Whether you are a pre-registration student or a senior staff nurse undertaking a postgraduate degree, writing academic essays for a university course is a skill, and like any of the more obvious clinically based nursing skills, it can be broken down into steps and developed with practice.
Identifying key words
The previous article in this series emphasised the importance of spending about an hour exploring the question and identifying exactly what it is asking. Consider a standard type of question: ‘Discuss the importance of an holistic assessment of a newly diagnosed diabetic teenage boy admitted to a medical ward for assessment and insulin management.’ If this was a question you were answering, what key words would you want to use for a literature search? A number of inexperienced nurses miss the significance of the word ‘holistic’ in this sort of question and focus their literature search on the physical aspects of assessment. Some miss the importance of being asked to focus on the assessment stage of nursing and include literature on the treatment stage. Other important key words to include in this literature search would be ‘newly diagnosed’, ‘teenage boy’ and ‘insulin management’.
Library based literature searching
The first part of your literature search will need to take place using your university or hospital library database. This can be accessed directly from the library terminal or online if you have remote access. This can be quite time consuming, particularly if you are unfamiliar with the software system. Most librarians will steer you in the right direction if you ask and they are not too busy.
The first stage is to insert key words one at a time into your search engine. This will give you many hundreds, if not thousands, of hits. Although this is initially daunting, it does give you an appreciation of the amount of literature relating to your topic. At this stage, it is probably worth saving a couple of pieces of literature from each search that appear to be key or useful pieces. You will also get an idea of the important dates required to focus your search. You may identify that there was a significant development 8 years ago, for example, which will make earlier literature less relevant or even out of date.
The next stage in your literature search is to start combining two of your key words and specifying the dates of the search. Save five or six pieces of literature that seem relevant to your assignment question. Then start a new search with two different key words and repeat this exercise until all the words have been included. Next, include three, four or more of the key words together and note any useful pieces of literature.
How do you know which pieces of literature to save?
There is no simple answer to this question; it will be dependent on how much literature you find, what type and strength of ‘evidence’ you are trying to find, to what degree you need to apply your findings to a specific client group and the relevance of changes or developments over recent years. Considering our example question of the importance of ‘holistic assessment’; it is unlikely that there will be any randomised controlled trials on this topic, therefore we are looking at possible qualitative studies or opinions of ‘experts’. Literature that connects holistic assessment with teenage boys would be very relevant, even if not specific to diabetes. As a general rule you should aim to be saving or printing about 30 pieces of literature for a standard 3000-word assignment.
Using other sources of literature
Using library-based search engines will help you find literature that has been published in mainstream journals and in other important sources such as the Cochrane Library and the National Institute for Health and Care Excellence. There are other sources of what is often called ‘grey literature’, which has not gone through the rigours of peer review. These are the results you get when typing key words into everyday search engines such as Google or Google Scholar. Although you should treat any results you find in this way with caution, they can reveal some useful literature such as care protocols and care pathways from other hospitals, which may give useful information to supplement the results of the more robust databases.
Don't forget the purpose of a literature search
The aim of a literature search within an academic essay is to help you find the most relevant and up-to-date evidence on which to base your discussion of the question and draw conclusions relating to the most appropriate way forward. When you first start a literature search it is easy to lose focus of the prime purpose of why you are doing it, and many students become satisfied with the first results of the search and are reluctant to refine or delve deeper, put off by the complexities of the technology or the time it takes. Remember, the purpose of developing the skill of literature searching is to enable you to master an important tool that will help you as a professional nurse deliver the complexities of evidence-based practice.