Delivering a systematic or scoping review for a thesis, capstone or journal and unsure what a reviewer will check first? This guide walks graduate nursing students through eight stages: question, protocol, search, screening, appraisal, extraction, synthesis and PRISMA 2020 reporting.
If you are a graduate nursing student who has to deliver a systematic or scoping review and are unsure what a reviewer will check first, this guide is for you. It covers reviews written for a thesis, dissertation, capstone or journal submission. It explains the stages in order, what each one produces and where the common errors occur.
A review is a study whose participants are published reports. That means it needs its own method, its own rules for inclusion and a record of every decision so that another reviewer could repeat it.
Quick answer. Choose the review type that matches your purpose, write a protocol before you search, search several databases with a documented strategy, screen and appraise with clear criteria, extract data with a piloted form, synthesize transparently and report using PRISMA 2020 (or the scoping review extension). Every stage should be reproducible.
| Type | Purpose | Question shape | Quality appraisal |
|---|---|---|---|
| Systematic review | Answer a focused question by synthesizing all eligible studies | Narrow, often PICO | Yes, always |
| Scoping review | Map the extent and nature of evidence on a broad topic | Broad, often Population, Concept, Context | Optional, often not done |
| Integrative review | Combine research with different designs, sometimes with theory | Moderately broad | Yes, adapted to designs |
| Rapid review | Deliver evidence quickly with simplified methods | Focused | Varies, state the shortcuts |
| Narrative review | Discuss a topic without a fixed protocol | Open | Not required, and less rigorous |
Check what your program accepts. Some programs call a literature review a systematic review, which invites criticizm if you have not followed the method. If you are writing a literature synthesis for a DNP project, the DNP literature synthesis guide may be a better fit.
A review is only as good as its question. A vague topic yields hundreds of studies that cannot be combined. Use a framework to force precision.
| Weak | Stronger | Why |
|---|---|---|
| What is known about nurse burnout? | In hospital nurses, what interventions have been evaluated to reduce burnout, and what outcomes were measured? | Names a population, a focus and outcomes |
| Does discharge teaching work? | In adults with heart failure, does nurse-led discharge education, compared with usual care, reduce thirty-day readmission? | Complete PICO with a clear outcome |
| What do patients think about telehealth? | How do adult patients in primary care describe their experience of telehealth visits? | Qualitative question with a context |
The examples are illustrative forms, not findings. Test your question by asking what would count as an eligible study. If you cannot answer, the question is not ready.
A protocol is a plan written before you search. It reduces bias because you cannot adjust criteria after seeing which studies exist. Many reviewers register systematic review protocols in a public registry such as PROSPERO, while scoping review protocols are often shared through platforms like the Open Science Framework. Check your program's expectations.
Record any change to the protocol with a date and a reason. Unreported changes are a common source of criticizm.
Search several databases, because none contains everything. For nursing topics, typical choices include MEDLINE through PubMed, CINAHL, Embase, PsycINFO and the Cochrane Library, depending on your access. PubMed, from the National Library of Medicine, is a free starting point.
| Concept | Controlled vocabulary | Keywords (examples of form) |
|---|---|---|
| Population | Subject headings for the group | Synonyms, singular and plural, spelling variants |
| Intervention or concept | Relevant subject headings | Related terms and abbreviations |
| Outcome or context | Relevant subject headings | Terms authors actually use |
Combine terms within a concept with OR, and combine the concepts with AND. Use truncation and phrase searching carefully, and record the exact string for each database, the date searched and the number of results.
Import results into a reference manager or a review tool, then remove duplicates and record how many were removed. Screening usually happens in two stages.
Ideally two reviewers screen independently and resolve disagreements by discussion or a third reviewer. If you are working alone, as many students are, say so, explain how you reduced error (for example by re-screening a sample after a break) and name it as a limitation.
Test the eligibility criteria on a small batch of records first. If two people would decide differently on the same record, the criteria need tightening.
The flow diagram shows records identified, duplicates removed, records screened and excluded, reports retrieved, reports excluded with reasons, and studies included. Build it as you go rather than reconstructing it at the end.
For systematic reviews, appraise each study so readers can judge how far to trust the findings. Use a recognized tool that matches the study design.
| Study design | Example tools |
|---|---|
| Randomized trials | Cochrane Risk of Bias tool (RoB 2), JBI checklist |
| Non-randomized interventions | ROBINS-I, JBI checklists |
| Cohort, case-control, cross-sectional | JBI checklists |
| Qualitative studies | JBI qualitative checklist, other recognized appraisal tools |
The JBI site hosts critical appraisal tools and methodology guidance, including for scoping reviews. Decide in the protocol how appraisal results will be used, for example to describe quality, to perform sensitivity analysis or to grade certainty.
Illustrative example, not a real client.
Problem. A DNP student began searching for a review on nurse-led discharge education with a rough idea of what she wanted. She tightened her inclusion criteria each time she saw a study she liked or disliked.
Tension. Her advisor pointed out that criteria adjusted after seeing the studies would make the review look selective, however honest her intentions were. Her searches were not recorded, so she could not show what she had done.
Turn. She stopped, wrote a protocol that fixed the question, criteria and appraisal tool, and re-ran her searches with the strings and dates saved. Any change after that went into a dated amendment log with a reason.
Proof. Her advisor accepted the method as reproducible and moved on to how she would handle studies with different outcome measures. That question belongs to the synthesis stage, which meant the earlier stages were now sound.
Payoff. The review's methods section was easy to write, because it described a plan she had actually followed.
Send your question, review type and program requirements, and get a quote for a protocol, search plan or full draft. The price is shown before you pay, and revisions are free for 14 days.
A data extraction form ensures you collect the same information from every study. Build it before you start, pilot it on two or three studies and revise.
A synthesis matrix is a good way to organize extracted data so that patterns become visible across studies. Where a report lacks information you need, note it as missing rather than guessing, and consider contacting the authors.
Synthesis is where a review becomes more than a list. Choose the method that suits your data and state it in the protocol.
When studies are too different to combine numerically, group them by theme, population, intervention or outcome and describe patterns, contradictions and gaps. State the criteria you used to group them.
For qualitative studies, code findings across reports and build analytic themes that go beyond the original studies. Keep an audit trail of coding decisions.
A meta-analysis pools numerical results when studies are similar enough in population, intervention and outcome. Report the pooled estimate with its confidence interval, and assess heterogeneity, commonly with the I squared statistic. Consider publication bias, for example with a funnel plot when enough studies exist.
Frameworks such as GRADE rate how confident you can be in a body of evidence, considering risk of bias, inconsistency, indirectness, imprecision and publication bias. Even a narrative review benefits from a short statement of certainty.
PRISMA 2020 is the widely used reporting guideline for systematic reviews. It includes a checklist and a flow diagram, and an extension (PRISMA-ScR) exists for scoping reviews. You can find them at the PRISMA statement site.
| Report section | What to include |
|---|---|
| Abstract | Structured summary of question, methods, results and conclusions |
| Introduction | Rationale and objectives, with the framework |
| Methods | Eligibility, sources, search strings, selection, appraisal, extraction, synthesis |
| Results | Flow diagram, study characteriztics, appraisal results, synthesis findings |
| Discussion | Interpretation, limitations of the evidence and of the review, implications |
| Other | Registration, protocol changes, funding, availability of data |
Include the full search strings as an appendix. If your program limits length, keep them in supplementary material.
This fictional plan shows how the stages connect. It is not a real review.
| Stage | Illustrative entry |
|---|---|
| Question | In adult inpatients, what nurse-led interventions have been evaluated to prevent hospital-acquired pressure injury, and what outcomes were measured? |
| Type | Scoping review, because the aim is to map interventions and outcomes |
| Eligibility | Adult inpatients, nurse-led interventions, any design, English, last ten years |
| Databases | PubMed, CINAHL and one other, plus reference lists |
| Screening | Two reviewers on a sample, then full text with reasons for exclusion |
| Extraction | Setting, intervention, outcomes, measurement |
| Synthesis | Descriptive mapping by intervention type and outcome |
| Reporting | PRISMA-ScR checklist with a flow diagram |
Notice that appraisal is optional for a scoping review, so its absence is stated and justified. That is a decision, not an oversight.
Many student reviews have one reviewer. That is workable if you are open about it and build in checks.
| Phase | Output | Check to build in |
|---|---|---|
| Protocol | Approved question, criteria and methods | Advisor or librarian review |
| Search | Saved strings, dates and result counts | Librarian peer review of the strategy |
| Screening | Include and exclude decisions with reasons | Re-screen a sample after a break, or ask a peer to screen a sample |
| Appraisal | Completed tool for each study | Second person appraises a subset |
| Extraction | Completed form for each study | Spot-check against the original papers |
| Reporting | Full draft with flow diagram and checklist | Complete the PRISMA checklist line by line |
State the single-reviewer approach and the checks in your methods, and list it as a limitation in the discussion. Reviewers value honesty here far more than silence.
Scoping reviews follow the same discipline of a protocol, a documented search and transparent screening, but their aim is to map evidence rather than answer a narrow effectiveness question.
A scoping review should not claim to show what works. It shows what has been studied, how and where the gaps are.
The discussion of a review has to speak to two different kinds of limitation, and students often blend them.
Avoid words such as "proves" or "confirms" when the evidence is limited. Match the strength of your language to the certainty of the evidence. For help turning findings into a project, see the evidence-based practice change guide.
Two simple tables, started on the first day, make the methods section and the PRISMA flow diagram almost write themselves. Rebuilding them at the end is slow and rarely accurate.
| Database | Date searched | Exact search string (saved) | Limits applied | Records found |
|---|---|---|---|---|
| Database 1 | Date | Paste the full string | Language, dates, filters | Number |
| Database 2 | Date | Paste the full string | Language, dates, filters | Number |
| Reference lists and other sources | Date | Describe the method | None or as applicable | Number |
| Stage | What to record |
|---|---|
| Identification | Records from each source, and the number removed as duplicates |
| Screening | Records screened, and records excluded on title and abstract |
| Eligibility | Reports sought, reports not retrieved, reports assessed in full |
| Exclusions | Reports excluded at full text, with a reason for each |
| Inclusion | Studies and reports included in the review |
Fill in every cell as you work, and never overwrite a number without noting why. If you need to update a search later, keep the old row and add a new one with the new date, so the history stays visible.
A reviewer or examiner cannot judge a review whose steps they cannot follow. Complete logs show that the process was systematic, and they let you answer questions such as "how many records did you screen?" without reconstructing anything. They also make it much easier to update the review if new studies appear before you submit.
You can, but a second reviewer improves reliability, especially for screening and appraisal. If you work alone, say so and describe how you reduced error.
A systematic review answers a focused question and appraises study quality. A scoping review maps the range of evidence on a broad topic and often does not appraise quality.
There is no fixed number. The number depends on your question and how much research exists. A review with few studies can still be valuable if it shows a gap.
Check your program and target journal. Registration is widely encouraged for systematic reviews, and it makes your work more transparent.
Any that handles duplicate removal and shared libraries works. Choose the one your library supports, and keep an export of your original search results.
The value of a review lies in its transparency. When the question, methods and decisions are visible, readers can judge the conclusions for themselves. For help designing the wider study around a review, see the research methods guide, or for projects that turn evidence into practice change, the evidence-based practice change guide.
If you would like a review drafted, structured or edited, get your instant quote. The price is shown before you pay. Delivered work comes with 14 days of free revisions, and refund terms are on the money-back guarantee page. Use any support in line with your institution's academic-integrity rules.