Appraisal of Literature

Task 4
The task requires that you:

Obtain a piece of literature from a journal, book or internet source.

The literature should be relevant to an aspect of nursing care you
have participated in, or observed, during practice.
Compare and contrast this literature with other sources on the
same aspect of care in order to judge the quality of the original
piece.
Use an appropriate framework to structure your appraisal. You
need not though apply a single literature appraisal framework or
checklist but rather it requires that you discuss the literature in a
systematic way in order to identify key themes about the chosen
aspect of care as well as any implications for practice.
This presentation is designed to introduce you to systematic
approaches to literature appraisal.

The Purpose of Appraising

Literature
to critically appraise and synthesise the

current state of knowledge relating to the

topic under investigation
..to demonstrate insight into the current state
of knowledge in the field and the major
questions being investigated, so that gaps
pertaining to current knowledge [and practice]
can be identified with confidence.
(Carnwell & Daly, 2001)

The Purpose of
Appraising Literature
A literature appraisal may seek to answer a number of
questions:
1.
Is the subject of interest to practitioners?
2.
If the literature is a research paper why and how was it
done?
3.
What has been found (research paper) or what new ideas
or arguments are presented (non-research paper)?
4.
What are the implications or issues for practice?
5.
Can the findings or ideas be used in practice? Who would
benefit and what are the opportunities or constraints?
(Adapted from le May, 1999)
You are trying to establish what the evidence base is concerning
your chosen aspect of nursing care and how it may or
should impact on your practice.

Phases in the Appraisal

of Literature
1.
2.
3.
4.
5.

Define the scope of the appraisal (what it

will cover)
Identify sources of relevant information
Appraise the literature
Write up the appraisal
(Polit & Hungler, 1991)
Apply the literature to the area of study
(Clifford, 1997)

1. Defining the scope

of the appraisal
The initial scope will be determined by your chosen

topic
You should try to include research based literature
Other theoretical works that focus upon the

discourses, conceptual frameworks and models

specific to your topic should be included
You may also include grey literature (published

outside of scholarly journals) e.g. commissioned

reports, organisational project papers and clinical
guidelines.

2. Identifying the sources

of relevant information
Library - books, journals, CD ROMS
IT sources - Electronic journals,

databases e.g. Medline, CINAHL,

EMBASE, ASSIA, ZETOC.
Internet sources e.g. Cochrane
Library, National Electronic Library
for Health

Availability of
Literature
You may be faced with two outcomes

at this stage:
Too little literature
broaden your search e.g. use different key
words, different journals, look at how the
area has been investigated by other
disciplines.
Too much literature

Use inclusion and exclusion criteria

Inclusion and Exclusion

criteria
Inclusion criteria:
Time frame, e.g. 1995-2000
Language or national context
Main focus of paper
Explicit methodology and outcomes
Exclusion criteria:
These may be dependent on your focus, field
of study, rigour or applicability to practice
(generalisability).

3. Appraising the
Literature
This involves reading.
Initially this may be a skim read of
contents to establish:
what has been done, why it has been

done and how it was done (research)

the current knowledge in the field and
possible gaps in theoretical knowledge
themes that emerge and give structure
to a more detailed review of each piece
of literature

Working with Themes

An example might be for the topic area of Handwashing.
Themes might emerge from your initial reading that
include:
Procedure
Compliance
Hospital Acquired Infections
Washing Agents
Accessibility of resources e.g.sinks
Staff education and training
You can then structure more detailed reading around
these theme areas or limit your focus to some rather
than all.

4. Writing the Literature

Appraisal
It will include an introduction, main body

and conclusion as with any other academic

work
The introduction could include:
an outline of the focus area and the
rationale for its choice
the aims and structure of the appraisal
sources of the literature used in the
appraisal
where the word limit allows include the
key search terms used

4. Writing the Literature

Appraisal
The main body might:
Divide the literature into content themes (this serves to
integrate theoretical and empirical literature)
Question the literature in each theme as follows:
Is the evidence conclusive, or is there theoretical
consensus?
Are there counter-arguments or any counter evidence?
If there is no counter-argument or counter-evidence
presented, can you think of any? This may be an
opportunity to apply your learning to practice, to
compare theory with practical realities.
If there are multiple viewpoints or positions regarding
the topic, what is your considered view?

4. Writing the Literature

Appraisal
Once the literature in each theme has been

reviewed and synthesised, a short

summary should identify the key
arguments and how they relate to the next
theme if you have more than one (this
ensures a logical flow in the review).

The final section should integrate the

theme summaries into a broad final

conclusion. Any gaps in theory or practice
should now be evident and both learning
and future action can be articulated.

References
Clifford, C. (1997) Nursing and Health Care Research: A skills-based
introduction, London, Prentice Hall
Carnwell, R. and Daly, W. (2001) Strategies for the construction of a critical
review of the literature, Nurse Education in Practice, Vol.1, pp.57-63
Le May, A. (1999) Evidence based practice Nursing Times Clinical
Monographs No 1, London, NT books/Emap Healthcare Ltd