Skip to content

Posts tagged ‘Brenna Quinn’

Standards of Rigor in Literature Reviews in Nursing

We are currently featuring an article focused on methodology for literature reviews titled “Characteristics of Reviews Published in Nursing Literature: A Methodological Review” authored by Coleen E. Toronto, PhD, RN, CNE; Brenna L. Quinn, PhD, RN, NCSN; and Ruth Remington, PhD, AGPCNP-BC. The article is available for download at no cost while it is featured, and we welcome you to read the article and return here to share your comments and feedback!  Here is a message from each of the authors describing how they came to be part of this project:


            During my graduate and doctoral programs I had published two integrative reviews: one in my masters program and one in my doctoral program.   Since my first student experiences conducting integrative reviews, I have found methodological approaches for conducting integrative reviews to be unclear.

            For four years, Ruth and I had co-taught a master’s level nursing research course where students produced integrative reviews.  During that time, we had found that many of the nursing research textbooks did not cover the integrative review process. We would direct our students to look to the literature for published integrative reviews to help guide them when conducting their reviews, but many reviews did not follow a standard format and instead confused our students. These educational experiences were the impetus for our need to explore in depth the characteristics of published nurse led reviews.

            One goal in conducting our review was to gain a better understanding of what a well-done review should look like and help us guide our students. However, our review’s findings confirmed what we had been witnessing in the classroom with our students, in that there was much variation on how this type of review is conducted and published.  An important implication from our review is that there needs to be consensus among editors, peer reviewers, researchers, faculty and students alike of what an integrative review is and how it should be performed and reported.  In the future, we hope to continue on with our research and explore this issue more fully.

            I feel fortunate to have connected with Brenna at the NLN Writing Retreat in 2016 and have her join our research team.  At that point, Ruth and I had been working on the project for over two years and so it was extremely helpful to have Brenna’s energy and fresh perspective move our project to completion.  Our wish for this blog is that it will generate discussion among the ANS readership.  Have readers experienced similar confusion about reviews as an editor, peer reviewer, researcher, educator or graduate student?  We would love to hear your thoughts, ideas and suggestions related to our research.


            Having published several integrative reviews, as well as serving as a reviewer for several prestigious nursing journals, I felt comfortable in taking on the co-teaching of the integrative review process as part of a graduate nursing research course. I started this process with what I thought was a good understanding of the difference between integrative reviews, systematic reviews and literature reviews.

            It was not long before I realized how much inconsistency there was in methodologies in published reviews and contradictory instruction to be found in the few textbooks that addressed conducting these reviews. I found that, as Coleen mentioned, the available resources confused students, rather than help them to produce a rigorous review.

            My naive hope for this review was to clarify the characteristics of types of reviews. Well, having spent many hours reading and analyzing nurse-authored reviews, I became even more aware of the variation in rigor of the methods in published reviews. In an attempt to clarify some of this confusion, we contacted the editors of journals that published reviews in our sample, to identify the evaluation criteria that reviewers were expected to follow, similar to what was done by Jackson nearly 40 years ago (Jackson, 1980). Similar to Jackson, we found that many editors rely on the authors’ and reviewers’ expertise. Could this be why the inconsistencies persist?

            I would like to add a word about the value of working in writing teams. As nurses, many of us like to think that we can do it all alone. However, diversity among research team members can improve the quality of the science. Stronger scientific contributions are produced when combining experienced writers’ knowledge and skills with the enthusiasm and energy of nurses new to professional writing.

Jackson GB. Methods for Integrative Reviews. Rev Educ Res. 1980;50(3):438. doi:10.2307/1170440.


            I attended the 2016 Scholarly Writing Retreat sponsored by the National League for Nursing and Chamberlain College of Nursing, and was very happy to begin a friendship with Coleen. We, along with eight other nurse faculty attendees, enjoyed a productive weekend of mentored writing in Washington, DC.  After returning home, Coleen reached out to ask me to join a project she and Ruth were working on about nursing literature reviews. Coleen did not know this, but Ruth was my undergraduate pharmacology instructor! Coleen and Ruth had, at this point, reviewed all nurse-authored literature reviews published in the year 2013 and wanted to add 2014 and 2015. They were in search of another team member to help with data collection, analysis, and writing, as well as keeping the team moving along on a reasonable schedule. I had published a few literature reviews, and was interested to learn more about what methods nurses were really using and how we could use data about current review methods to make suggestions to strengthen the quality of reviews in nursing. We had a few phone and video chat conferences and two face-to-face meetings throughout the project, but relied mostly on Dropbox for communication and file sharing. We efficiently completed our study and put together a manuscript we hope ANS readers will find informative.

L to R: Coleen Toronto, Ruth Remington and Brenna Quinn

Theory Integration to Explore Complexity

Our new featured article is titled “Using Theory Integration to Explore Complex Health Problems” by Brenna L. Quinn, PhD, RN, NCSN. We invite you to download the article while it is featured and return here to join discussion of these ideas.  In this message about her article, she describes the evolution of this article as a result of a rejection of another manuscript!

Brenna Quinn

Brenna Quinn

The idea for this article was actually born out of another article’s rejection. I met with my colleague Dr. Barbara Mawn to seek commiseration over the outright rejection and ask for help in writing an article about the importance of theory use and interdisciplinary integration, given that reviewer suggestions included removing the entire section on the study’s conceptual framework. Barbara’s mentorship was invaluable to the development of this article.  Said  conceptual framework is described in the ANS article as an example of interdisciplinary theory integration.

Use of theory to guide nursing research and clinical practice is underreported at best, but more likely is extremely underutilized. This is due to several factors, such as nurses receiving little education on theory use or confusion about how to interpret and apply theories to clinical practice.  Additionally, clinical nurses and nurse researchers may view nursing theories as too narrow to address the multi-faceted needs of patients or study populations.

Nurses know that they need to view patients and populations holistically, and cannot silo specific health problems.

Barbara Mawn

Barbara Mawn

For example: school nurses experience difficulty when assessing pain in children with intellectual and developmental disabilities. What kind of pain assessment tools has the nurse learned about? Has the school offered any continuing education opportunities regarding pain assessment for special populations? Do classroom teachers know which behaviors may be indicative of student pain? What is the ability of the student to report painful experiences?  Or, perhaps a nurse is working with a patient who has not been taking a medication prescribed for diabetes. The nurse must consider more than a presenting high blood glucose reading. Did the patient understand the nurse practitioner’s instructions for taking the medication? Can she access the pharmacy? Read the bottle? Administer the medication correctly? What is her level of cognition?

Many variables factor in to complex health problems faced by people today. However, this may not always appear clear to nurses and researchers when looking at nursing models. Using a non-nursing model, such as a model from psychology as described in the ANS article, can help frame the use of nursing theory components to the health problem at hand.

After reading this article, I hope nurses take the opportunity to explore both nursing and non-nursing theories that can guide and enlighten new approaches to clinical and research activities. Thank you for featuring this article on the ANS blog!

Quinn Picture1

%d bloggers like this: