Advanced practice toolkit

You may decide that it is essential for your professional practice that you summarise and critique relevant evidence. A literature review can also be undertaken to inform a research project.  It is useful to have a second reviewer involved, particularly for the study selection and data extraction processes. A librarian can also assist with developing the search strategy. Undertaking a literature review can be time consuming and must follow a robust process. The Knowledge Network librarians are invaluable in offering training to enable you to make the best use of the vast wealth of research evidence NHS Scotland provides via library search. This includes eBooks, research journals and databases for in depth literature review.

The Centre for Reviews and Dissemination publishes guidance on undertaking reviews. Review methodology is evolving constantly.  ‘Systematic reviews’ is an open access journal which publishes papers on the design, conduct and reporting of systematic reviews. Organisations such as JBI also update their handbooks to reflect evolving methodology.

The search method you select will be informed by your reason for carrying out the review. Examples of different types of review include umbrella reviews, rapid reviews, effectiveness reviews, and qualitative reviews. It is essential to develop a protocol setting out the question and methods for the review.

The following websites have detailed information on developing a protocol:

• The Cochrane Library
• JBI manual for evidence synthesis

You can find examples of completed protocols on PROSPERO

The literature review question

The way in which the literature review question or statement is formulated will depend on the purpose of the review.

For example, effectiveness reviews can use PICO, while qualitative reviews may use PEO. Clinical questions: PICO and PEO research.

Other question/ statement formats include SPIDER, ECLIPSE and SPICE. 

Developing the search strategy is key to finding the literature you need to answer the question. You need to decide where to search and which terms to use to search.

How to write a search strategy for your systematic review - Covidence.

The Knowledge Network will allow you to search ASSIA for social science information and EThOS will allow you to search for relevant theses. A librarian will be invaluable in helping you develop keyword and index terms. They can advise on using strategies such as truncation and wildcards to refine your search.

Inclusion and exclusion criteria are used to set the boundaries for your review.  Common inclusion and exclusion criteria include the date range, location of the study, participant, interventions, outcomes and study design. The inclusion and exclusion criteria are applied as part of the review process, after duplicates have been excluded and titles and abstracts screened to exclude irrelevant papers.

It is essential to keep track of the results of the search. The PRISMA flow diagram is a really effective way of doing this.

Reference manager systems like RefWorks and Mendeley are useful resources to save your papers. You can add papers directly to your preferred reference manager from some databases and it will also provide a reference list in the correct format.

Data extraction is the process of identifying the relevant data from the papers. Before undertaking this stage of the review, you need to be clear about what information you need to answer your question. You can develop your own form or use a ‘ready-made’ form, for example those produced by JBI. Regardless of which approach you choose, you must pilot the data extraction form, since changing it after you have started the data extraction process can lead to errors. Ideally two people will check the data extraction to ensure that it is accurate.

Depending on the resources available, you may be able to use specialised software such as RevMan or NVivo to manage the data.

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 has a wide range of critical appraisal tools, along with information about how to use them.

The information about the quality of the paper can be used to account for the differences and similarities between papers and integrated into the synthesis of the papers.

Data synthesis is the process where the data are combined and summarised to answer the review question. Quantitative data can be synthesised using meta-analysis, providing that the data are homogenous (a single type of data) and the studies are of good quality: https://www.york.ac.uk/media/crd/Systematic_Reviews.pdf 

It is also possible to report quantitative data narratively. The Synthesis Without Meta-analysis (SWiM) guideline has been developed to facilitate clear reporting of quantitative reviews that do not use meta-analysis for synthesis.

Qualitative data can be synthesised using a range of approaches. The Centre for Reviews and Dissemination has guidance on the conduct of narrative synthesis. Other approaches include that developed by JBI.  

The findings of your literature review can be disseminated informally through local meetings, relevant conferences, development days and newsletters. You may wish to contact your local advanced practice academy to discuss your research findings. Your evidence can also be published in professional or academic journals. Academic journals have their own styles and formats which can impact on the length and structure of your paper and usually require you to use a reporting guideline. You can find reporting guidelines on the EQUATOR network

Journal clubs can help practitioners to increase knowledge, develop skills and interest in research, critical thinking and appraisal skills. They can also help to promote evidence-based practice.  They can take place locally or virtually.

One of the many benefits of being in a journal club is that it can bring together practitioners with a common interest or field of practice.

Turas Learn has a range of guidance on journal clubs:

• EL009(v1) - How to run an effective journal club | Turas | Learn (nhs.scot)
• Journal club critical appraisal | Turas | Learn (nhs.scot)
• Journal clubs- what, why and how | Turas | Learn (nhs.scot)

Other useful guidance

• Council For Allied Health Professions Research
• Nursing Times' Journal Club FAQs | Nursing Times