Rethinking Systematic Review Assignment Design in Graduate Health Science Education from Librarians' Perspectives
DOI:
https://doi.org/10.18060/28463Keywords:
systematic reviews, cognitive load theory, educational theory, chunking, health science, graduate programsAbstract
Background: This article examines the problematic phenomenon of faculty assigning graduate health science students systematic reviews as semester-based assignments while expecting a health science librarian to be a willing support system for those students. Despite published conduct and reporting guidelines establishing that systematic reviews require a team, time, and methodological expertise, some faculty still turn to full systematic review assignments in the classroom. The authors propose applying cognitive load theory and chunking the systematic review process into manageable steps, allowing both faculty and students to better understand the required methodologies and to enhance educational outcomes.
Experience: The authors have often been invited to visit classes where faculty have required students to complete a full systematic review. These assignments often result in frustration among faculty, librarians, and students stemming from the faculty’s limited experience with the methodology and students feeling overwhelmed by the process. While the authors’ experiences with suggesting the adaptable assignments to faculty is limited at the time of this publication, it is the hope of the authors that by sharing these concepts with other health science librarians, the trend of adapting more appropriate review assignments will expand.
Discussion: Through applying cognitive load theory and chunking principles to simplify the systematic review process, the authors propose approaches to systematic review research methods that can improve the educational process, ameliorate faculty workload, and enhance student learning outcomes. As a result, students will be more prepared in future research endeavors. Challenges include faculty adoption and acceptance of different approaches to systematic review assignments, and a further burden on the librarians who support these types of assignments.
Takeaways: The authors aim to raise faculty awareness of proper systematic review methodologies by offering alternative assignments that enhance student learning outcomes and alleviate the librarian's teaching burden. Initial attempts to promote these adaptations have shown promise, with some faculty successfully revising their syllabi and capstone projects to align with the suggested modifications. Future research will include webinars for faculty on systematic review methodologies, followed by ongoing evaluations of how these modifications impact the health science curriculum.
References
Gopalakrishnan S, Ganeshkumar P. Systematic Reviews and Meta-analysis: Understanding the Best Evidence in Primary Healthcare. J Family Med Prim Care. 2013;2(1):9–14.
Aromataris E, Munn Z, editors. JBI Manual for Evidence Synthesis [Internet]. Available from: https://synthesismanual.jbi.global
Higgins JPT, Chandler J, Cumpston M, Li T, Page M, Welch V, editors. Cochrane Handbook for Systematic Reviews of Interventions version 6.4. 6.4. 2023.
Kolaski K, Romeiser Logan L, Ioannidis JPA. Principles for good scholarship in systematic reviews. Developmental Medicine & Child Neurology [Internet]. 2023 [cited 2023 Nov 8];n/a(n/a). Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/dmcn.15719
Moore A. Red for danger in systematic reviews? Eur J Hosp Pharm. 2021 Nov 1;28(6):299–300.
Moore RA, Derry S, McQuay HJ. Fraud or flawed: adverse impact of fabricated or poor quality research. Anaesthesia. 2010 Apr;65(4):327–30.
Nguyen PY, Kanukula R, McKenzie JE, Alqaidoom Z, Brennan SE, Haddaway NR, et al. Changing patterns in reporting and sharing of review data in systematic reviews with meta-analysis of the effects of interventions: cross sectional meta-research study. BMJ. 2022 Nov 22;379:e072428.
Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ. 2021 Mar 29;n160.
Pussegoda K, Turner L, Garritty C, Mayhew A, Skidmore B, Stevens A, et al. Systematic review adherence to methodological or reporting quality. Systematic Reviews. 2017 Jul 19;6(1):131.
Rethlefsen ML, Brigham TJ, Price C, Moher D, Bouter LM, Kirkham JJ, et al. Systematic review search strategies are poorly described and not reproducible: a cross-sectional meta-research study [Internet]. medRxiv; 2023 [cited 2023 Nov 15]. p. 2023.05.11.23289873. Available from: https://www.medrxiv.org/content/10.1101/2023.05.11.23289873v1
Fontelo P, Liu F. A review of recent publication trends from top publishing countries. Systematic Reviews. 2018 Sep 27;7(1):147.
Ioannidis JPA. The Mass Production of Redundant, Misleading, and Conflicted Systematic Reviews and Meta-analyses. Milbank Q. 2016 Sep;94(3):485–514.
Smith GD, Aveyard H, Jane N, Penny KI. Improving the conduct and reporting of meta‐analyses. Journal of Advanced Nursing (John Wiley & Sons, Inc). 2023 Sep;79(9):3186–8.
Torres G, Ledbetter L, Cantrell S, Alomo ARL, Blodgett TJ, Bongar MV, et al. Adherence to PRISMA 2020 reporting guidelines and scope of systematic reviews published in nursing: A cross-sectional analysis. J Nurs Scholarsh. 2024 Mar 30;
Uttley L, Quintana DS, Montgomery P, Carroll C, Page MJ, Falzon L, et al. The problems with systematic reviews: a living systematic review. Journal of Clinical Epidemiology. 2023 Apr 1;156:30–41.
Cañón-Montañez W, Rodríguez-Acelas AL, Cañón-Montañez W, Rodríguez-Acelas AL. Contributions of Systematic Reviews and Meta-analyses to Nursing Education, Research, and Practice. Aquichan [Internet]. 2021 Dec [cited 2024 Feb 2];21(4). Available from: http://www.scielo.org.co/scielo.php?script=sci_abstract&pid=S1657-59972021000402143&lng=en&nrm=iso&tlng=en
Cleary M. Essentials of building a career in nursing research. NURSE RESEARCHER. 2016 Jul;23(6):8–12.
Dotto L, T. O. Lemes L, O. Spazzin A, Sousa YTCS, Pereira GKR, Bacchi A, et al. Acceptance of systematic reviews as Master/PhD theses in Brazilian graduate programs in dentistry. Journal of Evidence-Based Medicine. 2020;13(2):125–9.
Einarsen KA, Giske T. Nursing students’ longitudinal learning outcomes after participation in a research project in a hospital. INT PRACT DEV J. 2019 May;9(1):1–10.
Lesley ML. Facilitating Students’ Success With Their Own Research Projects. Nurse Educator. 2011 Jun;36(3):107.
Milner K, Zonsius M, Alexander C, Zellefrow C. Doctor of Nursing Practice Project Advisement: A Roadmap for Faculty and Student Success. Journal of Nursing Education. 2019 Dec;58(12):728–32.
Orta R, Messmer PR, Valdes GR, Turkel M, Fields SD, Wei CC. Knowledge and Competency of Nursing Faculty Regarding Evidence-Based Practice. The Journal of Continuing Education in Nursing. 2016 Sep;47(9):409–19.
Puljak L, Sapunar D. Acceptance of a systematic review as a thesis: survey of biomedical doctoral programs in Europe. Syst Rev. 2017 Dec 12;6(1):253.
ten Ham-Baloyi W, Jordan P. Systematic review as a research method in post-graduate nursing education. Health SA Gesondheid. 2016 Dec 1;21:120–8.
Wissinger CL. Is there a place for undergraduate and graduate students in the systematic review process? Journal of the Medical Library Association. 2018 Apr 5;106(2):248–50.
Muraraneza C, Mtshali N, Bvumbwe T. Challenges in postgraduate research supervision in nursing education: Integrative review. Nurse Education Today. 2020 Jun 1;89:104376.
Schnall R. National Institute of Health (NIH) funding patterns in Schools of Nursing: Who is funding nursing science research and who is conducting research at Schools of Nursing? Journal of Professional Nursing. 2020 Jan 1;36(1):34–41.
Christian R, Palokas M. Systematic review methodology in graduate nursing education. JBI Evidence Synthesis. 2018 Mar;16(3):587.
Ferreira R, Sousa L, Nobre C, Nunes AC, Fonseca C, Ferreira Ó, et al. The Development of Research Skills in Nursing Postgraduate Training. Education Sciences. 2022 Feb;12(2):78.
Menzies JC, Emms K, Valler T. Developing research knowledge and capability in undergraduate nurses: evaluation of targeted placements. J RES NURS. 2021 Aug;26(5):408–24.
Borah R, Brown AW, Capers PL, Kaiser KA. Analysis of the time and workers needed to conduct systematic reviews of medical interventions using data from the PROSPERO registry. BMJ Open. 2017 Feb 1;7(2):e012545.
Price C. Systematic review as class assignments? [Internet]. Covidence. 2022 [cited 2023 Nov 8]. Available from: https://www.covidence.org/blog/elementor-2112/
Sayers J, Lopez V, Howard PB, Escott P, Cleary M. The Leadership Role of Nurse Educators in Mental Health Nursing. ISSUES MENT HEALTH NURS. 2015 Sep;36(9):718–24.
Sweller J, van Merriënboer JJG, Paas F. Cognitive Architecture and Instructional Design: 20 Years Later. Educ Psychol Rev. 2019 Jun 1;31(2):261–92.
Smith NE, Barbé T, Randolph J. Application of the cognitive load theory in prelicensure nursing education: a quantitative measurement focusing on instructional design. INT J NURS EDUC SCHOLARSH. 2022 Jan;19(1):1–12.
van Merriënboer JJG, Sweller J. Cognitive load theory in health professional education: design principles and strategies. Med Educ. 2010 Jan;44(1):85–93.
Venkat MV, O’Sullivan PS, Young JQ, Sewell JL. Using Cognitive Load Theory to Improve Teaching in the Clinical Workplace. MedEdPORTAL. 2020;16:10983.
Coffman S, Iommi M, Morrow K. Scaffolding as active learning in nursing education. Teach Learn Nurs. 2023 Jan;18(1):232–7.
Mauldin B. A Novel Teaching Strategy in Nursing Pharmacology: Learning Using Cognitive Load Theory. Nurs Educ Perspect. 2021 Nov;42(6):E158–60.
van Nooijen CCA, de Koning BB, Bramer WM, Isahakyan A, Asoodar M, Kok E, et al. A Cognitive Load Theory Approach to Understanding Expert Scaffolding of Visual Problem-Solving Tasks: A Scoping Review. Educ Psychol Rev. 2024 Jan 26;36(1):12.
McGowan BS, Reed JB, Yatcilla JK. Graduate student confidence following a for-credit systematic review course pilot. J Med Libr Assoc. 109(2):323–9.
Usher-Smith JA, Harrison H, Dennison R, Kelly S, Jones R, Kuhn I, et al. Developing training and opportunities for students in systematic reviews. Medical Education. 2021;55(11):1333–4.
Pawliuk C, Cheng S, Zheng A, Hal Siden H. Librarian involvement in systematic reviews was associated with higher quality of reported search methods: a cross-sectional survey of authors from Vancouver, BC. J Clin Epidemiol. 2023 Dec 8;111237.
Rethlefsen ML, Farrell AM, Osterhaus Trzasko LC, Brigham TJ. Librarian co-authors correlated with higher quality reported search strategies in general internal medicine systematic reviews. J Clin Epidemiol. 2015 Jun;68(6):617–26.
Spencer AJ, Eldredge JD. Roles for librarians in systematic reviews: a scoping review. J Med Libr Assoc. 2018 Jan;106(1):46–56.
Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015 Jan 1;4(1):1.
Rethlefsen ML, Kirtley S, Waffenschmidt S, Ayala AP, Moher D, Page MJ, et al. PRISMA-S: an extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews. Syst Rev. 2021 Dec;10(1):1–19.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021 Mar 29;n71.
lefebvre C, Glanville J, Briscoe S, Featherstone R, Littlewood A, Metzendorf MI, et al. Chapter 4: Searching for and selecting studies [Internet]. Cochrane Training. 2024 [cited 2024 Jan 12]. Available from: https://training.cochrane.org/handbook/current/chapter-04
Burls A. What is critical appraisal? [Internet]. 2009 [cited 2023 Nov 8]. Available from: http://www.bandolier.org.uk/painres/download/whatis/What_is_critical_appraisal.pdf
CASP Checklists - Critical Appraisal Skills Programme [Internet]. CASP - Critical Appraisal Skills Programme. [cited 2023 Nov 28]. Available from: https://casp-uk.net/casp-tools-checklists/
Rethlefsen ML, Schroter S, Bouter LM, Moher D, Ayala AP, Kirkham JJ, et al. Improving peer review of systematic reviews by involving librarians and information specialists: protocol for a randomized controlled trial. Trials. 2021 Nov 11;22(1):791.
Grant MJ, Booth A. A typology of reviews: an analysis of 14 review types and associated methodologies. Health Info Libr J. 2009 Jun;26(2):91–108.
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