“You are a pharmacist working in a medium sized (150 bed) community hospital
Please evaluate and assess the article (attached below) by Sin, et al, using the JAMA Critical Appraisal worksheet (also attached below). Note there is an error in the article, described below. For the article citation – please include at least the 1st two authors, complete title, journal name, volume, pages, and year published – just as you would cite the article in a term paper, presentation, etc. You will have you specify the study question for the assigned article. If there was more than one study question, specify at least the primary question that the investigators studied.
PLEASE NOTE: In the article, there is an ERROR that you need to be aware of (and a correction provided here): On page 1593 of the article, on the lower left-hand corner of the page, in the lower left paragraph, under the title “Risk of Subsequent ED Visits”, the second line of that paragraph reads: “Crudely, inhaled corticosteroids were associated with a 36% (relative risk [RR], 0.64; 95%CI, 0.52-0.79) reduction in the risk for a subsequent ED visit.” THIS LINE IS INCORRECT, and should be replaced with the following instead: “Crudely, the overall/baseline rate of subsequent ED visits, regardless of drug group or any other factor, was 36% (relative risk [RR] = 462 readmissions / 1293 subjects total = 0.36; 95% CI = 0.21-0.48).” All other calculations (in both the text and Table 3, etc.) are correct. Apologies for any inconvenience this error has caused (but it does show that they do happen, so you should always read articles critically and not be afraid to question something that doesn’t appear to be correct!).
For the questions that refer to “your patient,” use the clinical scenario below:
“You are a pharmacist working in a medium sized (150 bed) community hospital, with an active and busy emergency room that sees a variety of patients with acute medical conditions, and that has clinical pharmacy services integrated into the emergency room setting. You have noticed over the past year or so that many patients come to the emergency room with acute exacerbations of asthma, and require intensive intervention (often including inhaled therapies, intravenous corticosteroid infusions, even ventilator assistance in extreme cases), and you are interested in counseling your patients as to the most effective pharmacologic treatments for keeping them from having further emergency room visits due to exacerbations of their condition. This evening, you have a 23 year old female asthma patient that is asking you about “which inhaler I should use, to keep me from having another serious episode like this”, and you ran across a study by Sin et al. that seems to offer some potential evidence. ”
| Excellent | Good | Fair | Poor | ||
| Main Posting | 45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.
Supported by at least three current, credible sources.
Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.
At least 75% of post has exceptional depth and breadth.
Supported by at least three credible sources.
Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
35 (35%) – 39 (39%)
Responds to some of the discussion question(s).
One or two criteria are not addressed or are superficially addressed.
Is somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course readings for the module.
Post is cited with two credible sources.
Written somewhat concisely; may contain more than two spelling or grammatical errors.
Contains some APA formatting errors. |
0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately.
Lacks depth or superficially addresses criteria.
Lacks reflection and critical analysis and synthesis.
Does not represent knowledge gained from the course readings for the module.
Contains only one or no credible sources.
Not written clearly or concisely.
Contains more than two spelling or grammatical errors.
Does not adhere to current APA manual writing rules and style. |
|
| Main Post: Timeliness | 10 (10%) – 10 (10%)
Posts main post by day 3. |
0 (0%) – 0 (0%) | 0 (0%) – 0 (0%) | 0 (0%) – 0 (0%)
Does not post by day 3. |
|
| First Response | 17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English. |
15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English. |
13 (13%) – 14 (14%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited. |
|
| Second Response | 16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English. |
14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English. |
12 (12%) – 13 (13%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited. |
|
| Participation | 5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days. |
0 (0%) – 0 (0%) | 0 (0%) – 0 (0%) | 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days. |
|
| Total Points: 100 | |||||
