There is always a debate as to whether qualitative research has adhered to the concepts of reliability and validity and whether the research can be used for clinical decision making. Research shows that qualitative research has to establish objectivity together with reliability to help in making adjustments and influence the clinical decisions of the professionals. Because of this, critical appraisal for qualitative studies is significant steps to show whether a study incorporates qualitative evidence and whether the research is adhering to validity, objectivity, and reliability. The goal of the critical appraisal is to assess whether the study addresses the questions that are presented by the researcher and whether the process of conducting the research relates to interventions successfully. Joanna Briggs ‘critical appraisal checklist for qualitative research’ (2017) is a tool used to critically appraise an article through the lists that are generated and predefined. This paper assesses a study by Moran, Taylor, and Warren-Forward (2017) evidence-based practice in screening mammography initials the new interventions.


Keywords: Advanced practice, screening, mammography, Australian radiographers, radiography, breast screening programs, Joanna Briggs Institute, critical appraisal, systematic review.



In every academic research, it is essential to appraise the qualitative methodologies used and the eventual conclusions made as to whether they are within the interventions of incorporating the qualitative evidence. The main goal of critical appraisal in qualitative research is to show whether the research addresses the questions of the researcher and whether they mean full. It also assesses the process of researching different interventions together with the outcome. The quality is assessed through the level of reporting, the methodological rigour followed by the conceptual depth in research. The article “Assessment of the willingness of Australian radiographers in mammography to accept new responsibilities in role extension: Part two e qualitative analysis” by Moran, Taylor, Warren ( 2012), talks about advanced practices in screening mammography that is used by the Australian radiographers and what the professionals feel about this new intervention.  The Joanna Briggs Institute will be used in this evaluation. This is a faculty of health science research-based development organisation that is located in Aladin. The institute promotes support for health care programs that are evidence-based and gives a sense to resources for license, midwifery and medical health. There are more than 80 centres that collaborate with this entity. JBI Systematic Review gives the evidence for systematic review, literature and different interventions that are used. Systematic review analyses the available literature and its effectiveness and practice. The practice involved different steps that take into account the evidence-based methods used in critically appraising and synthesising the source. It also determines whether the research used is in line with a broader view of evidence that is developed by the institute. Methodologies and rigorous processes for critically appraising these sources before they can aid decision-making procedures in healthcare are important. They are used in qualitative research and economic evolution to determine accuracy in diagnostic tests. Various JBI tools are used for critical appraisal processes. Systematic reviews incorporate the findings and determine whether the finding and the conclusions by the researcher are done without possibly having a bias decision. Various systematic reviews involve a critical appraisal of evidence-based research. This appraisal is to give an analysis and assessment of the article about the assessment of the preparedness of Australian radiographers and radiologists operating in mammography to accept the extension roles. This is a qualitative study, and therefore, appraising the quality of the research determines the extent to which this study is addressing the willingness of these radiographs to accept the new responsibilities in the role of extension. All the papers selected in systematic review inclusion criteria that have been described by that protocol. An article is subjected to a rigorous appraisal, and the result used to inform an interpretation and a synthesis of study results and whether they are addressing the aims researcher. JBI analysis is developed by the collaborators of JBI and is therefore subjected and approved by the scientific committee of JBI.

Discussion on critical appraisal checklist

  1. Congruity between the stated philosophy and research method used.

Does this article state a theoretical perspective or a philosophical perspective on which this study is mainly based on? Does the report on the article state a methodological approach that has been adapted and their study is supposed to follow? Is there any congruence between these two perspectives?

This article has a theoretical perspective of the opinions of the radiographers about the traditional methods that had been used in screening. The article states that some researchers have published articles that discuss the advantages of advanced practice by radiographers in Australia. Radiographers are continuously implementing and using mammography screening about the demands of the advancements in medical technology. Advanced practices in the UK have established medical images that could be interpreted at the laboratory, and the process has taken place for more than 40 years. Ultrasound imaging has been around for more than 20 years, and other fields such as mammography screening have been used for the last couple of years. Petitioners have improved on a massive turn around, and they have benefited massively from referring their patients to this new technology. Enhanced consultant radiographers have improved breast screening in the United Kingdom National Health Service that gives an improved in reporting for the majority of the mammogram screening (Moran et al., 2013, 131). The researcher also has a protocol that is methodologically followed by the researcher. The congruence between the critical review that focuses on knowledge arising from the critique and action research approach focuses on working with the groups and reflect on issues of practice. By considering what could be different between these two, adherence is created. Identifying the new knowledge that arises out of the action taken becomes critical as well. Nonetheless, this study has also adopted an interpretative perspective that uses survey. There is an inner congruence between the interpretation view that focuses on the phenomenon and the survey conducted. The survey deals with asking standards questions about the willingness of the radiographers to accept their new responsibilities in the role extension. This approach focuses on asking the standard questions to a population. That was circulated do all the radiographers that are working in their breast cream programs in Australia.

  1. Congruity between the used research methodology and the represented analysis of data

Are the data analysis methods represented in a manner that is congruent with their methods for methodological position stated?

This research analyses the data by addressing the questions and the answers that have been given by the Australian radiographers working at the breast screening centres. It is therefore in congruence with the methodologies and the position that was stated by the researchers. This research pursued a phenomenological approach that is exploring the experiences of medical professionals through the process of asking them questions. The research is supposed to allow them to describe the experiences that they have had and what they feel about that responsibility in role extension. Some answers are analysed by the researchers that they got from asking questions.

The continuous shortage of radiologists can also be reflected by the shortage of radiographer services, especially the new technologies that can be used for breast screening. A similar problem can be seen in the UK which has also been elevated by the introduction of the assistant radiography. There is a question about the profession of Australian radiography workers in the department of breast cancer. The shortage of radiographers even impedes retirement of developer radiographers. There is the need to prepare for this change for the upcoming radiographers and the various initiatives to perform services that require a high level of skills.


  1. Congruence between the methodologies used in research on the interpretation of the results

Are the results interpreted by the research agreeing with the methodologies that have been used?

This paper used an approach that explored the experiences of the people and the results that can inform other practitioners about the differences of the different screening methods. There is congruence determines between the used methodology and the approach of interpretation. The study explored the experiences to generate practice checklist for the assessment. Hence, there is congruence between the methodologies used and the approach for interpreting and understanding the meaning to the participants (Moran et al., 2013, 131). The questionnaires were distributed to the Australian mammography workers who showed a repetitive nature for the mammography that was the biggest concern to breast imaging and also the biggest reason why they left the profession or worked part-time. The role extension may aid retention of the stuff through reducing the monotony of the workers and potential injuries experienced in work. The lack of recognition for agreeing on the current career dissatisfaction was the other problem identified by the professionals. There are several association bodies of radiography that showed the low reception of mammography.


  1. Congruity realised between the research methods used and the research questions together with the objectives


Is this study methodology appropriately addressing the research question for objectives?

This article has a research question that states whether the Australians working as radiographers and the use of mammography are willing to accept the well defined and the responsibilities in the role’s extension. The research question seeks to understand the meaning and the attitude of the people towards this new intervention and a phenomenological approach have been taken to examine the question. There is a congruity between the question and the methodology. This article also states that there is a research question meant to establish the advantages that have been realised and the possible disadvantages through the approaches pursued. The objectives have established the causes and effects be addressed through ethnographic approach. Ethnography develops an understanding of the cultural practices and would, therefore, being congruent. However, this approach is incongruent to the research questions.

  1. The Congruity between the used methodology in research and the methods for collecting data

Are the methods for data collection appropriate for the used methodology?

It is important to determine whether the method that has been used for collecting data at the most appropriate and they are the only possible solutions that the researcher could have used. The research methodology used in this study pursued used an approach of data collection through surveys and interviews. It is showing that there is a congruence between data collection and methodology. Hence, the methodology and the collection of data are congruent with the data collection methodology in this instance because the phenomenology is seeking for a vivid description of a phenomenon in the participant’s experience. This cannot be achieved through a written response for standardisation of the pasture.

  1. Locating a researcher from a cultural perspective and a theoretical perspective

In this study, are there any beliefs or cultural values that can potentially influence the outcome of the research before it is declared?

The researcher has a massive impact on qualitative research as they also belong to various and cultures. It is, therefore, possible that a researcher can be influenced by these values before they make the decision or a preferred opinion. Appraising evidence helps in knowing the culture of a researcher together with theoretical implications. Research or an article is of high quality if it can be determined that they are not affected by cultural backgrounds and beliefs that are not part of the study. In healthcare and healthcare research culture plays a massive role and influences most of the decisions as well as a perspective for the practitioners. A particular society or individuals share cultural patterns and ideas, and they are continually involving. At the same time, some medical practitioners struggle to cope with the changes in culture and how to balance the predominant cultures from the works that are trying to set the pace in the new setup. Culture affects the perspective of illness and how the practitioners believe about death together with their approaches that are used to treat and relieve pain. Healthcare professionals and patients also respect their cultures, especially in Australia. Very few radiographers at the radiologist became quite supportive for there an official duties such as biopsies. It can be concluded that role extension radiographers are a matter of when it will be fully used. Because of the success in the UK, it has paved the way and beneficial to other places such as Australia (Moran et al., 2013, 131). Responses to the questionnaire are also 70% that showed the keen interest that radiographers showed in role extension. It is true that the researchers were not affected by cultural perspectives. It is always important to demonstrate awareness of the touch of the patient to promote trust and deliver better quality health service while performing radiography. This promotes the acceptance or approval of adherence to treatment. It is always important to clarify that the researcher does not have any biasness towards and culture and how they treat patients differently. Culture should also note for part of the opinions in decision making.

  1. The Influence of the researcher on the conducted research

It is always important to clarify the influence that the researcher has on research and also the influence that the research has on the researcher. The question asked is, are there any potential possibilities of the researchers having a difference of this study or is there any information for the research process influencing the researcher in their way of interpreting research?

It is also important to examine whether there is such potential influence the process of data collection and whether the response given from the study did not have any influence from the researcher. In this study, the researcher does not have any influence on the decisions to collect the given data by the participants of the research and does not even influence the conclusions that have been made. The researcher is not influenced by the research itself through the process of decision making.


  1. Representations for the participants and their voices

It is important that an article provides illustrations of the user data showing the primary conclusions and representations of the participants in the study. This study represents the participants well, and their voices have been well represented. Conclusions have to mind about the participants. The participants here are the radiographers who have for a long time had an issue with too much work and monotony (Moran et al., 2013, 131). The researcher represents their voices in a well-arranged manner. The use of advanced practitioners who are operating within the UK has improved as well as an increased turnaround that has benefited both patients together with the referring doctors. Advanced consultation from the radiographers has also allowed National Health Service breast screening programs to give better reporting for the screenings that take place in mammograms screenings. Various advantages and disadvantages are associated with expanding the functionality of breast screening by radiographers. One of the benefits is the increased skill level that can improve their job satisfaction and raise the bar higher to excellent service delivery for the women who are undergoing screening through mammography. The other advantage raised by the participants is that it may attract and retain younger radiographers to the skills of screening in the field. The main disadvantage realised is that in case the changes are made, it may be difficult to learn from the similarity of the changes. Breast screening processes in Australia have realised double reporting from the inception in the year 1991. Within the last ten years, radiologists in Australia have increased by more than4% as the population increasing by 15% (Moran et al., 2013, 132). The demand for emerging services has also increased by 15%. This is a massive growth in the medical sector that have continuously been oppressed to the demand for replication of the imaging system, especially through screening mammography. The increasing number of women is the main target group for breast screening from the year 1996 onwards. It is also compounded by the historical fact that has made it difficult to retain various radiologists in breast screening programs. This difficulty has made the capacity of the programme to be stretched especially best of the elements of the national standards.

  1. Ethical consideration for an appropriate body

It is important to have ethical approval from an appropriate body especially and statement that shows approvals. The states have to give the most appropriate ethical considerations in research. This research shows ethical considerations, especially those that deal with consent. The researchers set the consent forms to be signed before conducting the research. Also, there is a consideration for the safety of the participants.

  1. Relationship identified inclusion analysis

The relationship between conclusion and analysis is important in research, especially when interpreting the data analysis. It is an area that is concerned with the findings and the views that are represented in the form of a word from the participants. Appraising a paper research work seeks to satisfy the participants through evening conclusions to allow the researcher to make meaning of the collected data. The data should be generated through interviews and other processes and arranged for further analysis. The identified inclusions also address the main theses in the research.

Contributions of the research towards health

This research has massive contributions to health. Radiographers have shown a massive interest in its development just the way it has become widespread within the UK. The advanced screening practice is something that is practised all over the world and has been part of radiography for the last 20 years. This is why the radiographers working in programs such as breasts screening process have been implementing it and performing research on them would help the researcher get their thoughts on the role extension. In this research, the author used the questionnaire that was distributed to the workers within breast screening processes in Australia (Moran et al., 2013, 130). The researchers also used automatic analysis to analyse the responses to the questions to investigate the numerous advantages and possible disadvantages that the participants may have realised in this respect. There have been different changes that these people have realised within the past two decades. When it comes to the methodology, the survey method determined the validity of the responses that were given by the participants. A total of 253 responders in the surveillance to determine the validity of responses. There was a total of 70% of the radiographer in Australia that gives their thoughts about the role of extension. Out of this, 49% gave comments about the changes that have been realised in the workplace. Majority of the responders were concerned about the potential problems that may be realised with the role of extension. The most commonly stated problem by the participants is the need for the mandatory training needed to use it completely and successfully. The training could also be the reasons why some professionals did not succeed in full implementation. The quality of service delivery depended on how skilled the professionals became in their duties that required more training was required for these technological changes to occur successfully (Moran et al., 2013, 131). There was a massive change from what people are used to in the film screening to digital mammography. This was a massive change in qualification and needed massive adjustments by the professionals. However, this is what the field of radiography needed.  There is also high-interest that the researcher realised about the extension of radiographers especially those that were impressed by the screen programs. The provision of voluntary changes in Australia is still in an evolution process, and not many people have adjusted to the new demands. The researcher concluded that this is a new program that has to be implemented fully but is still new to many workers in Australia.


In Conclusion, considering the debates that are ongoing in the healthcare sector about the validity and the reliability of the qualitative research, it is crucial to asses the research o recognise whether it meets the requirement ad the research questions of the researcher.  Qualitative research has to be valid, reliable and objective. They have to remain established to fit the qualitative research designs used. Hence, critical appraisal tools are used to determine these ideas and feats. This paper has used Joanna Briggs ‘critical appraisal checklist for qualitative research’ (2017) to appraise the research about the willingness of the radiographers in Australia to accept the changes that have been brought about by mammography. Critical appraisal used for qualitative is an important step in recognising the application of research interventions and qualitative evidence incorporation. The essential goal of appraisal in this context is to assess whether the study used underlying questions needed by the researcher and whether they are relating to the interventions and they required outcomes of the review. Hence, this research meets the requirements set by the author.







Reference List

Moran, S., Taylor, J.K. and Warren-Forward, H., 2013. Assessment of the willingness of Australian radiographers in mammography to accept new responsibilities in role extension: Part two–qualitative analysis. Radiography19(2), pp.130-136.