1. PhD-Nursing students
Furthering your research and
information skills
October 9, 2012
Ana Patricia Ayala
anap.ayala@utoronto.ca
Instruction and Faculty Liaison Librarian
Gerstein Science Information Centre

2. Goals of the session
1. Further/ develop your research skills
2. Achieve efficient and comprehensive
searches
3. Determine the type of studies best
suited for your topic
4. Critically appraise information
5. Discover tools to manage your citations
6. Practice!

3. Finding the evidence
1. Choose the right database(s) and search them
individually!
2. Search concepts separately
3. Find and use subject headings
– ALWAYS check Scope note, full tree
4. Also use keyword or textword (if necessary)
5. Combine using OR / AND as appropriate
6. Apply filters/limits
7. Revise – Research is an iterative process
8. Export to RefWorks or your citation management
of choice

4. Identifying your information needs
• Big Picture vs. research questions
• Big-picture questions:
– Who, what, when…
– (e)Books, EBM resources
• Research questions:
– Narrow, more complex questions
– Use PICOT/ PIE tools to help you focus your
research
– Journal articles, literature reviews, guidelines
– Article databases

5. PICO Structure
P Patient/Population/Problem - what sorts of participants,
from where, with what features?
I Intervention/Issue - what sort, dose, administered by whom,
with what level of expertise, where, and with what sorts of
monitoring?
C Comparison - what sort, dose, administered by whom, with
what level of expertise, where and with what sorts of monitoring?
O Outcome - both good & bad, of what sort, determined when,
defined how, ascertained & adjudicated by whom?
T Type of Study – systematic reviews, RCT, CT, retrospective
study, cohort study, case control, etc.
“T” is optional and depends on your individual research needs!

6. PIE structure – Qualitative research
P Patient/Population/Problem - what sorts of participants,
from where, with what features?
I Intervention/Issue - what sort, dose, administered by whom,
with what level of expertise, where, and with what sorts of monitoring?
E Evaluation – what types of studies where used to evaluate this? Did
the implementation work? systematic reviews, retrospective study, cohort
study, case control, mixed methods, use qualitative filters

7. Type of Question and the Ideal
Type of Study
• Therapy : RCT
• Prevention : RCT > Cohort Study > Case Control
• Diagnosis : Prospective, blind controlled trial comparison to gold
standard
• Prognosis : Cohort Study > Case Control > Case Series/Case Report
• Etiology/Harm : RCT > Cohort Study > Case Control
• Cost analysis : Economic analysis
Note: Meta-analyses and systematic reviews, when available, often
provide the best answers to clinical questions.

8. Systematic Reviews
• Synthesis of all high quality research on a topic,
carried out using very rigorous and repeatable
methods
• Cochrane Library is most well known source.
• Other sources include: PubMed Clinical Queries,
TRIP database, DARE, Joanna Briggs Institute,
MEDLINE, among others
– Access via Gerstein
• See examples of methods sections in the
Cochrane Library

9. Weak search

10. Satisfactory search

11. Comprehensive search

12. Comprehensive search - continued
• Search multiple databases
• De-duplicate in RefWorks / Endnote
• Systematic Reviews:
– Each synonym on separate line (100+ line searches)
• Expand / Focus
• Revise
• Redo!

13. Harvest subject headings

15. Databases of interest
• Medline (OVID) / PubMed
• CINAHL
• EMBASE
• PsycInfo
• HAPI
• Cochrane Library
• ProQuest Dissertations
and the list goes on…

16. Critical appraisal of the evidence
When appraising a resource, it needs to meet the
following three requirements:
1. Quality (the methodology should include trials that
are randomized and double blind to avoid selection
and observer bias)
2. Validity (trials need to mimic clinical practice, or used
in clinical practice, with outcomes that make sense)
3. Reliability (trials that are credible and repeatable)

17. Critical appraisal - continued
• Another aspect to consider when appraising
evidence is: "How does this inform my practice?"
• Different types of articles are critically appraised
using different criteria. For example, critical
appraisal of a therapy article would be different
to critically appraising a prognosis article.
• There are a number of checklists / tools available
to assist you in undertaking critical appraisal of
evidence.

18. Managing your citations and
references
• Save your searches / set-up alerts when
possible
• Export to citation management software
• Organize citations by folders / subfolders
• De-duplicate as necessary

19. Questions?

20. THANK YOU