CHC Evidence-Based Practice & Research Methods 5 — Questions and Answers
Question 1: In healthcare construction, 'evidence-based design' (EBD) is best defined as:
- Designing only to the minimum requirements of the FGI Guidelines
- The deliberate use of credible research to influence the design of the healthcare environment to achieve the best possible outcomes (Correct answer)
- Using computer-aided design software for all project drawings
- Applying value engineering principles to reduce project costs
Correct answer: The deliberate use of credible research to influence the design of the healthcare environment to achieve the best possible outcomes
EBD intentionally incorporates the best available research evidence to make design decisions that improve measurable patient, staff, and organizational outcomes.
Question 2: Which of the following sampling methods would yield the most representative data when studying patient wayfinding challenges across multiple hospital types?
- Convenience sampling from one urban academic medical center
- Stratified random sampling across hospital size, type, and geographic region (Correct answer)
- Purposive sampling of only facilities that have reported wayfinding complaints
- Snowball sampling starting from a single patient advocacy group
Correct answer: Stratified random sampling across hospital size, type, and geographic region
Stratified random sampling ensures proportional representation across key subgroups, reducing selection bias and improving generalizability.
Question 3: A CHC professional reviewing a study finds a p-value of 0.03 for a design intervention's effect on HCAI rates. This means:
- There is a 3% probability the intervention caused the outcome
- There is a 97% chance the study hypothesis is correct
- There is a 3% probability of observing the data (or more extreme) if the null hypothesis were true (Correct answer)
- The intervention reduces HCAI by 3%
Correct answer: There is a 3% probability of observing the data (or more extreme) if the null hypothesis were true
A p-value represents the probability of obtaining the observed results by chance alone if there were truly no effect, not the probability the hypothesis is true.
Question 4: When the CHC exam references 'grey literature,' this typically includes:
- Peer-reviewed journal articles with inconclusive results
- Reports, guidelines, and technical documents not published through commercial academic channels (Correct answer)
- Outdated construction standards no longer in use
- Preliminary architectural sketches and concept drawings
Correct answer: Reports, guidelines, and technical documents not published through commercial academic channels
Grey literature includes government reports, technical white papers, conference proceedings, and organizational guidelines that fall outside formal peer-reviewed publishing.
Question 5: A healthcare construction team wants to implement a 'Plan-Do-Study-Act' (PDSA) cycle to test a new hand hygiene station placement strategy. In the 'Study' phase, the team should:
- Identify the problem and set improvement goals
- Implement the new station placement on a pilot unit
- Analyze data collected during the trial to determine if the change achieved the desired result (Correct answer)
- Standardize the intervention across all units if successful
Correct answer: Analyze data collected during the trial to determine if the change achieved the desired result
The 'Study' phase of PDSA involves reviewing and analyzing data from the pilot to determine whether the intervention produced the intended improvement.
Question 6: Which element of a research study's design most directly addresses 'internal validity'?
- The breadth of the literature review included in the introduction
- Controls for confounding variables through randomization or statistical adjustment (Correct answer)
- The number of facilities included in the study sample
- The publishing journal's impact factor
Correct answer: Controls for confounding variables through randomization or statistical adjustment
Internal validity is the degree to which a study's results accurately reflect the true effect of the intervention, primarily protected by controlling confounders.
Question 7: Under the Center for Health Design's Pebble Project model, participating healthcare organizations contribute to the evidence base by:
- Funding academic university research departments exclusively
- Conducting and sharing post-occupancy research on their own facility projects to build collective industry knowledge (Correct answer)
- Submitting construction defect reports to regulatory agencies
- Providing design-build services to other member hospitals
Correct answer: Conducting and sharing post-occupancy research on their own facility projects to build collective industry knowledge
Pebble Project members conduct and publish their own facility research, collectively building a shared, real-world evidence base for healthcare design decisions.
CHC Evidence-Based Practice & Research Methods 5
In healthcare construction, 'evidence-based design' (EBD) is best defined as: