NURS 346 ALL SP26 Quiz 4 AA University of Maryland School of Nursing
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Researchers conducted a single-group quasi-experiment on the impact of protein shakes on weight gain in underweight teens. They found that average weight increased by 4 ounces (p=0.02) after the protein shakes. In the discussion section they claim "the intervention caused a significant improvement in weight for the teens and will transform the health of these young people." Based on the information provided, you conclude that:
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The clinical significance outweighs the lack of statistical significance.
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The researchers will not be able to generalize findings to all teens.
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The researcher's claims may go beyond what is shown by the findings.
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Future research should focus on fat intake as well as protein intake.
Explanation
Correct Answer: (C) The researcher's claims may go beyond what is shown by the findings. The researchers' claim that the intervention "caused" improvement and "will transform health" significantly overstates what the data actually supports. A single-group quasi-experiment lacks a control group, so causation cannot be established — only association. Additionally, a 4-ounce weight gain has questionable clinical significance, and declaring it will "transform health" is an unsupported overreach of the findings.
Why Other Options are Incorrect:
- A. This is incorrect because statistical significance is present (p=0.02). The issue is the lack of clinical significance and the overstated causal claims — not a trade-off between clinical and statistical significance.
- B. While generalizability is a legitimate concern with quasi-experimental single-group designs, the primary problem identified in this scenario is the researchers' exaggerated causal claims that go far beyond what the study design and data can support.
- D. While future research directions may be valuable, there is no evidence in the scenario to suggest fat intake is a relevant variable. This conclusion is speculative and not supported by the information provided.
Thirty preschool school children receive a 6-month intervention to improve social skills. The researchers use a single-group, pretest/posttest design. Based on this information, which of the following is the biggest threat to internal validity?
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Selection threat
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Temporal ambiguity
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Maturation
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History
Explanation
Correct Answer: (C) Maturation Maturation is the biggest threat to internal validity in this study. Over a 6-month period, preschool children naturally develop social skills simply due to normal growth and developmental progression — regardless of any intervention. Because there is no control group, it is impossible to determine whether improvements in social skills resulted from the intervention or from the children's natural maturation over time.
Why Other Options are Incorrect:
- A. Selection threat occurs when there are pre-existing differences between groups being compared. Since this is a single-group design with no comparison group, selection threat is not the primary concern.
- B. Temporal ambiguity refers to uncertainty about whether the cause preceded the effect. In a pretest/posttest design, the temporal sequence is clear — the intervention precedes the outcome measurement.
- D. History refers to external events occurring during the study that could affect outcomes. While possible, maturation is a far greater and more predictable threat given the young age of the participants and the 6-month timeframe.
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For most of the nurses, the intervention decreased stress from "severe" to "mild."
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The researchers set the alpha level at 0.05 and the p value returned was 0.03.
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The intervention was low-cost and easy to implement into the nurses' usual workflow.
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The researchers rejected the null hypothesis after comparing alpha and the p value.
Explanation
Correct Answers: (A) For most of the nurses, the intervention decreased stress from "severe" to "mild," (C) The intervention was low-cost and easy to implement into the nurses' usual workflow.
Option A describes clinical significance because it demonstrates a meaningful, real-world change in patient/nurse outcomes — a measurable shift from severe to mild stress represents a practically important improvement in wellbeing that goes beyond numbers.
Option C describes clinical significance because it addresses the practical applicability of the intervention in real clinical settings. Low cost and ease of implementation are clinically relevant factors that determine whether a finding can actually be translated into practice.
Why Other Options are Incorrect:
- B. Setting the alpha level at 0.05 and obtaining a p-value of 0.03 describes statistical significance — a mathematical comparison of probabilities used to determine whether results are due to chance, not whether they matter clinically.
- D. Rejecting the null hypothesis after comparing alpha and p-value is the definition of statistical significance — a purely mathematical/inferential process with no direct reference to real-world clinical impact.
Researchers investigated whether swimming, compared to yoga, improved balance in older adults. The researchers found that patients who swam scored better on a balance test than patients who did yoga. Which of the following best describes what "internal validity" means in this study?
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Balance was accurately measured by the tool used in the study.
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Swimming, not something else, was what improved balance.
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Experts examined the tool used and determined it was appropriate.
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The findings can be generalized to patients in other age groups.
Explanation
Correct Answer: (B) Swimming, not something else, was what improved balance. Internal validity refers to the degree to which a study can establish a true cause-and-effect relationship between the independent and dependent variables, ruling out alternative explanations. In this study, internal validity means that swimming itself — and not confounding variables such as motivation, baseline fitness, or other activities — was responsible for the improved balance scores.
Why Other Options are Incorrect:
- A. Accurately measuring balance with the tool describes instrument reliability and construct validity — not internal validity.
- C. Experts examining and approving the tool describes content validity, which relates to whether the measurement instrument is appropriate — not internal validity.
- D. Generalizing findings to other age groups describes external validity — the ability to apply results beyond the study population — not internal validity.
Researchers are investigating burnout in hospital-based nurses. Midway through data collection, a pandemic occurs, leading to an increase in hospital admissions and deaths. What is the main threat to the internal validity of this study?
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Maturation
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History
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Sample diversity
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Selection threat
Explanation
Correct Answer: (B) History History as a threat to internal validity refers to external events occurring during the study that are unrelated to the intervention but may influence the outcome. The pandemic is a major historical event that independently increased nurse burnout through elevated workload, moral distress, and increased patient mortality — making it impossible to attribute changes in burnout solely to the study variables.
Why Other Options are Incorrect:
- A. Maturation refers to changes occurring within participants due to natural passage of time (e.g., aging, fatigue). While nurses may experience fatigue over time, the pandemic is a discrete external event — not a natural developmental process.
- C. Sample diversity relates to external validity and the ability to generalize findings across populations. It does not threaten the internal causal relationship between variables.
- D. Selection threat involves pre-existing differences between groups. Since the pandemic affected all participants equally, this is not a selection issue but rather an uncontrolled external historical event.
When addressing the implications of their findings, researchers should:
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Discuss the limitations of the study if the editor of the publishing journal requires it.
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Acknowledge only the limitations that were beyond the control of the researchers.
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Discuss limitations of the study because no study is perfectly designed or implemented.
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Refrain from mentioning any limitations of the study because that may bias readers' views.
Explanation
Correct Answer: (C) Discuss limitations of the study because no study is perfectly designed or implemented. Discussing limitations is a fundamental component of research integrity and transparency. No study is without flaws in design, sampling, measurement, or implementation. Openly acknowledging limitations allows readers to critically evaluate the findings, understand the scope of applicability, and identify areas for future research.
Why Other Options are Incorrect:
- A. Limitations should be discussed routinely and proactively as a standard research practice — not only when required by a journal editor. Ethical research demands transparency regardless of external requirements.
- B. Researchers should acknowledge all significant limitations — including those within their control such as sampling choices, study design decisions, and measurement tools — not only those beyond their control.
- D. Omitting limitations is a form of research dishonesty that misleads readers and undermines the credibility of the findings. Transparency about limitations actually strengthens the integrity of the research.
Researchers assign participants to the intervention or control group based on which campus they attend, Baltimore or Shady Grove. Which threat to internal validity is most likely, based on the description provided?
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Mortality
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Selection
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History
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Maturation
Explanation
Correct Answer: (B) Selection Selection threat occurs when there are pre-existing differences between groups that are not due to random assignment. By assigning participants based on which campus they attend rather than through random assignment, the two groups may differ systematically in characteristics such as demographics, socioeconomic status, access to resources, or baseline health — making it impossible to attribute outcome differences solely to the intervention.
Why Other Options are Incorrect:
A. Mortality threat refers to differential dropout rates between groups during the study. There is no information provided suggesting participants are dropping out at different rates.
C. History threat involves external events occurring during the study that affect outcomes. Campus assignment does not involve an external event influencing the dependent variable.
D. Maturation refers to natural changes within participants over time due to aging or development. This is unrelated to how participants are assigned to groups.
Researchers provide standardized training to all research staff to ensure that a virtual reality intervention is delivered in the same manner regardless of which staff member is conducting the session. By doing this, the researchers are attempting to improve:
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Type II errors
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Power analysis
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Treatment fidelity
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External validity
Explanation
Correct Answer: (C) Treatment fidelity Treatment fidelity refers to the degree to which an intervention is delivered consistently and as intended across all participants and research staff. By providing standardized training to ensure all staff deliver the virtual reality intervention in the same manner, the researchers are directly improving treatment fidelity, ensuring that any observed effects are due to the intervention itself rather than variability in how it was administered.
Why Other Options are Incorrect:
A. Type II errors (false negatives) occur when a study fails to detect a true effect. They are primarily addressed through adequate sample size and statistical power, not through standardized training of staff.
B. Power analysis is a statistical calculation performed before a study to determine the sample size needed to detect a meaningful effect. It is unrelated to how consistently the intervention is delivered.
D. External validity concerns the generalizability of findings to other populations and settings. While consistent intervention delivery may indirectly support replication, the primary purpose of standardized training is treatment fidelity, not generalizability.
Researchers find that an intervention to improve weight gain in underweight teens increased weight by an average of 4 ounces (p=0.02). Based on the information provided, this study may be lacking:
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Treatment fidelity
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Generalizability
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Clinical significance
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Statistical significance
Explanation
Correct Answer: (C) Clinical significance Although the study achieved statistical significance (p=0.02), an average weight gain of only 4 ounces is unlikely to be clinically meaningful for underweight teenagers. Clinical significance refers to whether the magnitude of the effect is large enough to make a real, practical difference in patient outcomes. A statistically significant result does not automatically translate to a clinically important one.
Why Other Options are Incorrect:
- A. Treatment fidelity refers to how consistently the intervention was delivered. There is no information provided suggesting the intervention was implemented inconsistently.
- B. Generalizability (external validity) concerns whether findings can be applied to other populations. The scenario does not indicate problems with the study sample's representativeness.
- D. Statistical significance is clearly present, as indicated by a p-value of 0.02, which is below the standard threshold of 0.05.
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Convenience sampling to ensure an adequate sample size
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Objective tools for measurement that reduce potential bias
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Rigorous methods like use of power analysis or blinding
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Findings that show a statistically significant relationship
Explanation
Correct Answers: (B) Objective tools for measurement that reduce potential bias, (C) Rigorous methods like use of power analysis or blinding
Objective measurement tools reduce measurement bias and increase the accuracy and reliability of data collection. Using validated, standardized instruments rather than subjective assessments strengthens the credibility of the findings.
Rigorous methods such as power analysis and blinding directly strengthen study credibility. Power analysis ensures the sample is adequate to detect true effects, while blinding prevents participants and/or researchers from knowing group assignments, minimizing performance and detection bias.
Why Other Options are Incorrect:
- A. Convenience sampling introduces selection bias and limits representativeness. While it may help reach an adequate sample size, it weakens the credibility and generalizability of findings rather than strengthening them.
- D. Statistical significance alone does not indicate credibility or accuracy. A finding can be statistically significant but have no clinical meaning, or result from a poorly designed study. Statistical significance is one piece of evidence but does not on its own confirm study quality.
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