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Evidenced‐based practice is reflected in and underpins the proficiencies for nursing associates (Nursing & Midwifery Council 2018). Within this chapter, it has previously been acknowledged that research in clinical practice allows the nursing associate to acquire both objective and subjective information regarding the patients’ condition and their experiences of living with it. Gathering this type of information will guide and enhance what is gathered through the therapeutic nurse–patient relationship. While research plays an important factor in supporting the decision‐making process without acknowledging the credibility of the research, the question of whether the findings can be trusted needs to be addressed. Two ways to determine this refer to critical appraisal and hierarchy of evidence.

Poorly conducted research seriously compromises the integrity of the research process; therefore, critical appraisal of the quality of clinical research is central to inform decision‐making in healthcare. Critical appraisal is the process of carefully and systematically examining research evidence to judge its trustworthiness, its value and relevance in a particular context (Caldwell et al. 2011). It allows clinicians to use research evidence reliably and efficiently. Critical appraisal is intended to enhance the healthcare professionals’ skill to determine whether the research evidence is true and relevant to their patients (Burls 2009). Critiquing tools such as Caldwell et al.’s (2011) Critical Appraisal Skills Programme (2011) and Joanna Briggs Institute’s Critical appraisal tools (2017) are commonly used within nursing to critically appraise research.

Figure 6.1 Hierarchy of evidence.

Source: Based on Evans (2003).

Particularly, in medicine, there is a requirement to seek the best available evidence, and in order to understand this, knowledge of the hierarchy of evidence is required. Figure 6.1 illustrates how the hierarchy of evidence refers to a ranking system whereby a range of different methodologies are graded according to the validity of their findings (Evans 2003).

A number of hierarchies of evidence have been developed to enable different research methods to be ranked according to the validity of their findings. However, most have focused on the evaluation of the effectiveness of interventions.