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The objective of the proposed literature review is to identify the tools for overcoming the obstacles in the role of advanced practice registered nurses (APRNs) in the US healthcare system with the help of the Essentials of Masters Education in Nursing proposed by the American Association of Colleges of Nursing (AACN) (American Association of Colleges of Nursing, 2011). The project consists of the following stages: planning, research, determination of methodology, analysis, report drafting, finishing and presenting the report, and soliciting and responding to feedback. The current phase is dedicated to the results of the report incorporating a description of data employed during the review and limitations as prospects for future research.
The phase delineating the project results explains the choice of descriptive data tools and justifies the absence of statistical tools in the review. Following the previous phases of the project, this stage enriches the understanding of the literature review and the exceptional role of AACN Essentials of Masters Education in Nursing in overcoming the limitations of APRN position in the US healthcare industry.
The projects outcomes suggest that performing a literature review on such a significant issue is a helpful tool for the enhancement of healthcare system and job satisfaction of those engaged in it. The project is divided into several phases with concrete objectives, which makes it easier to follow the outcomes and recommendations. The purpose of the current phase is to present the results and delineate the limitations of the literature review.
Statistical Tools and Descriptive Data
As it was mentioned in phase 3 of the research, the use of statistical software for this project is optional due to the specifics of the topic. Therefore, at the final stage, it became apparent that no such software would be necessary. What concerns data produced as a result of the literature review, it will be mostly qualitative and will be described by narrative synthesis and meta-analysis.
To provide sufficient narrative synthesis and meta-analysis, it is necessary to take into consideration the number of the articles reviewed, their publication date, reliability, and outcomes. As a result of the performed search, it was possible to obtain a considerable number of scholarly peer-reviewed articles on the topic The impact of the AACN Essentials of Masters Education in Nursing on the elimination of the barriers in APRN roles in the US. Thirty-three articles were found with the help of Google Scholar, and twenty-one articles were obtained using other search engines and libraries. After removing the duplicates, forty-two sources were left. Upon exclusion of the sources unsuitable due to being outdated, thirty-four sources were left which were subjected to narrative synthesis and meta-analysis. These data analysis methods presuppose the typology of sources according to various aspects and finding common and exceptional features in them which allow to enhance the perception of the topic investigated.
For the current project, the chosen articles were divided according to the following principles. There was a group of sources devoted to the existing barriers in APRN roles in the US. Then, there was a number of articles investigating the AACN Essentials of Masters Education. Finally, there were several sources studying the ways of overcoming the barriers in APRN roles. With the help of narrative synthesis, the data obtained from the articles was analyzed and organized according to the findings. The fundamental obstacles to APRN roles in the US were identified and classified according to the degree of their seriousness and impact. The following barriers were singled out: the ones connected with practice and education (Gerard, Kazer, Babington, & Quell, 2014) and the ones determined by policies, laws, and established institutional practices (Altman, Butler, & Shern, 2016).
The Essentials of Masters Education in Nursing are considered an advantageous method of overcoming the barriers in APRN roles in the US by most of the reviewed articles authors. Another way of managing the limitations, as discussed in the reviewed articles, is the cooperation of various healthcare facilities and professionals focused on the elimination of the current problems in the healthcare industry.
Therefore, the descriptive data methods most suitable for the project are meta-analysis and narrative synthesis. These approaches made it possible to classify the sources obtained with the help of search engines and to analyze their strong and weak points. As a result, three major groups of articles were identified: the ones investigating current barriers in APRN roles in the US, the ones studying the elements of AACN Essentials of Masters Education, and the ones dedicated to eliminating the barriers in APRN roles.
Research Limitations of the Review
The proposed project may be subjected to a number of limitations which the author needs to acknowledge in order to be able to eliminate them. The most common limitations of a literature review are concerned with time and resources issues and the problem of bias.
The most common limitation of a literature review project is that it is likely to omit some rather important research results due to the insufficient amount of time for performing the search of the literature and its analysis (Booth, Papaioannou, & Sutton, 2016). In the case of the current project, some important articles could have been omitted because of several reasons. For one thing, the search by keywords may not always reflect the exhaustive results. The article itself may be dedicated to the research question, but its title may not incorporate the keywords of the study and thus not be suggested by the search engines. In such situation, it is possible not to obtain some useful sources. The second reason of research limitations connected with omitting crucial studies is the insufficient amount of time for the search. Due to this fact, some essential data could have been left out. Also, the most current articles are usually not easy to find and access. However, they may be used in further research on the subject.
The second major limitation of the current project is bias. This problem occurs when the authors prefer one method to the other, or when the person performing the literature review chooses to use statistically essential studies over negative ones (Jannot, Agoritsas, Gayet-Ageron, & Perneger, 2013). Jannot et al. (2013) emphasize that citation bias has become almost as widespread as publication bias. This tendency is rather adverse as it may lead to excluding some important research results from the literature review.
The next restraint to a completely successful review of literature is presented by the limitations of the articles reviewed. Some studies may have an insufficient sample or some methodological flaws which may cause a wrong perception about their results. If the research sample of the study is too small, it may be not reliable enough. Incorporating such articles in literature review may result in inaccurate data. While performing the review, the results of such articles could have been employed in the project because there was not enough time to check all papers thoroughly and completely avoid such insufficient sample limitations. Methodological defects in the reviewed articles may present a problem because it is not easy to identify them at first glance, and a reviewer may not be competent enough to see them. Thus, the proposed project may contain some articles whose methodology is not perfect, which leads to imperfect results.
Another limitation of the project is that the methods of collecting the data could have been wrong. When analyzing the findings, it became obvious that some other questions could have been included which would have brought a more thorough explanation of the issue. To eliminate the adverse outcomes of this limitation, suggestions for future research shall be provided with the specific questions that would be helpful in analyzing the problem.
Finally, a serious barrier to the most efficient literature review is presented by language mastery limitations. It was possible to perform the search only in English, whereas there may be some remarkably crucial articles written in other languages. This kind of limitation is a problem occurring frequently (Fink, 2014). Unfortunately, in the case of this project, it was impossible to overcome it and perform the search in other languages.
Thus, the major research limitations of the proposed literature review are concerned with various types of bias in the sources, the insufficient amount of time, restraints of the reviewed articles (methodological flaws or incomplete samples), and a language barrier. Identifying and admitting the limitations makes it possible to avoid similar problems in future and invite others to find ways of overcoming these limitations.
Conclusion
The current phase of the literature review project suggests the results obtained after choosing the sources and analyzing them. The phase justifies the absence of statistical tools due to the topic peculiarities. Descriptive data tools, namely meta-analysis and narrative synthesis, are outlined. Phase 4 explains the advantages of the chosen descriptive data techniques and their benefits for the project.
As a result of search engine findings and their analysis, 34 peer-reviewed articles from reliable sources were chosen for the study. After employing narrative synthesis and meta-analysis, the sources were subdivided according to their subject of investigation. Three major groups were delineated: articles concerned with the barriers in APRN roles in the US healthcare system, sources focused on studying the AACN Essentials of Masters Education, and studies concentrated on the approaches to overcoming the existing barriers.
The current project phase also delineates the limitations of the literature review as the perspective subject for further investigation. The core limitations are concerned with language barrier problem, a deficient amount of time for performing the research, the issues of insufficient samples or methodological flaws, and resources bias. Some of these limitations pertain solely to the researcher. For instance, a language barrier or the lack of time cannot be controlled by outside forces. However, such problems as authors bias or flaws in methodology are independent of the author of the literature review.
The basic aim of the current project phase is to present the limitations in order for the further researches to have an opportunity to improve them. Delineating the descriptive data tools provides vital assistance in understanding the project.
References
Altman, S., Butler, A., & Shern, L. (2016). Assessing progress on the Institute of Medicine report The future of nursing. Washington, US: National Academies Press.
American Association of Colleges of Nursing. (2011). The essentials of Masters education in nursing. Web.
Booth, A., Papaioannou, D., & Sutton, A. (2016). Systematic approaches to a successful literature review (2nd ed.). New York, NY: SAGE.
Gerard, S., Kazer, M., Babington, L., & Quell, T. (2014). Past, present, and future trends of Masters education in nursing. Journal of Professional Nursing, 30(4), 326-332.
Jannot, A.-S., Agoritsas, T., Gayet-Ageron, A., & Perneger, T. V. (2013). Citation bias favoring statistically significant studies was present in medical research. Journal of Clinical Epidemiology, 66(3), 296-301.
Fink, A. (2014). Conducting research literature reviews: From the internet to paper (4th ed.). Thousand Oaks, CA: SAGE.
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