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Richard.Jewell.net |
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Sample Critical Reviews by Students |
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See also the following online sample papers:
Critical Response: Harvard
Critical Review: Wisconsin
Critique: Rensselaer
The samples below are papers by students, unless specifically noted. They are examples of "A" level undergraduate writing or entry-level professional work. To get a better idea of how this type of paper is written, you will want to look at all the samples. Then compare the samples to each other and to what the "Basics" part of this chapter says.
The authors of all sample student papers in this Web site have given their permission in writing to have their work included in CollegeWriting.info. All such samples remain copyrighted by their original authors.
Unless otherwise noted, sample papers do not necessarily meet all requirements
an individual instructor or work supervisor may have. In addition, they are
single spaced, whereas a proper manuscript given to an instructor or
supervisor normally should be double spaced unless another format has been
requested.
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Sample One: Basic Review of a Book |
SPECIAL NOTES: This short, rough-draft critical review examines only a book that is a story-like, book-length essay. It has no other sources.
Inver Hills College
Rough-draft Critical Review
Eng 1114-91, Spring 2006
© 2006 by Laura Beres
A Critical Review of Man’s Search for Meaning
by
Laura Beres
Introduction
In Man’s Search for Meaning,
Viktor E. Frankl tells the very personal story of his experience as a prisoner
in a concentration camp during the Holocaust.
He presents this story in the form of an essay in which he shares his
arguments and analysis as a doctor and psychologist as well as a former
prisoner. This paper will review
Frankl’s story as well as his main arguments, and will evaluate the quality of
Frankl’s writing and focus on any areas of weakness within the story.
Summary
This section contains a summary of Frankl’s book, Man’s Search for
Meaning. Frankl begins his book
by stating that his purpose in writing the book is not to present facts and
details of the Holocaust, but to provide a personal account of the everyday life
of a prisoner living in a concentration camp.
He states, “This tale is not concerned with the great horrors, which
have already been described often enough (though less often believed), but…it
will try to answer this question: How
was everyday life in a concentration camp reflected in the mind of the average
prisoner?” (21). Frankl then goes
on to describe the three stages of a prisoner’s psychological reactions to
being held captive in a concentration camp.
The first phase, which occurs just after the prisoner is admitted to the
camp, is shock. The second phase,
occurring once the prisoner has fallen into a routine within the camp, is one of
apathy, or “the blunting of the emotions and the feeling that one could not
anymore” (42). The third phase,
which occurs after the prisoner has been liberated from the camp, is a period of
“depersonalization”, in which “everything appears unreal, unlikely, as in
a dream” (110). In this phase,
released prisoners also feel a sense of “bitterness and disillusionment”
when returning to their former lives (113).
Frankl describes each of these phases using psychological theory and
provides personal experiences to exemplify each of the stages.
Author’s
Arguments
As described above, Frankl’s main purpose for writing this book is to
present and analyze the average prisoner’s psychological reactions to the
everyday life of a concentration camp. His
three main arguments are his presentation and analysis of each of the
psychological stages that the average concentration camp prisoner experiences:
shock, apathy and depersonalization.
He bases his analyses of each of these stages on the actions of the
prisoners and his own personal thoughts and reactions as he experienced life in
a concentration camp.
For
example, Frankl argues that the second phase of apathy forces “the
prisoner’s life down to a primitive level” (47) in which “all efforts and
all emotions were centered on one task: preserving
one’s own life and that of the other fellow” (47).
He bases this theory on events he witnessed while living in the camp
himself, and states, “It was natural that the desire for food was the major
primitive instinct around which mental life centered.
Let us observe the majority of prisoners when they happened to work near
each other and were, for once, not closely watched.
They would immediately start discussing food” (48).
Frankl continuously uses examples from his experiences in the
concentration camp to illustrate and strengthen his psychological arguments
throughout the text.
Evaluation
This section contains an evaluation of Frankl’s book.
Firstly, the author is a survivor of the Holocaust and was a prisoner of
a concentration camp himself, which gives him the personal insight to be able to
comment on the psychological conditions of an average prisoner.
However, this also creates a bias and because of his personal experience,
he is unable to be entirely objective in writing his analysis.
Frankl acknowledges this bias in the beginning of his book, by stating,
“Only the man inside knows. His
judgments may not be objective, his evaluations may be out of proportion.
This is inevitable. An
attempt must be made to avoid any personal bias, and that is the real difficulty
of a book of this kind” (24-25). Although
he is aware of this bias, it creates a partiality that will sway the readers
throughout his story and it serves as a minor weakness in his writing style.
A second weakness in Frankl’s writing is in the assumptions he
sometimes makes to prove his point. He
makes overarching generalizations several times in his book, making statements
that, although may have been true for himself and those around him, might not
have been true for every prisoner in every concentration camp during the
Holocaust. For example, in one
instance, he says, “The prisoner of
Finally, Frankl sometimes becomes too technical and verbose in his
writing style, which makes it very hard for the average reader to understand.
One example of this is as follows. Frankl
states, “I remember an incident when there was an occasion for
psychotherapeutic work on the inmates of a whole hut, due to an intensification
of their receptiveness because of a certain external situation” (102).
This sentence, which is overly wordy and complicated, makes it difficult
for the average reader to understand exactly what he is saying.
A reader can easily get frustrated when trying to decipher the author’s
meaning due to overly complicated language, and this is a third weakness of
Frankl’s writing.
Conclusion
This critical review has evaluated the book Man’s Search for Meaning,
by Viktor E. Frankl. The
psychological theories that Frankl presents are very interesting and he does a
good job of illustrating these theories with his own personal experiences.
However, his writing is weakened by the presence of bias, the overarching
assumptions he occasionally makes, and his sometimes overly technical and
verbose language.
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Sample
Two: Basic Review of an Article/Essay |
SPECIAL NOTES: This short, rough-draft critical review examines only one short, argumentative essay and has no other sources.
University of Minnesota
Eng 3027, Advanced Expository Writing
Critical Review
© 2001 by Petter Woll
Review of "Condom use will increase the spread of
AIDS"
by
Petter Woll
Introduction
The use of condoms to prevent unwanted pregnancies and, even more important, the spread of sexual transmitted diseases (STDs) has been controversial. This critical review examines an article that links condom usage to the spread of AIDS. The article, "Condom use will increase the spread of AIDS," was written by Anthony Zimmerman, a Catholic priest. As the title of the article indicates, the author is against the use of condoms to prevent the spread of AIDS and other STDs. In fact, he claims that teaching children how to use condoms will eventually increase the spread of AIDS. Although the author has some good points, his article is biased and contains some misinterpretation of data from others’ analysis of the effectiveness of the condom.
Summary
This sections contains a summary of the article "Condom use will increase the spread of AIDS." In his introduction, Zimmerman says that condom usage "may break its [AIDS] spread in the short run; but accelerates its spread in the long run" (p. 111). He bases his conclusion on an analysis done for the World Health Organization (WHO) published in Population Reports. The results from this analysis indicated that condoms users have a one-third lower risk for acquiring STDs compared to non-condom users. This, however, provides small comfort for the author. He says that using a condom is like playing Russian roulette.
There are two reasons why condom usage will increase the spread of AIDS. Firstly, the promotion of condoms by the authorities, like teachers and health workers, increases sexual promiscuousity. This leads to miseducation of adolescents, breaking down their natural and cultural barriers against sex before marriage. Secondly, condom usage promotes a false sense of security and a pseudo-responsibility.
According to the author, the most prevalent HIV virus is the one that spreads more easily through sodomitic (anal) intercourse among homosexual men. However, if today’s trend continues, the African type, which spreads through heterosexual intercourse, "may strike our schools like the atom bombs which devastated Nagasaki and Hiroshima" (p.113).
In his conclusion, the author draws parallels to the Black Death that haunted Europe during the fourteenth century. This is the scenario he pictures if schools promote sexual education. It is already happening in Uganda, he says, where AIDS is endemic.
Arguments
This section looks into the author’s arguments and what these arguments mean to the general population. In addition, counterarguments from the public and professional spheres are contrasted with those of the author.
AUTHOR’S ARGUMENTS AND IMPLICATIONS
The main purpose for the article written by Zimmerman is to abolish the promotion of condom use in the society. He argues for this by saying that promotion of condom use will increase the spread of AIDS. According to the author, there are two reasons for this. One is that the promotion of condom usage will increase sexual immorality: that is, more sex before marriage. If people are more frequently exposed to sex, they will have sex earlier in adolescence, compared to if they are exposed less frequently. Exposure increases the risk of acquiring HIV and, thus, developing AIDS. The other reason why condom usage will increase the spread of AIDS is that it leads to a false sense of security and something the author calls pseudo-responsibility. People, he says, who promote condom usage advertise condoms as reducing the risk of transmitting HIV. This, according to the author, misleads ordinarily people to think that all sex is safe, and therefore it increases their sexual behavior.
The implication of the author’s arguments is that to reduce the spread of AIDS and avoid a future catastrophe having the same devastating effects as the black plague in Europe on the 14th century, promotion of condom use must be stopped.
CONTRASTING OPINIONS
Zimmerman has a very moralistic view on sexuality that is not compatible with the public’s view. The trend today is that young people start having sex earlier than before. Also, there are few people who wait to have sex until they are married. This trend was illustrated by the controversial movie, "Kids," made by a sixteen-year-old American boy, which has been highly debated by health workers.
The view on condoms in the sphere of public health is that they are our best means of reducing the spread of sexual transmitted infections like HIV. In one study that looked at the transmission rate among heterosexual partners with one partner infected by HIV, among the 123 couples that consistently used condoms, none of the partners became infected, whereas 12 of the 122 who didn’t consistently use condoms became infected.
For optimum effect in using a condom, correct use and storage is a necessity. Therefore, health workers travel around to schools to teach adolescents to use condoms correctly. This method belongs to the principles of harm reduction, which says: "You should not use, but if you do…." Several studies have confirmed that up to the present time, this is the most effective method for preventing the spread of STDs. Some people go as far as to say that condoms should be made as common as toothpaste and toilet paper, in order to protect us against infections.
Evaluation
This section contains an evaluation of the article. Firstly, the author’s arguments appear to be biased towards his Christian beliefs. He is a Catholic priest and has a very moralistic view of sex. In his opinion, sex before marriage is immoral. A minority in the American population would support this kind of view. His views on sexuality are, in short, not consistent with current views within the population. Furthermore, he shows prejudice against homosexuals and Africans. He holds these two groups as the source of the HIV virus. The fact that the virus is more prevalent in these two groups does not mean that they are the source of the spread. In his article he says that "the ghetto of sodomites is going into extinction, and that could lead to the extinction of AIDS." This is an extremely prejudiced statement, and it has parallels to Hitler’s statements about Jews: if we eliminate all the homosexuals, we can get rid of AIDS.
Another negative point about this article is that it is very argumentative with little support. The author throws out statements, giving no evidence or supporting details for them. This is bad writing, and the author loses his creditability.
Finally, he misinterprets information from other data and gives the wrong information or only parts of the truth. The data from the analysis done for the WHO indicate that condoms significantly decrease the risk of transmitting HIV. However, Zimmerman overlooks this, and instead interprets it to show that condoms increase the spread of HIV. Furthermore, he refers to the endemic situation in Uganda, and claims that this is the situation we are going to experience in the future if the promotion of condoms continues. What he fails to mention is that the situation in Uganda could have been avoided with the promotion of condoms. The number one cause of the spread of HIV is unprotected sex, and with the correct use of condoms, the spread can effectively be reduced.
Conclusion
This critical review has evaluated the article "Condom use will increase the spread of AIDS" by Anthony Zimmerman. The arguments in the article show the presence of bias, prejudice, argumentative writing without supporting details, and misinformation. These points weaken the author’s arguments and reduce his credibility.
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Sample Three: Critical Review with Research |
SPECIAL NOTES: This critical review examines three essays and has additional sources.
University of Minnesota
Eng 3027,
A Critical Review of Three Articles on
Music and Feminist Pedagogy
by
Sarah Pearson
Introduction
The importance of feminism in music has come to the forefront in many colleges and universities. However, for several reasons, one of which is that scholars hold differing views on the relevancy and appropriateness of feminism in the musical realm, feminism has not been included as quickly in music as in other fields. Neuls-Bates offers another reason for this lack of speed: "The discipline of women's studies has been slower to develop in the field of music . . . mainly because of the necessary, time-consuming tasks involved in obtaining performances of composer's works" (265). In other words, music is slow to incorporate women’s studies because of the intense effort required to change an already well-respected, dependable curriculum. This critical review will examine three different articles on this issue and evaluate their contents based on a set of criteria. Each of the articles, published in College Music Symposium, is written from a feminist viewpoint. The authors discuss the importance of including a feminist curriculum within the college setting, noting the positive benefits of using it in the classroom. Their main argument is that not enough of this type of teaching is being used in conservatories. One article is well written with supporting details and potential solutions, while the other two include only general observations and offer no solutions.
Background
Some background about this issue is useful. Prior to the 1970’s, white middle- and upper- class males dominated colleges. Because of this, women’s issues often were ignored. In the early 1970's, joint efforts were made by women across the country to try to persuade colleges and universities to incorporate women’s issues into their curriculum. They felt that this incorporation would fill a vacancy for women attempting to earn a degree. Many people believed that exploring the numerous ways women helped to shape society would result in higher self-esteem among women and give them a better understanding of the world. Slowly the schools began implementing programs for women and started using textbooks that focused more attention on women’s achievements in particular fields. Currently many departments within colleges have at least a small part of their curriculum devoted to women. Feminists spent countless hours convincing departments to add these issues. It has particularly been a struggle for both feminists and music departments to agree on what subjects should or should not be included in an already well-established field.
Summary
A summary of the articles shows that the first one, "Feminist Scholarship and the Field of Musicology: I" by Jane M. Bowers, discusses the issues of feminism and its place in music. Published in College Music Symposium, this article focuses on the subject of music history. Bowers argues that the "great" male composers dominate music history, and almost nothing is said about women composers. That music history lacks a feminist viewpoint is not surprising, she argues, as nearly all the disciplines in the arts have little emphasis on women’s issues. One reason for the void is that many scholars have felt that it was not suitable to incorporate women’s issues into their particular field. According to Bowers, "[T]he scope of musicology is . . . not defined by lived social realities, and hence its purview, like those of philosophy and literature, is similarly less suited to the incorporation of women . . ." (83). She believes this presents a dilemma to feminists, who must now explain why women’s studies are relevant to music. Bowers goes on to discuss historical ideas about women and their function in music. She cites recent discoveries about the influence of women musicians in the nineteenth century. In her conclusion she restates the argument that there is a lack of research and studies being done on women in music. She suggests searching for ways to emphasize women’s compositions by focusing on the differences between men and women’s compositional styles, and looking at the instrumental music of women.
The second article, "Women, Women's Studies, Music and Musicology: Issues of Pedagogy and Scholarship" by Susan Cook, also focuses on the importance of including women in research. Also published in College Music Symposium, this article contends that women's studies need to be included in more music courses. Because of a lack of research of women in music, teachers are unable to integrate the subject into their curriculum. Even with some research available, professors are unsure how to use it. According to Woods, whom Cook quotes, "We continue to operate within a conservative methodology, whether compensatory or contributory, that is not necessarily feminist and not specifically female. Rather it tends to relate and relocate women to the accepted canon of great artists and great works" (95). Instead of incorporating women into the canon, Cook believes professors are pushing them to the fringes, including them only when time will allow. Cook then mentions numerous studies done recently that have helped advance feminist ideas in the classroom. She feels this is a start, but much more research is needed in order to push professors into using the information in their lectures.
Cook also discusses ways in which feminism has changed teaching styles. She believes the traditional lecture has begun to give way to an open forum, with the teacher leading the discussion. There is also an emphasis on equality in all classroom situations: for example, teachers offer students more freedom concerning grades, class management, and lecture (98).
The third article, also published in College Music Symposium, is "Application of Feminist Pedagogy: An Introduction to the Issues" by Barbara Coeyman. It looks at ways of incorporating feminism into the current curriculum. Unlike in the first two articles, the author does not emphasize research and its importance to changing the curriculum; rather, she focuses on possible outcomes if feminism is applied in the classroom. Her main argument is that the current music curriculum can be enhanced and can lead to an enlightened classroom if feminism is applied.
Throughout the article, Coeyman attempts to justify feminist pedagogy by contrasting it to traditional teaching. She argues that "[traditional teaching] emphasizes formal constructions, static content, and context-free artistic creation" (77), whereas feminist pedagogy emphasizes students' creativity and encourages professors to become more involved in the actual learning process. Coeyman further promotes feminist pedagogy by discussing its four main principles, which, according to her, include diversity, a voice for everyone, responsibility, and application to real life situations. She suggests several ways of applying these ideas through personalizing classroom lectures, including women composers in the canon, and allowing students to "learn by doing" ( 83).
Analysis of Arguments
All three of these articles contain similar arguments about feminism and music education. First, the authors believe that more feminist issues need to be incorporated into music classes. Second, they imply that a music student’s education is not wholly complete without the feminist viewpoint. Lastly, Cook and Coeyman argue that feminist pedagogy can unite students and faculty inside and outside of the classroom.
More in Curriculum
First, each author states that music courses do not emphasize women’s issues enough and need to begin incorporating more into the curriculum. Bowers states, "If more than scant attention were paid to the interaction of music history with social history, as well as to the attempt to include music as an aspect of and in relation to culture in the large-areas which are virtually neglected within musicology-women would also become a more relevant subject for study" (84). By this statement Bowers shows her belief that feminist ideas could be incorporated into music curriculum if scholars would exert a little more effort. Both Cook and Coeyman agree with Bowers that most music courses do not place enough emphasis on women. The main argument among instructors is that there is not enough research available to be able to add it to the curriculum. However, according to others such as Neuls-Bates, "[A]t the present time there are quite sufficient materials to implement courses about women in music . . ." (Zaimont 265). Thus the authors' arguments in this regard have some validity.
Complete Education
Second, the authors imply that a student's education is not complete without the
feminist viewpoint. While neither directly state this, both Cook and Coeyman allude to
this idea. Cook closes her article by stating that feminist pedagogy can add to the
overall musical experience (98). Coeyman follows the same lines by stating that including
feminism in the classroom can inspire both students and faculty and can benefit the
overall person (77, 85).
Bowers, unlike the first two, does not focus on the education aspect, yet she promotes
this idea through her constant emphasis on continued research of women. Commenting on a
survey of articles focusing on women, she states, "Their central concern was the
degree to which research on women had achieved a place in the mainstream of the
disciplines where it had previously been absent" (81). This statement and numerous
others throughout the article show her belief that research is important and can improve
the overall education of a person. All of these authors argue fervently that feminist
ideas can enhance music students' education, though none offer any evidence that this is
true.
Unity of Students and Faculty
Lastly, the articles by Cook and Coeyman offer the idea that feminist pedagogy can unite students and faculty. They both propose this through discussion of alternative classroom teaching techniques. Cook suggests that a more nontraditional lecture format can provide an encouraging atmosphere in which students can learn. She states that nontraditional teachers can " help all students to find their own answers and give birth to their own ideas" (97). Thus she is arguing that if teachers use feminist methods, they will stimulate students to think for themselves and producing better communication in the classroom. Coeyman also argues that letting students become more involved in the classroom allows for better communication between the professor and student, creating a feeling of shared power (83), again a feminist method. By emphasizing these and other feminist methods, such as a relaxed, non-threatening classroom experience, these authors promote the belief that feminist pedagogy can bring the professor and student together.
Evaluation
Although all of these articles offer well-supported arguments, they also have weaknesses. At times some of them appear to lack solid solutions to the problem, tend to show bias towards the feminist viewpoint, and may exaggerate the oppression of women composers in music.
Lack of Solid Solutions
A lack of solid solutions appears to exist in Bowers' and Cook's articles. Bowers, in particular, fails to offer a solid solution as to how to incorporate more feminist issues into the music history curriculum. While she suggests alternatives to research within music, she omits discussing solutions to changes in the current curriculum. Like Bowers, Cook also neglects to provide any solutions to the problem. She focuses on the differences between traditional teaching and feminist pedagogy, discussing possible types of alternative teaching methods. Though she notes that change is necessary, she fails to offer suggestions as to how these changes could be integrated into the classroom (98). In contrast to the first two articles, Coeyman does focus on possible ways to begin incorporating feminism into music courses. She suggests using women's compositions during lessons, offering non-musical courses that can amplify students' music classes, and giving students a larger voice in how a class is run (83-84). Combined with some aspects of traditional teaching, these methods could help enhance music students' education.
Bias
All three articles are also infused with a bias towards feminism. In her article, Bowers portrays this bias when she states, "However inadvertent the neglect of women ensuing from these patterns of musicological research, the result has perpetuated the myth of female insignificance" (83). Her use of the words "neglect" and "female insignificance" show her strong feelings about feminist issues. Cook and Coeyman use this same type of wording in their articles, but also show their bias through ignoring the positives of traditional teaching. They comment only on the negative aspects, making their suggestions seem more valid. Coeyman especially uses this tactic when she describes ways to change traditional lecturing. For instance, as quoted before, she labels traditional studies as "static," "context-free," and "dictatorial" (77). By using these terms she degrades standard teaching and enhances her own ideas about alternative methods.
Exaggeration
Each author also exaggerates the oppression of women musicians in the nineteenth century. First, Bowers continually comments on her belief that women musicians have not been treated fairly throughout history. She states, "Further, women's compositions were frequently reviewed in gender-biased ways, and overt discrimination . . . was used against women who tried to enter male domains" (87). This statement is only partly true. Clara Schumann was one example of a woman who composed and performed across Europe. According to Green, "Clara Schumann . . . was the acknowledged peer of the top male performers of the day" (60). Many other women musicians were also well-respected in the music field such as Fanny Mendelssohn, Cecile and Natalie Chaminade, Amy Beach, and Sofia Gubaidulina. Bowers fails to acknowledge the impact these women had on music and ignores the freedom they had in performing and composing.
Cook and Coeyman do not directly exaggerate the oppression, but they often allude to it. Cook comments on continued open hostility to women's studies programs in higher education, while Coeyman describes the field of music as a white male- dominated scene (Cook 93; Coeyman 75). While neither openly state it as Bowers does, they still assume that all women were excluded from music and have just recently begun to be accepted. Contrary to this, in recent years many universities have felt it imperative to include women’s studies in their curriculum. According to the College Music Society, for example, "To combat the trend toward tunnel vision [in music] and to ensue that students and faculty integrate knowledge from various disciplines, educational requirements need to be expanded and reinvigorated" (6). Contrary to Cook and Coeyman’s beliefs, many music departments have realized their curricula need to include more than just one race or gender’s point of view.
Conclusion
This critical review has considered three different
articles. Each article focuses
on the issue of feminism and its place in the college music setting. Bowers and Cook look
at the research aspects, observing that a lack of research inhibits inclusion of women in
the classroom. Coeyman concentrates on the importance of including women in history
lectures and offers suggestions for alternative teaching methods. While all three articles
are well written, they fail to discuss the benefits of traditional teaching, focusing only
on the positives of feminism. They believe feminism will foster growth in the education of
many students. According to Ropers-Huilman, "[F]eminist teaching provides options for
teachers and administrators as they seek to educate and encourage respectful communities
grounded in difference" (19). However true this may be, to say that this
will only happen by using a feminist pedagogy is one-sided, and this
one-sidedness is
evident in the arguments of all three authors’ articles. Their arguments insinuate that
feminist teaching is the only solution to improving a music school’s curriculum. This
misleads the reader and focuses the attention on feminism while ignoring all other
viewpoints.
Works Cited
Bowers, Jane M. "Feminist
Scholarship and the Field of Musicology: I." College Music Symposium
29 (1989): 81-92.
Coeyman, Barbara.
"Applications of Feminist Pedagogy to the College Music Major Curriculum:
An Introduction to the Issues." College Music Symposium 36
(1996): 73-90.
College Music Society. Music in
the Undergraduate Curriculum: A Reassessment.
Cook, Susan C. "Women,
Women’s Studies, Music and Musicology: Issues of Pedagogy and
Scholarship." College Music Symposium 29 (1989): 93-100.
Green, Lucy. Music, Gender,
Education.
Neuls-Bates, Carol. "Creating
a College Curriculum for the Study of Women in Music." The Musical
Woman: An International Perspective. Ed. Judith Lang Zaimont.
Ropers-Huilman, Becky. Feminist
Teaching in Theory and Practice.
Additional Sources
Banner, Lois. Women in Modern America: A Brief History. 2nd ed. Orlando: Harcourt Brace Jovanovich, 1984.
Kimball, Roger. Tenured Radicals. New, York: Harper & Row, 1998.
Langer, Cassandra. A Feminist Critique. New York: Harper Collins, 1996.
Levine, Lawrence. The Opening of the American Mind. Boston: Beacon Press, 1996.
Mark, Michael L. Contemporary Music Education. 3rd ed. New York: Simon & Schuster Macmillan, 1996.
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Sample
Four: Scientific Critical Review with Research
SPECIAL NOTES: This is a scientific critical review of six articles and has an additional source. Please note that it uses CBE documentation and citation (the name-and-year method). The bibliography at the end would, in a normal manuscript, start on a separate page. The paper also uses underlining, bold marking, and the use of brackets to show various elements of organization.
This paper contains highly scientific language: a "rhizotomy" is a surgical procedure in which the spinal nerve roots are cut. If you have not taken advanced courses in the paper's subject area, you may wish, instead, to simply skim the paper by reading the first sentence or two of each paragraph. Note: the content of this paper has not been checked for accuracy; however, the organization, style, and overall presentation are of high quality.
University of Minnesota
Eng 3027, Writing in the Health Sciences
Critical Review
© 1997 by Susan Toyli
A Critical Review of Six Articles on Selective Dorsal Rhizotomies
by
Susan Toyli
Introduction
This paper reviews [type of paper] six articles on the use of selective dorsal rhizotomies (SDR) in children with cerebral palsy [subject]. Doctors began performing rhizotomies "for the relief of spasticity in 1913" (Marty, Nishida, & Thatcher 1995, p 374). Although this procedure has existed for nearly one hundred years, it has just recently become a treatment for children with spastic cerebral palsy. The six articles here reviewed deal with selective dorsal rhizotomies. The information within these articles falls under the general categories of procedure, results, discussion, and consequences [summary of first body section]. The main argument in each of these articles is that children with spastic cerebral palsy should undergo rhizotomies to alleviate their spasticity [summary of second body section]. Three of the articles have well presented arguments, while the other three set forth arguments that appear weak because of biased presentations [summary of third body section]. Dorsal rhizotomies are currently the subject of intense interest because they relieve spasticity in children with cerebral palsy, but can also have many adverse side effects [purpose or reason for this paper]. Although some side effects do exist, it would appear that dorsal rhizotomies effectively relieve spasticity and improve ambulation in children with spastic cerebral palsy [author’s final conclusion].
Summaries
The six articles [transition phrase repeated in all three body sections] here reviewed all contain information that falls under the four general categories of procedure, results, discussion, and consequences [topic sentence]. Although the articles do not necessarily contain all of these sections, each one does possess at least one of these categories.
The articles "Selective posterior rhizotomy: experience of 30 cases" by Marcelo Garcia Erro, Nestor Vallejos Meana, and Edgardo Schijman (1993) and "Selective posterior rhizotomy for children with cerebral palsy: a 7 year experience" by Gerard R. Marty, Takashi Nishida, and Steven W. Thatcher (1995) both describe the surgical procedure followed during a dorsal rhizotomy. According to these articles, before rhizotomies are performed, children undergo a preoperative evaluation. If the child’s spasticity can be alleviated by this procedure, the rhizotomy is performed. Because rhizotomies involve the rootlets of nerves, the surgery begins with a laminectomy (Marty et al. 1995, p 375). According to Marty et al., "Limited laminectomy is performed with preservation of the facet joints and the dura is opened to the midline." After the laminectomy, surgeons inspect the rootlets and use an intraoperative technique to locate abnormal nerves. The abnormal sensory root is then "separated into its component rootlets." After this separation, the dura mater of the spinal cord is closed, and the rhizotomy is complete.
In addition to describing the surgical procedure followed during a rhizotomy, many of the articles also describe the procedures and evaluation methods on which their experiments are based. Five of the articles evaluate the level of functional improvement in specific areas of children’s lives. Two articles in particular, "Foot Contact Pattern following Selective Dorsal Rhizotomy" by Janet Adams, Lauren M. Beller, Leslie D. Cahan, and Jacqueline Perry (1995) and "Predictors of Ability to Walk after Selective Dorsal Rhizotomy in Children with Cerebral Palsy" by Michael R. Chicoine, Bruce Kaufman, Tae Sung Park, and George P. Vogler (1996) focus specifically on evaluating the gait patterns of children before and after dorsal rhizotomies.
As described in the former article, footswitches follow the foot contact pattern of children both pre- and postoperatively. Footswitches monitor foot contact while reflective markers measure the degree of flexion at the hip, knee, and ankle joints (Adams et al. 1995, p 77). Clinical evaluations also determine the amount of range of motion present in the children. The clinical evaluation in this study "included goniometric measurement of passive range of motion and strength." In the second article, Chicoine et al. (1996) attempt to determine whether the success of rhizotomies is associated with the amount of preoperative dorsiflexion. They test this hypothesis by measuring foot movement and by having therapists evaluate the walking ability of children before and after rhizotomies.
The articles by Marty et al. (1995) and Erro et al. (1993) and the article "Selective posterior lumbrosacral rhizotomy for the management of cerebral palsy spasticity" by L.J. Arens and J.C. Peter (1993) also attempt to determine the level of functional improvement in children receiving rhizotomies. These articles evaluate not only gait patterns but also many other functional categories. Erro et al.’s study is much like Marty et al.’s in that both studies look at many aspects of children’s lives to determine the effectiveness of rhizotomies. Their studies examine the effects of rhizotomies on ambulation as well as on many other tasks. To evaluate functional improvement on specific tasks, Marty et al. use the Functional Independence Measure for Children (WeeFIM). According to Marty et al., the WeeFIM scale is "the most widely used evaluation scale of function in children…" (p 379). The study by Arens and Peter also evaluates functional improvement. Their study includes evaluation of sitting, standing, and power after a rhizotomy.
All of the articles that evaluate functional ability following a dorsal rhizotomy find that rhizotomies have positive effects. These positive effects can include decreased spasticity, increased ambulation, and increased mobility. Adams et al. (1995) find that stride length and heel contact improve after rhizotomies. Chicoine et al.’s study (1996) is even more specific than Adams et al.’s and reveals that most children who undergo rhizotomies receive increased gait scores.
The results of these two studies are not unique. Many of the authors of the other reviewed articles also discuss the relationships they discover between rhizotomies and functional ability. Marty et al.’s research (1995) points out a positive correlation between rhizotomies and increased ambulation. In addition to this discovery, Marty et al. also find a correlation between rhizotomies and WeeFIM scores. The results of Erro et al.’s study (1993) show an even greater correlation between rhizotomies and functional ability than Marty et al.’s research. Erro et al.’s study claims that the results of rhizotomies were successful in one hundred percent of the cases treated. Arens and Peter’s article (1993) present a positive correlation between rhizotomies and functional ability, but also includes a number of individuals who fail to show an increased level of postoperative function.
After the articles state their findings, they discuss the data they obtained. Adams et al. explain that spasticity is usually the major cause of a disordered foot contact pattern. During the course of their study, they determined the positions of both the knee and ankle are essential to foot contact. According to Adams et al., spasticity is "the major cause of dysfunction and a target of surgical intervention" in foot contact disorders (p 79). Chicoine et al.’s discussion also focuses on factors that predict the ability to walk. These researchers devote their discussion to dorsiflexion. The results of their study lead them to believe that the level of bilateral dorsiflexion a child possesses determines the child’s gait score. Chicoine et al. state that "analysis of data from these 90 children reveals a correlation between dorsiflexion tasks and maximal gait score" (p 713). They conclude that the amount of preoperative dorsiflexion helps predict the success of a rhizotomy.
The discussions in the articles by Marty et al. (1995), Erro et al. (1993), and Arens and Peter (1993) are much more general than the discussions in the two previously described articles. All of these articles examine the general effects of dorsal rhizotomies on children with cerebral palsy. They believe that if children have been properly assessed preoperatively, rhizotomies improve mobility, self-care, and ambulation.
The article "Severe Lumbar Lordosis after Dorsal Rhizotomy" by Kevin Crawford, Lori A. Karol, and J. Anthony Herring (1996) differs from all of the other articles because instead of looking at the positive results attained by rhizotomies, it presents two case studies of children whose rhizotomies caused lordosis. According to Crawford et al., because of this complication, both children lost function and ambulation (p 336). The authors also describe other side effects associated with rhizotomies. They say that researchers have "found that the incidence of spondylolysis and spodylolisthesis in children who have rhizotomies is greater than that in the general population of cerebral palsy patients" (p 337). This article concludes that the use of selective dorsal rhizotomies requires careful consideration as well as follow-up medical examinations.
Arguments/Interpretations
The main argument within all six articles [transition phrase] is that children with spastic cerebral palsy should receive dorsal rhizotomies to relieve their spastic symptoms [topic sentence]. All of the articles stress the importance of a careful preoperative evaluation to screen rhizotomy patients, and to make sure that children are proper candidates for dorsal rhizotomies.
Although all of these articles present the idea that dorsal rhizotomies are beneficial to children with spastic cerebral palsy, the factors that the authors believe help predict the success or failure of a rhizotomy differ from article to article. By explaining these factors, the authors make implications not only about the conditions necessary for rhizotomies to be effective treatments, but also about when they feel dorsal rhizotomies should be used to treat children with spastic cerebral palsy.
The articles by Marty et al. (1995), Erro et al. (1993), and Arens and Peter (1993) all give very general criteria for the prediction of the effectiveness of dorsal rhizotomies. By presenting positive data supporting the use of rhizotomies, they argue that rhizotomies are effective treatments for children with cerebral palsy as long as the patient meets three requirements. These requirements are that the child has spastic cerebral palsy, is motivated, and is willing to participate in follow-up therapy.
Marty et al. (1995) and Erro et al. (1993) all stress the importance of follow-up therapy after rhizotomies. Because of this, they argue that the age as well as the strength and intelligence of the patient should be taken into consideration during a preoperative examination. Marty et al. explain that "SDR is most successful when performed in motivated children between 3 and 12 years . . ." (p 375). They argue that these children respond positively to rhizotomies because they are motivated and willing to cooperate with therapists. In addition to these factors, the articles also specify that a rhizotomy candidate should exhibit spastic or hypertonic cerebral palsy. The reason that this specification is made becomes clear in Arens and Peter’s article (1993). They state, "Spasticity is often associated with weakness and many patients derive useful functional support from spasticity of the legs in standing and walking" (p 747). Children with hypotonic cerebral palsy actually use spasticity to walk. According to Arens and Peter, if their spasticity is removed, they show a decrease in function and could lose their ability to walk.
These three articles present a positive correlation between rhizotomies and increased function, and lay out a very general set of criteria for determining the necessary conditions for this procedure. They argue that dorsal rhizotomies effectively treat children with spastic cerebral palsy, and at the same time they imply that this general set of criteria should determine whether rhizotomies are performed. The general public would probably be divided on the arguments and opinions present in these articles because the authors show a very positive correlation, but leave the circumstances required for this procedure general and somewhat open for interpretation. Because of this fact, many doctors are attempting to come up with a more definite set of criteria to determine when rhizotomies are effective. Adams et al.’s article (1995) and Chicoine et al’s article (1996) both attempt to set forth such a set of criteria.
"Foot Contact Pattern Following Selective Dorsal Rhizotomy" by Adams et al. (1995) focuses on the position of ankle and knee placement before and after dorsal rhizotomies. Adams et al. believe that to have a proper gait pattern, "there must be a functional balance between mobility and stability at the hip, knee, and ankle to support the limb" (p 79). Spasticity can cause abnormal forefoot placement. Observation of forefoot contact therefore allows for evaluation of the degree of spasticity as well as the functional balance between mobility and stability (p 79). The amount of preoperative spasticity may determine the success or failure of a rhizotomy. According to Adams et al., "The postoperative changes depend on the degree that spasticity obstructed preoperative function" (p 81). Because the amount of preoperative spasticity may determine whether a rhizotomy improves ambulation, these researchers believe that evaluation of foot contact patterns may allow doctors to predict the probability of a rhizotomy’s success.
The article "Predictors of Ability to Walk after Selective Dorsal Rhizotomy in Children with Cerebral Palsy" (Chicoine et al. 1996) sets out an even more specific set of criteria than Adams et al.’s article (1995). Whereas Adams et al.’s article focuses on hip, foot, and ankle placement to determine the success of a rhizotomy, Chicoine et al.’s article presents the idea that the amount of preoperative bilateral dorsiflexion determines whether rhizotomies will improve ambulation in children with cerebral palsy. Chicoine et al. explain, "To analyze the efficacy of these therapeutic interventions, one must understand what factors predict future ability to walk" (p 713). The authors of this article feel that predictive factors such as the amount of bilateral dorsiflexion should be used to evaluate candidates for dorsal rhizotomies.
By arguing for specific sets of criteria to evaluate the need for a dorsal rhizotomy, these articles point out the situations in which dorsal rhizotomies are most effective. They also oppose the view presented in Marty et al.’s (1995), Erro et al.’s (1993), and Arens and Peter’s (1993) articles that dorsal rhizotomies effectively treat the general population of children with spastic cerebral palsy. Chicoine et al. (1996) state that "predictions can effect management decisions" (p 713). These studies attempt to determine not only whether or not rhizotomies are effective, but also the best form of treatment for children with cerebral palsy. The general public would probably favor the criteria presented in Adams et al.’s (1995) and Chicoine et al.’s articles over the more general criteria offered n the previous articles because their studies attempt to determine exactly when rhizotomies are effective.
The article "Severe Lumbar Lordosis after Dorsal Rhizotomy" (Crawford et al. 1996) looks at the side effects caused by selective dorsal rhizotomies. This article introduces many possible side effects and seems to imply that caution must be used in choosing candidates for this procedure. Crawford et al. postulate that a hip-flexion contraction can cause the lumbar spine to become "hyperlordotic to maintain an upright posture" (p 339). The authors therefore indicate that hip-flexion contraction should be evaluated before the administration of rhizotomies. They imply that this evaluation could help avoid side effects and increase the success rate of the rhizotomy procedure.
Evaluation
Although all six articles [transition phrase] all reach the conclusion that dorsal rhizotomies should be used to treat spastic cerebral palsy, their methods of coming to this conclusion differ in the quality of their presentations [topic sentence]. Some of the articles possess strong central arguments that support their conclusions; others set forth biased arguments that cause the reader to question their findings.
Strengths [sub-subtitle]
Three of the articles present strong central arguments favoring the use of dorsal rhizotomies to alleviate spasticity in children with cerebral palsy. Through their central arguments, these articles show a positive correlation between rhizotomies and an improved level of function. These articles are well presented because they clearly define the circumstances that led to a positive correlation and also mention the possible side effects and realistic outcomes of the rhizotomy procedure.
Arens and Peter’s article (1993) not only clearly identifies its methods but also explains and discusses its results. This article breaks its methods section into many subsections including gender, type of cerebral palsy, associated intelligence, and follow-up procedure. Under each of these subsections, Arens and Peter discuss their methods in detail. By discussing these methods, they give their reader a clear picture of the actual conditions under which their study was conducted. They also clearly present their results sections by dividing it into subsections, including a portion that discusses postoperative complications. In this section, Arens and Peter mention that "2 children with severe lordosis developed wound haematomas, and 1 had a temporary cerebrospinal leak" [sic] (p 746). The authors include and discuss both the positive and negative outcomes they discovered. By doing so, they give their readers a clear sense of the actual effects of the rhizotomy procedure. Because of this organization and inclusion of detail, the article’s argument that dorsal rhizotomies effectively treat children with cerebral palsy is well supported.
Adams et al.’s article (1995) is much like Arens and Peter’s (1993) in that both present a realistic view of the possible effects of rhizotomies. Adams et al. explain that although rhizotomies can help improve ambulation, abnormalities in gait still persist after this procedure (p 81). The procedure reduces the amount of spasticity that the patient experiences, but, as the authors point out, "underlying motion control deficits persist." As Crenshaw (1992) says, rhizotomies improve sensory function but cannot eliminate contractions (p 2301). Adams et al. give the reader a glimpse of both the positive effects of rhizotomies and an understanding of their limitations. In doing so, the authors develop a strong article. They present the reader with an unbiased study and allow the reader to fully understand the effects as well as the limitations of the rhizotomy procedure.
Chicoine et al.’s article (1996) also has an unbiased presentation of information that leads to a strong article. In this study, Chicoine et al. attempt to prove that the amount of preoperative dorsiflexion influences the success of the rhizotomy procedure. In their discussion section, the authors address and clearly explain their findings as well as the shortcomings of their experiment. Chicoine et al. state, "Neither the unilateral dorsiflexion task nor the bilateral dorsiflexion task was associated with the maximal gait score for children with spastic quadriplegia" (p 713). By pointing out the set of situations in which no correlation exists, the authors strengthen their conclusions in situations in which a positive correlation was found. This inclusion of detail makes Chicoine et al.’s findings stronger and also supports the use of rhizotomies in children with bilateral dorsiflexion.
Weaknesses [sub-subtitle]
The other reviewed articles develop weak arguments that cause the reader to question whether or not rhizotomies are truly effective procedures. The arguments within these articles appear weak because their authors either fail to present an opposing point of view or fail to explain the criteria they used to establish their results.
The article by Marty et al. concludes that rhizotomies improve function in a selected group of children with cerebral palsy. In their conclusion, Marty et al. (1995) write, "Long-term observation of patients indicates that SDR increase functional ability in a selected group of cerebral palsy patients" (p 380). The problem with this article is that its authors never define the criteria they used to determine the selected group of children who do show increased function after rhizotomies. They offer a general set of criteria for determining proper candidates for dorsal rhizotomies, but never specifically label these children as children who should receive rhizotomies. In the course of their article, they only suggest that these children should be considered rhizotomy candidates.
In addition to this, the authors spend most of their article discussing the positive results they have obtained, but fail to compare their results with a control group of children who did not receive rhizotomies. Marty et al. (1995) even admit that they believe there is a positive correlation between SDR and increased functional ability, but that "no data are available regarding the natural course of development in unoperated patients" (p 380). This inattention to detail and biased presentation of information lead the reader to question whether or not the authors of this article have presented enough evidence to substantiate the claim that rhizotomies improve function.
Erro et al.'s article leaves the reader with many of the same questions as Marty et al.'s article. This study claims to demonstrate results that are "satisfactory in 100% of the cases treated" (Erro e al. 1993, p 476). The authors of this article never substantiate their claim, however, by explaining the exact criteria they used to deem their results satisfactory. Their "Results" and "Discussion" sections mention many different outcomes, but fail to create a standard set of evaluation criteria. This leaves their conclusion unsubstantiated as well as questionable.
Crawford et al.'s article is much like the two articles previously mentioned in that it puts forth a very biased point of view. Although this article favors the use of rhizotomies, it also explores the side effects associated with this procedure. In its exploration, it attempts to advance the need for postoperative screening for children receiving rhizotomies, even though they report that the incidence of "lordosis "was no greater after the rhizotomy" ( 1996, p 337). According to Crawford et al. (1996), the rate of lordosis is the same in the general population of children with cerebral palsy as it is for the population of children receiving rhizotomies (p 337). Instead of specifying the need for lordosis screening for the population of children with cerebral palsy as a whole, the authors advance the notion that children receiving rhizotomies should be given extra screening for lordosis. This biased presentation of information leads the reader to question not only the authors' opinion that children receiving rhizotomies should receive extra screening for lordosis, but also the authors' opinion that rhizotomies are useful procedures.
Conclusion
This paper has looked at and reviewed six articles written about selective dorsal rhizotomies. Doctors use dorsal rhizotomies to alleviate spasticity in children with spastic cerebral palsy. Although many articles, doctors, and therapists support the use of rhizotomies, this treatment is still considered controversial because of its possible adverse side effects (Crenshaw 1992, p 301). The risk of side effects is quite low, however, if a child undergoes a thorough preoperative evaluation and is properly diagnosed as having spastic cerebral palsy. Dorsal rhizotomies can effectively reduce spasticity and improve ambulation and therefore should be used in children with spastic cerebral palsy.
References
Arens LJ, Peter JC. 1993. Selective posterior lumbosacral rhizotomy for the
management of cerebral palsy spasticity. South African Medical Journal
83:745-77.
Chicoine MR, Kaufman BA, Park TS, Vogler GP. 1996. Predictors of ability to
walk after selective rhizotomy in children with cerebral palsy. Neurosurgery
38(4):711-14.
Crawford K, Herring JA,
Crenshaw AH, editor. 1992.
Erro MG,
Marty GR, Nishida T, Thatcher SW. 1995. Selective posterior rhizotomy for
children with cerebral palsy: a 7-year experience. Child's Nervous System 11
(7):374-80.
Additional Sources
Albright AL, Barry MJ, Fasick MP, Janosky J. 1995. Effects of continuous intrathecal infusion and selective posterior rhizotomy on upper extremity spasticity. Pediatric Neurosurgery 23(2):82-85.
Andelman PD. Boop FA, Brown RE, Kymer PJ, Lawhorn CD, Schmitz ML, Shirley R. 1995. Continuous epidural morphine/butorphanol infusion following SDR in children. Child's Nervous System 11(7):621-24.
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