Advanced practice toolkit

Once you have developed your question, you can use it to identify search terms. This short video shows you how to turn search terms into a strategy.

You can also have a go at trying out your own clinical question with this activity. The activity is designed to walk you through the process of going from your “PICO” question to the steps of a rapid search (a few minutes) for the evidence.

There are a range of sources of clinical evidence. Secondary sources of evidence include systematic reviews and clinical guidelines and practice standards. Secondary sources have searched for primary studies and compared and evaluated them to draw conclusions or make recommendations. Reviews and guidelines will also detail the risks and limitations.

Evidence based reviews and guidelines are available from a range of sources. Some may have restricted access unless you use the Knowledge Network to access them. The Knowledge Network is accessible by using your NHS email address and password. You can access the Knowledge Network here http://www.knowledge.scot.nhs.uk/home.aspx

Sources of secondary evidence include:

• Cochrane Library
• Scottish Intercollegiate Guidelines Network (SIGN)
• JBI
• National Institute for Health and Care Excellence

Some professional organisations and peer reviewed journals may also have guidelines and literature reviews.

Primary sources of evidence are original research, and these are usually found in peer-reviewed academic journals. To help locate relevant research, you can use databases to search for evidence.

Useful databases include CINAHL – a database which covers nursing and allied health journals and PubMed (Medline) which covers medicine, nursing and allied health professions, as well as biomedical research and policy.

To access CINAHL or Medline, you need a subscription. The Knowledge Network provides free access to the databases.

PubMed is free to use and allows you to save your search, as well as email the results to you. You can also create alerts and PubMed will email details to you when relevant papers are published.

PubMed has a range of resources to help you search effectively. This short video demonstrates how to use Medical Subject Heading (MESH) to search.

If the research paper is available online, PubMed can link you to it. If the paper is Open Access, it will be available without the need to log in. If a journal requires a subscription, you may be able to access it using your log in information for the Knowledge Network.

You can store relevant papers in a Reference Manager, like RefWorks or Mendeley. They are free to use reference management systems to store and organise your references. You can import papers from Medline, CINAHL and PubMed as well as other sources including The Knowledge Network Library Search. If you are writing a report or assignment, it can even insert references in the correct format.

Once you’ve found primary research, you will need to make a judgement about the quality of the paper by critically appraising it. Checklists are available to help focus on the important aspects of a research paper to enable you to evaluate the validity of the study and its relevance to your practice. It is important to choose the appropriate checklist for the research design. Usually, the research design is stated in the title of the paper or in the abstract.

The Critical Skills Appraisal Programme (CASP) has a range of checklists, as well as resources on how to use them.

The critical appraisal tools from the Centre for Evidence Based Medicine are particularly useful because they provide information about what you should look for when you’re critiquing research, as well as where the information can be found.

JBI Manual for Evidence Synthesis has a wide range of critical appraisal tools, along with information about how to use them.

Undertaking critical appraisal can be daunting. You can learn about critical appraisal by taking part in workshops or by reading reviews of research. Systematic reviews make judgements about the quality of research. By reading a systematic review and then reading the original paper, you can begin to understand how research methods contribute to the quality of the study and how it influences the findings.

To support you with critical appraisal you can access a range of resources on Turas. This page includes a critical appraisal skills programme CASP checklist, CASP eLearning modules, and practical exercises.