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KMTC Research Methods — Topic-by-Topic Summary Notes

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TOPIC 1: Concepts of Research

• Describe phenomena (descriptive)
• Explain cause-effect relationships (explanatory)
• Predict outcomes
• Control or improve practice

• Systematic and organised
• Empirical (evidence-based)
• Objective and unbiased
• Replicable
• Ethical

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TOPIC 2: Research Designs

A. Descriptive Designs

• Describe characteristics of a population or phenomenon
• E.g., surveys, case studies, cross-sectional studies
• No manipulation of variables

B. Observational Designs

C. Experimental Designs

• Randomised Controlled Trial (RCT): Gold standard; random allocation to treatment/control
• Quasi-experimental: No randomisation; natural groups
• Pre-test / Post-test: Measures before and after intervention

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TOPIC 3: The Research Process

1. Identify a research problem
2. Review existing literature
3. Formulate objectives / hypothesis / research questions
4. Choose research design
5. Develop methodology (sampling, instruments)
6. Collect data
7. Analyse and interpret data
8. Write and present findings
9. Publish / disseminate

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TOPIC 4: Identifying & Prioritising the Research Problem

• Clinical observation, patient complaints
• Literature gaps
• Policy needs, community health issues

• Feasible (resources, time, skills available)
• Interesting to the researcher
• Novel (adds new knowledge)
• Ethical
• Relevant to health needs

• Research question: Open-ended (e.g., "What factors contribute to…?")
• Hypothesis: A testable prediction (e.g., "There is a significant association between X and Y")
  • Null hypothesis (H₀): No effect / no difference
  • Alternative hypothesis (H₁): There is an effect / difference

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TOPIC 5: Literature Review, Referencing & Citation

• Shows existing knowledge
• Justifies the study
• Avoids duplication
• Identifies gaps

1. Define search terms
2. Search databases (PubMed, Google Scholar, WHO, MoH Kenya)
3. Critically appraise sources
4. Synthesise and write

Mugenda, O. M. (2007). Research Methods: Quantitative and Qualitative Approaches. Nairobi: ACTS Press.

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TOPIC 6: Research Methodology & Protocol Development

Key Concepts:

Sampling Methods:

Instrument Development:

• Questionnaire: Self-administered; closed or open-ended questions
• Interview guide: Structured, semi-structured, or unstructured
• Observation checklist
• Document review guide

• Content validity, construct validity, criterion validity

• Test-retest, inter-rater reliability

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TOPIC 7: Data Collection, Processing, Analysis & Interpretation

Data Collection:

• Primary data: Collected first-hand (interviews, questionnaires, observation)
• Secondary data: Already collected (records, reports, registries)

Data Processing:

1. Editing — Check for completeness and accuracy
2. Coding — Assign numerical codes to responses
3. Entry — Input into software (SPSS, Excel, EpiInfo)
4. Cleaning — Correct errors before analysis

Data Analysis:

• Descriptive statistics: frequencies, percentages, mean, median, mode, range, standard deviation
• Inferential statistics: chi-square test, t-test, ANOVA, correlation, regression

• Thematic analysis
• Content analysis

Interpretation:

• Compare findings to objectives and hypotheses
• Relate to existing literature
• State limitations

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TOPIC 8: Presentation & Report Writing

Research Report Structure:

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TOPIC 9: Basic Statistics

Health Data Gathering:

• Vital registration, surveys, health facility records, surveillance systems

Key Demographic & Health Rates:

Descriptive Statistics:

• Mean — sum of values ÷ number of values
• Median — middle value when ordered
• Mode — most frequently occurring value
• Standard Deviation (SD) — spread of data around the mean

Inferential Statistics:

• Used to draw conclusions about a population from a sample
• Chi-square (χ²): Tests association between categorical variables
• t-test: Compares means of two groups
• ANOVA: Compares means of three or more groups
• p-value: If p < 0.05, result is statistically significant

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TOPIC 10: Ethical Issues in Research

1. Respect for Persons — Autonomy; informed consent
2. Beneficence — Do good; minimise harm
3. Justice — Fair selection of participants

• Purpose of study
• Procedures involved
• Risks and benefits
• Confidentiality assurance
• Right to withdraw without penalty

• Institutional Ethics Review Committee (at KMTC or hospital)
• Kenya Medical Research Institute (KEMRI) — for larger studies
• National Commission for Science, Technology and Innovation (NACOSTI)

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TOPIC 11: Research Funding

• Sources: Government grants (MOH, NACOSTI), NGOs, international bodies (WHO, USAID, Wellcome Trust), institutional funds
• Budget Components: Personnel, supplies/materials, travel, data management, overheads
• Budget Justification: Every item must be justified in relation to the study objectives

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TOPIC 12: Research Publication

1. Select an appropriate journal (scope, impact factor)
2. Follow the journal's Author Guidelines (word count, referencing style)
3. Submit manuscript for peer review
4. Respond to reviewer comments (revision)
5. Final acceptance and publication

• East African Medical Journal
• African Journal of Health Sciences
• BMC Health Services Research

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Quick Revision Summary Table

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• Mugenda O.M. & Mugenda A.G. (2009). Research Methods: Quantitative and Qualitative Approaches. ACTS Press, Nairobi.
• Newmann L. (2008). Social Research Methods: Qualitative Approaches. Allyn and Bacon.
• Baker D.J.P. (2008). Practical Epidemiology. ELBS, London.
• Creswell J.W. — Research Design: Qualitative, Quantitative and Mixed Methods Approaches.

KMTC Research Methods — Practice Exam Questions by Topic

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TOPIC 1: Concepts of Research

MCQs

• A. Collecting data from patients in a hospital
• B. A systematic, empirical, and critical investigation of phenomena
• C. Reading textbooks to find answers to clinical questions
• D. Asking colleagues for their opinions on a health issue

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• A. Applied research
• B. Action research
• C. Basic/pure research
• D. Descriptive research

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• A. Quantitative
• B. Experimental
• C. Cohort
• D. Qualitative

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• A. It is systematic
• B. It is based on the researcher's personal opinion
• C. It is replicable
• D. It is objective

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Short Answer

Model Answer:

1. To describe health phenomena and patterns of disease
2. To explain cause-and-effect relationships
3. To predict health outcomes
4. To control disease or improve clinical practice

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TOPIC 2: Research Designs

MCQs

• A. Cross-sectional study
• B. Case-control study
• C. Cohort study
• D. RCT

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• A. Randomly assigns participants to groups
• B. Follows participants forward in time
• C. Looks backward from disease to exposure
• D. Collects data at a single point in time

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• A. Cross-sectional study
• B. Quasi-experimental study
• C. Randomised Controlled Trial (RCT)
• D. Descriptive survey

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• A. Cohort study
• B. Cross-sectional study
• C. Case-control study
• D. Longitudinal study

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Short Answer

Model Answer:

• Cohort study: Starts with exposed vs. unexposed individuals; follows them forward in time to see who develops disease (prospective). Good for calculating incidence and relative risk.
• Case-control study: Starts with people who already have the disease (cases) and those who do not (controls); looks backward to identify past exposures. Good for rare diseases. Calculates odds ratio.

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Model Answer: Advantages: Quick and inexpensive; can study multiple variables simultaneously Disadvantages: Cannot establish cause and effect; susceptible to prevalence-incidence bias

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TOPIC 3: The Research Process

MCQs

• A. Data collection → Problem identification → Literature review → Analysis
• B. Problem identification → Literature review → Methodology → Data collection → Analysis → Report writing
• C. Hypothesis → Data collection → Problem identification → Literature review
• D. Report writing → Analysis → Data collection → Problem identification

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• A. Writing a hypothesis
• B. Identifying a research problem
• C. Collecting data
• D. Reviewing literature

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Short Answer

Model Answer:

1. Identify the research problem
2. Review existing literature
3. Formulate objectives, hypothesis, or research questions
4. Choose a research design
5. Develop methodology (sampling, instruments)
6. Collect data
7. Analyse and interpret data
8. Write and present findings / publish

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TOPIC 4: Research Problem, Objectives & Hypothesis

MCQs

• A. Feasible
• B. Novel
• C. Numerical
• D. Ethical

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• A. Research question
• B. Alternative hypothesis
• C. Null hypothesis
• D. Research objective

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• A. "Malaria is a big problem in Kenya"
• B. "Why do patients not take their medication?"
• C. "Despite free TB treatment, defaulter rates at Meru County Hospital remain at 35% — factors contributing to this are unknown"
• D. "I want to study hypertension"

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Short Answer

Model Answer:

• H₀ (Null): Hand-washing training has no significant effect on the rate of hospital-acquired infections.
• H₁ (Alternative): Hand-washing training significantly reduces the rate of hospital-acquired infections.

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Model Answer:

• Feasible: Yes — community visits can be tracked, postnatal records exist
• Interesting: Yes — relevant to CHW programmes in Kenya
• Novel: Likely — limited local data in Kisumu County
• Ethical: Yes — no harm to participants; consent obtainable
• Relevant: Yes — postnatal care is an SDG/MoH priority

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TOPIC 5: Literature Review, Referencing & Citation

MCQs

• A. Show the examiner how many books you have read
• B. Copy ideas from other researchers
• C. Identify gaps in existing knowledge and justify the study
• D. Replace the methodology section

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• A. [1]
• B. (Author, Year)
• C. Author (page number)
• D. {Author: Year}

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• A. (Author, Year) in the text
• B. Numbered superscripts or numbers in brackets in the text
• C. Footnotes at the bottom of each page
• D. Author's surname only

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Short Answer

Model Answer: Mugenda, O. M. (2009). Research methods: Quantitative and qualitative approaches. ACTS Press.

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Model Answer:

1. Define key search terms related to the research topic
2. Search relevant databases and sources (PubMed, Google Scholar, WHO, MoH Kenya reports)
3. Critically appraise and select relevant sources
4. Synthesise and write the review, linking findings to the research problem

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TOPIC 6: Research Methodology & Sampling

MCQs

• A. Simple random sampling
• B. Stratified random sampling
• C. Systematic sampling
• D. Cluster sampling

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• A. Purposive sampling
• B. Stratified random sampling
• C. Convenience sampling
• D. Systematic sampling

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• A. Simple random sampling
• B. Systematic sampling
• C. Purposive sampling
• D. Cluster sampling

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• A. Reliability
• B. Objectivity
• C. Validity
• D. Precision

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• A. Validity
• B. Reliability
• C. Sensitivity
• D. Specificity

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Short Answer

Model Answer:

• Probability sampling: Every member of the population has a known, non-zero chance of being selected. Example: Simple random sampling.
• Non-probability sampling: Not every member has an equal chance of selection; based on researcher judgment or convenience. Example: Purposive sampling or convenience sampling.

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Model Answer:

1. Size of the target population
2. Expected prevalence or proportion of the variable of interest
3. Desired level of confidence (usually 95%)
4. Acceptable margin of error (usually 5%)

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TOPIC 7: Data Collection, Processing & Analysis

MCQs

• A. Secondary data
• B. Archival data
• C. Primary data
• D. Historical data

---

• A. Editing
• B. Coding
• C. Cleaning
• D. Tabulation

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• A. Mode
• B. Median
• C. Mean
• D. Range

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• A. Compare means of two groups
• B. Test association between two categorical variables
• C. Measure the spread of data
• D. Calculate the median

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• A. There is a 3% probability the study is correct
• B. The result is statistically significant (p < 0.05); reject H₀
• C. There is no significant difference between the groups
• D. The sample size was too small

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Short Answer

Model Answer:

• (a) Mean: (12+15+15+18+20+22+25) ÷ 7 = 127 ÷ 7 = 18.1
• (b) Median: Middle value of ordered set = 18
• (c) Mode: Most frequent value = 15

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Model Answer:

1. Editing — Review filled questionnaires for completeness, legibility, and consistency
2. Coding — Assign numerical codes to categorical responses
3. Data entry — Input coded data into software (SPSS, Excel, EpiInfo)
4. Data cleaning — Identify and correct errors or missing values before analysis

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TOPIC 8: Research Report Writing

MCQs

• A. Chapter 2
• B. Chapter 3
• C. Chapter 1
• D. Chapter 5

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• A. Chapter 1
• B. Chapter 2
• C. Chapter 3
• D. Chapter 4

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• A. Chapter 2
• B. Chapter 3
• C. Chapter 4
• D. Chapter 5

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Short Answer

Model Answer:

Chapter	Content
Chapter 1	Introduction: background, problem statement, objectives, hypotheses, justification, scope/limitations
Chapter 2	Literature Review: synthesis of existing studies related to the topic
Chapter 3	Methodology: design, target population, sampling, instruments, data collection procedure, ethical considerations
Chapter 4	Results/Findings: tables, graphs, narratives presenting data
Chapter 5	Discussion, Conclusions & Recommendations
References	All cited sources in correct format
Appendices	Questionnaires, consent forms, budget, work plan

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TOPIC 9: Basic Statistics & Health Rates

MCQs

• A. 2 per 1,000
• B. 20 per 1,000
• C. 40 per 1,000
• D. 0.4 per 1,000

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• A. New cases of disease in a specified period
• B. All existing cases (new + old) at a point in time
• C. Deaths due to a specific disease
• D. The birth rate in a population

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• A. 0.2 per 1,000
• B. 2 per 1,000
• C. 20 per 1,000
• D. 200 per 1,000

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• A. Mean
• B. Mode
• C. Median
• D. Standard deviation

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Calculation Questions

Model Answer:

• (a) CBR = (9,000 / 300,000) × 1,000 = 30 per 1,000 population
• (b) CDR = (1,500 / 300,000) × 1,000 = 5 per 1,000 population

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TOPIC 10: Ethics in Research

MCQs

• A. Beneficence
• B. Non-maleficence
• C. Justice
• D. Autonomy

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• A. The researcher forces participants to sign a form
• B. Participants voluntarily agree to participate after being fully informed of the study
• C. The hospital administrator approves the study
• D. Only the researcher decides who participates

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• A. The Ministry of Education
• B. KEMRI / NACOSTI
• C. Kenya Bureau of Standards
• D. The National Assembly

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• A. Paraphrasing
• B. Summarising
• C. Plagiarism
• D. Citation

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Short Answer

Model Answer:

1. Purpose and objectives of the study
2. Procedures involved and time required
3. Potential risks and benefits to the participant
4. Assurance of confidentiality and anonymity
5. Right to withdraw at any time without penalty or consequence

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Model Answer:

1. Respect for Persons (Autonomy): Individuals should be treated as autonomous agents; informed consent must be obtained; vulnerable persons need extra protection.
2. Beneficence: Researchers must maximise benefits and minimise harm to participants.
3. Justice: Benefits and burdens of research should be distributed fairly; no group should be exploited for the benefit of another.

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TOPIC 11 & 12: Research Funding & Publication

MCQs

• A. Patient consultation fees
• B. NACOSTI grants
• C. Hospital admission charges
• D. Student examination fees

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• A. The author's supervisor only
• B. Independent expert reviewers in the relevant field
• C. The hospital CEO
• D. Medical students

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Short Answer

Model Answer:

1. Personnel costs (research assistants, data entry clerks)
2. Materials and supplies (stationery, printing of questionnaires)
3. Transport and travel costs
4. Data management and analysis (software, consultancy) (Also acceptable: communication, overheads, publication costs)

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STRUCTURED / LONG ANSWER QUESTIONS (Exam-style)

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Model Answer: (a) "Despite available services, a high proportion of diabetic patients at [name] Health Centre miss scheduled follow-up appointments; the factors contributing to this are not documented."

(b) Objective: To determine factors associated with missed clinic appointments among diabetic patients at [name] Health Centre. Hypothesis H₀: There is no significant association between transportation cost and missed clinic appointments among diabetic patients.

(c) Cross-sectional descriptive design — it allows collection of data at one point in time, is quick, inexpensive, and suitable for identifying prevalence and associated factors in a clinic population.

(d) Simple random sampling (from clinic register) or systematic sampling (every nth patient). Systematic sampling is preferable given an ordered register — practical and efficient.

(e) Obtain informed consent; ensure confidentiality of patient information; obtain ethical approval from the institutional review committee.

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Model Answer: Descriptive Statistics summarise and describe the main features of a dataset without drawing conclusions beyond the data itself.

• Examples: Mean age of patients (e.g., mean = 45 years); frequency table showing percentage of males vs. females.
• Used when: Presenting baseline characteristics of a study population; summarising survey findings.

Inferential Statistics use sample data to make inferences or draw conclusions about a larger population; involves hypothesis testing.

• Examples: Chi-square test to test association between smoking and lung disease; t-test to compare mean blood glucose between two treatment groups.
• Used when: Testing whether differences between groups are statistically significant; determining if findings can be generalised to the population.

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Quick MCQ Recap (Mixed Topics — for timed practice)

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KMTC Research Methods — 40 High-Frequency Predictable MCQs

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SECTION A: Concepts of Research (Q1–5)

• A. Gathering information from the internet
• B. A systematic, empirical and critical investigation aimed at discovering new knowledge
• C. Reading journals and summarising findings
• D. Asking experienced clinicians for their opinions

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• A. Basic research
• B. Pure research
• C. Applied research
• D. Historical research

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• A. It is replicable
• B. It is based on personal bias
• C. It is systematic
• D. It is empirical

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• A. Experimental research
• B. Quantitative research
• C. Qualitative research
• D. Descriptive research

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• A. Fulfil academic requirements
• B. Improve patient care and health outcomes
• C. Secure research funding
• D. Publish papers in journals

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SECTION B: Research Designs (Q6–11)

• A. Cohort study
• B. Cross-sectional study
• C. Case-control study
• D. Randomised Controlled Trial

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• A. Longitudinal study
• B. Cohort study
• C. Cross-sectional study
• D. Case-control study

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• A. Cross-sectional study
• B. Cohort study
• C. Case-control study
• D. Randomised Controlled Trial (RCT)

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• A. Whether they have the disease or not
• B. Their exposure status (exposed vs. unexposed)
• C. Convenience of access
• D. Random allocation to treatment groups

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• A. RCT
• B. Cross-sectional study
• C. Case-control study
• D. Cohort study

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• A. A true experimental design
• B. A quasi-experimental design
• C. A case-control study
• D. A cohort study

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SECTION C: Research Process & Problem Formulation (Q12–16)

• A. Reviewing literature
• B. Collecting data
• C. Identifying a research problem
• D. Writing the hypothesis

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• A. Empirical
• B. Ethical
• C. Extensive
• D. Explanatory

---

• A. Research question
• B. Research objective
• C. Alternative hypothesis
• D. Null hypothesis

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• A. Research problem
• B. Research hypothesis
• C. Research design
• D. Research instrument

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• A. "HIV is a serious disease in Africa"
• B. "I want to study malnutrition"
• C. "Despite supplementation programmes, 40% of children under 5 in Turkana remain stunted; contributing factors are unknown"
• D. "How can we improve health in Kenya?"

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SECTION D: Literature Review & Referencing (Q17–20)

• A. Demonstrate the researcher's reading ability
• B. Identify gaps in existing knowledge and justify the study
• C. Replace the methodology section
• D. List all books available on the topic

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• A. [1]
• B. (Author, Year)
• C. Author [page number]
• D. Superscript number¹

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• A. Systematic review
• B. Literature review
• C. Meta-analysis
• D. Narrative review

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• A. Paraphrasing
• B. Summarising
• C. Referencing
• D. Plagiarism

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SECTION E: Sampling Methods (Q21–26)

• A. Simple random sampling
• B. Stratified random sampling
• C. Systematic sampling
• D. Purposive sampling

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• A. Cluster sampling
• B. Stratified random sampling
• C. Systematic sampling
• D. Convenience sampling

---

• A. Simple random sampling
• B. Systematic sampling
• C. Purposive sampling
• D. Cluster sampling

---

• A. Sample
• B. Strata
• C. Target population
• D. Study unit

---

• A. Convenience sampling
• B. Purposive sampling
• C. Simple random sampling
• D. Snowball sampling

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• A. Reliability
• B. Validity
• C. Sensitivity
• D. Precision

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SECTION F: Data Collection & Analysis (Q27–31)

• A. Primary data
• B. Raw data
• C. Secondary data
• D. Quantitative data

---

• A. Editing
• B. Cleaning
• C. Coding
• D. Tabulation

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• A. 10
• B. 12
• C. 8
• D. 15

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• A. Mean
• B. Standard deviation
• C. Mode
• D. Median

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• A. t-test
• B. ANOVA
• C. Chi-square test
• D. Pearson correlation

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SECTION G: Statistics & Health Rates (Q32–36)

• A. 10 per 1,000
• B. 20 per 1,000
• C. 40 per 1,000
• D. 80 per 1,000

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• A. Prevalence
• B. Incidence
• C. Mortality rate
• D. Case fatality rate

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• A. The null hypothesis is accepted
• B. The result is not statistically significant
• C. The result is statistically significant; reject the null hypothesis
• D. The study has a 2% chance of being wrong

---

• A. 0.2
• B. 2
• C. 5
• D. 20

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• A. Descriptive statistics
• B. Parametric statistics
• C. Inferential statistics
• D. Nominal statistics

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SECTION H: Research Ethics & Report Writing (Q37–40)

• A. Justice
• B. Autonomy
• C. Beneficence
• D. Veracity

---

• A. Kenya Bureau of Standards (KEBS)
• B. Kenya Medical Research Institute (KEMRI) / NACOSTI
• C. Kenya Medical Association (KMA)
• D. Ministry of Education

---

• A. Chapter 1
• B. Chapter 2
• C. Chapter 3
• D. Chapter 4

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• A. Introduction
• B. Literature review
• C. Methodology
• D. Results

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✅ ANSWER KEY

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📊 Score Yourself

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Examiner's tip: Questions on sampling methods, hypothesis types, p-value interpretation, health rate calculations, and research ethics appear in virtually every KMTC Research Methods exam. Master those first.

KMTC Research Methods — 40 MCQs with Answers & Explanations

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SECTION A: Concepts of Research

• A. Gathering information from the internet
• B. A systematic, empirical and critical investigation aimed at discovering new knowledge
• C. Reading journals and summarising findings
• D. Asking experienced clinicians for their opinions

---

• A. Basic research
• B. Pure research
• C. Applied research
• D. Historical research

---

• A. It is replicable
• B. It is based on personal bias
• C. It is systematic
• D. It is empirical

---

• A. Experimental research
• B. Quantitative research
• C. Qualitative research
• D. Descriptive research

---

• A. Fulfil academic requirements
• B. Improve patient care and health outcomes
• C. Secure research funding
• D. Publish papers in journals

---

SECTION B: Research Designs

• A. Cohort study
• B. Cross-sectional study
• C. Case-control study
• D. Randomised Controlled Trial

---

• A. Longitudinal study
• B. Cohort study
• C. Cross-sectional study
• D. Case-control study

---

• A. Cross-sectional study
• B. Cohort study
• C. Case-control study
• D. Randomised Controlled Trial (RCT)

---

• A. Whether they have the disease or not
• B. Their exposure status (exposed vs. unexposed)
• C. Convenience of access
• D. Random allocation to treatment groups

---

• A. RCT
• B. Cross-sectional study
• C. Case-control study
• D. Cohort study

---

• A. A true experimental design
• B. A quasi-experimental design
• C. A case-control study
• D. A cohort study

---

SECTION C: Research Process & Problem Formulation

• A. Reviewing literature
• B. Collecting data
• C. Identifying a research problem
• D. Writing the hypothesis

---

• A. Empirical
• B. Ethical
• C. Extensive
• D. Explanatory

---

• A. Research question
• B. Research objective
• C. Alternative hypothesis
• D. Null hypothesis

---

• A. Research problem
• B. Research hypothesis
• C. Research design
• D. Research instrument

---

• A. "HIV is a serious disease in Africa"
• B. "I want to study malnutrition"
• C. "Despite supplementation programmes, 40% of children under 5 in Turkana remain stunted; contributing factors are unknown"
• D. "How can we improve health in Kenya?"

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SECTION D: Literature Review & Referencing

• A. Demonstrate the researcher's reading ability
• B. Identify gaps in existing knowledge and justify the study
• C. Replace the methodology section
• D. List all books available on the topic

---

• A. [1]
• B. (Author, Year)
• C. Author [page number]
• D. Superscript number¹

---

• A. Systematic review
• B. Literature review
• C. Meta-analysis
• D. Narrative review

---

• A. Paraphrasing
• B. Summarising
• C. Referencing
• D. Plagiarism

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SECTION E: Sampling Methods

• A. Simple random sampling
• B. Stratified random sampling
• C. Systematic sampling
• D. Purposive sampling

---

• A. Cluster sampling
• B. Stratified random sampling
• C. Systematic sampling
• D. Convenience sampling

---

• A. Simple random sampling
• B. Systematic sampling
• C. Purposive sampling
• D. Cluster sampling

---

• A. Sample
• B. Strata
• C. Target population
• D. Study unit

---

• A. Convenience sampling
• B. Purposive sampling
• C. Simple random sampling
• D. Snowball sampling

---

• A. Reliability
• B. Validity
• C. Sensitivity
• D. Precision

---

SECTION F: Data Collection & Analysis

• A. Primary data
• B. Raw data
• C. Secondary data
• D. Quantitative data

---

• A. Editing
• B. Cleaning
• C. Coding
• D. Tabulation

---

• A. 10
• B. 12
• C. 8
• D. 15

---

• A. Mean
• B. Standard deviation
• C. Mode
• D. Median

---

• A. t-test
• B. ANOVA
• C. Chi-square test
• D. Pearson correlation

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SECTION G: Statistics & Health Rates

• A. 10 per 1,000
• B. 20 per 1,000
• C. 40 per 1,000
• D. 80 per 1,000

---

• A. Prevalence
• B. Incidence
• C. Mortality rate
• D. Case fatality rate

---

• A. The null hypothesis is accepted
• B. The result is not statistically significant
• C. The result is statistically significant; reject the null hypothesis
• D. The study has a 2% chance of being wrong

---

• A. 0.2
• B. 2
• C. 5
• D. 20

---

• A. Descriptive statistics
• B. Parametric statistics
• C. Inferential statistics
• D. Nominal statistics

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SECTION H: Research Ethics & Report Writing

• A. Justice
• B. Autonomy
• C. Beneficence
• D. Veracity

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• A. Kenya Bureau of Standards (KEBS)
• B. Kenya Medical Research Institute (KEMRI) / NACOSTI
• C. Kenya Medical Association (KMA)
• D. Ministry of Education

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• A. Chapter 1
• B. Chapter 2
• C. Chapter 3
• D. Chapter 4

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• A. Introduction
• B. Literature review
• C. Methodology
• D. Results

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📋 Quick Answer Reference

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📊 Score Tracker

Priority revision areas: Sampling methods (Q21–26), Health rate calculations (Q32–35), Hypothesis types (Q14–15), Research designs (Q6–11), and Ethics (Q37–38) — these appear in nearly every KMTC exam sitting.

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KMTC Research Methods — Complete Question Bank

MCQs | SAQs | LAQs | Application Questions

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SESSION 1 & 2: CONCEPTS OF RESEARCH

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MCQs

• A. Collecting opinions from colleagues
• B. A systematic, empirical and critical investigation of phenomena to generate new knowledge
• C. Reading and summarising textbook content
• D. Searching the internet for health information

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• A. Deductive reasoning
• B. Inductive reasoning
• C. Predictive research
• D. Analytical research

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• A. Inductive
• B. Exploratory
• C. Deductive
• D. Descriptive

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• A. Experimental
• B. Predictive
• C. Descriptive
• D. Analytical

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• A. Exploratory
• B. Descriptive
• C. Predictive
• D. Analytical

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• A. The study of drugs and their effects on the body
• B. The study of distribution and determinants of disease in populations
• C. The study of bacteria causing infections
• D. The clinical management of infectious diseases

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• A. Inductive and deductive reasoning only
• B. Basic and applied research
• C. Quantitative and qualitative approaches
• D. Descriptive and experimental designs

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• A. Improving clinical practice
• B. Generating profit for hospitals
• C. Informing health policy
• D. Discovering new treatments

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Short Answer Questions (SAQs)

Model Answer: Definition: Research is a systematic, controlled, empirical, and critical investigation of phenomena, guided by theory or hypotheses, about presumed relations among such phenomena.

Four characteristics:

1. Systematic — follows a structured, planned process
2. Empirical — based on observable evidence, not opinion
3. Objective — free from personal bias
4. Replicable — can be repeated by other researchers and yield similar results (Also acceptable: ethical, valid, reliable)

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Model Answer:

• Inductive reasoning: Moves from specific observations to broad generalisations. Researcher collects data first, then develops a theory. Common in qualitative research. Example: Observing that several malnourished children come from households without latrines → concluding poor sanitation contributes to malnutrition.
• Deductive reasoning: Starts with an existing theory or hypothesis, then collects data to test it. Common in quantitative research. Example: Hypothesising that exclusive breastfeeding reduces diarrhoea, then testing this in a study.

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Model Answer:

Type	Healthcare Example
Exploratory	Preliminary study on factors affecting vaccine uptake in a new county
Descriptive	Prevalence survey of hypertension in adults in Nairobi
Analytical	Case-control study on risk factors for cervical cancer
Predictive	Study predicting diabetes risk based on BMI and family history
Experimental/Applied	RCT testing a new wound dressing for diabetic foot ulcers

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Application Question

Model Answer: (a) Exploratory research — because the problem is not well understood yet. There is no established theory about WHY readmissions are occurring, so an exploratory approach would first describe the scope of the problem and identify potential contributing factors before a more focused study is designed.

(b) Mixed methods — quantitative component would measure the readmission rate (numbers, percentages, demographics) while the qualitative component (interviews/focus groups) would explore patients' lived experiences, barriers to follow-up, and reasons for returning. Using only one approach would miss either the scale or the depth of the problem.

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SESSION 2–3: RESEARCH PROBLEM

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MCQs

• A. Background
• B. Methodology
• C. Justification/Rationale
• D. Literature review

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• A. A mistake found in a previous study
• B. An area where knowledge is absent, insufficient, or contradictory
• C. The difference between two studies' sample sizes
• D. The time between two research publications

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• A. Research problem
• B. Research hypothesis
• C. Research objective
• D. Conceptual framework

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• A. Hand hygiene training will reduce HAIs by 30%
• B. There is a significant association between smoking and lung cancer
• C. There is no significant difference in recovery time between patients on drug A and drug B
• D. Patients who exercise have better glycaemic control

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• A. Lists all the references cited in the study
• B. Shows the statistical tests that will be used
• C. Diagrammatically illustrates the relationship between study variables
• D. Describes the sampling procedure

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• A. Errors made during data collection
• B. Conditions the researcher accepts as true without testing
• C. Limitations caused by small sample size
• D. Hypotheses that have been proven

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SAQs

Model Answer:

1. Background context — what is the current situation / what is known
2. Magnitude of the problem — data showing the extent of the problem (statistics, rates)
3. The specific gap — what is NOT yet known or not documented locally
4. Consequences — what happens if the problem is not addressed
5. Proposed solution — what the study intends to investigate

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Model Answer:

• Research objective: A declarative statement of what the study will achieve. Begins with an action verb. Example: "To assess factors associated with non-adherence to ART among HIV-positive adults at Mombasa County Hospital."
• Research question: An interrogative (question) form of the objective. Example: "What factors are associated with non-adherence to ART among HIV-positive adults at Mombasa County Hospital?" Both cover the same content — objectives are stated as intentions; questions are stated as inquiries.

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Model Answer: A conceptual framework:

1. Visually represents the relationship between the independent variable(s), dependent variable(s), and any intervening/confounding variables
2. Guides the researcher on what to measure and how variables interact
3. Provides a theoretical basis for the study, linking it to existing knowledge and making the research logic clear to the reader

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Application Question

Model Answer: (a) Despite regular clinic attendance, a significant proportion of diabetic patients at [Name] Health Centre continue to have poorly controlled blood glucose levels (HbA1c >7%). The specific factors contributing to this poor glycaemic control have not been documented at this facility.

(b)

• General objective: To determine factors associated with poor glycaemic control among diabetic patients attending [Name] Health Centre.
• Specific objective 1: To assess dietary practices among diabetic patients at the health centre.
• Specific objective 2: To determine the level of physical activity among diabetic patients at the health centre.

(c)

• H₀: There is no significant association between dietary practices and glycaemic control among diabetic patients at the health centre.
• H₁: There is a significant association between dietary practices and glycaemic control among diabetic patients at the health centre.

(d)

1. Self-reporting bias — patients may over-report adherence to diet/medication
2. Small sample size at a single facility limits generalisability of findings

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SESSION 4–6: REVIEW OF LITERATURE

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MCQs

• A. A textbook summarising several studies
• B. A review article synthesising previous work
• C. An original research article published by the researcher who conducted the study
• D. A newspaper report about a health study

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• A. Original research article in The Lancet
• B. A PhD thesis
• C. A systematic review article
• D. Government surveillance data (primary collection)

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• A. Writing the review
• B. Searching databases
• C. Defining keywords and search terms
• D. Critically appraising articles

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• A. SPSS
• B. Mendeley / Zotero / EndNote
• C. EpiInfo
• D. Microsoft Excel

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• A. Author (Year). Title. Journal, Volume(Issue), pages.
• B. Title. Author. Journal. Year. Pages.
• C. [Number] Author. Title. Journal Year; Volume: pages.
• D. Author — Title — Year — Journal — Pages.

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• A. Published more than 20 years ago
• B. From a blog or unverified website
• C. Peer-reviewed, current (within 10 years), and relevant to the topic
• D. Written in any language regardless of translation accuracy

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SAQs

Model Answer:

1. Identify and define keywords/search terms related to the research topic
2. Search relevant databases (PubMed, Google Scholar, HINARI, WHO IRIS, MoH Kenya)
3. Screen titles and abstracts for relevance
4. Critically appraise selected full-text articles for quality and relevance
5. Synthesise findings and write the review, linking evidence to the research problem

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Model Answer:

	Definition	Examples
Primary	Original, first-hand research accounts	1. Original journal article 2. PhD/MSc thesis
Secondary	Interprets or summarises primary sources	1. Systematic review/meta-analysis 2. Textbook chapter

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Application Question

Model Answer: (a) PubMed / MEDLINE; Google Scholar; WHO IRIS; HINARI; African Journals Online (AJOL); MoH Kenya reports

(b) "Postnatal care," "PNC attendance," "maternal health Kenya," "rural health-seeking behaviour," "postnatal follow-up"

(c) 1. Peer-reviewed (published in a credible journal) 2. Current (published within the last 10 years) 3. Relevant to the topic (postnatal care/Kenya/Africa) 4. From a credible, identifiable author/institution

(d) (Wanjiru & Odhiambo, 2021)

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SESSION 7–8: RESEARCH METHODS

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MCQs

• A. Target population
• B. Sampling frame
• C. Accessible population
• D. Study unit

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• A. Census
• B. Cohort sub-study
• C. Pilot study
• D. Feasibility trial

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• A. Fisher's formula
• B. Yamane's formula
• C. Cohen's d
• D. Cronbach's alpha

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• A. Pearson's r
• B. Cronbach's alpha
• C. Chi-square
• D. p-value

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• A. Content validity
• B. Construct validity
• C. Test-retest reliability
• D. Inter-rater reliability

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• A. Results
• B. Methodology
• C. Discussion
• D. Conclusion

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• A. Laboratory test
• B. Observation checklist
• C. Structured questionnaire with Likert scale
• D. Document review guide

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SAQs

Model Answer:

	Definition	How tested
Validity	The extent to which an instrument measures what it is intended to measure	Content validity (expert review), criterion validity (comparison to gold standard)
Reliability	The extent to which an instrument gives consistent results on repeated use	Test-retest, inter-rater reliability, Cronbach's alpha
Key point: An instrument can be reliable without being valid, but a valid instrument must also be reliable.

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Model Answer: Purpose: To pre-test the research instrument and data collection procedure on a small sample before the main study to identify and correct problems.

Four things assessed:

1. Clarity and comprehensibility of questions
2. Time required to complete the instrument
3. Validity and reliability of the instrument
4. Logistical challenges (access to participants, data entry process)

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Model Answer:

1. Obtain ethical clearance — from IRB/KEMRI before any data collection
2. Train research assistants — standardise administration of instruments
3. Conduct pilot study — pre-test instrument; make corrections
4. Obtain informed consent — from all participants before collecting data
5. Administer instruments — questionnaires, interviews, observations per protocol
6. Edit collected data daily — check for completeness and accuracy in the field

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Application Question

Model Answer: (a) Target population = all 5,000 secondary school students in Bungoma County. Appropriate technique = Cluster sampling (schools as clusters, then stratified/random sampling within schools) OR Stratified random sampling (stratify by school, then randomly sample from each).

(b) n = 5,000 / (1 + 5,000 × (0.05)²) = 5,000 / (1 + 5,000 × 0.0025) = 5,000 / (1 + 12.5) = 5,000 / 13.5 = 370 students

(c) Self-administered structured questionnaire. Justification: Students are literate; questionnaire is efficient for large samples; allows respondents to answer sensitive questions (e.g., sexual practices) in private; standardised responses allow easy quantitative analysis.

(d) Validity: Submit instrument to research supervisors/content experts for review (content validity). Reliability: Conduct a pilot study on 10% of sample size from a similar school not in the study; calculate test-retest reliability or Cronbach's alpha; revise ambiguous items.

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SESSION 9: RESEARCH ETHICS & PROPOSAL FORMAT

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MCQs

• A. Respect for persons
• B. Beneficence
• C. Veracity
• D. Justice

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• A. Research limitation
• B. Sampling bias
• C. Research fraud/misconduct
• D. Informed consent violation

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• A. Research dissertation
• B. Research report
• C. Research proposal
• D. Concept paper

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• A. Longer and more detailed
• B. A shorter, preliminary document that introduces the research idea
• C. Submitted after data collection
• D. Only required for PhD studies

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• A. Statistical analysis in clinical trials
• B. Ethical principles for medical research involving human subjects
• C. Funding of health research in Africa
• D. Publication standards for medical journals

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• A. Participants are paid to take part
• B. Participants join only because their doctor told them to
• C. Participants freely choose to join after receiving full information, with the right to withdraw at any time
• D. Participation is compulsory for all eligible individuals

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SAQs

Model Answer:

1. Informed consent — participants must be fully informed and voluntarily agree to participate
2. Confidentiality — personal information must not be disclosed; use codes instead of names
3. Anonymity — where possible, participants' identities should not be traceable
4. Right to withdraw — participants can leave the study at any time without penalty
5. Ethical approval — study must be approved by a recognised ethics committee (KEMRI/NACOSTI/institutional IRB) before commencing

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Model Answer: Preliminary pages: Title page, Declaration, Dedication, Acknowledgements, Table of Contents, List of Tables/Figures, Abstract, Abbreviations

Chapter	Content
Chapter 1	Introduction: background, problem statement, research questions, objectives, hypothesis, justification, scope, limitations, assumptions, conceptual framework, operational definitions
Chapter 2	Literature Review: thematic review of primary and secondary sources
Chapter 3	Methodology: research design, study area, target population, sampling frame, sample size, sampling technique, data collection instruments, pilot study, validity/reliability, data collection procedure, data analysis plan, ethical considerations
References	All cited sources in APA/Vancouver format
Appendices	Questionnaire/instruments, informed consent form, budget, work plan/Gantt chart, introductory letter

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Model Answer: Research fraud (misconduct) is deliberate violation of research integrity through dishonest practices that compromise the validity and trustworthiness of research findings.

Three forms:

1. Fabrication — inventing/making up data or results that were never collected
2. Falsification — manipulating, altering, or omitting data to change research outcomes
3. Plagiarism — using another person's ideas, data, or writing without proper attribution

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Application Question (LAQ)

Model Answer:

(a) Title: Factors Associated with Tuberculosis Treatment Default among Patients Attending [Name] District Hospital, Western Kenya: A Cross-Sectional Study

Background: Tuberculosis (TB) remains a major public health concern in Kenya, ranking among the top 10 causes of death. The WHO END TB Strategy targets treatment success rates of ≥90%. However, treatment default — defined as interruption of treatment for ≥2 consecutive months — remains a significant barrier. In Western Kenya, default rates at district facilities have been reported at 15–30%, well above the national target of <5%. Factors such as poverty, distance to facility, drug side effects, and stigma have been implicated but are poorly documented at district level.

Problem Statement: Despite free TB treatment provided under the national DLTLD programme, high default rates persist at [Name] District Hospital, compromising treatment outcomes and contributing to drug resistance. The specific factors driving this default have not been studied at this facility.

(b) General Objective: To determine factors associated with TB treatment default among patients at [Name] District Hospital.

Specific Objectives:

1. To assess socio-demographic characteristics of TB patients who defaulted treatment
2. To identify patient-related factors (knowledge, side effects, stigma) associated with default
3. To determine health system factors (distance, drug availability, staff attitude) associated with default

(c) Design: Descriptive cross-sectional study — appropriate for determining prevalence and associated factors at one point in time. Population: All TB patients enrolled in the hospital's TB register in the past 2 years (defaulters and non-defaulters). Sampling: Systematic random sampling from the TB register — every 2nd patient selected until sample size is reached. Sample size: Yamane's formula or Fisher's formula based on estimated 25% default rate, 95% confidence level. Instrument: Interviewer-administered structured questionnaire covering demographics, treatment history, knowledge, side effects, and health system factors. Records review for treatment outcomes.

(d)

1. Informed consent — patients (defaulters) must be informed of the study purpose and voluntarily agree; no coercion since they fear penalties for default
2. Confidentiality — TB patient data is sensitive; identifiers must be removed; data stored securely; findings reported in aggregate form

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SESSION 10: RESEARCH SUPERVISION & DISSEMINATION

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MCQs

• A. Conduct the research on behalf of the student
• B. Guide, mentor, and provide academic direction to the student researcher
• C. Write the research proposal for the student
• D. Approve funding for the study

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• A. Filled with as much text as possible for completeness
• B. Concise, with key points, visuals, and minimal text
• C. Read word-for-word from the research report
• D. Used only for the methodology section

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• A. Meeting supervision deadlines
• B. Collecting and analysing data independently
• C. Choosing supervisors' research topics for them
• D. Seeking feedback and incorporating corrections

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SAQ

Model Answer: Supervisor's roles:

1. Provide academic and methodological guidance throughout the research process
2. Review and give written feedback on proposal, chapters, and final dissertation
3. Advise on ethical issues, analysis, and interpretation of findings
4. Track student progress and ensure adherence to timelines

Student's responsibilities:

1. Identify a research problem and develop the proposal independently
2. Meet supervision appointments and deadlines
3. Conduct data collection, entry, and analysis as planned
4. Incorporate supervisor's feedback and submit revised work promptly

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Application Question

Model Answer: (a) 1. Title slide (title, author, institution, date) 2. Introduction/Background & Problem Statement 3. Objectives & Methodology (brief) 4. Key Results/Findings (tables, charts) 5. Discussion, Conclusions & Recommendations

(b) 1. Speak clearly and at a moderate pace — face the audience, not the screen 2. Keep slides simple: use bullet points, graphs, and visuals rather than dense text 3. Practice beforehand and stay within the allotted time; be prepared for questions

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COMPREHENSIVE LONG ANSWER QUESTIONS (LAQs)

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Model Answer (b): n = 10,000 / (1 + 10,000 × 0.05²) = 10,000 / (1 + 10,000 × 0.0025) = 10,000 / (1 + 25) = 10,000 / 26 = 385 participants

Systematic sampling: Obtain a complete register of the 10,000 adults (sampling frame). Calculate the sampling interval: k = N/n = 10,000/385 ≈ 26. Randomly select a starting point between 1 and 26 (e.g., No. 14). Then select every 26th person thereafter: 14, 40, 66, 92... until 385 are selected.

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📋 QUESTION BANK SUMMARY

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Exam strategy: LAQs in KMTC research exams almost always ask you to either (1) write/critique a research proposal section, (2) calculate sample size, or (3) describe ethical principles with application to a clinical scenario. Master those three and you cover the highest-mark territory.

KMTC Research Methods — Final MCQs with Answers

60 Questions Covering All Timetable Topics

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SECTION 1: CONCEPTS OF RESEARCH (Q1–12)

• A. Data collection
• B. Research
• C. Observation
• D. Auditing

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• A. Deductive reasoning
• B. Experimental reasoning
• C. Inductive reasoning
• D. Predictive reasoning

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• A. Inductive reasoning
• B. Exploratory research
• C. Deductive reasoning
• D. Descriptive research

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• A. Applied research
• B. Action research
• C. Basic/pure research
• D. Descriptive research

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• A. Experimental
• B. Descriptive
• C. Analytical
• D. Predictive

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• A. Exploratory
• B. Descriptive
• C. Analytical
• D. Basic

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• A. The clinical management of infectious diseases
• B. The laboratory diagnosis of pathogens
• C. The study of distribution and determinants of disease in populations
• D. The pharmacological treatment of epidemics

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• A. Quantitative research
• B. Qualitative research
• C. Experimental research
• D. Mixed methods research

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• A. Based on the researcher's personal beliefs
• B. Cannot be repeated by other researchers
• C. Systematic, objective, and replicable
• D. Uses only secondary data

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• A. Secure academic qualifications
• B. Improve patient care and health outcomes
• C. Earn research grants
• D. Publish articles in international journals

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• A. Experimental
• B. Analytical
• C. Exploratory
• D. Predictive

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• A. Descriptive
• B. Analytical
• C. Exploratory
• D. Predictive

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SECTION 2: RESEARCH PROBLEM (Q13–22)

• A. Writing the hypothesis
• B. Reviewing literature
• C. Identifying a research problem
• D. Selecting a sample

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• A. A mistake in a previous study's methodology
• B. An area where knowledge is absent, insufficient, or contradictory
• C. The difference in sample sizes between two studies
• D. A period with no published research on a topic

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• A. Feasible
• B. Numerical
• C. Ethical
• D. Relevant

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• A. Problem statement
• B. Research hypothesis
• C. Specific objective
• D. Conceptual framework

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• A. Research question
• B. Null hypothesis
• C. Alternative hypothesis
• D. Research objective

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• A. Research problem
• B. Conceptual framework
• C. Research hypothesis
• D. Background of the study

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• A. Limitations
• B. Assumptions
• C. Hypotheses
• D. Delimitations

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• A. The statistical tests to be used
• B. The boundaries and coverage of the research
• C. The number of research assistants needed
• D. The budget for the study

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• A. Gantt chart
• B. Flow chart
• C. Conceptual framework
• D. Research matrix

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• A. Background
• B. Scope
• C. Justification/Rationale
• D. Methodology

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SECTION 3: REVIEW OF LITERATURE (Q23–30)

• A. Secondary source
• B. Tertiary source
• C. Primary source
• D. Grey literature

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• A. Literature review
• B. Narrative review
• C. Meta-analysis
• D. Scoping review

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• A. Show the examiner how many books the student has read
• B. Identify gaps in existing knowledge and justify the new study
• C. Replace the methodology section
• D. List all available publications on the topic

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• A. SPSS
• B. EpiInfo
• C. Mendeley
• D. Microsoft Excel

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• A. [1]
• B. (Author, Year)
• C. Superscript¹
• D. Author [page]

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• A. Written by a popular author regardless of credentials
• B. Published more than 20 years ago for historical context
• C. Peer-reviewed, current, and relevant to the research topic
• D. From any website or blog

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• A. Writing the review chapter
• B. Searching databases for articles
• C. Defining keywords and search terms
• D. Critically appraising articles

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• A. A textbook summarising multiple studies
• B. A systematic review article
• C. An original journal article reporting a clinical trial
• D. A newspaper health column

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SECTION 4: RESEARCH METHODS — DESIGN & SAMPLING (Q31–42)

• A. Cohort study
• B. Cross-sectional study
• C. Case-control study
• D. Randomised Controlled Trial

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• A. Cohort study
• B. Cross-sectional study
• C. Case-control study
• D. Randomised Controlled Trial (RCT)

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• A. Cross-sectional study
• B. Case-control study
• C. Cohort study
• D. Descriptive survey

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• A. True experimental design
• B. Quasi-experimental design
• C. Case-control study
• D. Cross-sectional study

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• A. Target population
• B. Sample
• C. Sampling frame
• D. Study unit

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• A. Simple random sampling
• B. Stratified random sampling
• C. Cluster sampling
• D. Systematic sampling

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• A. Cluster sampling
• B. Systematic sampling
• C. Stratified random sampling
• D. Purposive sampling

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• A. Simple random sampling
• B. Convenience sampling
• C. Cluster sampling
• D. Purposive sampling

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• A. Fisher's formula
• B. Cochran's formula
• C. Yamane's formula
• D. Cohen's d

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• A. Purposive sampling
• B. Convenience sampling
• C. Snowball sampling
• D. Simple random sampling

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• A. Stratified sampling
• B. Systematic sampling
• C. Cluster sampling
• D. Simple random sampling

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• A. Sample
• B. Target population
• C. Sampling frame
• D. Accessible population

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SECTION 5: DATA COLLECTION, VALIDITY & ANALYSIS (Q43–52)

• A. Pre-test analysis
• B. Feasibility study
• C. Pilot study
• D. Validity test

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• A. Reliability
• B. Specificity
• C. Validity
• D. Precision

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• A. Content validity
• B. Test-retest reliability
• C. Construct validity
• D. Inter-rater reliability

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• A. Primary data
• B. Secondary data
• C. Experimental data
• D. Qualitative data

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• A. Editing
• B. Cleaning
• C. Tabulation
• D. Coding

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• A. 6
• B. 8
• C. 10
• D. 7

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• A. Mean
• B. Mode
• C. Median
• D. Standard deviation

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• A. Chi-square test
• B. ANOVA
• C. Pearson correlation
• D. Independent samples t-test

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• A. The study has a 0.1% error rate
• B. The null hypothesis is accepted
• C. The result is statistically significant; reject H₀
• D. The sample size was inadequate

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• A. Results
• B. Methodology
• C. Introduction
• D. Discussion

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SECTION 6: RESEARCH ETHICS & PROPOSAL FORMAT (Q53–60)

• A. Validity, Reliability, Objectivity
• B. Respect for Persons, Beneficence, Justice
• C. Autonomy, Veracity, Fidelity
• D. Informed consent, Anonymity, Confidentiality

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• A. Justice
• B. Autonomy
• C. Beneficence
• D. Non-maleficence

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• A. Sampling bias
• B. Type II error
• C. Research fraud/misconduct
• D. Random error

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• A. Kenya Bureau of Standards
• B. Ministry of Education
• C. KEMRI / NACOSTI
• D. Kenya Medical Association

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• A. Beneficence
• B. Justice
• C. Voluntary participation / Autonomy
• D. Confidentiality

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• A. Research dissertation
• B. Concept paper
• C. Research report
• D. Abstract

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• A. Chapter 1 — Introduction
• B. Chapter 2 — Literature Review
• C. Chapter 3 — Methodology
• D. Chapter 4 — Results

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• A. Literature review
• B. Discussion of findings
• C. Informed consent form and research instruments
• D. Research objectives

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✅ COMPLETE ANSWER KEY

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📊 Score Guide

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High-frequency exam topics: Sampling methods (Q35–42), Hypothesis types (Q16–18), Belmont principles (Q53–54), Study designs (Q31–34), p-value interpretation (Q51), and Research fraud (Q55). These appear in virtually every KMTC research exam.

KMTC Research Methods — Complete Topic Summaries

Based on Zone 7 Final Timetable Topics

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TOPIC 1: CONCEPTS OF RESEARCH

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Definition

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Purpose of Research in Healthcare

1. Describe health phenomena and disease patterns
2. Explain cause-and-effect relationships
3. Predict future health outcomes
4. Improve clinical practice and patient care
5. Inform health policy and resource allocation
6. Develop new treatments, drugs, and interventions

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Characteristics of Good Research

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Types of Research

By Purpose

By Approach

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Reasoning in Research

• Inductive reasoning: Specific observations → General conclusions (Qualitative)
• Deductive reasoning: General theory/hypothesis → Specific test (Quantitative)

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Concepts of Epidemiology

• Definition: Study of the distribution and determinants of disease in populations
• Distribution: Who gets it? Where? When? (person, place, time)
• Determinants: Why? What causes it?
• Key measures: Incidence, Prevalence, Mortality rate, Morbidity rate

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TOPIC 2: RESEARCH PROBLEM

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Research Gap

• Clinical observation
• Unanswered questions in published literature
• Policy or programme needs
• Community health priorities

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Identifying & Prioritising a Research Topic

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Background of the Study

• Reviews the global, regional, and local context of the problem
• Uses statistics and data to show the MAGNITUDE of the problem
• Leads logically to the problem statement

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Problem Statement

1. Context — what is the current situation
2. Magnitude — statistics showing extent of the problem
3. The gap — what is NOT yet known locally
4. Consequences — what happens if unaddressed
5. Proposed investigation — what the study will explore

✏️ Example: "Despite free TB treatment under the DLTLD programme, default rates at [Name] Hospital remain at 30%, well above the national target of <5%. The specific factors driving this default have not been studied at this facility."

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Research Questions

• Interrogative form of the objective
• Open-ended questions guiding data collection
• Example: "What factors contribute to TB treatment default at [Name] Hospital?"

Research Objectives

• General objective: Broad statement of the overall aim
• Specific objectives: Narrow, measurable, action-oriented sub-goals
• Begin with action verbs: assess, determine, compare, establish, evaluate, identify

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Hypothesis

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Limitations, Assumptions & Scope

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Conceptual Framework

• A visual or narrative diagram showing the relationship between variables
• Shows: Independent variable(s) → Dependent variable(s) and any confounding/intervening variables
• Guides what to measure and how variables interact

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TOPIC 3: REVIEW OF LITERATURE

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Definition

Purpose

1. Show what is already known
2. Identify knowledge gaps justifying the study
3. Avoid duplication of existing research
4. Provide a theoretical basis for the study
5. Guide choice of methodology

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Sources of Literature

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Steps for Conducting a Literature Review

1. Define keywords and search terms
2. Search relevant databases (PubMed, Google Scholar, HINARI, WHO IRIS, AJOL)
3. Screen titles and abstracts for relevance
4. Retrieve and critically appraise full-text articles
5. Synthesise findings thematically and write the review

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Characteristics of Good Literature

• Peer-reviewed — evaluated by independent experts before publication
• Current — published within the last 5–10 years (unless seminal work)
• Relevant — directly related to the research topic
• Credible — from a recognised author/institution/journal
• Accessible — available in full text for verification

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Citation and Referencing

APA Style (used at KMTC)

• In-text: (Mugenda, 2009)
• Two authors: (Wanjiru & Odhiambo, 2021)
• Reference list: Mugenda, O. M. (2009). Research methods: Quantitative and qualitative approaches. ACTS Press.

Vancouver Style

• In-text: Numbered [1] or superscript¹
• Used in clinical/medical journals

Referencing Software

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Meta-analysis vs. Systematic Review

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TOPIC 4: RESEARCH METHODS

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A. Study Designs

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B. Study Area, Target Population & Sampling

Key Definitions

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Sample Size Determination

• Yamane's formula (known population): n = N / (1 + N(e²))
  • N = population size, e = margin of error (usually 0.05)
• Fisher's formula (unknown/large population): n = Z²pq / d²
  • Z = 1.96 (95% confidence), p = expected proportion, q = 1-p, d = 0.05

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Sampling Techniques

Probability (Random) Sampling

Non-Probability Sampling

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C. Data Collection

Types of Data

• Primary data: Collected fresh by the researcher (questionnaires, interviews, observation)
• Secondary data: Already existing (hospital records, MOH reports, registers)

Data Collection Instruments

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D. Pilot Study

• A small-scale trial run of the instrument on ~10% of sample from a similar but separate population
• Tests: Clarity of questions, time required, validity, reliability, logistics
• Corrections made BEFORE the main study begins

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E. Validity and Reliability

Validity — "Are we measuring the right thing?"

Reliability — "Do we get consistent results?"

Key rule: An instrument can be reliable WITHOUT being valid, but a valid instrument MUST also be reliable.

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F. Data Entry, Processing & Analysis

Processing Steps

1. Editing — check completeness and accuracy of filled instruments
2. Coding — assign numbers to categorical responses
3. Entry — input data into software (SPSS, Excel, EpiInfo)
4. Cleaning — identify and correct errors/missing values

Data Analysis

Key Statistics

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G. Discussion, Conclusion & Recommendation

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TOPIC 5: RESEARCH ETHICS

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History of Research Ethics

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Belmont Report — Three Core Principles

1. Respect for Persons (Autonomy)

• Individuals are autonomous agents — they decide for themselves
• Informed consent must be obtained
• Vulnerable groups (children, prisoners, mentally ill) need extra protection

2. Beneficence

• Maximise benefits to participants and society
• Minimise harm and risk
• Benefits must clearly outweigh risks

3. Justice

• Fair selection of participants — no group exploited for another's benefit
• Risks and benefits distributed equitably across society

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Ethical Considerations in Research

1. Informed consent — fully inform and obtain voluntary agreement
2. Confidentiality — do not disclose personal information; use codes
3. Anonymity — identities not traceable in data or reports
4. Right to withdraw — at any time, without penalty
5. Ethical approval — from IRB/KEMRI/NACOSTI before commencing
6. Non-maleficence — do not harm participants physically or psychologically
7. Voluntary participation — no coercion or undue inducement

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Research Fraud (Misconduct)

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Ethical Approval in Kenya

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TOPIC 6: CONCEPT PAPER, PROPOSAL & DISSERTATION FORMAT

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Concept Paper

• Length: 2–5 pages
• Purpose: Introduce the research idea to supervisors or funders before full proposal
• Contents: Working title, background, problem, objectives, proposed methodology, significance

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Research Proposal Format (KMTC)

Preliminary Pages

• Title page
• Declaration
• Dedication
• Acknowledgements
• Table of contents
• List of tables and figures
• Abstract (300–500 words)
• List of abbreviations

Chapter Structure

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Dissertation Format (Final Completed Study)

• Chapter 4: Results/Findings — tables, graphs, narratives
• Chapter 5: Discussion, Conclusions & Recommendations
• Complete references
• Full appendices including raw data summary, ethical approval letter

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Difference: Concept Paper vs. Proposal vs. Dissertation

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TOPIC 7: RESEARCH SUPERVISION & PRESENTATION

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Role of the Supervisor

1. Provide academic and methodological guidance
2. Review and give written feedback on proposal chapters and dissertation
3. Advise on ethical issues, analysis, and interpretation
4. Track student progress and ensure adherence to deadlines
5. Recommend student for ethical clearance and final submission

Role of the Student

1. Identify the research topic and write the proposal independently
2. Meet supervision appointments and submission deadlines
3. Collect, enter, and analyse data as per the approved protocol
4. Incorporate feedback promptly and submit revised work
5. Maintain a supervision log/progress tracker

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Preparing a Research PowerPoint Presentation

Essential Slides

Tips for Effective Presentation

• Keep slides concise — bullet points, not paragraphs
• Use graphs and tables to present data visually
• Face the audience — do not read slides word-for-word
• Practice beforehand; stay within allotted time
• Be prepared to answer questions on methodology and findings

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QUICK MASTER REFERENCE TABLE

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Exam tip: These summaries cover every topic on your Zone 7 timetable. For the CAT and final exam, focus on being able to: (1) define and give examples, (2) compare/contrast two similar concepts, and (3) apply concepts to a given clinical scenario. Those three skills answer 90% of KMTC research exam questions.

SIRS → Sepsis → MODS → Death

Your Body Can Kill Itself — Made Easy

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THE BIG IDEA 🧠

Imagine your body's defense system is like a fire alarm. A small fire (infection/injury) triggers the alarm. But sometimes the alarm goes so crazy it burns down the whole house trying to put out the fire. That is SIRS → Sepsis → MODS.

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STEP 1: SIRS

Systemic Inflammatory Response Syndrome

What is it?

Think of it as:

🔥 "The body overreacts to a problem"

Diagnosis — ANY 2 of these 4 criteria:

Key point:

• SIRS can happen WITHOUT infection — burns, pancreatitis, major trauma all cause SIRS
• It is the body's inflammatory fire alarm gone loud

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STEP 2: SEPSIS

When SIRS + Infection = Sepsis

What is it?

Simple formula:

🦠 SIRS + Infection = SEPSIS

Think of it as:

"Your immune system is fighting an infection but it's fighting TOO hard — and now it's damaging your own organs in the process."

What happens inside the body:

1. Bacteria/virus enters the blood
2. Immune system releases cytokines (chemical alarm signals) — TNF, IL-1, IL-6
3. These cytokines cause widespread inflammation throughout the body
4. Blood vessels dilate (widen) → blood pressure drops
5. Blood clots abnormally in small vessels → blocks organ blood flow
6. Organs begin to receive less oxygen

Signs of Sepsis (qSOFA — quick bedside tool):

• Altered mental status (confusion)
• Respiratory rate ≥ 22/min
• Systolic BP ≤ 100 mmHg

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STEP 3: SEVERE SEPSIS & SEPTIC SHOCK

Severe Sepsis:

Sepsis + Organ dysfunction The fire is now burning the organs

Septic Shock:

Severe sepsis + Persistent hypotension despite giving IV fluids

• Systolic BP < 90 mmHg even after fluid resuscitation
• Body needs vasopressors (drugs to squeeze blood vessels) just to maintain pressure

Think of it as:

🚨 "Blood pressure has collapsed. The organs are in danger. This is a medical emergency."

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STEP 4: MODS

Multiple Organ Dysfunction Syndrome

What is it?

Think of it as:

💥 "The fire has spread to every room in the house."

Organs that fail — one by one (or all at once):

Key rule:

The more organs that fail, the higher the mortality.

• 1 organ failing → ~15–20% death
• 2 organs → ~40–50%
• 3+ organs → >80% death

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THE FULL CASCADE — SIMPLIFIED

INFECTION / INJURY / BURN / TRAUMA
           ↓
    Body overreacts
           ↓
         SIRS
  (inflammation everywhere)
           ↓
    + Confirmed Infection
           ↓
        SEPSIS
  (immune system overdrive)
           ↓
    Organs not getting blood
           ↓
     SEVERE SEPSIS
   (first organ starts failing)
           ↓
   BP crashes despite fluids
           ↓
     SEPTIC SHOCK
           ↓
  Multiple organs now failing
           ↓
         MODS
           ↓
    ⚠️ DEATH (if untreated)

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WHY DOES THE BODY KILL ITSELF?

Normal response vs. SIRS/Sepsis response:

The paradox:

The body's own defense mechanism — inflammation — becomes so exaggerated that it destroys healthy tissue, collapses blood pressure, and shuts down organs. The cure becomes the killer.

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MANAGEMENT SUMMARY

The Sepsis 1-Hour Bundle (Surviving Sepsis Campaign)

Remember: TIME = ORGANS

Every hour of delay in antibiotics increases mortality by ~7%

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MEMORY TRICKS 🧠

Temp + Heart Rate + Respiratory Rate + WBC

"Soldiers Start Shooting Madly" S = SIRS, S = Sepsis, S = Shock, M = MODS

Severe Sepsis = organ dysfunction Septic Shock = organ dysfunction + BP won't come up with fluids

"Lungs, Kidneys, Liver, Heart, Brain, Blood, Gut" "Lucky Kidneys Let Heart Beat Bright Green"

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QUICK SUMMARY TABLE

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Bottom line: Your body's immune system is designed to protect you. But when it loses control — whether from infection, trauma, or burns — it attacks everything, including your own organs. The key to saving patients is recognising the cascade early and breaking it with fluids, antibiotics, and organ support before MODS sets in.