categories become the indicators that practitioners and assessors can use in assigning points, as the ISBARR evaluation tool is based on a point system.

The decision to anchor the evaluation tool on the ISBARR framework is a practical yet very appropriate approach to measuring and determining effective communication in the hospital/clinical setting. The ISBARR evaluation tool has a simple format and scoring system, and only has few indicators from which the assessor would look into. In situations where assessments are quickly needed to provide feedback to practitioners and improve the quality of communication between nurses and physicians, the ISBARR evaluation tool responds to this need.

Just as important and critical to the framework from which the evaluation tool was anchored in are the statistical analyses used and tested on the evaluation tool. The testing conducted on the tool was based on the evaluation assessments of 36 junior graduate students, and from their assessments, the tool was determined to have a very high inter-rate reliability score, with all indicators having correlation coefficients between the interval of .833-.96. Further, out of the indicators tested in the tool, only two items measured 'only' "high" in terms of correlation coefficient scores: "identifying the problem early" and "following an orderly sequence." However, the author also reported that subsequent tests showed an improvement in these two items, demonstrating that all items in the evaluation tool tend to be assessed and interpreted consistently across all assessors who used the tool (182).