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Library Resources for the UVA School of Nursing

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My Approach to Literature Searching

Most of my searches begin with a well-designed PICO question.  The PICO question can be placed in a table to help determine inclusion and exclusion criteria, which will be used later in the process.

Credit: Ecker, E. D., & Skelly, A. C. (2010). Conducting a winning literature search. Evidence-based spine-care journal, 1(1), 9.

Once I have my PICO question and inclusion/exclusion criteria, I begin searching the databases. 

I usually start my search in PubMed.  For example, if I'm doing research on the efficacy of vitamin C on sepsis patients in the ICU, my search might start using my three terms connected by the Boolean Operator AND: vitamin C AND sepsis AND ICU.  PubMed automatically assigns entered terms to associated subject headings, called MeSH, provided that you don't use double quotes around phrases, such as quality of life.  Double quotes can be used to search phrases in all other database.  In this search, PubMed found MeSH terms for vitamin C (Ascorbic Acid), sepsis (Sepsis), and ICU (Intensive Care Units).  See Search Details in the right column to see how PubMed interprets a search. 

("ascorbic acid"[MeSH Terms] OR ("ascorbic"[All Fields] AND "acid"[All Fields]) OR "ascorbic acid"[All Fields] OR "vitamin c"[All Fields]) AND ("sepsis"[MeSH Terms] OR "sepsis"[All Fields]) AND ("intensive care units"[MeSH Terms] OR ("intensive"[All Fields] AND "care"[All Fields] AND "units"[All Fields]) OR "intensive care units"[All Fields] OR "icu"[All Fields])

Please note that you can also modify the search and run it again.  For instance, if I wanted to narrow the search, I could remove some redundant keywords and replace [All Fields] with [TIAB].  TIAB limits the search to title and abstract fields.  Here's what the modified search would look like:

("ascorbic acid"[MeSH Terms] OR "ascorbic acid"[TIAB] OR "vitamin c"[TIAB]) AND ("sepsis"[MeSH Terms] OR "sepsis"[TIAB]) AND ("intensive care units"[MeSH Terms] OR "intensive care units"[TIAB] OR "icu"[TIAB])

The Boolean Operator OR is used to search terms related to each other.  For example, vitamin C and ascorbic acid are related, so they would be combined in ( ) using OR.  Most searches that you perform will contain both ORs and ANDs.

I then go to CINAHL where I can either copy and paste my search strategy, now ("vitamin C" OR "ascorbic acid") AND sepsis AND (ICU OR "intensive care units"), into Basic Search, or I can use CINAHL Headings to search each unique term (keyword) and CINAHL subject heading, if there is one.  In this case, CINAHL Headings and MeSH use the same subject headings: Ascorbic Acid, Sepsis, and Intensive Care Units. 

If the number of results is too high, I can either AND additional terms, or I can use Limit tools in PubMed and CINAHL, such as publication range or type of publication (e.g., Systematic Reviews/RCTs).  If the number of results is too low, I can use the Boolean Operator OR to add additional related terms, or remove a keyword or two.  I can also search the full-text of articles in CINAHL (select option to search full text), Science Direct (see link below in Other Databases and Tools), or Google Scholar, which is also linked below.

I then copy and paste my search into  Web of Science and Cochrane to find systematic reviews and RCTs/CCTs.  Please note that there is a separate tab for Trials.  If needed, I also selectively search additional subject-specific databases, such as PsycINFO, Social Sciences Database, Joanna Briggs,, ERIC (Educational Literature), or PILOTS (traumatic stress literature). After searching the databases above, I sometimes search Google Scholar, especially if I need additional studies.  Google Scholar searches the full-text of articles, which yields a larger set of results.

I might also search grey literature (anything not published in journals) by doing a Site search in Google.  My grey literature search in Google might look like this: ("vitamin C" OR "ascorbic acid") AND sepsis AND (ICU OR "intensive care unit")  Using following my search retrieves content only from .org sites. I would then re-run the search using and then in place of  I also search the Agency for Healthcare Research & Quality.

As I search each database and website, I export all citations into a citation manager (see box below).


Citation Managers

Choose either F1000 Workspace, Zotero, Mendeley, or New RefWorks to manage your citations.  All of these citation managers are free; however, Zotero and Mendeley limit free storage - Zotero (300MB) and Mendeley (2GB).  The University of Virginia provides unlimited free storage for F1000 Workspace and RefWorks.

I support all four citation managers.  Please email me if you have any questions about which citation manager is best for you.

How to Use a Citation Manager for Your Literature Review:

(Use the PRISMA generator, or the modified PRISMA flow diagram (linked below), to represent article review process.)

  1. Export citations from all databases, grey literature, and hand searching, into a single folder in your citation manager
  2. Removed all close duplicates from folder (F1000 Workspace does this automatically)
  3. Create a subfolder for Inclusion and several subfolders for each exclusion criteria (e.g., Not Relevant, Not USA, Not Research, Not Adult) . 
  4. Scan all citations (titles and abstracts) for initial screening.  Move each citation into one of the subfolders.
  5. Create a subfolder called Final Results.  Re-screen articles in Inclusion subfolder using full text articles.  Articles will either be moved to the Final Results subfolder or to one of the exclusion subfolders.
  6. Optional: Screen remaining articles using a quality assessment tool, such as CASP.  If you do this, create another subfolder called CASP Results.  Move all citations from the Final Results subfolder to either an exclusion subfolder or the CASP Results subfolder.
  7. Use your citation manger's Word tool to facilitate in-text citations.
  8. Use your citation manger to create your final bibliography.

Create Search Alerts

Finding Images

If you need images for a presentation, start with the sources below. 

  • AccessMedicine note that you can send the image directly to a PowerPoint slide

  • BioImage Search biomedical images you can use i.e., images with Public Domain & Creative Commons licenses

  • ClinicalKey search your term using the Multimedia limit under the All tab.

Historical Images (Contributed by Dan Cavanaugh, head of CMHSL Historical Collections).

Images of Nurses at the University of Virginia

Digital Public Library of America (DPLA)

Locally photographed nursing uniforms from our collection.

National Library of Medicine’s Historical Image Database

Civil War image collections hosted by the Library of Congress

World War II propaganda posters

Tests and Surveys

  • PsycTESTS provides access to psychological tests, measures, scales, surveys, and other assessments as well as descriptive information about the test and its development and administration

  • Mental Measurements Yearbook find reviews, reliability and validity information for commercially available tests

  • ERIC use Tests/Questionnaires limit in Publication Type

  • CINAHL use Questionnaire/Scale limit in Publication Type

Where to Publish

Check these sources to find the best match for an article you want to get published.

  • Directory of Nursing Journals a collective of nursing editors and publishers focused on meeting the research needs of the nursing profession

  • JANE (Journal/Author/Name Estimator) enter keywords and JANE will find best matching journals

  • JournalGuide in addition to searching by journal name, category or publisher, authors can use the title and abstract of a paper to discover journals that have already published articles on similar topics

  • Journal Citation Reports (JCR) tool for determining Impact Factor of a journal

Intro to JRC (3 min video)

What is Open Access? (8 min. video)

How to determine if journal is peer reviewed

Ulrich's International Periodicals Directory  listings of periodicals from over 200 countries.  Look for refereed icon  to determine peer review status.

What is the peer review process?

How to determine Journal Impact Factor and impact of article

An article that has been cited by other authors has greater impact than other less-cited articles.  Keep in mind, that current articles will be cited by fewer authors.

  • Journal Citation Reports tool for determining Impact Factor of a journal
  • Web of Science For articles, check Times Cited for number of times article was cited by articles in Web of Science.  Check Usage Count for number of times article was downloaded or exported to citation manager.
  • Google Scholar for articles, check Cited By for number of times article was cited by anything accessed by Scholar
  • Altmetric Bookmarklet tool for determining influence or interest in a journal article
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