Reading, writing and systematic review

Title. Reading, writing and systematic review. Aim. This paper offers a discussion of the reading and writing practices that define systematic review. Background. Although increasingly popular, systematic review has engendered a critique of the claims made for it as a more objective method for summing up research findings than other kinds of reviews. Discussion. An alternative understanding of systematic review is as a highly subjective, albeit disciplined, engagement between resisting readers and resistant texts. Reviewers of research exemplify the resisting reader when they exclude reports on grounds of relevance, quality, or methodological difference. Research reports exemplify resistant texts as they do not simply yield their findings, but rather must be made docile to review. These acts of resistance make systematic review possible, but challenge claims of its greater capacity to control bias. Conclusion. An understanding of the reading and writing practices that define systematic review still holds truth and objectivity as regulative ideals, but is aware of the reading and writing practices that both enable and challenge those ideals.     

Meta-analysis and decision analysis bridge research and practice

Research synthesis methods provide meaningful quantitative data through systematic review of the research literature and translation of these findings into practice implications. Meta-analysis has been the gold standard for translation of research findings into practice. Decision analysis has emerged as an alternative to and extension of meta-analysis. Examples, contrasting the application of meta-analysis and decision analysis, are presented and discussed in relation to its relevance in providing clinical direction. The methods are points along the continuum of translating research findings into practice. Meta-analytic studies provide an essential foundation for estimating and assigning the probabilities used in decision analysis, whereas the outcomes of decision analysis provide data for estimating the cost effectiveness of different interventions or treatment options. Decision analysis can assist in bridging the research-practice gap. Nurse researchers are urged to collaborate with other disciplines that have used these methods to refine translation and use of research findings in practice.     

Indicators of undergraduate nursing students' satisfaction with their learning journey: An integrative review

ObjectivesIn Australia Bachelor of Nursing programmes are delivered via both internal and distance modes yet there is little knowledge of the indicators of undergraduate nursing students' satisfaction with the learning journey. This integrative review was undertaken to uncover the indicators of undergraduate nursing students' satisfaction with their learning journey.DesignIntegrative review. A review of key papers was undertaken. Only peer-reviewed papers published in scholarly journals from 2008 onwards were included in this integrative review.Data sourcesPubmed, CINAHL, Google Scholar, Cochrane, Wiley Online and ProQuest Central databases were searched for relevant papers.Review methods49 papers were appraised, by a minimum of two team members. CASP tools were used when evaluating qualitative research, systematic and integrated reviews while survey research was evaluated using a tool specifically developed for this purpose by the research team. All tools used to assess the quality of the research studies contained comprehensive checklists and questions relevant for the particular type of study. Data related to these checklists was extracted and the research team appraised the quality of each article based on its relevance to the topic, internal and external validity, appropriateness of data analysis technique(s), and whether ethical considerations were addressed. Seventeen papers were included in the final analysis. Data analysis involved a systematic approach using content analysis techniques.ResultsThis integrative review sought to identify indicators of nursing students' satisfaction with their learning journey. Authentic learning, motivation, resilience, support, and collaborative learning were identified by this integrative review as being key to nursing students' satisfaction with their learning journey. Sub themes were identified within each of these themes that assist in explaining nursing students' views of their learning journey.ConclusionThe findings showed that higher satisfaction levels are attained when nursing students feel included and supported during their learning journey.     

Implementing remote triage in large health systems: A qualitative evidence synthesis

Remote triage (RT) allows interprofessional teams (e.g., nurses and physicians) to assess patients and make clinical decisions remotely. RT use has developed widespread interest due to the COVID‐19 pandemic, and has future potential to address the needs of a rapidly aging population, improve access to care, facilitate interprofessional team care, and ensure appropriate use of resources. However, despite rapid and increasing interest in implementation of RT, there is little research concerning practices for successful implementation. We conducted a systematic review and qualitative evidence synthesis of practices that impact the implementation of RT for adults seeking clinical care advice. We searched MEDLINE®, EMBASE, and CINAHL from inception through July 2018. We included 32 studies in this review. Our review identified four themes impacting the implementation of RT: characteristics of staff who use RT, influence of RT on staff, considerations in selecting RT tools, and environmental and contextual factors impacting RT. The findings of our systemic review underscore the need for a careful consideration of (a) organizational and stakeholder buy‐in before launch, (b) physical and psychological workplace environment, (c) staff training and ongoing support, and (d) optimal metrics to assess the effectiveness and efficiency of implementation. Our findings indicate that preimplementation planning, as well as evaluating RT by collecting data during and after implementation, is essential to ensuring successful implementation and continued adoption of RT in a health care system.     

An example of the use of systematic reviews to answer an effectiveness question

Systematic reviews assist nurses, other health care providers, decision makers, and consumers in managing the explosion of health care information by synthesizing valid data and reporting the effects of interventions. Nurses are increasingly using systematic reviews to guide their practice and develop policy. The purpose of the article is to outline the steps involved in conducting a systematic review with examples taken from a systematic review titled "Strategies to Manage the Behavioral Symptoms Associated With Alzheimer's Disease." The steps of a systematic review include: (a) formulating a well-defined question, (b) developing relevance and validity tools, (c) conducting a comprehensive search to retrieve published and unpublished reports, (d) assessing the reports using relevance and validity tools, (e) data extraction, (f) synthesis of the findings, and (g) report writing. Understanding the steps involved in a systematic review will assist nurses in critically appraising reviews and in conducting their own reviews.     

Nurses’ competence in genetics: An integrative review

The aim of this integrative review was to update a mixed method systematic review by Skirton, O'Connor, and Humphreys (2012) that reported on nurses’ levels of competence in using genetics in clinical practice. Three electronic databases were searched using selected key words. Research studies published in English between January 2011 and September 2017 reporting levels of nurse competence in genetics or genomics were eligible for inclusion. The selected studies were subjected to thematic analysis. Three main themes were identified: (i) genomic knowledge and utilization, (ii) perceived relevance to practice, and (iii) genomic education. While the reviewed papers produced varied findings, many nurses were shown to have poor genomic knowledge and/or competency, and yet there was a consensus that most nurses believe genomics is important to their practice. The present review indicated that in the past 5 years nurses have made minimal progress toward achieving the core genomic competencies appropriate for clinical practice.     

Pre- and postloss features of adolescent suicide bereavement: A systematic review

Despite increasing clinical and research interest in suicide bereavement the impact of suicide on adolescents is still poorly understood. This systematic review aims to disentangle pre- and postloss features that affect response to grief in this age group. The literature was analyzed after a systematic search and hand-check of retrieved articles. The impact of suicide is affected by (a) preloss features related to personal/family history of mental health, family life, suicidal behavior, and type and emotional closeness of relationship; and (b) postloss issues such as quality of remaining relationships. Future research and bereavement support should consider these broader contexts.     

The quality of reporting might not reflect the quality of the study: implications for undertaking and appraising a systematic review

The systematic review has become an increasingly popular method of synthesizing findings on a topic in order to inform clinical practice, commissioning of care, and future research. A central component of the systematic review is an assessment of study quality or risk of bias, i.e. an assessment of how near to the ‘truth’ the findings of the study are. While undertaking a recent systematic review, it became apparent that the outcomes of the quality appraisal process were somewhat different across systematic reviews where the same randomized controlled trials had been included. The quality of the report writing of the randomized controlled trials included was identified as one possible reason for this discrepancy. This had implications upon the conclusions drawn by the review. It is suggested that reasonable attempts to contact study authors should be made in order to inform the quality appraisal process while undertaking systematic reviews of randomized controlled trials and that the presence or absence of this process should be considered by research consumers when appraising the quality of a systematic review. This process enables a full assessment of study quality rather than simply an assessment of the quality of report writing.     

The quality of reporting might not reflect the quality of the study: implications for undertaking and appraising a systematic review

Abstract

The systematic review has become an increasingly popular method of synthesizing findings on a topic in order to inform clinical practice, commissioning of care, and future research. A central component of the systematic review is an assessment of study quality or risk of bias, i.e. an assessment of how near to the ‘truth’ the findings of the study are. While undertaking a recent systematic review, it became apparent that the outcomes of the quality appraisal process were somewhat different across systematic reviews where the same randomized controlled trials had been included. The quality of the report writing of the randomized controlled trials included was identified as one possible reason for this discrepancy. This had implications upon the conclusions drawn by the review. It is suggested that reasonable attempts to contact study authors should be made in order to inform the quality appraisal process while undertaking systematic reviews of randomized controlled trials and that the presence or absence of this process should be considered by research consumers when appraising the quality of a systematic review. This process enables a full assessment of study quality rather than simply an assessment of the quality of report writing.     

The Experiences of Clinical Academic Nurses: A Meta-Aggregation

ObjectiveHistorically, clinical academic careers were only available for dental and medical professions. The title of a clinical academic nurse is recognized as a role that concurrently engages in both clinical practice and research. This systematic review aimed to synthesis qualitative evidence to understand the experiences of clinical academic nurses.Data SourcesA meta-aggregation systematic review was conducted. Key search terms were used in CINAHL and MEDLINE. The review has been reported according to ENTREQ checklist. This meta-aggregation review followed the principles from Joanna Briggs Institute (JBI) and the reviewers conducted a methodological quality assessment on all included studies. Qualitative studies which explored experiences of clinical academic nurses were included.ConclusionA total of 2,202 articles identified five studies met the inclusion criteria. Five synthesized findings from the included qualitative studies, related to (i) clinical academic preparation, (ii) challenges, (iii) enablers, (iv) clinical practice, and (v) role expectation of clinical academic nursing roles. The meta-aggregation has identified that although there are numerous clinical academic nursing discussion articles, commentaries, and editorials on the topic area, few empirical studies have explored the perceptions and experiences of clinical academic roles in nursing.Implications for Nursing PracticeThis systematic review has highlighted the variety of reported experiences of clinical academic nursing in relation to implications for practice, research, and leadership. Clinical academic roles are being developed across the nursing professions outside of medicine, and effective leadership it is important to support sustainable career pathways and curricula and to enable the evaluation of these roles. This review has made an important contribution to the literature by highlighting several issues to consider in developing and safeguarding the progress already made in clinical academic nursing career pathways.