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NURS 6052 Week 7 Assignment: Critical Appraisal of Research
Sample Answer for NURS 6052 Week 7 Assignment: Critical Appraisal of Research Included After Question
Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.
Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.
In this Assignment, you will use appraisal tools to conduct a critical appraisal of published research. You will then present the results of your efforts.
To Prepare:
Review the Resources and consider the importance of critically appraising research evidence.
Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
Review and download the Critical Appraisal Tools document provided in the Resources.
The Assignment (Evidence-Based Project)
Part 4A: Critical Appraisal of Research
Conduct a critical appraisal of the four peer-reviewed articles you selected and analyzed by completing the Critical Appraisal Tools document. Be sure to include:
An evaluation table
A levels of evidence table
An outcomes synthesis table
Part 4B: Critical Appraisal of Research
Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.
A Sample Answer For the Assignment: NURS 6052 Week 7 Assignment: Critical Appraisal of Research
Title: NURS 6052 Week 7 Assignment: Critical Appraisal of Research
There is an overwhelming volume of clinical research articles that have been published over time. These papers have both similarities and differences in terms of their content, objectives, timelines, authors, methodologies, findings among other aspects. This brings difficulties for those browsing medical literature for the most relevant and helpful papers for their varied reasons. Critical Appraisal is one of the ways through which this problem can be navigated. With Critical Appraisal, research papers can be examined critically and systematically to determine their integrity, relevance, and value (Morrison, 2017). This is achieved by examining factors such as internal validity, how the study was conducted, methodology among other aspects. This paper will give an example of a critical appraisal of two qualitative research studies for a better understanding of the process.
Example 1
The first article is The perceptions and perspectives of patients and health care providers on chronic disease management in rural South Africa: a qualitative study authored by Eric Maimela, Jean-Pierre Van Geertruyden, Marianne Alberts, Sewela Modjadji, Herman Meulemans, Jesicca Fraeyman, and Hilde Bastiaens in 2015. The paper was conducted in Limpopo province in South Africa to find out and describe the perceptions and perspectives of patients and health care providers on chronic disease management. The authors report that the burden of chronic diseases is increasing worldwide. This problem is commonly addressed by chronic disease management interventions that have been developed over time. The problem is further compounded by other factors such as patients’ and physicians’ perceptions, which influence the implementation and the success of the interventions. However, the exact perception of patients and health care providers on these interventions which can either motivate or hinder their participation, successful implementation, and outcomes has not been fully established in South Africa. To address this issue, the authors developed two questions to answer;
- First, how do individuals with distinct chronic diseases experience their encounters with professional health care providers (HCP) and what are their expectations and suggestions?
- And secondly, how do HCP perceive the current CDM and what are their expectations and suggestions for the future CDM?
These questions and the purpose of the paper show greater relevance to the problem. This is because they will unravel how perceptions have contributed to the growing prevalence of chronic diseases in the world and how such knowledge can be used to address the situation.
The study employed focus group discussion with both patient and health care providers and the data called was audio recorded. This offered an adequate method of discussing the perceptions of both patients and nurses concerning the topic exhaustively. The authors have enriched the paper with both qualitative and quantitative research papers to develop and justify their assertions. Few of the references date back to the early 2000 and late 1990s while most of them are between 2007 and 2014. They develop a strong case through the use of available literature stating limited information as the only weakness they found. They develop no framework from their findings.
Execution of the research followed the due ethical considerations by seeking approval of the University of Limpopo Medunsa Research Committee and the Department of Health in Limpopo Province before the start. The results show that what clinicians practice is different from what is documented in research interventions. Additionally, it reports that what clinicians recommend to patients is different from what patients do at home. This is because both nurses and patients hold different perspectives and perceptions on the interventions and also, different interventions apply only to different communities, cultures, and patients. Such dynamics interfere with the success and effectiveness of the interventions. With this knowledge, health care providers can employ the most appropriate intervention and make necessary adjustments to the available ones to maximize the expected outcomes. As such, the research study relevantly answered the research questions and achieved its objectives.
Example 2
The second article is Patient perceptions of patient-centered care: empirical test of a theoretical model authored by Cheryl Rathert, Eric S. Williams, Deirdre McCaughey, and Ghadir Ishqaidef in 2015. The study aimed to determine the perceptions of patients concerning patient-centered care from the care they receive. The authors identify patient-centered care as an important contributor to positive clinical outcomes and patient satisfaction. Most hospitals do not offer patient-centered care but disease‐ or physician‐centered kinds of care. Patient-centered care should be offered in the manner and time required by the patients. Some nurses who think they do this confused it with process-centered care. The study, therefore, aims to establish the fact by applying the theoretical model of the Picker Institute and the IOM to collect patient perceptions data on various dimensions of patient-centered care. They tend to establish how such perceptions influence patients’ ratings of care. The authors enroot their argument on the available literature and the fact that the Picker Institute theoretical model has not been tested as a unified model to justify their approach. To achieve their objective, the authors developed two research questions;
- Are the theoretical dimensions of patient‐centered care predictive of overall quality of care ratings?
- Is each of the theoretical dimensions equally predictive of overall quality of care ratings?
These questions and objectives are relevant to the study questions because the will directly determine how patients’ perceptions on patient-centered care influence their understanding of care quality. It will also tell whether care ratings based on such perceptions are valid or not.
The study used questionnaires containing seven dimensions of care developed from the Picker Institute theoretical model. Participants were emailed the questionnaires to give their perceptions accordingly on a scale of 1 to 4 at most. In the end, the participants were asked to give their overall ratings and satisfaction on the care they received on a scale of 1 to 5. As such the method will adequately answer the coiled research questions. There is no specific perspective that develops the paper though the authors cite many researcher papers to support their assertions. Most of the references were published between 2012 and 2000 with only two extending into the 1990s. even though the literature reinforces the applicability of the Picker Institute theoretical model and the importance of patient-centered care, the authored reports a gap in testing the model as a unified model. No framework is developed.
The paper does not detail any ethical considerations adopted before or after the study or during data collection. The result shows that the theoretical model adopted for patient-centered care can give information that can be used to predict overall quality ratings of care. Among the seven dimensions, emotional support was found to be the top and strongest influencer of quality ratings followed by coordination of care and physical comfort. The study contributes to the possibility and necessity of incorporating patient-centered care into practice. The management can identify what is lacking from the data and provide incentives for their incorporation into practice to enhance evidence-based management for improvement of positive outcomes. The results can also direct further research by highlighting relevant areas of emphasis and interest. Therefore, the paper has achieved its objective and answered its research
questions.
References
Maimela, E., Van Geertruyden, J. P., Alberts, M., Modjadji, S. E., Meulemans, H., Fraeyman, J., & Bastiaens, H. (2015). The perceptions and perspectives of patients and health care providers on chronic diseases management in rural South Africa: a qualitative study. BMC health services research, 15(1), 143.
Morrison, K. (2017). Dissecting the literature: the importance of critical appraisal. Royal college of surgeons.
Rathert, C., Williams, E. S., McCaughey, D., & Ishqaidef, G. (2015). Patient perceptions of patient‐centred care: empirical test of a theoretical model. Health Expectations, 18(2), 199-209.
5 The clinical issue of interest is cognitive decline in patients with Alzheimer disease. 4 Cognitive decline in AD is characterized by short-term memory, language impairment, impaired reasoning, poor judgment, difficulty managing complex tasks, and visuospatial dysfunction. 5 Pharmacological therapies for AD help to slow or reverse the progression of AD but do not reverse cognitive decline. Thus, there is a major need to identify non-pharmacological approaches to improve cognitive function in the early stages of the disease before the symptoms progress. 4 The following evaluation table will analyze four peer-reviewed articles that focus on the impact of non-pharmacological approaches in improving cognitive function.
6 Full APA formatted citation of selected article.
7 Article #1 Article #2 Article #3 Article #4
5 Butler, M., McCreedy, E., Nelson, V. A., Desai, P., Ratner, E., Fink, H. A.,. & Kane, R. L. (2018). 8 Does cognitive training prevent cognitive decline? 9 A systematic review. 5 Annals of internal medicine, 168(1), 63-68. https://doi.org/10.7326/M17-1531
Hill, N. 5 T., Mowszowski, L., Naismith, S. L., Chadwick, V. L., Valenzuela, M., & Lampit, A. (2017). 10 Computerized cognitive training in older adults with mild cognitive impairment or dementia: a systematic review and meta-analysis. 5 American Journal of Psychiatry, 174(4), 329-340. https://doi.org/10.1176/appi.ajp.2016.16030360
4 Weng, W., Liang, J., Xue, J., Zhu, T., Jiang, Y., Wang, J., & Chen, S. (2019). 4 The transfer effects of cognitive training on working memory among Chinese older adults with mild cognitive impairment: 9 a randomized controlled trial. 4 Frontiers in aging neuroscience, 11, 212.
https://doi.org/10.3389/fnagi.2019.00212 Giovagnoli, A. R., Manfredi, V., Parente, A., Schifano, L., Oliveri, S., & Avanzini, G. (2017). 4 Cognitive training in Alzheimer’s disease: 11 a controlled randomized study. 4 Neurological Sciences, 38(8), 1485-1493. https://doi.org/10.1007/s10072-017-3003-9
Evidence Level *
I I I I
Conceptual Framework
The theoretical basis is not provided.
The theoretical basis is not provided.
The theoretical basis is not provided.
The theoretical basis is not provided.
9 · The study conducted a systematic review of randomized controlled trials.
- The authors searched Ovid MEDLINE, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trials for pertinent literature published between January 2009 and July 2017.
- Inclusion: The study included randomized trials of cognitive training interventions that enrolled adults with either normal cognition or mild cognitive impairment (MCI) if the studies:
- Followed the subjects for at least 6 months;
- Gave the cognitive performance or incident dementia outcomes;
iii. Were published in English.
- Exclusion: Studies were excluded if they only included persons diagnosed with dementia.
9 · Systematic review and meta-analyses of randomized controlled trials.
- Inclusion: RCT studies with at least 4 hours of drill and practice; with a clear cognitive rationale; videogames, or virtual reality. 15Studies combining CCT with other interventions were included if the control group received the same adjacent intervention.
- Exclusion: RCT studies were excluded if less than 50% of the cognitive intervention was CCT or not involving interaction with a computer.
4 · Design- Randomized control trial.
- Enrolled subjects (N = 65) were randomly grouped to a cognitive training group (N = 33) or a control group (N = 32).
- Inclusion criteria
- Age ≥60 years old.
- No significant visual or auditory impairment.
iii. The Montreal Cognitive Assessment (MoCA, <26 when education level >12 years or MoCA <25 when education level ≤12 years).
- Meets the MCI diagnostic criteria of the NINCDS-ADRDA.
- Informed and freely to give informed consent.
-
Exclusion criteria:
- Meets the dementia diagnostic criteria of DSM-V and NINCDS-ADRDA.
- On antipsychotics, or have stopped for less than 3 months.
iii. Taking part in other cognitive training projects.
- Declined to participate in the study.
4 Design- Randomized control trial.
Inclusion criteria:
- Mild to moderate dementia MMSE score >15)
- Probable AD
iii. Impairment in memory or executive functions
- Schooling ≥5 years
- Informed consent
Exclusion criteria:
iii. Unilateral spatial neglect
- Stroke
- Epilepsy
- Traumatic brain injury
vii. History of psychosis, major depression, bipolar disorder, or substance abuse.
Sample/Setting
2 The number and characteristics of
patients, attrition rate, etc.
- The researchers identified 35 publications of 34 unique RCTs of cognitive training interventions. 11 of the publications had medium or low risk of bias (5– 16).
- The mean age of study subjects’ was ≥60 years old, with a diagnosis of MCI or dementia (of any etiology), confirmed by assessing the inclusion criteria or baseline scores against standardized diagnostic criteria.
- Sixty-two participants with MCI above 60 years old were recruited.
- Setting- Communities in China.
- Sample- 39 AD patients.
- Setting- Participants were recruited at one center.
- Dependent variables- cognition and behavior.
17 · Independent variables- Computerized cognitive training.
- Dependent variables- working memory, execution function, reasoning ability, verbal ability, and ability of daily living.
- Independent variables- Cognitive training · Dependent variables- initiative, episodic memory, mood, and social relationships.
- Independent variables- cognitive training.
Measurement
- Mean- MMSE Scores · Pooling of standardized mean differences across studies was conducted using a random-effects model.
- Egger’s test of the intercepts was utilized to formally test asymmetry.
- The Duval and Tweedie trim and fill was utilized to quantify the magnitude of small study effect.
- ANCOVA was used to test the training effect. The data of cognitive assessments (T2) was the dependent variable, and the grouping condition was the independent variable while controlling for age, gender and baseline data (T0).
- Separate paired sample t tests examined the results of other neuropsychological test, setting significance as p < 0.003 for 15 comparisons.
2 Data Analysis Statistical or
- The study analyzed and reported cognitive test results by direction of effect and statistical significance.
- Analyses were conducted for overall cognitive outcomes and for each cognitive or behavioral domain independently.
- Data were analyzed by IBM SPSS and 21.0 and Mplus Version 8.2.
- The independent-sample t-test and χ2 test were utilized to compare the baseline data of the cognitive training group with that of the control group.
- Multiple stepwise regression analysis, entering age, schooling, group membership, and baseline test scores.
2 Findings and Recommendations
General findings and recommendations of the research · For healthy older adults, cognitive training enhanced cognitive performance in the trained domain but not in other domains, this had moderate-strength evidence.
- Results for individuals with MCI showed no effect of training on performance.
- There was insufficient evidence on the impact of cognitive training on prevention of cognitive decline or dementia.
- The study recommends that patients be provided education on how to interpret advertising for cognitive training programs and products.
- The study established that CCT is efficacious on global cognition, some cognitive domains, and psychosocial functioning in persons with MCI.
- Authors recommend longer-term and larger-scale trials to assess the effects of CCT on conversion to dementia.
- Compared to mental leisure activities (MLA), subjects in the cognitive training group demonstrated significant effects in both the trained (working memory) and untrained (execution function and ability of daily living) domains.
- The study showed that in persons with mild to moderate AD, a defined cognitive training was associated with improved or stabilized initiative and episodic memory compared to non-cognitive therapies such as AMT and NE.
- The study recommends the use of cognitive training and non-cognitive treatments to improve mood in AD patients.
Describe the general worth of this research to practice.
What are the strengths and limitations of study?
What is the feasibility of use in your practice?
- The research is of minimal worth since it does not offer sufficient evidence on whether cognitive training decreases the risk for future MCI or dementia.
- It does not provide enough evidence for health care providers to support or encourage any particular cognitive training to lower the risk for cognitive decline or onset of dementia.
- Strengths: The researchers only analyzed studies with low or medium risk of bias which reduces the potential for publication bias.
- Limitations: Outcomes mostly evaluated test performance instead of global function or dementia diagnosis.
- The risk of implementing cognitive training on patients with MCI is that it may have no impact in reducing the risk for cognitive decline or reducing the risk of developing dementia.
- Feasibility: Cognitive training can easily be implemented in my practice since we provide care to older adults who need cognitive training to improve performance in the aspect of training.
- CCT can be applied in clinical practice on patients with MCI to improve their cognition, memory, working memory, and attention. It can also be used to enhance psychosocial functioning and depressive symptoms in dementia patients.
- Strengths: The study compared effect size estimates and precision in active- and passive-controlled trials.
- Limitations: Functional outcomes were measured primarily using proxy measures that are prone to multiple-source bias.
- Risks: Implementing CCC can be associated with lack of improved cognition or function in dementia patients.
- Feasibility: CCT is feasible for use in my practice since we have embraced the use of technology among the staff and our patients. Patients with MCI can thus be provided with CCT interventions to enhance cognition.
- The research is useful to clinical practice as it shows that cognitive training can be used in patients with MCI to improve cognitive function, working memory and daily life ability of daily living.
- Strengths: The study employed a randomized control study, which helped to compare the impact of two treatment modalities (Cognitive training and mental leisure activities).
- Limitations: The study used a small sample size and most of the subjects were female, which limits generalizability.
- Risks: Implementing cognitive training can have a transfer effect on execution function.
- Feasibility: The cognitive training programs can easily be implemented in our practice on AD patients.
- The research is useful to clinical practice as it proves that combining cognitive training and non-cognitive therapies may have useful clinical implications.
- Strengths: The study employed a randomized control study, which helped to compare the impact of two treatment modalities (Cognitive training vs. AMT and NE).
- Limitations: There was a failure to control for multiple comparisons comparatively to the sample size.
- Risks: Implementing cognitive training can have a transfer effect on execution function.
- Feasibility: The cognitive training programs can easily be implemented in our practice on older adults with MCI.
Key findings
- In older adults with supposed normal cognition, cognitive training seemed to provide some degree of protection against reducing performance in the domain of training but no broader cognitive or functional benefit.
- Cognitive training enhances cognitive test performance in otherwise healthy older adults, for the domain trained.
- Small- moderate effects were exhibited for global cognition, working memory, attention, learning, and memory, except nonverbal memory.
- There was an impact in psychosocial functioning, including depressive symptoms.
- In dementia, significant effects were seen in overall cognition and visuospatial skills, · The study revealed that the impact of cognitive training on overall cognitive function, working memory and daily life ability of daily living of MCI can be maintained for at least 3 months.
- Complete mediating effects of cognitive training were found in executive function through working memory and working memory in ability of daily living though executive function.
- At the end of the cognitive training, initiative significantly improved, while, at the end of active music therapy (AMT) and neuro-education (NE), it was unchanged. Episodic memory had no changes at the end of cognitive training or AMT and worsened after NE.
Outcomes
- Inadequate evidence on whether cognitive training decreases the risk for future
MCI or dementia.
- Cognition training had a high level of acceptance in the in-home MCI older adults in urban communities.
- The compliance in the cognitive training process was satisfactory.
- Mood and social relationships improved in the three groups, with greater changes after active music therapy (AMT) or neuro-education (NE).
General Notes/Comments · Cognitive training can be incorporated as part of health promotion interventions in healthy older adults to improve their cognitive test performance.
- Cognitive training can effectively improve working memory in older adults with MCI.
- In patients with mild to moderate AD, cognitive training can enhance patients’ initiative and stabilize memory, while the non-cognitive measures can improve the psychosocial aspects.
A Sample Answer 2 For the Assignment: NURS 6052 Week 7 Assignment: Critical Appraisal of Research
Title: NURS 6052 Week 7 Assignment: Critical Appraisal of Research
The critical appraisal of research has revealed that cognitive training effectively improves cognitive function in persons having mild cognitive impairment (MCI) and dementia. Cognitive training can also improve cognitive performance in older patients since they have a high risk of cognitive decline. MCI often precedes dementia. It is characterized by mainly normal functions in spite of objective evidence of cognitive decline. MCI is a major risk factor for dementia, falls, and high healthcare costs. The risk increases relatively with impaired cognitive domains and severity of symptoms. Cognitive training is the best practice that emerges from the research analysis. 5 Butler et al. (2018) revealed that cognitive training improved cognitive performance in healthy elderly persons. Therefore, it the training be incorporated in the preventative care of older adults to lower the risk of declined cognitive function, which is common in advanced age.
Cognitive training can be implemented using technology computerized cognitive training (CCT). 10 Hill et al. (2017) demonstrated CCT as an effective and safe approach for promoting cognitive function in the elderly. Besides, CCT value has been established in improving cognition and psychosocial functioning, including alleviating depression and neuropsychiatric symptoms and improving the quality of life of individuals MCI. Furthermore, Weng et al.’s (2019) study shows that cognitive training significantly impacts the domains of executive function, memory, and performance of ADLs. The impact on these domains can be sustained for at least three months. It can convey to other untrained areas, including executive function. Executive function also enhances the ability to carry out ADLs. The study justifies cognitive training as a practical approach to enhance working memory in elderly persons having MCI. 4 Giovagnoli et al. (2017) further show that cognitive training is useful in increasing initiative and stabilizing memory in persons with mild-moderate AD.
Conclusion
The above peer-reviewed articles include two systematic reviews of randomized controlled trials and Randomized control trials. 4 The studies sought to evaluate the impact of cognitive training in improving cognitive function in AD patients. They support my PICOT by establishing that indeed cognitive training is a feasible intervention that can improve cognitive function in AD patients. Therefore, the interventions can be incorporated in patients’’ treatment plans.
References
5 Butler, M., McCreedy, E., Nelson, V. A., Desai, P., Ratner, E., Fink, H. A.,. & Kane, R. L. (2018). 8 Does cognitive training prevent cognitive decline? 9 A systematic review. 5 Annals of internal medicine, 168(1), 63-68. https://doi.org/10.7326/M17-1531
Giovagnoli, A. 4 R., Manfredi, V., Parente, A., Schifano, L., Oliveri, S., & Avanzini, G. (2017). 4 Cognitive training in Alzheimer’s disease: 11 a controlled randomized study. 4 Neurological Sciences, 38(8), 1485-1493. https://doi.org/10.1007/s10072-017-3003-9
Hill, N. 5 T., Mowszowski, L., Naismith, S. L., Chadwick, V. L., Valenzuela, M., & Lampit, A. (2017). 10 Computerized cognitive training in older adults with mild cognitive impairment or dementia: a systematic review and meta-analysis. 5 American Journal of Psychiatry, 174(4), 329-340. https://doi.org/10.1176/appi.ajp.2016.16030360
4 Weng, W., Liang, J., Xue, J., Zhu, T., Jiang, Y., Wang, J., & Chen, S. (2019). 4 The transfer effects of cognitive training on working memory among Chinese older adults with mild cognitive impairment: 9 a randomized controlled trial. 4 Frontiers in aging neuroscience, 11, 212. https://doi.org/10.3389/fnagi.2019.00212
6 Critical Appraisal Tool Worksheet Template
Grading Rubric
Performance Category | 100% or highest level of performance
100% 16 points |
Very good or high level of performance
88% 14 points |
Acceptable level of performance
81% 13 points |
Inadequate demonstration of expectations
68% 11 points |
Deficient level of performance
56% 9 points
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Failing level
of performance 55% or less 0 points |
Total Points Possible= 50 | 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points |
Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic topics. |
Presentation of information was exceptional and included all of the following elements:
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Presentation of information was good, but was superficial in places and included all of the following elements:
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Presentation of information was minimally demonstrated in all of the following elements:
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Presentation of information is unsatisfactory in one of the following elements:
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Presentation of information is unsatisfactory in two of the following elements:
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Presentation of information is unsatisfactory in three or more of the following elements
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16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points | |
Application of Course Knowledge
Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations |
Presentation of information was exceptional and included all of the following elements:
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Presentation of information was good, but was superficial in places and included all of the following elements:
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Presentation of information was minimally demonstrated in the all of the following elements:
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Presentation of information is unsatisfactory in one of the following elements:
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Presentation of information is unsatisfactory in two of the following elements:
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Presentation of information is unsatisfactory in three of the following elements
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10 Points | 9 Points | 6 Points | 0 Points | |||
Interactive Dialogue
Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic. |
Demonstrated all of the following:
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Demonstrated 3 of the following:
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Demonstrated 2 of the following:
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Demonstrated 1 or less of the following:
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8 Points | 7 Points | 6 Points | 5 Points | 4 Points | 0 Points | |
Grammar, Syntax, APA
Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error. |
The following was present:
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AND
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The following was present:
AND/OR
AND/OR
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The following was present:
AND/OR
AND/OR
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The following was present:
AND/OR
AND/OR
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The following was present:
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The following was present:
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0 Points Deducted | 5 Points Lost | |||||
Participation
Requirements |
Demonstrated the following:
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Failed to demonstrate the following:
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0 Points Lost | 5 Points Lost | |||||
Due Date Requirements | Demonstrated all of the following:
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |
Demonstrates one or less of the following.
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |