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Systematic review methodology in graduate nursing education

Christian, Robin; Palokas, Michelle

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JBI Database of Systematic Reviews and Implementation Reports: March 2018 - Volume 16 - Issue 3 - p 587-588
doi: 10.11124/JBISRIR-2017-003704
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Nursing educators have a responsibility to teach students how to apply current best practice principles to everyday clinical practice. However, this is a difficult challenge. In 2009, the number of published scholarly journal articles surpassed 50 million.1 The increase in available information makes it difficult to keep up with research translation to clinical practice. As healthcare consumers expect providers to use the best evidence when providing care and treatments, rapid dissemination of medical information increases the demand for excellent health care, hence updates and advancement in nursing education are required.2,3

In the United States (US), graduate nursing curriculum and competencies are dictated by multiple governing bodies. Nurses with higher degrees, such as Master's or Doctoral degrees, are taught to apply outcomes of research to solve clinical problems and disseminate the results to advance practice.4 Doctoral programs in the US have two areas of focus, clinical practice (knowledge application) and research (knowledge generation).3 The knowledge application degree is the Doctor of Nursing Practice (DNP), and the knowledge generation degree is the Doctor of Philosophy (PhD) in nursing. The DNP competencies prepare graduates to practice at the highest clinical level and disseminate research findings into practice.3 The DNP prepares nurses to apply appropriate knowledge in a specific setting with assessment, intervention and evaluation being key components to implementation and translation.3 The PhD competencies prepare graduates in conducting scientific research and increasing empirical knowledge to improve healthcare and patient outcomes.3 The skills needed for the PhD graduate are knowledge of relevant theory, research methodologies and statistical analysis.3

Evidence-based practice concepts need to be included in graduate nursing education to provide the competencies and skills required for knowledge generation and application. Evidence-based practice competencies include clinical decision-making, critical thinking, problem identification and outcome measurement.5 The four competencies are inherent in systematic review methodology. Systematic reviews use a rigorous and transparent method to provide an unbiased synthesis of multiple studies to answer a clinical question.6

Systematic reviews are the gold standard of research syntheses and a critical element of informing nursing practice and the development of best practice guidelines.6,7 Performing a systematic review is a highly qualified academic undertaking that requires comprehensive knowledge of research methodologies and analytical skills.8 Teaching graduate nursing students to conduct a systematic review gives them hands-on application of evidence-based practice competencies to prepare them for real-world application and translation.

There is current evidence to support systematic reviews as a research method in graduate nursing education.7 Due to the structure and rigorous steps required, there are many advantages in the learning experience of graduate students writing systematic reviews. The benefits include: pre-determined methods to identify and critically appraise relevant studies to answer a clearly articulated question, development of critical appraisal skills and critical thinking, opportunity to engage in a broad range of research methodologies, and no requirement of ethical approval due to the use of secondary data.7 In the writing of a systematic review, the graduate student learns many skills such as excellent record keeping, abstract thinking, high computer literacy, literature searching skills for multiple databases, critical appraisal, and an understanding of diverse research methodologies.7 The graduate student also has several publication opportunities with the completion of a systematic review.

The development of a systematic review is also an excellent opportunity for DNP and PhD students to work together. Collaboration between PhD researchers and DNP practitioners has been recommended as essential to furthering the nursing profession.9 The systematic review process is an ideal mechanism to promote collaboration and collegiality between the two programs. By sharing knowledge and resources during the systematic review process, the PhD and DNP students further a unique but necessary dimension to nursing education.

Graduate nursing students need relevant knowledge and the tools to further nursing research as an integral part of evidence-based practice.8 The systematic review process can provide the needed knowledge and tools. Health care will benefit most when nurses contribute to the summary and synthesis of research, therefore including the necessary methodological components in graduate curriculum is imperative.6 By giving graduate nursing students the tools and knowledge needed for the generation and translation of research, we will be molding competent nursing leaders who can provide essential contributions in shaping the future of health care.


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