This would be a quantitative study. Louise Regan, RN, PhD, who is a nurse practitioner, for her master's thesis in 1993 for the University of Conn did a study that might be a good process example. She compared a critical care nurse's ability to remove a pulmonary artery catheter with a medical resident's ability. She identified the complications of removing the PA catheter and compared the incidence of those complications occurring when the nurses removed the catheter versus the medical resident. She also looked at other benefits or issues. There was no statistical difference between the two groups in complications although clinically the nurses had fewer complications. The other observation was the wait time for the nurses to remove the PA line versus the residents. It was less for the nurses. This topic was different but the process might be something you could use. https://chip.uconn.edu/person/louise-reagan-phd/

Good luck!

Many thanks but I am having difficulty locating louise Regans study.

Nicola Shaw : are you a nurse?

no i am a reporting radiographer

Hi Nicola,

I am wondering if you need to clarify what exactly you are intending to measure? in your intro, you identify several different goals. The first is to compare whether ANPs and jnr doctors can provide equivalent levels of documentation when completing the clinical details on the XR request cards. Is this in isolation from any follow up or review of the results? If you are just wanting to know about the completion of the order form, then a simple audit will allow you to address this aspect. For this, you would first need to identify the expected standard - ie under what circumstances should the forms be completed (what are appropriate conditions, what information needs to be included, what level of detail, what are the compulsory/required details, what additional information eg description of injury, site or requested view). This could be done either retrospectively or prospectively for each group of practitioners.

The second aspect relates to the transferability of the education program currently being offered to the ANPs. This requires further clarification also. What you need to consider, is first of all whether the teaching is the only variable that currently influences tha existing difference (if you demonstrate this through the audit). If it is, then a pre and post test might be appropriate, where you could compare the findings prior to introducing the teaching to a repeated audit following the introduction. Again, the risk is that other factors which are influencing the results may also change over time.

Most studies reviewing the roles of advanced practice nurses and doctors are looking at the equivalency of outcomes, so the models may not be measuring the same elements you are looking for, and generally they are aimed at determining if the service provided by the nurse is equal to that of the physician in terms of patient satisfaction, accuracy of x-ray interpretation, or overall standard of care. I am attaching some articles for you to look over, but I am not sure these are actually what you need to replicate.

Hope this helps

Sandy

Nicola

First off the glib answer is that you are talking about a comparative study. A fuller answer rather depends on your design, how you choose to go about making the comparison and (as indicated above) the outcomes (or other) that you are going to compare. The answer above that say " this is a quantitative study" is (probably) true although it does sound like you may be comparing quality, not quantity of information on the request form. The quantitative / qualitative terms as a major research descriptive isn't that helpful (what colour is this box? - "green": qualitative. How many green boxes? "7" Quantitative - what colour are these boxes? "7 green the black"....probably qualitative, as it resembles the the first question but.....)

It looks to me that you actually have 2 major questions (objectives) but each of these can be reduced a number of more specific questions that need answering (aims). From there you can think about how you would make the comparisons you need but the first question (quality of requests) feels like a descriptive observational study ('blind' rating of the quality of requests against some form of criteria). The second (improving training) lends itself to a trial - ideally randomised but some form of quasi experiment might be adequate / the best you can do....

Lots of examples of trials on nurse practitioners and similar out there and lots of studies measuring the outcomes of educational programmes ( but be careful of simple pre-test post test as this just tells you 'education works' - which is reassuring but not really what you need to know).

The comparison of quality of requests is harder but this is a measurement / rating issue. i suspect that there are similar studies out there but you will need to develop of find criteria by which 'good' can be reliably and validly judged.

Dear Nicola

If you plan to compare the impact of education on the quality of reporting in nurses and doctors, I suggest designing four groups and using pre-test post-test for all of them. The intervention and control group for both advanced nurse practitioners and junior doctors.

My first response is that it is a biased study if you are comparing experienced APRNs to "junior" doctors, however you are defining that. Be careful to compare apples to apples; students to students, first year interns to first year NP graduates, etc. It sounds like as a radiographer you have noted a difference in the level of details given by APRNs vs. doctors, in favor of APRNs. Otherwise I am assuming you would not be looking to have APRN training provided to doctors. Keep in mind there is a difference between knowledge and performance. Knowledge would be measured by giving the doctors a test and the NPs a test. Performance would be measured by a chart review of some sort. Or you could measure both. It may well be that the physicians have just as much knowledge, but choose not to take the 30 seconds to add the clinical information because their productivity standards are higher (among other possible reasons). Then it is a systems issue about how to make it easier to get the information where it needs to go, vs. a training issue.

Dear Peter

Why focus on only nurses and not all non-medical practitioners? Advanced Clinical Practitioners are widely utilised in a range of settings now and their base profession is less important than their additional education and scope of practice.

ACPs come from a variety of backgrounds but will share training programmes, both academic and workplace-based to enable them to perform their role effectively.

(not sure whether or why the Question above from Els Freshwater is being addressed to me...the original question was ANP vs Junior Doctors - I presume that this is the real life issue facing Nicola who asked the question about study type...yes, there are lots of other non medical practitioners and indeed lots of other questions that could be asked (as alluded to above by others...)

Sorry Peter - I was looking at it on my phone and it looked like your question, not Nicola's.