Nursing Library Research: Advanced (transcript from June 5 2019)

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Joined us on Monday, we had Introduction to Nursing Research at Walden Library. And we had a lot of fun zooming through all kinds of stuff, you can still see the recording. We talked about accessing the library from any browser, we talked about using course guides for readings and assignments, we talked about accessing your subject area, your program as a page that librarians but just for you for specific databases and guides and help and things like that.  You do not want to go through the 150 databases looking for something nursing appropriate, we have them all in one place.


We also looked at several database options and getting to the full text, once you found the one, the wonderful resource, sometimes figuring out how to get to the PDF itself can be challenging.


We will look at keywords how to generate synonyms, how to find more keywords. we will be looking at the hierarchy pyramid but we will not get too focused on that pyramid.  We will look at identifying and searching filtered and unfiltered resources.  And then if we have time, we may get into some Grey Literature and clinical queries and a little bit of citation management.  They  are well documented on our website if we do not get to that.


This is how I divided us up into basic and advanced searching competencies, this is straight from the new nursing 6052 test book. The blue ones are basic searching competencies and the orange are more advanced.  We will look at many of these tonight but I want you to be aware of them.  If you are in 6052, and you have questions, the index of the book is great for that.


Just to give you an idea of what will be expected of you as a student at Walden.  I know we have a couple undergraduates in here, they are not quite as stringent with you all but those at the graduate level will be expected to be familiar with these concepts.


The pyramid the one on the left, this thing is pretty ancient, 2006 which is a lot.  They have reformatted it, the lovely one on the right is located in the 6052 classroom and it has pop outs so you can see what each one is.  But do not get attached to any of these pyramids.  We will talk about the pyramid is a structure for evaluating a paper, a study, a research article that you have in front of you.  But there's all kinds of pyramids.


Two more types of pyramids -- they pretty much have the same things down here more or less, but when you get to the top, they have something called, metaanalysis.  Those are not on these older permits because there were not very many of them at the time, there weren't even many systematic reviews in 2006 but now we have lots.  Meta-analyses are analyses of the systematic reviews.


It gets even more complicated.  Don't get too caught up in the different levels because-- then I found this one also in the textbooks for nursing 6052 that takes into account the medical record of the patient and the decisions support that you have there.  Some types of evidence are more important than others, if you realize that I think you will do okay unless you are just using the "I just know" top of the pyramid of something you have been doing as a nurse for the last 10-15-50 years.


The pyramid consists of filtered resources at the type.  Your systematic reviews, metaanalysis, and critically appraise things.  That means that a panel of experts has looked at all of the studies available on your topic or on an aspect of the topic.  They are making recommendations.  They are synthesizing all the information in those different studies and producing a recommendation in their field of study.


There are systematic reviews, one of the best places to get those is Cochran.  Joanna Briggs, we have guidelines for the critically appraise topics.  And then critically appraised articles.  I want to show you an example of that from the ACP Journal club.


It is taking a particular clinical question here, about the long chain fat he a since and whether it will help you avoid a second heart attack or a first one for that matter -- and these are the clinical impact ratings by specialty.  The general medicine people think this is great evidence, the cardiology think it is great evidence, neurology maybe not so much and then public health is the fourth one.


They have synthesized it in regard to these various areas and it just crazier and crazier when you look at all the types of evidence.


It is helpful to have an understanding if it is an expert opinion, a qualitative descriptive study, things like that, where it might fall.  The assignments in various classes treat this a little differently.  The types of evidence, it is helpful to have a general idea but do not get too caught up in the numbers.  The numbers of evidence here or the levels here.


We two assignments for nursing 6052.  This is underway right now and easily our biggest class but we do not have a ton of students from the class tonight.  But the week two assignments are similar to some of the assignments in other classes.  And so they want you to identify a clinical issue of interest and they want you to pick four different databases and find four peer-reviewed articles.  And that is not all that unusual.


Let's show you how to do that for all of that.  For nursing databases, specifically, there are a couple of different ways to get there.


If you go to the select a subject, you can go to the nursing research page and see all of our stuff from there.  Or if you go to databases A-Z, you can narrow that down to the nursing database.   And I will go ahead and show you that, so this is the library homepage. will get you there from any browser.  Select a subject is here, and then nursing.


This might be a good place for you to bookmark, not only so you can see our lovely glamour shots on the left, but so you can know there is help for you as you get farther into your studies.


Under the nursing database tab, we have several individual databases and these are the most popular.  And then I wanted to point out this "view all nursing databases" here.  Because we have several others.  We have the most popular at the top, but then we get down to oddball ones like the Joanna Briggs, ScienceDirect, things like that that may be useful to you, even if they are not in the top five or six of those.


other things on the page if you are asked to go to a particular journal, you can browse nursing journals, things like that.  If you are asked to do a literature review, whether it be small or about to start on your dissertation, this can be helpful.  Tests and measures, theories, and evidence-based practice research guide.  And that is where you will find lots and lots of information on the pyramid, which databases to use for which levels, things like that.  And this is all from the nursing research page.  Which is right here.


In the nursing research page, if you are just starting your research and you just need an article, any article to do a discussion post or a quick survey or some kind of investigative research, and it does not say exactly what you have to do, you can come here and start your research.  One of the things great about the nursing classes is that most will ask you to pick the topic.  And it is helpful to pick a topic you are interested in or that affects you in some way because that is quite motivational.


Before I start are there any things I have skipped over or stop for, Lisa?


>>     LISA PRESLEY:  We don't have any questions so far, Julie, and I think your pacing seems good.


>>    JULIE JAMES:  Okay, so I will start my nursing research in this gold box forgot a particular clinical issue of interest right now, because my husband had a heart attack two weeks ago and it was the widow maker.  So I want to see what is going on with the cardiac diet.  On his discharge instructions, each time they refer to "the cardiac diet" it was like it was something that was a given.  I started with cardiac diet in my gold box and if you have not seen this before, you will have to log in once per session -- it looks like the portal but it is not.


Cardiac diet.  Only 2000 articles.  Mediterranean diet adherence, longterm high-fat diet.  I was surprised there were only 2000 and then I'm going  these are going back to 1895, it may be I could do a little better so I separate this out into two separate concepts.


One of the things wonderful about this particular search interface is the three search boxes.  If you keep your concepts separate it will understand it better but also offer you some alternative words.


Cardiac, maybe that is not what it is calling it.  Let me type in "cardiac or heart or cardiovascular". I will take any of those three words, that is why there is an or between them.  I go from 2000 results to 4 million.


I really just want to know what is the best things I should be cooking by feeding and consuming with the husband.


Now we have 181,000, which is a little more than we started with there. This might be a good time to see -- let's take that, we got them back to 1874.  So I will put in 2014, and I will click on enter, and then click the peer-reviewed scholarly journals only.  I don't really want anybody's speculation, I want a peer-reviewed scholarly journal about this issue.


Now I am down to 50,000.  That is within the last five years, that is a nice healthy hit list.  Well, I will not be reading 50,000 articles -- I wonder if I can find a systematic review or meta-analysis.


Because I want somebody to filter the information to synthesize it for me.  And that worked really well.  I am back to 2000 but they are all going to be a higher level of evidence.  This is something specific called a portfolio diet. This one is Nutrition Metabolism and Cardiovascular Disease April 2018.  I want the most up to date information because some of my discharge -- my husband's discharge papers -- actually said, only two egg yolks a week.  And I thought that was this proved quite a while ago.  And it said no shrimp and that is also debatable so I wanted to look these things up in a more reliable way, that is recent.  Especially nutrition these days but all types of information, it it is just exploding.  There's too much that you could possibly process, so it helps to make sure you have the most recent and most comprehensive.


If I wanted to go further with this, to put egg yolks -- if I'm really concerned about that egg yolks thing and I just want to see about the egg yolks, nothing.  Well, that would be because by default this database searches the title, the abstract, the subject headings and the keywords.


And it looks like there probably was not anything done specific , and only on eggs.  Yes, there is, this is the impact of a whole egg.  I was too specific when I put in egg yolks, and I need to just say, eggs.


This looks like 10 pretty good articles here in the last five years.  That is one of our controllable aspects of disease control, my husband is freaking out because everything he puts it in his mouth he says, am I allowed to eat this or not?


This is how I found a systematic review or meta-analysis by using keywords.  Some of the other databases and some individual databases have limiters, but it works pretty well to use it as a keyword.


Do you have questions about this process that I just flew through right here?


>>     LISA PRESLEY:  There's a question about comparing this to Thoreau -- the question is, what database is Thoreau searching across --


>>    JULIE JAMES: if this is just searching across nursing databases, is the search from our home page and it will have more multidisciplinary stuff in it, it will have business source, education sources.   The nursing one does include SocINDEX and psychINDEX.


If I was doing something on the cost impact across the cardiac diet -- I might visit the business area to start but starting off and Thoreau  might give me too much out of my topic area were as going to the nursing home page and searching in this gold box would be more focused two MEDLINE, PsychINDEX, SocINDEX and a couple little ones.


When you get into masters and doctorate level constants, frequently you have to specify which database you use, and the goal boxer to the top of the nursing page and Thoreau. Is not really sufficient.  They are looking for that you have been comprehensive, maybe that you have search more than one database.  For instance, with the 6052 assignment, or with any nursing assignment, CINAHL would be a great place to start because it is all about the nursing.


MEDLINE is always a good complement to CINAHL because it uses the same interface here so that is why you can go and choose databases and choose MEDLINE and CINAH together or use the combined search here, but when you get into each individual database, this is MEDLINE, this is different limiters down here than the others.  Each one can be a little different.  Sue cannot really get into super specific searches when  you are doing more than one database at a time.  So I suggest all nursing students get really cozy with CINAHL and figured out and learn how to use it, and then maybe pick a couple others.  The ProQuest nursing and allied health source has a similar interface but not quite the same.


Let me show you quickly how I would translate that over, because I did cardiac OR cardio-- and it has different hits here. OR Heart. These are just things that other people have tried, so not necessarily spelled right, that is a good thing to know.  And then diet or nutrition in the second box.


This one only has two boxes but you can add a row and add another row if you like.


I usually like to click on the search button before you get in too far, and then just make sure you got the right words.  We did this in the other database so does not as necessary.  The ProQuest interface is a little bit weird in that the modify search works better than the back button.  Little quirks about each database can be frustrating, but if you learn them in the initial part of the quarter or if you learn them earlier in your Walden career, it is an investment in time to learn these databases now so that you can use them effectively later.


One of the things about ProQuest databases and it goals for nursing and allied health and others, by default it is not just search the title aspect keyword search subject headings like the last database, it searches everywhere.  So if you are bringing that down to not search everywhere but to search in the subjects and indexing, that may be a more focused search, and take us from 200,000 hits, that can be off in the distance, it too closer to 10,000 hits.


The left, you can limit it to the peer-reviewed.  And on the date range thing is a little weird, you can slide the slider or enter a date range, but you do have to enter the full date range there.


Everything that gets limited like that you have to do a little where's Waldo defined it on the page sometimes.  I can go back to modify search and put in that fourth row and then say, systematic review  OR meta-analysis. change that to subjects in indexing because we do not want to pick up the ones that are having is the systematic review and the reference, want something that actually is going to tell me what the results are.


That is how you translate that same search over into ProQuest.


A third database that might be interesting to get to know is Enbase. This is a more internationally focused third database.  it likes to use its own vocabulary, one of the first things I want to show you here is this, quick search.  It only does the first -- it only does the first box, but you need to change the other boxes to quick search unless you are looking for a journal name.  Which I am not.


I find these to be pretty good when I do use them in Enbase. This has a lot of scientific things going on that are experimental.  Another thing to know about this database is by default, it shows you the newest first, so you will see a lot of 2019.


This is not a very focused search we have almost 300,000, but I love over here, the limits.  Because you can do this study types from here and you don't just have to use a keyword type of limiter.  But if you are looking for particular comparative study or systematic review, metaanalysis, you can put that there.


These limits in Enbase on the side, none of them will actually go like it did in our last two databases.  You have to click this button out here -- how many times have I forgot to do that?  A good thing that this one does is it tells us -- it keeps a record of our search and knowing what terms you searched is sometimes going to be part of your assignment to tell them that.


Enbase it's a little weird, but this article should also be in MEDLINE, but frequently the Enbase will get it first because MEDLINE takes longer to process and sometimes when evil fulltext it will not get you there because it is in process and has not actually been published yet.


Enbase is a weird database but it finds things that I don't find elsewhere so it can be useful.  Especially if it is a topic or you are having trouble, but a topic that might be better covered by countries that have socialized medicine.  Because they have a little bit more leeway in record-keeping and some of the other procedures governed by insurance companies here in the US.  If you find a European or Scandinavian Journal, they may have information we are not seeing here in the US.


Questions about ProQuest or Enbase while I fly through and give you a general idea of how to search -- those are the three big interfaces that you would have to know here in the library.  Spotted no new questions have come in.


>>    JULIE JAMES:  I must be doing something right.  Let's go back here.  I did a little bit of that keyword search strategy.  I divided up the topic into separate concepts.  I explored what the pop ups were suggesting.  I do not always take the pop up suggestions, and you can always edit them if there is a word that just does not fit, things like that.  You can consult the -- when you are in CINAHL subject headings and put in, cardiovascular, you can explore to see what types of headings they have in there.  So if you wanted to see all about their preferred words for all of these types of diseases, the cardiovascular abnormalities and things like that -- there is a similar function in MEDLINE.  It is called MESH, for medical subject headings, so if you are stuck for words, that may be a good option for you.


I also want to show you Boolean operators.  These are one of those phrases in librarianship that people roll their eyes at because it is not very descriptive but it means AND OR and NOT.


Describe your search results in terms of the number of articles returned on original research or what you would initially put in like the 2000 -- I got when I put in cardiac diet.  And then how this changed is you added search terms using your Boolean operators.  For example, this is my favorite way to explain Boolean.  This is my matrix of how I select my chocolate choices.  As I love chocolate I love chocolate of all kinds.  And if I just want chocolate that is in here, that will be -- you are standing in the candy aisle or at the Chocolatier, and Nestlé, Hershey, Godiva, Godiva, chocolate by itself.  Nuts by itself here any intersection of chocolate and nuts here is where you'll find things.  Like the Hershey's bar with almonds, the Mr. Goodbar.


If you are a chocolate fan and you like Carmel or nougat, that would be chocolate and caramel.  Nougat would be the Three Musketeers or those little chocolates with the pocket of caramel that was is all over your shirt.  Those would be in here.  And if you're just having nuts and caramel or nougat, that would be something like your Payday, but this is the sweet spot for me, right in the middle that has chocolate and nuts and caramel or nougat in there, all the way.  And you can see that is a much smaller area that will have all three.


That is the basics of Boolean, this is your AND where they overlap.  To have caramel or nougat, that is OR.


For answers to get more complicated is when you need to get more specific.


I don't just like chocolate, the word chocolate will pick up milk chocolate, dark chocolate, it will pick up white chocolate because it will pick up any articles for which the word chocolate is in there.


Let's say I do not think that milk chocolate is worth the calories.  As my metabolism slows down I would prefer a dark or white chocolate.  That is where I would add the word NOT to my search.  I would say NOT milk, and that would eliminate the milk chocolate bars from my stash.  If I didn't get enough hits from my chocolate and nuts or caramel and nougat, I can get more specific about the nuts because they might not use the word, nuts.


You might need to specify in your search, almonds or pecans or walnuts or peanuts or pistachios.  Or whichever ones you would like to include.


I put in there, nuts or pecans or pistachios -- it would pick up all the ones that have the specific nuts in them.  And not just the word, nuts, or the generality of nuts.


If you happen to know a Mars bar, that has both caramel and nougat, now that I mention it.  And those that have all three are like your Snickers, your Turtles, and baby Ruth.


Any questions about this whole Boolean AND OR NOT?


>>     LISA PRESLEY:  No, no questions about that or chocolate.  Thank you, Julie.


>>    JULIE JAMES:  All right.  Let me turn off my little bought because we can go back to our previous search.


Let's say I had all I want to know about eggs and I do not want to see anymore articles on eggs.  Here is where I would do the NOT.  It will say I want this and this and this but NOT eggs. And it will kick out the egg articles.  It does not come up a lot but when it does --it when you have a hitless in every other article is something in left field, whether it be a homonym that sounds exactly like yours  or you are seeing all these articles about medical students.  Anyone to articles only about nursing students, you can actually save NOT medical students.  And I would say NOT medical students OR medical education.  Because it would take out both of those.  So do not rely on the little pop ups, but that is a Boolean in a nutshell. AND OR and NOT.


Handout has all of this in there.  I did your demo.  The matrix.  This matrix is particular to nursing 6052, but it is not as intimidating as it seems at first glance.  You basically have to say why you chose an article.  The aims of the research, methodology can be kind of tricky, I will get into that in a moment.  And then reliability and validity.


These are things to consider about all articles, more or less.  In week four of the nursing 6052, when you have to apply your PICOT question and find systematic reviews, it helps to know that when you are finding things related to a PICOT very rarely will all the elements be in there.


Especially if you get into detail.  So, let's say, my husband's PICOT question would be in a 50 something man, how about an overweight 50 something-year-old man, does a cardiac diet decrease the chances of having a second heart attack?  That kind of thing.  Your elements your PICOT, P- prevention, I-- intervention. The PICOT question, you will not find all the elements but if you have a population and an intervention or an outcome.  The outcome I may be looking for is not having a second heart attack, and I may be trying to find the intervention that will help him not have a second heart attack.


So the methodology on how we get there can be really confusing.  So I put all of these in the handout so you can download them because when people are looking for a qualitative article, let's say -- I will take out systematic review and medical students.  Can I just put in qualitative, meaning something that is not measurable, it is more about their feelings about how things, their perceptions, stuff like that?


I am only finding 709 that have the word qualitative in the subject title and abstract.


If we go -- there it is -- this is our quick answers on qualitative articles.  I put a link in the handout because all of these are like secret words that mean qualitative.  I am not exactly sure what ethnographic means but it is a type of qualitative research.  Same with phenomenological, same with grounded theory.


If I took a bunch of these words and added them to my search, I could say qualitative OR ethnographic OR phenomenological -- those are all types of qualitative studies.  And so that should bring my hits up a little bit, fingers crossed.


It is thinking about it.  It brought us up a little bit but you can actually put all of those in there.


There will not be as many qualitative articles is quantitative, partly because the electronic medical record have made quantitative research much easier because we have all the data after the fact.   So you can pull information out of the EHR in aggregate or individually and  there's just a lot more data to work with these days, and that was part of the whole affordable care act in making the EHR worth it for everyone all around.


If you have not explored the qualitative, quantitative types of research, it is helpful to be familiar with that, but for general research purposes, then we get to mixed methods that uses more than one kind -- but hopefully undergraduate and master students do not have to do too much of the qualitative and quantitative, but you should know what they are and generally have that type of research is done.




>>     LISA PRESLEY:  No questions.


>>    JULIE JAMES:  Wow, you guys are a quiet bunch.  On the right, this is a little freaky, this is a Prisma diagram, this is for those in 6052 and doctoral students because this is another way you can express your searches.  You could say, this person found 1182 articles in MEDLINE, they identified records from other sources, this is why they them out and did not take those into account when they were writing this systematic review.


Those are a lot of little concepts like the Prisma diagram but don't get too bogged down in the details unless you are doing a systematic review in which case we should talk.


This is my favorite page in the whole library website, it is get help. Again you will find it on most of the pages in the library website.  So when you cannot figure it out, to get help -- here we have recorded webinars.  If you would like to see what this class was like last quarter when it was all about nursing 6052.  But the nursing 6052 classes changed completely from last quarter.  This also has technical help for trouble with videos or PDFs.  If the database is not working in my check to see if it is down for some reason because we will post it on this page.


If you are just totally lost at this point, then I would really recommend doing some of the library skills guides and tutorials so you understand some of the vocabulary being used and can build upon it as you continue your career.


Quick answers.  This is one of my favorites.  She said something about qualitative but I do not remember what it was -- you can go just put in qualitative, to get to this pic you can put in all types of questions and it does not have to be library specific because we have academic skills Center in here, things from the writing center and other places so it may help you there.


Then ask a librarian.  If you have not used this service, it is a little busy this time of year in the first couple weeks of the quarter.  But if you send us an email, we have shifts going all through the day and the evening, and that is probably the best way to do it, by email. .  If you happen to notice that we are on chat, you can ask a quick chat question.  Is not really appropriate for a literature review or something more involved like that, but we can help you as best we can.


And then the phone option is a message service.  You will leave a voicemail and you will get a reply by email.  So I am thinking it might be more efficient if you start the conversation by email so you can copy and paste, I am on this page are this is the article I am trying to find, things like that.  Go ahead and paste into email and then we don't have to try to listen to the email and transcribe what you are saying.


And doctoral students can make an appointment under the doctoral research appointment.  This is all under the "get help".  And this would be a great place to bookmark, to just any time you are floundering, go ahead and put a keyword in there and see what comes up.  And that is looking like that.  And I put a link in the handout straight to that help page.


These are some other links for a per capita handout in PDF format so it would be easy for you to click on the links and get to these.  The nursing research home, we talked about.  Evidence-based practice guide.  The nursing databases, that whole 15 of those nursing databases.  We do have a little help on forming your PICOT question and then my favorite page the library, get help, page.


What questions do you have for me now? Surely, we have some questions?


>>     LISA PRESLEY:  I hate to disappoint you, Julie but we do not have any questions.


>>    JULIE JAMES:  Okay.  I tried to finish up in 45 minutes and I did that all right but I wanted to allow some time for questions.  Because traditionally, the students will bring us just some of the most out of left field questions, and it is almost like a game show trying to answer them.  So does anybody have any questions for us? Are you stuck on an assignment? Or are you stuck in a particular database? Do you want to talk about chocolate preferences?  I do realize it is not very helpful to my husband to talk about chocolate and nuts and caramel and things like that.


>>     LISA PRESLEY:  We have a quick question about if -- about the recording for the webinar.


>>    JULIE JAMES:  Yes, the recording provided that I did it right -- will go out as soon as it is finished processing which is about two hours after we are done.  If it is a question about Monday's webinar, I put the link in the handout so you can download it from here.  And yes, I agree that Snickers is awesome.


If you download the handout you can get to the Monday session -- it is not on our YouTube channel yet,  but I am hoping it will be within about a week or so since I get it a little cleaned up.


All of our webinars are recorded, they all have transcripts, does take a while to get the captions changed into transcripts.  So let us know if you need that more quickly and we will get that for you.


Otherwise, let us know how else we can help you.  Hit that "ask a librarian" and let us know where you are stuck and we can provide you with some resources.


Any other questions here?


I totally agree with the not too many foods are totally bad except -- although snack foods, the hub mix, the tortilla chips, the Fritos, all that salt and fat -- those are the things we are working on now.  But yes, I am doing actual research here also.


Thank you everyone for coming and we will let you go and give you back a few minutes of your time. But you do have our contact information if there's something else we can help you with.  Bye, everyone.



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