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Health and Social Care: Literature Searching & Reviewing

Library subject guide for nursing, midwifery, health and social care

Literature reviewing - the overview

A literature review can form a part of any assignment but it is perhaps more commonly associated with work at dissertation and Masters levels. It should represent an overview of a specific question , sketching out the state of that subject and the ongoing debates and research at that point in time. Your literature search will have been wide ranging and systematic in approach and may use sources as wide ranging as books, journal articles, government policies, web pages, theses etc. Your review of the literature will involve critical analysis of the arguments and positions, not just a description of the literature.

Look at the powerpoint slides below for a brief outline of literature reviewing.

 

In health and  social care the two main types of literature review are the narrative or integrative literature review and the systematic review.

Traditional or Narrative Literature Review

  • Broad in focus. Does not always address a specific question.

  • Not comprehensive in literature included.

  • Does not  always state reasons for inclusion of papers.

  • Not structured in approach to searching for literature or critical appraisal

   Example of a traditional /narrative literature review


Integrative Review

  • Reviews, critiques, and synthesises  literature on a topic in an integrated way.
  • Summarises past theoretical and empirical literature on a topic.
  • Attempts to generate new frameworks and perspectives on that topic.
  • Does not always use explicit systematic approaches in searching or data analysis therefore quicker to complete  (when compared with systematic reviews).
  • Potential for bias and lack of rigour.

Example of an integrative review


Systematic Review

A review of research literature using  a systematic, explicit,  accountable and dcocumented methodology.

The key characteristics of a systematic review are:

  • Rigor: use of systematic methods to answer set research question

  • Transparency: every step is described; nothing left to reader’s imagination

  • Replicability: a second researcher should arrive at the same conclusions

 

Systematic reviews are carried out by a team, or at least two, individuals and usually take 12 months or more to undertake.

Students undertaking undergraduate, Masters or PhD dissertations should take a systematic approach to reviewing the literature but they will not be expected to complete a full systematic review following full Cochrane Library methodologies.

 

Example of a systematic review

 

 

 

A good literature review should:

  • Address a focused, explicit research question.
  • Take a systematic approach to the searching of the literature.
  • Document the search process so that it is replicable  by others  (often a requirement for publication within many academic journals)
  • Demonstrate that a wide range of sources have been searched.
  • Undertake a critical analysis of the retrieved literature, not merely describe what has been read.
  • Justify why particular items of literature are being referred to. They should summarise the current state of research,  perhaps debates that have taken place over a period of time within that topic or arguments for and against a particular aspect of the topic.
  • Relate the question to the larger body of knowledge within which your topic sits, and to put your work into context.
  • Summarise the current state of the research evidence.
  • Identify the gap in the literature that your research question is going to answer.

 

Common Mistakes

  • Review is too descriptive. No critiquing or critical evaluation of the evidence. No identification of strengths and weaknesses. It becomes an essay, not a review. It does not set the foundation for your own research process.
  • It becomes a dumping ground to write down everything you know about the topic  or is presented as a series of quotes from the papers you have read.
  • Not enough time has been allocated to searching and reviewing the literature. Do your literature reviewing early. It helps inform your final research question, future methodologies and identifies whether there is indeed a "gap" in the current research literature that your queston is going to answer.
  • Literature used is not from scholarly peer reviewed sources.
  • There is no documentation or explanation of how the search was undertaken and the key terms used. No explanation of inclusion/exclusion criteria.
  • Referencing does not follow the School guidelines. It is not consistent in style or presentation.
  • There has been no revision or proof reading. Thinking develops as you write. Go back over what you have written a few days after you have done it. Check grammar and language – give it to someone else to proof read.

Here are 5 top tips towards a stress free  literature review

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Literature reviewing - the process

 

Identify an area from practice that you are interested in – ideally something the practice area can benefit from.

The question you develop from this topic should be focused, manageable and answerable within the timescales you have.

 

There are two frameworks that are commonly used to formulate research questions:

PICO   - (quantitative research)

  • Patient/Population - Who or What?
  • Intervention - How?
  • Comparison - What is the main alternative? (If appropriate)
  • Outcome - What are you trying to accomplish, measure, improve, effect?

Leeds University Library (2015) The PICO model. Leeds: The Library.

 

SPIDER  (qualititative or mixed methods research)

  • Sample  = smaller group of participants than in quantitative research
  • Phenomenon of Interest -  behaviours, decisions, and individual experiences.
  • Design   - theoretical framework
  • Evaluation – outcomes, constructs , attitudes, views etc
  • Research type –qualitative or mixed methods

 

Further Information

University of Leeds. Leeds Institute of Health Sciences (2016)   Search Concept Tools.

Cooke, A. Smith, D, and  Booth, A (2012) Advancing qualitative methods: beyond PICO: the SPIDER tool for qualitative evidence synthesis Qualitative Health Research  22 1435-1443,

 

 

Decide on the types of literature  relevant to your question

  • Have any reviews or systematic reviews been undertaken already?
  • Is your topic liable to throw up qualitative, quantitative or mixed methods papers?
  • Are there any  health board, local or national government policies that are relevant to your topic to put it into context?
  • Are there any PhD theses that have been written in your  field?
  • What about “grey literature”  - nowadays this often refers to items published on the web, eg from leading charities or policy, campaign or think tank groups.

 Draw up a search strategy (1) :  keywords, phrases, concept identification

  • Start by putting your research question at the top of a piece of A4 paper. Draw a table underneath with one column representing  each of the main concepts or ideas in your question. Most people have 2 or 3 main concepts within their questions.
  • Within each column, write down as many keywords or phrases that are used to describe this concept. This becomes the keyword list for searching databases. A carefully planned list of keywords and synonyms will mean you are not likely to miss literature when you search.
  • Recommended reading:  De Brun, C (2013) Searching Skills Toolkit . 2nd ed. Chichester:Wiley. Chapter 6 : Building a search strategy

Search  Strategy (2): Decide on Inclusion /Exclusion Criteria

  • On  your search plan, explicitly state your inclusion and exclusion criteria. These will help focus your database search strategy for your literature review   eg

 What countries are you including or excluding? Do you need to go back 5, 10, or 20 years or more and can you explain why? Are you concerned with a particular age group of client? What types of research are you including/excluding - qualitative or quantitative or mixed methods? Are you limiting your search to certain languages?
 


 Search Strategy (3): List the sources to search

The evidence sources you search will depend on your topic.  You should be searching more than one of the subject specific databases in your field using  a combination of the keywords and phrases from your search plan. There is a full list of appropriate  evidence sources /databases on the Home page of this LibGuide.


Search Strategy (4): Carry out the search  and record the search strategy

Video : Finding evidence using CINAHL

You can automatically record & save the search strategy you type into a database. This can be printed as an Appendix in your assessment and demonstrates your planned, systematic approach to your literature search. 

Keeping track of literature

Writing a literature review will mean that you will collect a large number of pieces of information from many sources.  Before you begin searching, give some thought as to how you are going to manage this information.You will need to manage both the full text that you download, and the references. You can do this manually, on your computer,  or we would recommend using specialist reference management software.

Reference management software will enable you to automatically  export references you collect from database searches and store them in the reference manager.   Once you have read each paper you can then make personal research notes and store these within each reference inside the reference manager.

Use the software  to format the citations within the text of your review. It will also produce the reference list at the end of your document formatted in a style of your choosing (preferably one recomended by the School).

See the referencing page on this guide for a helpsheet and some videos on how to get started with Endnote, Edinburgh Napier’s referencing management software.

NHS Scotland users can also use the Refworks ref management software supplied on the NHS Knowledge network site instead of Endnote,  if they would prefer.

What is critical appraisal? Why do we do it?

Following retrieval of all pertinent research papers from your literature search, critical  appraisal will identify the strengths and weaknesses of what you have found. Authors may exaggerate their findings or there may be methodological flaws in the research.  Critical appraisal lets you make informed decisions about the quality of the research evidence.
 

Critical appraisal is often carried out using checklists that help signpost areas to look for while reading a paper. There are different types of checklist depending on the type of research you are reviewing.


Critical Appraisal Tools / Checklists

CASP - eight critical appraisal tools  for use when reading different types of research. The most well known list from the Critical Appraisal Skills Programme

Cardiff University - Critical Appraisal Checklists

SIGN six lists from the Scottish Intercollegiate Guidelines Network

Equator Network - guidelines to promote transparent and accurate reporting  of health research

CEBMfour lists from Oxford's Centre for Evidence Based Medicine


Critical Appraisal Resources

Book

 Greehalgh, T (2010) How to read a paper :  the basics of evidence-based medicine. 4th ed. Chichester : Wiley-Blackwell/BMJ Books

 

Videos

Two excellent videos from Andrew Booth at SCHARR at the University of Sheffield. These take you through the actual process of appraising papers using the CASP tool.

Appraising a Quantitative Study             [13 mins]

Critical Appraisal of a Qualitative Study  [12 mins]

 

 

 

 

 

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