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Can nursing epistemology embrace p-values?

Christine H K Ou1, Wendy A Hall1, Sally E Thorne1

  • 1School of Nursing, University of British Columbia, Vancouver, BC, Canada.

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|February 16, 2017
PubMed
Summary

This study critically examines the uncritical use of probability values (p-values) in nursing and health care evidence. It argues for a deeper reflection on statistical significance testing

Keywords:
evidence-based practicenull hypothesis significance testingnursing disciplinenursing epistemologyp-values

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Area of Science:

  • Nursing Research
  • Health Sciences
  • Statistical Methodology

Background:

  • Correlational probability values (p-values) are widely accepted in nursing and health care for evidence evaluation.
  • Significance testing, rooted in the natural science paradigm, is uncritically adopted in evidence-based practice.
  • Nursing's engagement with the controversies surrounding significance testing as evidence has been limited.

Purpose of the Study:

  • To critically examine the entrenchment of p-values as the gold standard for scientific knowledge in the postpositivist paradigm.
  • To explore the reasons behind the uncritical adherence to significance testing in nursing and health care.
  • To advocate for a critical reflection on the limitations of p-values within nursing epistemology.

Main Methods:

  • Qualitative analysis of the role of statistical significance testing in evidence-based practice.
  • Examination of the historical and philosophical underpinnings of p-value usage in scientific research.
  • Literature review focusing on the debate surrounding statistical evidence in health and social sciences.

Main Results:

  • P-values have become an entrenched, yet uncritically accepted, mechanism for evaluating evidence in nursing and health care.
  • The reliance on significance testing overlooks the complex and contextual factors inherent to nursing epistemology.
  • Nursing has not sufficiently participated in the broader scientific discourse on the evidentiary value of p-values.

Conclusions:

  • Nursing must critically reflect on the limitations of p-values as a measure of evidence.
  • Rethinking the reliance on significance testing is crucial for advancing nursing knowledge.
  • A more nuanced understanding of evidence is needed, considering nursing's unique epistemological landscape.