Using the evidence
For the purposes of writing an academic assignment it is important to have an understanding of the status of the evidence when you are referring to it. For qualified midwives it is also important to have an understanding of the evidence for clinical care in order to meet the needs of your professional responsibility (NMC 2004). Where the information comes from established sources that include systematic reviews, NICE guidelines or guidelines from other professional bodies, for example: the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives (RCM) for care in the UK, then it is reasonable to assume that the information can be used to support the information you give in your text about care and its evidence base. As you become more familiar with some of the issues around research and practice, you will become aware that some criticisms have been levelled at the processes which inform the development of these guidelines. This is part of your developing experience and understanding of how research informs practice. Where you begin to question some of the information used in the guidance, as long as you can support these challenges with other evidence or theories from published papers, then this is an acceptable form of professional debate which you can include in your assignment.
This next part of this article sets out a very basic framework for reviewing published research studies. These skills are important when they can help you understand the background to clinical care and the guidelines that support this. At the same time, better understanding of the research evidence might also cause you to question some of these aspects of information and look for further evidence yourself, that is, become a researcher!
While almost everyone is familiar with searching the internet for information, searching information databases such as the one compiled by MIDIRS, requires a few essential skills to avoid pulling up hundreds of references that are not really of interest. Information about the basic skills needed to search the MIDIRS Database is available in an article published recently in the MIDIRS Midwifery Digest (Brumby 2010).
As a general rule, before you begin your search you should identify the main area(s) of interest; these are called ‘key words’. Having identified your key words, the next clarification is the date of publication. Most Universities give guidance on the formation of assignments that includes referencing guidance which might suggest that any reference papers have to be from a period of less than five or ten years ago. If that is the case, then you can immediately limit the search to that time frame. This should make the number of papers easier to deal with as well as meaning that the information is current. There are some papers about research studies that were undertaken some time ago, which offer insights into the framework of how evidence has developed as well as how midwifery research has contributed to this. Two papers published in the MIDIRS Midwifery Digest address the role of these classic studies and might help you understand where reference to these are appropriate within a text about current care (Rees 2007, Hundley 2008). A time frame is, of course, not relevant where you are looking at research based on an historical framework. Another aspect of searching is to consider whether the country where the research was conducted is of relevance to you. If this is the case, then you need to limit your search to the relevant location(s). You should also refer to your University guidance as it might be that you are asked to provide only a limited number of papers as references. In addition, you might be asked to give more details about the references in the form of an annotated bibliography which will in turn limit the number you can include anyway.
Even when you have attended to these details, your first search might produce rather more papers than you anticipated. If this is the case, then it might be worthwhile looking again at the key word(s) you have used for your search and seeing if you can reduce these or make the focus clearer for the ones you have selected.
Once you have your little list, the only information you have about the paper is some form of summary or abstract. For the majority of scientific papers, there will be a structured abstract which gives basic information about the study aims, methods, findings and implications. Where you have a clear idea about what information you are looking for, these abstracts have sufficient information to identify papers that will be of use to you. However, keep the list of all the papers you first obtained so that you can re-visit this decision later if you need to.
Having identified the papers that are relevant, it is ESSENTIAL that you obtain the full version of the paper as you need to be able to go through the research process in detail, to understand what was done, why and how. I am sure my ex-students will groan at this point as I used this so often during my sessions on research, but I think one way of helping you develop a system of your own for reviewing and reading research papers is to think of them in the same way as you would a recipe for a cake. When baking, before you set out to make anything, you look at the recipe to find out what ingredients and equipment are needed, what you are going to do with them and what it will look like in the end. In terms of looking at the research paper, it is a good idea to just read it straight through, note any points that are not clear, but go back to these later. Now you will have an overview of study and can look at the detail more clearly.
Approach to baking a cake:
The cooking process
The final product
I should also add it is helpful to know who you are baking it for and, if you are not doing this in your own kitchen, that you have permission to make a mess in someone else’s!
Even if you do not bake, I am sure you will be familiar with this process and will be able to follow me as I apply this to reading and understanding a research study: