When you first went to work for your current organization, experienced colleagues may have shared with you details about processes and procedures. Perhaps you even attended an orientation session to brief you on these matters. As a “rookie,” you likely kept the nature of your questions to those with answers that would best help you perform your new role.

Over time and with experience, perhaps you recognized aspects of these processes and procedures that you wanted to question further. This is the realm of clinical inquiry.

Clinical inquiry is the practice of asking questions about clinical practice. To continuously improve patient care, all nurses should consistently use clinical inquiry to question why they are doing something the way they are doing it. Do they know why it is done this way, or is it just because we have always done it this way? Is it a common practice or a best practice?

In this Assignment, you will identify clinical areas of interest and inquiry and practice searching for research in support of maintaining or changing these practices. You will also analyze this research to compare research methodologies employed.

To Prepare:

• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry. Keep in mind that the clinical issue you identify for your research will stay the same for the entire course.
• Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
• Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.
• Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.

Part 1: Identifying Research Methodologies

After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template (uploaded) to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:

• The full citation of each peer-reviewed article in APA format.
• A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.
• A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.
• A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.
• A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

By Day 7 of Week 3

Submit your Evidence-Based Project.

TO EDITOR:  I’ve uploaded a few articles…some on personality disorders and some on pain management in opioid addicted patients.  Whichever one you choose that has the most info is fine with me. Personality disorders interests me more though but it will be the theme for the rest of the semester so whichever has the most info available.  I included the database I found them in attached to name of file since that may be relevant to the assignment.  Hopefully you can add some other peer reviewed articles as well for more info. Needs two outside resources and two course specific ones.

RUBRIC:Evidence-Based Project, Part 1: Identifying Research Methodologies

Excellent	Good	Fair	Poor
Part 1: Identifying Research MethodologiesAfter reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following: <br *The full citation of each peer-reviewed article in APA format. <br *A brief statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.   *A brief description of the aims of the research of each peer-reviewed article.       *A brief description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.	81 (81%) – 90 (90%)The response accurately and clearly provides a full citation of each article in APA format. The responses accurately and thoroughly explain the selection of these articles and/or how they relate to a clinical issue of interest, including a detailed explanation of the ethics of research. The responses accurately and clearly describe the aims of the research. The responses accurately and clearly describe the research methodology used, and clearly identify the type of methodology used with specific and relevant examples. The responses accurately and clearly describe the strengths of each of the research methodologies used, including a detailed explanation of the reliability and validity of how the methodology was applied in each of the articles selected. The responses provide a complete, detailed, and specific synthesis of two outside resources related to the selection of articles and two or three course-specific resources.	72 (72%) – 80 (80%)The response accurately provides a citation of each peer-reviewed article in APA format. The responses accurately explain the selection of these peer-reviewed articles and/or how they relate to a clinical issue of interest, including an accurate explanation of ethics. The responses accurately describe the aims of the research of each peer-reviewed article. The responses accurately describe the research methodology used and type of methodology used with some examples. The responses accurately describe the strengths of each of the research methodologies used, including an explanation of the reliability and validity of how the methodology was applied in each of the peer-reviewed articles selected. The responses provide an accurate synthesis of at least one outside resource related to the selection of the peer-reviewed articles. The response integrates at least one outside resource and two or three course-specific resources.	63 (63%) – 71 (71%)The response inaccurately or vaguely provides a citation of each peer-reviewed article in APA format. The responses inaccurately or vaguely explain the selection of these articles and/or how they relate to a clinical issue of interest, including the explanation of the ethics. The responses inaccurately or vaguely describe the aims of the research of each article. The responses inaccurately or vaguely describe the research methodology used and the type of methodology used, with only some examples. The responses inaccurately or vaguely describe the strengths of each of the research methodologies used, including the explanation of the reliability and validity of how the methodology was applied in each of the articles selected. The responses provided vaguely or inaccurately synthesize outside resources related to the selection of the articles. The response minimally integrates resources that may support the responses provided.	0 (0%) – 62 (62%)The response inaccurately and vaguely provides a citation of each peer-reviewed article in APA format or is missing. The responses inaccurately & vaguely explain the selection of these articles and/or how they relate to a clinical issue, including the explanation of ethics of research, or they are missing. The responses inaccurately and vaguely describe the aims of the research, or they are missing. The responses inaccurately and vaguely describe the research methodology used, the type of methodology used with no examples present, or they are missing. The responses inaccurately and vaguely describe the strengths of each of the methodologies used, including the explanation of the reliability and validity of the methodology, or they are missing. The responses provide a vague and inaccurate synthesis of outside resources related to the selection of the articles and fail to integrate any resources to support the responses provided, or is missing.
Written Expression and Formatting—Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided, which delineates all required criteria.	5 (5%) – 5 (5%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided, which delineates all required criteria.	4 (4%) – 4 (4%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated but are brief and not descriptive.	3.5 (3.5%) – 3.5 (3.5%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic.	0 (0%) – 3 (3%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. No purpose statement, introduction, or conclusion is provided.
Written Expression and Formatting—English Writing Standards: Correct grammar, mechanics, and proper punctuation.	5 (5%) – 5 (5%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided, which delineates all required criteria.	4 (4%) – 4 (4%)Contains a few (one or two) grammar, spelling, and punctuation errors.	3.5 (3.5%) – 3.5 (3.5%)Contains several (three or four) grammar, spelling, and punctuation errors.	0 (0%) – 3 (3%)Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

Solution:- Evidence-Based Project, Part 1: Identifying Research Methodologies

The philosophy of practice that is premised on the use of only interventions that have been proven by research to be efficacious is referred to as evidence-based practice or EBP. But the body of EBP knowledge is not static but dynamic as it keeps on changing day by day as new evidence of efficacy emerges. This new knowledge for EBP is generated by a process known as clinical inquiry which is undertaken by using the PICOT model

This model requires the identification of the clinical issue of interest or problem (P) requiring evidence-based interventions. Alternatively, the patient population (P) this issue affects is identified as well as the problem itself. This is followed by the intervention to be investigated (I), the comparison or current intervention (C), the expected outcome (O), and the time-frame for the application of the intervention (T) (Melnyk & Fineout-Overholt, 2019).

In this EBP project, the clinical issue of interest chosen is the treatment of personality disorders. For this, the PICOT statement or question is “In adult patients diagnosed with a personality disorder (P), does the use of psychotherapy combined with pharmacotherapy (I), compared to pharmacotherapy alone (C), result in better symptom remission (O) within a span of six months (T)?” The purpose of this paper is therefore to analyze four peer-reviewed articles from research databases CINAHL, PubMed, Cochrane, and ProQuest that provide evidence for the best intervention to manage personality disorders.

Full citation of selected article	Article #1	Article #2	Article #3	Article #4
	Choi-Kain, L.W., Albert, E.B., & Gunderson, J.G. (2016). Evidence-based treatments for borderline personality disorder. Harvard Review of Psychiatry, 24(5), 342–356. https://doi.org/10.1097/hrp.0000000000000113	Ellison, W.D. (2020). Psychotherapy for borderline personality disorder: Does the type of treatment make a difference? Current Treatment Options in Psychiatry, 7, 416-428. https://doi.org/10.1007/s40501-020-00224-w	Pearce, S., Scott, L., Attwood, G., Saunders, K., Dean, M., De Ridder, R., Galea, D., Konstantinidou, H., & Crawford, M. (2018). Democratic therapeutic community treatment for personality disorder: Randomised controlled trial. The British Journal of Psychiatry, 210(2), 149-156. https:/doi.org/10.1192/bjp.bp.116.184366	Timäus, C., Meiser, M., Bandelow, B., Engel, K.R., Paschke, A.M., Wiltfang, J., & Wedekind, D. (2019). Pharmacotherapy of borderline personality disorder: What has changed over two decades? A retrospective evaluation of clinical practice. BMC Psychiatry, 19(393), 1-11. https://doi.org/10.1186/s12888-019-2377-z
Why you chose this article and/or how it relates to the clinical issue of interest (include a brief explanation of the ethics of research related to your clinical issue of interest)	This article was chosen as it relates to the clinical issue of interest in that it investigates evidence-based treatments for borderline personality disorder. BPD is one of the personality disorders as classified by the DSM-5 (Sadock et al., 2015). The ethics of research have been avoided in this research as it is a review of previous trials on therapies for PDs.	This article was chosen because it relates to the clinical issue of interest. It is about reviewing the current evidence-based psychotherapeutic treatments that are available for BPD as one of the PDs. The issue of ethics did not arise as the research was not a primary study but a filtered one.	This article was chosen because it is about investigating the efficacy of democratic therapeutic community (DTC) treatment for personality disorders. This is how it relates to the clinical issue of interest. On ethics, the subjects were allowed to give informed consent (autonomy) and they were not harmed in any way during the study (nonmaleficence). Lastly but not least, they were assured that the study would benefit them, respecting beneficence (Haswell, 2019).	The choice of this article was informed by the fact that it addresses the issue of pharmacotherapy in the management of BPD. Being retrospective, the confidentiality of the patient information in the charts used was maintained to avoid causing psychological harm by breaching privacy in a violation of the principle of nonmaleficence (Haswell, 2019).
Brief description of the aims of the research of each peer-reviewed article	The aim of this review was to evaluate four major available peer-reviewed therapies for BPD.	The aims were (i) to provide a summary of available evidence-based psychotherapeutic treatments for BPD, and (ii) to evaluate their effectiveness and the evidence supporting that.	The aim of te study was to assess whether DTC could reduce in-patient admission and improve the mental health of personality disorder patients.	The aim was to assess the quality of the available drug treatment for BPD in inpatients.
Brief description of the research methodology used Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.	The methodology was a systematic quantitative review of existing literature. Each of these modalities was assessed individually and their merits and demerits and compared against the others.	The methodology is a qualitative systematic review of the available scholarly evidence.	This was a quantitative study in the form of a randomized controlled study/ trial or RCT.	The methodology was a quantitative retrospective evaluation of practice.
A brief description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.	The strength of this paper is in its being a review of several primary research articles on the subject. It is therefore a summary of sorts which is better than a single study focussing on one therapy. Its reliability and validity depends on the collective reliability and validity of the four articles reviewed. Being a review, its validity and reliability are sound.	The major strength of this methodology is that filtered research provides the best and highest evidence in the pyramid of evidence at level 1. As a sum of the primary studies reviewed, the validity and reliability or generalizability of this study is beyond reproach (good).	The main strength of this study design is that it is experimental in nature and is therefore the best way to establish causality.	The strength of this study is that it is a primary study that generated new knowledge to enrich existing EBP. The sample size was n = 87 and this was enough to guarantee validity and generalizability of the results.
General Notes/Comments	The findings of this study are instrumental in generating new knowledge for enriching EB clinical practice.	This study adds to the body of knowledge available for EBP.	Being an experimental primary research study, this work is invaluable in generating entirely new knowledge about causality for EBP.	The study provides required evidence for pharmacotherapeutic interventions against BPD which is a PD.

Conclusion

This identification of research methodologies has been conducted systematically according to the tenets of clinical inquiry. A clear issue of clinical interest has been identified and a PICOT statement generated with it to facilitate the search for evidence from published peer-reviewed literature.

Reputable research databases have been used to search for evidence and finally four of the several articles retrieved have been reviewed in the matrix above. They show clearly that psychotherapy is the best intervention for personality disorders, but that prudent clinical practice requires that a combination of psychotherapy and pharmacotherapy be used for the best patient outcomes.

References

Choi-Kain, L.W., Albert, E.B., & Gunderson, J.G. (2016). Evidence-based treatments for borderline personality disorder. Harvard Review of Psychiatry, 24(5), 342–356. https://doi.org/10.1097/hrp.0000000000000113

Ellison, W.D. (2020). Psychotherapy for borderline personality disorder: Does the type of treatment make a difference? Current Treatment Options in Psychiatry, 7, 416-428. https://doi.org/10.1007/s40501-020-00224-w  

Haswell, N. (2019). The four ethical principles and their application in aesthetic practice. Journal of Aesthetic Nursing, 8(4), 177-179. https://doi.org/10.12968/joan.2019.8.4.177

Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice, 4^th ed. Wolters Kluwer.

Pearce, S., Scott, L., Attwood, G., Saunders, K., Dean, M., De Ridder, R., Galea, D., Konstantinidou, H., & Crawford, M. (2018). Democratic therapeutic community treatment for personality disorder: Randomised controlled trial. The British Journal of Psychiatry, 210(2), 149-156. https:/doi.org/10.1192/bjp.bp.116.184366

Sadock, B.J., Sadock, V.A., & Ruiz, P. (2015). Synopsis of psychiatry: Behavioral sciences clinical psychiatry, 11^th ed. Wolters Kluwer.

Timäus, C., Meiser, M., Bandelow, B., Engel, K.R., Paschke, A.M., Wiltfang, J., & Wedekind, D. (2019). Pharmacotherapy of borderline personality disorder: What has changed over two decades? A retrospective evaluation of clinical practice. BMC Psychiatry, 19(393), 1-11. https://doi.org/10.1186/s12888-019-2377-z