Critical Appraisal

1) Study validity:

  Study question:

It’s well defined and can be answered using the RCT study.


The students were randomized to intervention and control groups by a method that ensured   that the assignment was random.(tossing a coin )

The randomization list was concealed from students, teachers and researchers.

The students in groups were similar at start of the study as pointed out by the authors in the participants and method section.


Students and researchers were not blinded to the intervention.


Were all patients accounted for at end of the study?

  No. -

If not, how many patients were lost to follow-up and for what reasons?

21 students declined to participate in data collection   - and reasons were not stated.

Were the students analyzed in the groups they originally were randomized to?

    - Yes.

Interventions   and co-interventions:

Were the interventions described in sufficient detail to be repeatable by others?

Yes, in the participant and methods section.

Were the two groups cared for in a similar way except for the study intervention?

Yes, they were.

  1) Results :

Selection of outcomes:

    Does the article report all relevant outcomes including side effects?

      - No, it just reported the outcomes in the results section without side effects.

Effect size:

    Was there a difference between the outcomes of the treatments,         and how big was it?

    -   No, there was no difference.

    How reliable is the estimate: what are the confidence   intervals?

      - Table 4.

3) Applicability:

  Using results in your own setting:

Are your patients so different from those studied that the   results may not apply to them?

- They might be same and it could be revealed by doing   researches.

Is your working environment so different from the one in the   study that the methods could not be used there?