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FLEX (MEDD 419, MEDD 429, MEDD 449)

Information and resources in support of medical progam FLEX projects

Introduction

Literature reviews explore the extent of research conducted on a given subject, synthesizing findings, and identifying trends and gaps in the research. They are an essential component of any research inquiry and fundamental to Evidence-Based Practice.

Types of Reviews

Reviews span in scope from narrative to scoping to systematic and many in between, with no standardized definitions. At the two polar ends of the spectrum, we have:

  • Narrative reviews: Loosely defined or undefined searching methodology, lacking criticism and/or synthesis.
  • Systematic reviews: Explicit search methodology, inclusion criteria and critical evaluation and summation.

To read more about types of literature reviews, check out Literature Reviews Explained or the classic article A typology of reviews: an analysis of 14 review types and associated methodologies.

Know what your project requires

Your FLEX project will determine where on the spectrum your review lies. Demonstrating an awareness of key issues before joining a project may require a narrative review. Participating in a meta-analysis may require a systematic review. The former may be done individually in a short amount of time. The latter will be collaborative and may span the better part of year.

In either case, a review is not a commentary or opinion piece based on a select set of references supporting a given argument. It is an attempt to objectively draw conclusions from the literature reviewed.

Be systematic

No matter the nature of your review, be clear in you intentions and systematic in your approach. Establishing author motivation and detailing one’s methodology lends both transparency and rigour to the review and reviewer.

Have an introduction and methodology section that outlines the 'why' and 'how': why the review is needed; where you searched; how you searched; and what your selection criteria was.

Review Outline

The skeletal framework of a review includes the title, introduction, methods, discussion, and conclusion.


Title

Indicate in the title that the work is a review.

Introduction

Concisely outline the need for or purpose of the review. Answer why the review is being undertaken.

Methodology

Indicate where you searched and what concepts or terms you searched for. Define your inclusion/exclusion criteria. Ask yourself, 'will this outline allow the reader to replicate my search?' The answer should be 'Yes'. If the review is more narrative, this 'Yes' will have qualifiers.

Discussion

Put the literature in conversation along identified themes as defined by the original research question. Evaluate research on an individual level and a collective level. Note limitations of studies. Identify where in the review process there is potential for bias; this should be documented as part of the full review process.

Conclusion

How do the themes in the discussion relate to the purpose established in the introduction? Where does the research converge, where is there discord, where are there gaps - what are the implications for practice, further research or policy? What you sum up will depend on your original question and the scope of the review.

The Process

Clearly articulate your question

If clinical, your question should be very concise. If exploratory, your terminology may be more vague. In either case, your question should be simple in structure and direct. Articulating a clear question generally means doing a preliminary search of the literature alongside discussion either with your advisor or librarian. Check out this tutorial for using PICO to help with this.

Identify the type of research that will best answer your question

This is your inclusions/exclusion criteria. If clinical, ask what sorts of studies provide the best evidence for your inquiry. If exploratory, think about intellectual paradigm or author motivation. For all review types, consider aspects of publication type, language, geography, and date.

Conduct your research

Identify where to look and the concepts/terms that best match your inquiry.

Gather your research

Use a citation manager to collate your findings, track notes and commentary, and help you generate in text citations and a bibliography.

Read and annotate

Develop a system for tracking themes. This may be through your citation management software, paper index cards, an excel sheet or a word document, whichever works best for you. Record a summary of each work, and critically evaluate the ideas, methods and results. Use a tool and terminology that will allow you to group themes together.

One popular tool is the Matrix Method, a table with headers to group identified themes.

Example:

Journal Article Authors Date Purpose Country Method
New Zealand patients' understanding of brand substitution and opinions on copayment options for choice of medicine brand. Lessing C; Ashton T; Davis P. 2016 To better understand the views and experiences of New Zealand patients on switching between brands of prescription medicines and on alternative funding options for the provision of medicines. New Zealand Self-administered questionnaire to selected patients at community pharmacies.
Renal patients' views on generic prescribing and substitution: example from the United Arab Emirates. Al Ameri MN; Mohamed W; Makramalla E; Shalhoub B; Tucker A; Johnston A. 2013 Establish current patient awareness and understanding of generic drug substitutions. United Arab Emirates Multiple-choice survey of 188 patients in 2 hospitals.

See: Health sciences literature review made easy: the matrix method, by Judith Garrard.

Write your review

Put pen to paper.

Writing the Review

The structure of a review greatly impacts the information it conveys. They can be arranged chronologically or thematically. In general, a chronological approach should be avoided as the intention of a review is to engage the findings in the research with a critical evaluation in such a way that merges congruent ideas, polarizes incongruent ideas, and highlights gaps.

Use clear and concise language.

Need help? In addition to contacting your librarian, each campus offers writing services through online resources, tutorials and mentoring.

Additional Resources

Online guides to conducting systematic reviews
Books and articles on writing reviews in the health sciences

Parker R, Sikora L. Literature Reviews: Key Considerations and Tips From Knowledge Synthesis LibrariansJournal of graduate medical education. 2022;14:32-35.

Purssell, Edward, et al. How to Perform a Systematic Literature Review: A Guide for Healthcare Researchers, Practitioners and Students. Springer International Publishing, Cham, 2020.

Green BN, Johnson CD, Adams A. Writing narrative literature reviews for peer-reviewed journals: secrets of the trade. Journal of Chiropractic Medicine. 2006;5(3):101–17.

Grant MJ, Booth A. A typology of reviews: an analysis of 14 review types and associated methodologies. Health Information & Libraries Journal. 2009 Jun;26(2):91–108.

Choi AR, Cheng DL, Greenberg PB. Twelve tips for medical students to conduct a systematic reviewMedical teacher. 2019;41:471-475.

Gordon M, Grafton-Clarke C, Hill E, Gurbutt D, Patricio M, Daniel M. Twelve tips for undertaking a focused systematic review in medical educationMedical teacher. 2019;41:1232-1238.

Ferrari R. Writing narrative style literature reviews. Medical writing (Leeds). 2015;24:230-235.

Lingard L. Writing an effective literature review: Part I: Mapping the gapPerspectives on medical education. 2018;7:47-49.

Lingard L. Writing an effective literature review: Part II: Citation techniquePerspectives on medical education. 2018;7:133-135.

Lingard L. Joining a conversation: the problem/gap/hook heuristicPerspectives on medical education. 2015;4:252-253.

Munn Z, Pollock D, Khalil H, et al. What are scoping reviews? Providing a formal definition of scoping reviews as a type of evidence synthesisJBI evidence synthesis. 2022.