Assessing the strengths and
weaknesses of action research
art&science
nursing standard: clinical research education
33-35
Using the web to develop an EN
conversion course 37-40
Introducing non-invasive positive
pressure ventilation 42-45
Assessing the strengths and
weaknesses of action research
Karim K (2001) Assessing the strengths and weaknesses of action research. Nursing Standard.
15, 26, 33-35. Date of acceptance: December 20 2000.
Abstract
Background Proponents of action
research claim that it is not just for
researchers, but helps to empower research
participants to make changes in practice.
This literature review examines some of the
evidence for and against a research
methodology that might still be unfamiliar to
many nurses.
Conclusion Action research often lends itself
to small-scale studies and is time-consuming.
The value of such a methodology is that it
provides a powerful means of improving and
enhancing practice.
T
HE TERM action research was proposed
first by Kurt Lewin in the mid-1940s. It
requires researchers to investigate practical
issues occurring in the everyday social world
(Coolican 1993). The idea was that researchers
would enter a social situation, attempt change
and monitor the results.
Blaxter et al (1996) defined action research as:
... the study of a social situation with a view to
improving the quality of action within it, and
Bowling (1997) described it as a community-
based method that can be used in a variety of
settings including hospitals, health clinics, clubs,
factories and schools.
The method has become increasingly popular
especially in professions that require a hands on
approach, such as education and health and
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Continuing professional development
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Nursing Standards Art&Science
Multiple-choice self-assessment 54
section, visit the website at
Practice profile assessment 55 www.nursing-standard.co.uk
Kelvin Karim BA, BN, RGN,
DipDN, is Community Macmillan
Nurse, Little Bloxwich Day
Hospice, Walsall, West Midlands.
social care, although, as Blaxter et al (1996)
point out, the method can be used by others
including commercial organisations.
Action research cannot be categorised as either
qualitative or quantitative. Indeed, methods
used by both quantitative and qualitative
researchers can be employed. As Webb (1990)
indicates, action research developed as a result
of the limitations of quantitative and qualitative
methods.
The action researcher has a different view of
the world, which is based on critical theory. Crit-
ical theorists, who believe that where there is
imbalance of power between two parties, one
of them will end up being disempowered (Ellis
and Crookes 1998), aim to change the world by Online archive
empowering the subjects of inquiry to bring
about social change. According to Webb For related articles visit our
(1990), traditional approaches to research online archive at:
involve smash and grab the researcher enters www.nursing-standard.co.uk
a situation, grabs the data required and leaves and search using the key
again. The action researcher attempts to work words below.
with participants on an equal basis. Action
researchers act as facilitators and all are integral
to the process. Key words
Decentralising and democratising the research
process are integral aspects of critical theory. In Research methods
professions such as nursing, where research is
often seen as belonging to academics and being These key words are based
far removed from the everyday practicalities of on subject headings from the
clinical practice, this can be an overriding factor British Nursing Index. This
in bridging the theory-practice gap (Wright and article has been subject to
Dolan 1991). double-blind review.
According to Waterman et al (1995), adopting
march
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art&scienceliterature review
nursing standard: clinical research education
Box 1. The strengths of
action research
Educative
Involved with individuals as
members of social groups
Problem-focused,
context-specific and
future-oriented
Involved in change
intervention
Aimed at improvement
and involvement
A cyclic process in which
research, action and
evaluation are interlinked
Founded on a research
relationship in which those
involved are participants in
the change process
(Hart and Bond 1995)
REFERENCES
Argyris C, Schon DA (1991) Participatory
action research and actions science
compared: a commentary. In Whyte
WF (Ed) (1991) Participatory Action
Research. Thousand Oaks CA, Sage.
Baggott R (1994) Health Care in Britain.
London, Macmillan.
Bassey M (1999) Case Study Research in
Educational Settings. Buckingham,
Open University Press.
Blaxter L et al (1996) How to Research.
Buckingham, Open University Press.
Bowling A (1997) Research Methods in
Health. Buckingham, Open University
Press.
Coolican H (1993) Research Methods and
Statistic in Psychology. London,
Hodder and Stoughton.
Department of Health (1998) A First Class
Service: Quality in the New NHS.
London, The Stationery Office.
Duffy ME (1986) Quantitative and
qualitative research: antagonistic or
complementary? Nursing and Health
Care. 8, 6, 356-357.
Ellis L, Crookes P (1998) Philosophical
and theoretical underpinnings of
research. In Crookes P, Davies S (Eds)
Research into Practice. London,
Baillire Tindall.
Endersby C, Oliver R (1994) Teaching and
Assessing Nurses. London, Baillire
Tindall.
Gibbon B, Little V (1995) Improving
stroke care through action research.
Journal of Clinical Nursing. 4, 2,,
93-100.
Hart E, Bond M (1995) Action Research
in Health and Social Care: Guide to
Practice. Buckingham, Open University
Press.
Hunt M (1987) The process of translating
research findings into nursing
practice. Journal of Advanced
Nursing. 12, 1, 101-110.
34 nursing standard
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action research as a method means that research
findings are more likely to be incorporated into
practice. The strengths are outlined in Box 1.
Examples of action research projects include
the introduction of team nursing in an elderly
care ward (Webb 1989); improving the provision
of care to stroke patients (Gibbon and Little 1995);
and the development of a specialist practitioner
role for children in accident and emergency
departments (Jones 1996).
Action research does have weaknesses, partic-
ularly in relation to the relationship between the
researcher and the researched, the scientific
rigour of the method, and constraints on imple-
menting change.
The research relationship
The relationship between the researcher and the
researched might be criticised as being too close.
The researcher might not be able to develop an
objective detachment from participants and data
and, therefore, is likely to compromise his or her
role and potentially introduce bias (Duffy 1986).
Conversely, the very closeness of the researcher
and researched might result in more honest and
valid data. But can action research really deliver
a partnership between researcher and partici-
pant that is empowering and equal?
Often action researchers take an active, critical
and emancipatory stance (Marshall and Rossman
1999). They require certain diplomatic and com-
munication skills to effect change. The action
researcher, therefore, has the capacity to lead
participants in a direction of his or her own
choosing. Leadership styles can appear democ-
ratic while actually being autocratic. In any
case, different leadership strategies are likely to
be used at different times, depending on what
people are seeking to achieve (Endersby and
Oliver 1994).
Research participants skills in leadership and
communication are likely to be less developed
than the researchers and they will have less of
an understanding of the research process itself.
So they will expect the researcher to provide
direction and guidance. Enabling people to
interact might not be too difficult for the
researcher, but all parties must be aware of the
potential for action research participants to be
manipulated for the researchers own ends
under the guise of collaboration, democracy and
empowerment.
Achieving an equal partnership between the
researcher and the participants is potentially
problematic. Trying to empower participants
might not readily translate into practice because
professionals can often feel threatened when their
power base is undermined. Inter-professional
rivalry also often dictates that professionals seek
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to protect their own territory. This is essentially
why empowerment of service users has not
occurred in practice (Malin and Teasdale 1991).
Scientific rigour
Scientific rigour in action research might be less
important to its proponents than the method-
ologys usefulness to participants (Argyris and
Schon 1991). The need to produce immediate
and practical research findings puts pressure on
participants, which might lead them to pay
scant attention to methodological rigour. Rapid
appraisal techniques, such as local interviews
and successive workshops and meetings, are
often set up to elicit views and perceptions and
to formulate a plan of action.
Nevertheless, if done properly, action research
can be a time-consuming process, which is one
disadvantage perceived by critics of the method
(Ellis and Crookes 1998). Critics also argue that
the findings of action research are limited in
their applicability to the local situation and can-
not be generalised across a wider population.
(McDonnell 1998).
Trying to deflect some of this criticism, action
researchers attempt to demonstrate rigour by
triangulating research methods (Bowling 1997).
Validity, however, is not easy to establish. Ellis
and Crookes (1998) suggest that it must be
established through self-validity, participant
validity and peer evaluation.
Implementing change
Action research tends not to take into account the
fact that organisations are composed of a number
of different professions. Change, therefore, can-
not usually be brought about without affecting
other healthcare workers or systems (Hunt 1987).
The objectives of managers and clinicians do
not necessarily converge. Managers who might
wish to introduce unwelcome change will use
the research process and the researcher and par-
ticipants might introduce their own agendas.
Managers can, therefore, encourage researchers
to enter into an area of conflict from which they
can later detach themselves.
Alternatively, managers might be able to use
the research process to appear to be doing
something, when in reality they have set up the
clinical staff to fail.
As Hunt (1987) points out, changing inappro-
priate organisational contexts and resources is
generally beyond the capacity of one individual.
Hunts study explored the process of translating
research findings into nursing practice. One of
the areas identified was in relation to mouth
care. Changing practice in something as basic
to nursing practice as mouth care involved

negotiations with the central sterile supply
department (CSSD) and the supplies department.
Hunt points out that the processes for negotiating
change were cumbersome and time-consuming.
Ward sisters could still choose to ignore policy
decisions, and management systems failed to
ensure that agreed changes were implemented
and maintained.
Being able to effect all but the most minor
changes in practice relates to questions of power
and influence organisational politics. White
(1988) suggests that nurses: ... are still thought
of as being tools by which many policies are
implemented rather than makers or partners in
the making of policy. This is in contrast to the
position of doctors who remain a powerful lobby
within policy-making processes at every level
(Baggott 1994). This is likely to be a function of
the bureaucratic nature of organisations, usually
grounded in the biomedical model, that creates
for nurses what Jolley and Brykczynska (1993)
term constructed powerlessness.
Webbs study (1989) involving the introduction
of team nursing in an elderly care ward, meant
that doctors had to liaise with individually
named nurses regarding individual patients.
Webb describes the consultant as supportive
and that he had accepted that his ward round
would be conducted by team co-ordinators,
rather than the nurse in charge.
However, what would have happened if he
was not supportive and had objected strongly to
change? The change that Webb and her col-
leagues were able to achieve, it is suggested, was
successful because it essentially involved the
nurses themselves, and the medical staff raised
no real objections.
The intractability of others cannot, however,
be grounds for not conducting research. Indeed,
reducing the theory-practice gap is a key feature
of modernising the NHS through the clinical
governance initiatives (DoH 1998). The clinical
governance framework is, in turn, underpinned
by evidence-based clinical practice, defined by
Muir Gray (1997) as: ... an approach to deci-
sion-making in which the clinician uses the best
evidence available, in consultation with the
patient, to decide upon the option which suits
that patient best.
Evidence-based clinical practice requires practi-
tioners to think about practice in a constructively
critical manner by reviewing the best evidence to
inform the process of change. Meyer (1999)
argues that action research, by dealing in the
reality of practice, is more likely to represent the
truth as compared to other research methods.
Action research is, therefore, particularly suited
to the development of solutions to improve
practice (Hart and Bond 1995).
Meyers systematic review of the literature
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art&scienceliterature review
nursing standard: clinical research education
(1999) revealed 333 references to studies that
indicated an action research approach from the
mid-1980s to the mid-1990s. Of these, 131 were
categorised as related to change in healthcare
practice, and the remainder to changing health-
care education, changing occupational healthcare
practice or changing public health practices.
Just over half of the studies reported positive
changes that occurred through action research.
Clearly, action research can be a powerful tool
for change.
Conclusion
Action research has a great many strengths. The
research process might be made relevant and
responsive to the needs of researchers, participants
and the world of work. It provides a powerful
means of improving and enhancing practice as
well as bridging the theory-practice gap.
Action research also has its weaknesses.
Methodologically, it might be difficult and time-
consuming. Researchers and participants need
to approach the method carefully and ask search- Jolley M, Brykczynska G (1993) Nursing:
Its Hidden Agenda. London, Edward
ing questions about whose agenda is really being
Arnold.
addressed. They must also be transparent about Jones S (1996) An action research
the limitations of their research when presenting investigation into the feasibility of
experienced registered sick childrens
the findings.
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