Chapter 6 Understanding and Critically Appraising the Literature Review Copyright © 2018, Elsevier Inc. All Rights Reserved. Learning Objectives Discuss the purposes of the literature review in quantitative and qualitative research. Critically appraise the literature review section of a published study for current quality sources, relevant content, and synthesis of relevant content. Conduct a computerized search of the literature. Write a literature review from a synthesis of critically appraised literature to promote the use of evidencebased knowledge in nursing practice. Copyright © 2018, Elsevier Inc. All Rights Reserved. 2 What Is the Purpose of a Literature Review? Identifies theoretical and scientific knowledge Identifies what is known and unknown about the topic Identifies available evidence for use in practice Identifies contribution of present study to knowledge base Copyright © 2018, Elsevier Inc. All Rights Reserved. 3 What Are the Typical Sources Included in a Literature Review? Periodicals and journals Internet publications Monographs Encyclopedias Conference papers Theses and dissertations Books and textbooks Copyright © 2018, Elsevier Inc. All Rights Reserved. 4 What Are the Two Types of Sources? Primary sources In research, written by the person(s) who conducted the research In theory, written by the theorist(s) who developed the theory Secondary sources Paraphrase the works of researchers and theorists Copyright © 2018, Elsevier Inc. All Rights Reserved. 5 What Questions Are Important When Critically Appraising Literature Reviews? Are primary sources cited in the review? Are the references current? Are relevant studies identified and described? Are relevant theories identified and described? Are relevant landmark studies described? Are the studies critiqued? Copyright © 2018, Elsevier Inc. All Rights Reserved. 6 Questions for Critically Appraising Literature Reviews Are sources paraphrased to promote the flow of content? Is the current knowledge about the research problem described? Does literature review identify gap(s) in the knowledge base that provides a basis for study? Is the literature review clearly organized, logically developed, and concise? Copyright © 2018, Elsevier Inc. All Rights Reserved. 7 What Components Might the Nurse Research Include in the Literature Review? What is known and not known about the topic? The focus of the study Sources must be current—published within the past 5 years Landmark studies may be included if essential to the background of the problem. Copyright © 2018, Elsevier Inc. All Rights Reserved. 8 What Sources Would Be Suitable for a Literature Review? Academic libraries—colleges and universities Special libraries—hospitals, Sigma Theta Tau Center for Nursing Scholarship Interlibrary loan Online search Public libraries Copyright © 2018, Elsevier Inc. All Rights Reserved. 9 Which Databases Are Suitable for Nursing and Allied Health Reviews? • • • • • • CINAHL Medline OVID EBSCO host GALE Cengage Cambridge Scientific Copyright © 2018, Elsevier Inc. All Rights Reserved. 10 Audience Response Question What is the primary purpose for reviewing relevant literature? a. Delineate the existing knowledge base of an identified problem. b. Develop conceptual and operational definitions of variables. c. Interpret previous research findings. d. Select the research design. Copyright © 2018, Elsevier Inc. All Rights Reserved. 11 How Are Keywords Defined? Major concepts or variables of a research problem or topic used to search a database May be single terms or phrases Most databases have a thesaurus that can be used to identify keywords. Each keyword used should be listed in a written search plan. Copyright © 2018, Elsevier Inc. All Rights Reserved. 12 What Might the Nurse Research Record From the Search? Name of database Date of search Exact search strategy used Number of articles found Percentage of relevant articles found This information can be stored in a table. Copyright © 2018, Elsevier Inc. All Rights Reserved. 13 How Can the Nurse Researcher Limit the Search? • To English language • The publication dates to recent years • To papers that are research • To full-text articles (this can be risky) • Peer-reviewed publications Copyright © 2018, Elsevier Inc. All Rights Reserved. 14 What Sources Can Be Utilized When Searching the Internet? Search engines provide the means to search the Internet. Some are better than others. Google Scholar is an excellent search engine. University libraries provide a list of good search engines. You may find information on the Internet that is useful to your topic. Copyright © 2018, Elsevier Inc. All Rights Reserved. 15 Audience Response Question Which of the following indexes would provide the largest number of relevant nursing sources? a. Cumulative Index to Nursing and Allied Health Literature b. International Nursing Index c. MedLine d. Nursing Studies Index Copyright © 2018, Elsevier Inc. All Rights Reserved. 16 What Are the Advantages and Disadvantages of Obtaining Information on the Internet? Advantage: information is more current than that found in books. Disadvantage: information is uneven in terms of accuracy. There is no screening process for information put on the Web. It is important to check the source of any information obtained on the Web to judge its validity. Copyright © 2018, Elsevier Inc. All Rights Reserved. 17 What Does the Researcher Include in the Synthesis of Sources? Compile findings from all selected studies. Analyze and interpret clustered findings. Specify current state of research-based knowledge. Copyright © 2018, Elsevier Inc. All Rights Reserved. 18 What Are the Steps in Writing a Review of the Literature? Purposes Document current knowledge of selected topic Indicate findings ready for use in practice Outline Introduction Empirical literature Summary Copyright © 2018, Elsevier Inc. All Rights Reserved. 19 What Is Included in the Introduction? Indicates focus or purpose of review Describes organization of sources Indicates basis for ordering: Most important to least Earliest to most recent Categories Copyright © 2018, Elsevier Inc. All Rights Reserved. 20 What Is Included in the Data-based Literature? Includes quality studies relevant to topic For each study, purpose, sample, sample size, design, and specific findings are presented, using paraphrasing rather than direct quotes. Scholarly, but brief, critique of study’s strengths and weaknesses Copyright © 2018, Elsevier Inc. All Rights Reserved. 21 What Is Included in the Summary Section? Concise presentation of research knowledge about selected topic—what is known and not known Judgment stating whether there is adequate knowledge to direct change in clinical practice Brief statement of proposed change in practice Copyright © 2018, Elsevier Inc. All Rights Reserved. 22 Unfolding Case Study As the nurse manager working in a pediatric emergency room you work to improve the quality of care for the patients and families who are served in the department. You attend a talk given by a mother who lost her daughter as a result of improper breakdowns in communication. You would like to implement a policy in your department to be sure this breakdown does not occur in your health system. This is the story of Josie King: http://www.josieking.org/whathappened This is the video of the lecture that you attended: King, S. (2001). The Josie King Story. Quality and Safety Education in Nursing. Retrieved from: http://qsen.org/videos/the-josie-king-story/ Copyright © 2018, Elsevier Inc. All Rights Reserved. 23 Searching for Evidence You and your colleagues conduct a search to find literature to support the potential change in practice policy. What components will be included in the literature review? Copyright © 2018, Elsevier Inc. All Rights Reserved. 24 Identify the PICOT Question You begin your search by identifying the population (P), intervention (I), comparison (C) of interventions, and what goals or outcomes (O) you hope to achieve, and the timing (T) in which the study was conducted. This will assist the nurse researcher with matching the search criteria to your practice setting, research problem/s, intervention/s, or question/s. P—patients in a pediatric emergency department I—implementing code HELP C—compare existing communication policy O—increased communication and patient satisfaction T—timing of study Copyright © 2018, Elsevier Inc. All Rights Reserved. 25 Identify Search Strategies Based on PICO Design keywords to search evidence Identify databases available Review current practice guidelines Search for similar populations and settings Copyright © 2018, Elsevier Inc. All Rights Reserved. 26 Critically Appraising Your search has yielded quite a few resources, articles, policies, and guidelines. How will you discern the sources and decide what to use for your practice change? Copyright © 2018, Elsevier Inc. All Rights Reserved. 27 Case The nursing team has completed the review of the literature and has convinced management to implement a Condition H communication system. The research team will then evaluate the effectiveness of the intervention. What will the research team include when they write the literature review? Copyright © 2018, Elsevier Inc. All Rights Reserved. 28
