Clinical Appraisal
By Ian A. Lane
Clinical AppraisalJul 23, 2021
111. Balancing Life and Death and Nursing Science
What it takes to be a nurse scientist-in-training and a practicing clinician at the bedside requires a level of emotional maturity I think is likely entirely unique. I have immense respect for your work, and no one should ever make you feel as if you are a lesser researcher or scholar because of your clinical practice. Relationships with patients is why we do what we do.
110. Dr. Carrie-Ellen Briere on biomarker research in nursing: The benefits and components of human breastmilk
Dr. Briere's recent publication can be read, here: https://www.mdpi.com/2072-6643/16/3/362
109. Philosophical laziness and problems of replication
108. Practice-changing clinical research is rare
How often should you expect the clinical research in your field to change your practice? If we assume Price's Law holds in health research regarding the validity of non-Null findings, we should expect a small fraction of published research to provide 'true' results. And amongst them, a smaller and smaller number will harbor all the 'large' effects.
107. Dr. Jacqueline Nikpour on expanding RN practice in Primary Care
Jackie Nikpour joins the podcast to discuss her crucial work in the space of primary healthcare and share her thoughts on what it means for RNs to work at the top of their license in primary healthcare in the U.S.
106. Dr. Pamela Grace on Nursing Ethics
Dr. Pamela J. Grace joins the podcast for an episode dedicated to a discussion about how nurses can 'do right' by their patients.
105. Don’t mistake experience for truth
104. Scientific evidence trumps medical eminence
The burden of proof to demonstrate efficacy of biomedical tools (namely, drugs or surgery) is on biomedical scientists and physician-investigators. We are too quick, as a society, to assume their science is particularly good, just because it's popular, they're confident in what they do, and what they do appears impressive. Eminence is trumped by evidence every time, and some things that were hitherto dearly held beliefs by medical scientists as true have been crumbling down around them over the last fifteen years. Some biomedical findings are true and stand the test of time. Most don't.
103. The unique canvas of nursing practice
It is easier to differentiate nursing from other health disciplines when you realize that the framework from which you're practicing not only implies unique processes but leads to distinct, if overlapping, outcomes, and that it's not all about tactics and techniques. Techniques and tactics, while similar, are grounded and applied from distinct frameworks of knowing and unique strategies, in service of often different goals.
102. A hat tip to my NP colleagues
101. You are more than a mini medic
Medicine is almost always treated as 'the standard' against which other disciplines of healthcare are measured. But why should that be? What right has it earned to maintain that position beyond historical power hierarchies? Certainly contemporary evidence doesn't support that stance.
You are an expert nurse. You are not a lower order version of medicine's implementation arm without prescriptive or diagnostic authority. And you're certainly not the punching bag for a medically-centered hospital system. You are an autonomous professional. Embody that and remember who you are and from where you came.
100. On the concepts of data saturation and counting qualitative data
"Don't quantify your qualitative data." Except when you do it without realizing it...
Also, sidebar, yay for 100 episodes of the pod.
99. Quant methods aren’t coming to the rescue
98. Maintaining stamina and excellence in your bedside nursing practice (with Michelle Boivin, BSN, RN)
In this episode, I speak with a well-respected PICU colleague of mine and bedside nursing expert, Michelle Boivin, BSN, RN, about how she has managed to maintain her bedside practice for over 20 years.
97. Dr. Karen Braccialarghe on simulation in nursing education
https://about.me/ianlane/
https://youtube.com/@clinicalappraisal
96. Dr. Mallory Perry-Eaddy on being an early career investigator
https://about.me/ianlane/
https://youtube.com/@clinicalappraisal
95. How can I mitigate heel stick pain in newborns?
https://about.me/ianlane/
https://youtube.com/@clinicalappraisal
94. Is there really a 'medical model?'
According to the fan-favorite 30-year celebratory piece she wrote in Nursing Science Quarterly in 2017, Dr. Jacqueline Fawcett, Ph.D., RN, FAAN implies that: because the 'medical model' doesn't exist as a conceptual model (from what Dr. Fawcett could find from a brief, non-systematic review), medicine, per se, does not have discipline-specific knowledge and, therefore, isn't a discipline but rather is a 'trade.' Ergo, "medical model" doesn't really exist at all.
This is all predicated on faulty reasoning, illogical leaps and poor empirical and philosophical work on the part of Dr. Fawcett. The fact that no one on the Editorial side of this publication didn't reject this just speaks to the fact that because Dr. Fawcett is a 'Living Legend," no one wishes to challenge her. This needed to be challenged, and is one of the sorts of pieces that does more harm to our profession publicly than it helps. This serves merely to alienate us from the rest of contemporary healthcare, at a time when our field continues to dwindle and our resources follow suit.
https://youtube.com/@clinicalappraisal
https://about.me/ianlane/
93. How should I secure my nasal tube? (McNeely et al., 2023)
about.me/ianlane/
youtube.com/@clinicalappraisal
92. Debunking Carper's Ways of Knowing
What else is there to say.
https://about.me/ianlane/
https://www.youtube.com/@clinicalappraisal/videos https://www.buymeacoffee.com/ianalaneRN https://www.paypal.com/paypalme/clinicalappraisal
91. Nurse-led chronic wound care (Sili et al., 2023)
about.me/ianlane/
www.youtube.com/@clinicalappraisal/videos
www.buymeacoffee.com/ianalaneRN
www.paypal.com/paypalme/clinicalappraisal
90. Nursing - What is it? (Hall, 1963)
A review of Lydia E. Hall's seminal 1963 work: "Nursing - What is it?"
An important addition to the Clinical Appraisal Nursing Theory podcast series and the inaugural YouTube video podcast upload.
Watch on YouTube: https://www.youtube.com/@clinicalappraisal
89. Leveraging the zone of proximal development to grow as a scientist
Struggling with imposter syndrome? In academics, this feeling never goes away. And there's no magical threshold that comes with taking more and more classes to makes you 'ready' to write that first grant or paper. It's time, now, to push yourself to new heights.
Watch on YouTube: https://www.youtube.com/@clinicalappraisal
88. Dr. Bernard Garrett on Anti-Empiricism in Nursing
A discussion with Nurse Theorist and Scientist, Dr. Bernie Garrett, from UBC School of Nursing, on the problem of New Age Spiritualism in Nursing.
87. Pod-Brief: Qualitative biases & Importance of Clinicians in EBP
A brief discussion of the challenges and biases that arise when interpreting qualitative research, as well as the pivotal role of clinical insights in advancing evidence-based practice in health sciences.
86. Why are you so skeptical?
This episodes discusses the philosophical importance of skepticism in scientific pursuits.
85. Psych nursing before Thorazine (feat. Dianne Lane, MSN, RN)
In this episode, Ian speaks with his grandmother, Dianne Lane, a masters-prepared psychiatric nurse and nurse researcher who is now 90 years old. In it, she describes what life was like as a psychiatric nurse pre-psychotropic drugs.
84. What does it mean to advance nursing practice?
What is an advanced nurse? Is prescription authority synonymous with APRN practice? What constitutes an APN? These are issues dealt with in this episode of the podcast.
83. Dr. Phyllis Whitehead on unique contributions of clinical nurse specialists to care teams
In this episode, Ian speaks with National Association of Clinical Nurse Specialists (NACNS) President, Dr. Phyllis Whitehead, PhD, APRN/CNS, FAAN, about how she conceptualizes the unique contributions to patient care of CNS trained nurses and how one might differentiate the roles of CNS practitioners from nurse practitioners.
82. Dr. Stephanie Griggs: Sleepy hormones and cosinor models
In this conversation, Ian talks with Dr. Stephanie Griggs, PhD, RN, FAAN, a sleep self-management expert in pediatrics, focused on young adult health. Stephanie is an assistant professor of nursing at Case Western Reserve University and an up-and-coming force to be reckoned with in academic sleep and diabetes self-management research. Specifically, Ian and Stephanie talk about her academic trajectory and how she came to be using a novel time series modeling technique known as cosinor models to better understand the nuances of individuals' patterns and biological rhythms.
81. Good critical appraisal is tricky
80. My quantitative methods origin story
In this episode, Ian details his journey through quantitative health science and how he originally became interested in statistical methods as applied to research on human health.
79. Research is multimodal
78. An argument for the DNP-MSCI
77. Laboring down on the science of birth (with Melissa Anne Dubois)
76. Dr. Anne Marie Rafferty on the politics of nursing knowledge
In this episode, Ian speaks with Dr. Anne Marie Rafferty, a nurse, scholar, educator and historian from the UK, about a 1996 book she published entitled "The Politics of Nursing Knowledge," which was largely predicated on her doctoral dissertation work in medical sociology and modern history. They discuss how the book has shaped her career, her thinking, and where some of the big problems are in need of tackling in the field, and traverse elements of the historical context that undergirds many of these contemporary nursing and health policy issues.
75. Dr. Jacqueline Fawcett on Nursology
In this episode, Ian interviews a Living Legend in Nursing, Dr. Jacqueline Fawcett, PhD, RN, FAAN. Jacqueline is internationally recognized for her work in meta-theoretical underpinnings of nursing science and practice, and has been credited as revivifying a term from the 1970s, "Nursology", as being most appropriate for our discipline, to distinguish it as a discipline similar to biology or psychology or sociology. Ian was able to ask Jacqueline why she prefers the term and where it originated, how she envisions the linkages between theory and practice in nursing, and how and whether it is possible or necessary to develop a theory-driven nursing science. Enjoy!
http://nursology.net
74. Why should I care about Nursing Theory?
73. Trade-offs in clinical research
72. One method of reviewing randomized trials
In this episode, Ian details his methodology for reviewing intervention studies, particularly randomized controlled clinical trials (RCT) and other human subjects experiments in the biomedical or biobehavioral sciences. This is merely the method that has worked for him over the years, and provides the most bang for his buck. Others' mileage may vary of course. But these are the pieces at least to be on the lookout for, when reading intervention research in biomedicine.
71. Dr. Rosemary Taylor on bullying in nursing
70. Interpreting data on monoclonal antibodies
In this episode, Ian revisits the notion of number needed to treat (NNT) and absolute risk ratio (ARR) from a few episodes ago, in light of some new claims made about mAb therapies for the treatment of COVID-19 patients, given some of the public support for their early use. As always, the approach taken is a methodological one, and the focus is not on COVID-19 per se.
69. Carving a clinical research path as a DNP (feat. Dr. Patricia M. Delgado)
In this episode, Ian speaks with Dr. Patricia M. Delgado, DNP, APRN, DCNP. Patricia is a DNP-prepared principal investigator with extensive training in adult-gerontological primary care and subspecialty training in dermatology about her journey into clinical research, what hurdles she overcame to be afforded the opportunity to be a PI, and her perspective on the viability of this path for others with similar training. Her interests in the intersection of psychiatric and dermatological research was also discussed, from the perspective of there being unique and important questions to answer from her vantage point as a DNP-prepared clinical researcher.
68. Quality improvement "vs." Clinical Research
In this episode, Ian reviews some literature and some questions surrounding the idea of whether quality improvement (QI) projects are just "research lite" or whether they have valid standing in and of themselves apart from research. Many people have written on whether QI is just 'research which doesn't require IRB approval and can't be gneralized,' while others are staunch proponents of the immediacy and primacy of QI initiatives, for various reasons, some of which will be explored in this episode. Ian discusses three primary components of this problem which are interesting to him: 1. QI and research may only differ on the front end regarding human subjects and ethics committees, 2. QI and traditional clinical investigations might be bridged by leveraging implementation science, and 3. generalizability and statistical inference may be the Achille's heel of the QI proponent.
67. Methodological rigor and the Delta variant
66. On shared meaning
In this episode, Ian takes a more esoteric thought-ride through the bramble of lived experience and shared health-illness experiences to arrive at a tentative conclusion that perhaps the development of a methodology to evaluate the ontological legitimacy of an externally valid measure of shared health-illness experiences is perhaps tenable after all... (then again, this is all just interesting pontificating at this point).
65. Exploring the MSCI for clinical experts (with Dr. Marcie Harris-Hayes)
64. Dr. Yvette Conley on using Omics to study symptoms
63. Dr. Angela Starkweather on clinical and translational nursing science
In this episode, Ian speaks with Dr. Angela Starkweather, PHD, ACNP-BC, CNRN, FAAN, Professor of Nursing at UConn School of Nursing and NINR-funded translational pain scientist, about biobehavioral mechanisms of pain and symptom self-management. They also talk at length about maintaining clinical competence as a clinical researcher in nursing science and balancing one's career aspirations across domains.
62. Dr. Theresa Koleck on applying NLP and data mining to symptom science
In this episode, Ian speaks with Dr. Theresa A. Koleck, PhD, RN, from University of Pittsburg School of Nursing about her expertise in omics and biomedical informatics. Dr. Koleck recently published a fascinating first-author paper in Nursing Research focused on the use of natural language processing (NLP) in the study of five deliberately selected symptoms. This project was a methodologically-focused feasibility pilot of the use of NLP and the NimbleMiner R-Studio Shiny package, created by one of her nurse scientist colleagues at Columbia University (Dr. Max Topaz). Additionally, they discuss Dr. Koleck's broader interests in symptoms and symptom burden.