The written critical appraisal should be a narrative summary of the strengths and weaknesses that you note in the study. Use the following guidelines to examine the significance of the problem, fit of the framework, rigor of the methodology, and quality and relevance of the findings in published studies.

Introduction and Literature Review
1. What are the research problem and purpose?
a. Is the problem clinically relevant?
i. What evidence do the authors use to support their claim of clinical relevance (see question 2)?
b. Does the purpose narrow and clarify the focus or aim of the study?
c. What is the research question?
i. What is the null hypothesis?
2. Does the literature review provide a rationale and direction for the study?
a. What fields are represented among the sources?
b. Do the authors cite classic work in the field?
c. Do the authors use the review of literature to support their claims to clinical relevance?
d. Are the sources > 6 years from date of publication?
3. Is there an identifiable theoretical framework?
a. Is the framework presented with clarity and linked to the study purpose, variables, and findings?
4. What are the study variables?
a. Do the variables reflect the concepts identified in the framework?
b. Are the variables conceptually defined?
5. Are Evaluate the objectives, questions or hypotheses, and variables; are they logically linked to the study purpose, framework, design, and results?

Methods
1. What is the study design?
a. Did the authors do something to participants to measure an outcome (experimental), or did they simply observe something about participants (observational).
b. What are the strengths and weaknesses of the design?
2. Respond to the following questions that are relevant to the design used in the study.
a. For experimental methods:
i. If the study had a treatment, is it consistently implemented?
ii. Are participants, data collectors, and/or researchers blinded to the treatment?
iii. If the study has treatment and comparison groups, are these groups equivalent?
b. For observational designs
i. Is the timing and method of the observation likely to capture the relevant experience?
ii. What is the role of the observer with relation to the participants? Are they known to one another already, or is the observer naïve to the setting or people involved? How does this status influence the data collected?
3. What kind of sampling technique do the authors use?
a. What are the potential biases in the sampling method?
b. Is the sample size sufficient to avoid a Type II error?
c. Was the sample size determined by a power analysis?
d. Was the attrition rate high?
e. Was the sample likely to find people with the relevant condition for study?
4. What measurement methods were used and are they clearly described?
a. Are the variables operationally defined based on previous research and/or theories?
5. Respond to the following questions that are relevant to the measurement approaches used in the study.
a. Scales and questionnaires
i. Are techniques to administer, complete, and score the instruments provided?
ii. Are the reliability and validity of the instruments described?
iii. If the instrument was developed for the study, is the instrument development process described?
b. Observation
i. Are the techniques for recording observations described?
ii. Is interrater reliability described?
c. Physiological measures
i. Are the accuracy, precision, and error of the physiological instruments discussed?
ii. Are the methods for recording data from the physiological measures clearly described?
6. Data collection
a. Is the training of data collectors clearly described and adequate?
b. Is the data collection process conducted in a consistent manner?
c. Are the data collection methods ethical?
7. Are the rights of human subjects protected?
a. Are the HIPAA privacy regulations followed in conducting the study?
b. Is there any potential coercion to participate, or are participants at any risk of harm by participating?
8. Evaluate the study design: does it provide a means to examine all of the objectives, questions, or hypotheses and the study purpose?

Results/Conclusions
1. What method of data analysis do the authors use?
a. Do data analyses address each objective, question, or hypothesis?
b. Are data analyses guided by, and consistent with, the theoretical framework?
c. Are data analysis procedures appropriate to the type of data collected?
d. What are the strengths and weaknesses of the chosen analytic methods?
2. Are tables and figures used to synthesize and emphasize certain findings?
a. Are the figures and tables clear?
b. Do the figures and tables supplement, or simply repeat, the written analysis?
c. What additional information do the tables and figures offer?
3. Was the sample size sufficient to detect significant differences?
a. Was a power analysis conducted to examine non-significant findings?
b. Was the study designed to be able to detect a clinically relevant difference between study groups?
4. Evaluate the results: do they examine all of the objectives, questions or hypotheses and the study purpose?
5. What are the conclusions?
a. Are the conclusions guided by, and consistent with, the theoretical framework?
b. Do the authors include all of the objectives, questions or hypotheses and the study purpose?
c. Are the conclusions based on statistically significant and clinically relevant results?
d. Are significant and non-significant findings explained?
e. Were the statistically significant findings also examined for clinical relevance?
f. Are the implications for practice consistent with study conclusions?
6. Did the researchers identify important study limitations?
a. What other limitations might be a factor in the utility of these results?
7. Do the authors put study findings in the context of previous research?
a. Do the authors provide relevant ideas for future research?
8. Evaluate this study: Based on the findings of this study, and in the context of previous research, is it appropriate to generalize the study findings?
a. What is the level of evidence offered by this study?