MID6210 Assessment 2: Systematic review (2500)
MID6210 Assessment 2: Systematic review (2500)
Specific criteria to be considered in conjunction with the SNM Assessment rubric:
NOTE: this assignment builds on assignment one to complete the review process.Please continue to use the word document from assignment one and submit assignment two as a complete review.Assignment one will not be re-marked.
abstract to the front of prior to yoursubmission. Maximum Points 50 Rubric Points
100
Paper Formatting as per APA 7th and SNM Guidelines
Submitted via TurnItIn;Title page;Page numbers;Use 2cm line -spacing throughout the entire paper;Spacing MUST be consistent between the headings/subheadings and the text and
Times New Roman size 12 or Ariel size 11, in black colour and same size font throughout. (5) Structure/presentation
20
Paragraphing & Logic / presentation
Logical arguments and logical connection between ideas;Well-developed paragraphs;Use of first or third person and
Appropriate professional language. (5) Findings
Present the key findings of your reviewEvidence of linking the findings to the review question and EBP
Discussion
Evidence of linking the review findings to midwifery practice, incorporating comparable literature and the NMBA standards where appropriate
Identify the limitations of the review and recommendations for future researchRelevance to midwifery practice
State the implications of your review findings on future clinical practice and EBP in maternity care.
Conclusion
Provide a concise summation of the outcomes of the systematic review process.
Please do not include any new information or references in the conclusion.
Abstract
The last component of this assignment requires you to prepare an abstract (This would usually be presented at the start of your systematic review i.e at the top of assignment one). For ease of marking please insert after the conclusion.
Background
Aims and objectivesStudy design
Methods
Results
Conclusion
Relevance to clinical practice
(5)
(5)
(5)
(2.5)
(2.5) Content 40
Evidence of critical thinking appropriate to level of education.
Evidence of application of professional standards and/or EBP throughout assessment.
(5)
(5)
Application of critical thinking
20
Referencing & APA
Strict APA 7th ed. Formatting is required.
Marks will not be awarded if the referencing is unclear or incorrect.
(5) Referencing
10
English Language
Grammar, spelling and punctuation were error free;Sophisticated use of all sentence and paragraph writing conventions were clearly demonstrated; and
logical application of arguments throughout paper. (5) ELP
10
Critical Review of a Contemporary Practice Issue
Student name- Ashlee Rusiecki
Student number- 10455436
School of Nursing and Midwifery, Edith Cowan University
Unit code and title- MID6201.2 Midwifery Project
Lecturer Melanie Welfare
Due date- 28th August 2023
Word count- 2460
Table of Contents
Background 3
Aims and Objectives 6
Methods6
Criteria for Selection6
Search Strategy7
Quality Appraisal 8
Data Extraction and Analysis9
Results10
References13
Planning a systematic review
Background
In Australia, it is becoming more common to advise women to have an induction of labour based on a suspected oractualclinical problem (Middleton et al., 2020). Macrosomia is a term that defines a newborn as larger than the average baby, and approximately one in ten newborns are born weighing four thousand grams or more (Australian Institute for Health and Welfare, 2022). There are many terms for macrocosmic babies, another term is large-for-gestational age, the term is commonly used when they weigh above the 90th percentile for their gestation when intrauterine (Australian Institute for Health and Welfare, 2022). A study was conducted that provided evidence that, in two-thousand and ten, thirty-five percent of women have been induced compared to twenty-five point two percent of women in two thousand and ten (Australian Institute for Health and Welfare, 2022). In Australia, health professionals recognise suspected foetal macrosomia as a problematic issue that can increase the risk to the newborn and mother during birth (Middleton et al., 2020). For example, it can cause shoulder dystocia and injuries to the mother and the newborn or lead to an instrumental birth (Seijmonsbergen-Schermers et al., 2020). Therefore, evidence suggests that when suspected foetal macrosomia is detected that obstetricians and healthcare professionals recommend induction of labour as the baby is above the average percentile and weighs more than four thousand grams (Middleton et al., 2020). It is highly recommended by health professionals including gynaecologists and obstetricians to have an induction of labour (Royal Australian and New Zealand College of Obstetricians and Gynaecologists., 2021). This reduces the risk of trauma and instrumental births with women that have a suspected foetal macrocosmic baby on board (Coates et al., 2020). Induction of labour is highly recommended to reduce the number of incidences of trauma to the newborn, the risk of caesarean birth, and perineal trauma, and it can increase the duration of labour (Dahlen et al., 2021).
Current evidence suggests that inductions of labour are an indication of suspected foetal macrosomia across the states and territories of Australia (Rydahl et al., 2019). In the Australian Capital Territory, the evidence is at three-point three percent, and in Queensland it is at nine-point four percent, this equates to one in ten women being inductions of labour as recommended due to foetal macrosomia (Australian Institute for Health and Welfare, 2022). Suspected foetal macrosomia is measured through serial ultrasounds and fundal height, this has been evidenced that it can be significantly inaccurate (Coates et al., 2020). These methods of measurement are the only options on how to measure the foetus while it is intrauterine, therefore the only way to determine macrosomia (Coates et al., 2020). Even though it cannot be one hundred percent accurate it is screened in every visit to try and prevent any risk to the women of the foetus (Dahlen et al., 2021). Evidence suggests that the accuracy of ultrasound scans to determine estimated birth weights is less than fifty percent correct (Rydahl et al., 2019).
Macrocosmic newborns can also lead to birth injuries for the newborn and the women causing shoulder dystocia in labour as proven in the literature (Seijmonsbergen-Schermers et al., 2020). This evidence is backed up by the Royal Australians and New Zealand College of Obstetricians and Gynaecologists, therefore inductions of labour are strongly recommended (Royal Australian and New Zealand College of Obstetricians and Gynaecologists., 2021). Inductions of labour are associated with an increased risk of adverse maternal outcomes, for example, infection, caesarean sections, haemorrhage, and adverse neonatal outcomes, for example, special care nursery admission, birth trauma, resuscitation, hypothermia, and hypocalcaemia (Teitler et al., 2019). These contributing factors influence birth APGAR scores, the APGAR is measured to determine the babys condition after birth (Bowen et al., 2019). The Apgar scores are recorded at one minute following birth and five minutes, there are five components looked at when recording the scores and each component receives two points. (Bowen et al., 2019). The scores are made from the newborns appearance, pulse, reflex, activity/tone, and respiration (Bowen et al., 2019). For women, these birth outcomes and scores can influence and impact these birth experiences negatively compared to women who spontaneously labour and have better APGAR scores (Seijmonsbergen-Schermers et al., 2020).
A study of induction of labour and premature rupture of membranes contributes to low APGAR scores (Sohail et al., 2022). Another contributing factor to poor APGAR scores at birth was by using cervidil which is a method of induction that can cause foetal distress during labour (Simpson, 2020). Inductions of labour can be a long process; therefore, women can get an epidural early which can cause low APGAR scores another study suggested (Sinkey et al., 2019). Evidence suggests that induction of labours is subjective and can be argued that it causes birth injuries for newborns and women (Coates et al., 2020). Evidence suggests that spontaneous labour and vaginal deliveries have a higher chance of the newborns Apgar scores being within normal limits without any compromise due to the physiological birth process (Sinkey et al., 2019).
The research suggests that women found weighing up of risks and benefits of induction of labour versus spontaneous labour for macrocosmic newborns difficult (Bowen et al., 2019). Therefore, doing a systematic review will examine the available research on induction of labour and suspected foetal macrosomia to highlight any areas for future research. It could also assist in the decision-making process for women who are facing a similar situation.
Aims and Objectives
A literature review's objective is to gather current, pertinent research on the subject topic and to synthesise it into a comprehensive overview of the body of knowledge in the area. This, therefore, equips you to present your case or carry out independent study on the subject. This systematic review will aim to examine all research that can affect the decision-making process regarding macrosomia. By completing the literature review it will identify ways to interpret existing research and reveal any gaps that are found in the literature.
It will also identify if the induction of labour or spontaneous labouring influences incidences of neonatal or maternal outcomes. Does spontaneous labour compared to induction of labour increase the risk of shoulder dystocia and increase the chances of an instrumental birth, resulting in birth injuries? If suspected foetal macrosomia is identified as an induction of labour causing any adverse outcomes for the mother or babies, for example, episiotomy, post-partum haemorrhage, instrumental birth, or an emergency caesarean. To examine how accurate identifying macrosomia is during pregnancy and how to manage compared to the unknown. This research aims to investigate the outcomes for women who are having an induction for macrosomia and does this lead to complications at birth of low APGAR scores. A comparison of APGAR scores between term babies whose weight by ultrasound is estimated above the ninety-fifth percentile, where the mothers labour was spontaneous or induced.
Method
Criteria for study selection
Population: The population will be focussed on all/any pregnant women of any age across Australia.
The phenomenon of interest: The review will be evaluating the newborn APGAR scores for term gestations compared to induction in labour. Do interventions in the physiological process affect the outcome of the baby and mother? Context: The review will be across Australia in the hospital setting due to the nature of the question.
Other considerations: The review will focus on peer-reviewed, quantitative articles within five years, in a hospital setting, and will be completed in a timeframe of over a year. Limitations will be English-only articles to assist the reviewers as English is the primary language in Australia.
The above will be the criteria for the study selection to minimise any irrelevant information. The criteria for study selection will assist the researchers identify the correct components to gather evidence-based information and filter out any irrelevant data.
Search Strategy
The systematic review will detect primary quantitative research regulating the review questions through a wide range of databases. The database will include CINAHL and Medline, Google Scholar and Google will be used to do a grey literature search will be completed to ensure unpublished studies are found. The keywords used will be outlined in the table below. The words will be entered into the database using search strings to find literature specifically related to the research question for example OR and AND. The keywords will be shifted around to provide the best literature that supports the review question. The reference list will be manually searched along with the study citations to ensure up-to-date literature.
Subject Keyword/Search Terms
Macrosomia Macrosomia OR Large baby OR Large for gestation age OR LGA OR big baby AND >90th percentile
Induction of Labour Early Delivery OR Induction of labour OR IOL OR intervention
Pregnant Women Pregnant women OR Birth of a Woman
Spontaneous Labour Spontaneous labour OR expected management AND physiological birth OR Spontaneous onset of labour
APGARS APGAR Scores AND well-being OR Birth Wellbeing OR well baby at birth AND delivery
Quality Appraisal
Before being subjected to the Joanna Briggs Institute Critical Appraisal Checklist for Quantitative Research, each study that meets the inclusion requirements will first be evaluated for methodological validity by two reviewers (Joanna Briggs Institute, 2020). Each study will be evaluated for its worth and quality, and any research that does not adhere to the pertinent standards and methodology will be disregarded (Joanna Briggs Institute, 2020). Any disagreements among the reviewers will be settled by discussion or, if necessary, the involvement of a third or fourth reviewer (Joanna Briggs Institute, 2020). The original reviewers will be contacted directly for clarification if more details are required (Joanna Briggs Institute, 2020). The reviewers will filter through all evidence to ensure it is informed to date Evidence-Based Practice (Joanna Briggs Institute, 2020).
Reviewers will use the appropriate Joanna Briggs Institute Critical Appraisal Checklist for the pertinent study to undertake a quality evaluation after building a list of publications that are appropriate for systematic review inclusion (Joanna Briggs Institute, 2020). Every study that does not meet a requirement on the applicable Joanna Briggs Institute Critical Appraisal Checklist will have its suitability for inclusion determined on an individual basis (Joanna Briggs Institute, 2020). For example, a Randomised Controlled Trial will not be included in the review if it does not satisfy criteria one and three on the Joanna Briggs Institute Critical Appraisal Checklist (Joanna Briggs Institute, 2020). However, due to the intervention on the subject and control treatments and the impossibility to blind participants and staff to the randomisation, adherence to criteria two, five, and six for studieswill not be necessary for inclusion (Joanna Briggs Institute, 2020).
Data Extraction and Analysis
A thematic analysis is when data is collected from a variety of different research but has common themes (Fugard & Potts, 2022). By analysing the data is can identify the common ground between the data, recognise the patterns in the text, and provide clarification (Higgins et al., 2022). The step of thematic analysis is to become familiar with the data, identify similar codes, search the themes, review the themes, define the themes, and synthesise and write up (Fugard & Potts, 2022).
Data extraction is the process through which information from the studies included in the systematic review is gathered to help answer the review question such as data on research characteristics and findings (Higgins et al., 2022). One significant way that the Systematic Review goes beyond the conventionally published literature to present a review of current information relating to the area of interest is through the process of extracting, synthesising, and merging data from multiple research (Fugard & Potts, 2022). A systematic approach should be used to extract data and reduce errors, much like in the previous processes (Higgins et al., 2022). The results (or outcomes) extrapolated from individual research papers that are pertinent to the review topic make up the data synthesised in a systematic review (Fugard & Potts, 2022).
Each study will go through a manual data extraction process to find the quantitative data as per the Cochrane Handbook for Systematic Reviews of Interventions (Higgins et al., 2022). To facilitate easier data synthesis, the information from each eligible study's findings will be manually recorded into a review analysis document (Fugard & Potts, 2022). The data must be pertinent to the subject and inquiries of the review (Higgins et al., 2022). Any information that does not meet the review's inclusion requirements will be disregarded (Fugard & Potts, 2022). The review analysis document will get the data as verbatim copies to be shown in tables and graphs (Higgins et al., 2022).
Results
The details of what should be included when presenting the results of your search are presented in this, the last phase in the systematic review process (Booth et al., 2022). For a review's discussion, restrictions, and recommendations to be applied in routine clinicalpractice, the reader must be able to comprehend and understand the discussion (Booth et al., 2022). Consequently, this task is crucial for the review process. When writing the results, it is important to ensure that the results are answering what research is already out there, what will guide practice, by doing future research what will be achieved (Booth et al., 2022).
The preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) declaration has developed into the norm around the world for summarising and analysing research findings (Rayane et al., 2022). Systematic reviews that do not follow the PRISMA recommendations will frequently not be accepted for publication in peer-reviewed journals (Rayane et al., 2022). The most popular method for outlining a systematic review's search strategy and research selection procedure is a flow diagram (Rayane et al., 2022).
A reader can comprehend the extent of the research and its applicability to the review question from the flow diagram (Rayane et al., 2022). The flow diagram provides a clear representation of the literature review and should list the databases utilised for the search, the method for choosing which studies to include and which to exclude, the number of studies involved in the search, and the total number of studies included in the review (Rayane et al., 2022). The review findings and debate gain credibility from this open account (Rayane et al., 2022).
125964544195Records identified through:
Database search (n =485)
Additional records identified through other sources.
(n =16)
Records after duplicates removed.
(n = 328)
Records Screened
(n = 328)
Reports excluded.
(n =317)
Full-text articles assessed for eligibility.
(n = 11)
Full-text articles excluded, with reasons (n= 8)
Not peer reviewed (n =3)
Insufficient details (n =1)
Reason 3 (n = 4)
etc.
Studies included in research.
(n =3)
Identification of studies via databases
Identification
Screening
Included
Eligibility
00Records identified through:
Database search (n =485)
Additional records identified through other sources.
(n =16)
Records after duplicates removed.
(n = 328)
Records Screened
(n = 328)
Reports excluded.
(n =317)
Full-text articles assessed for eligibility.
(n = 11)
Full-text articles excluded, with reasons (n= 8)
Not peer reviewed (n =3)
Insufficient details (n =1)
Reason 3 (n = 4)
etc.
Studies included in research.
(n =3)
Identification of studies via databases
Identification
Screening
Included
Eligibility
See below: PRISMA 2020 flow diagram for new systematic reviews which included searches of databases (PRISMA, n.d.).
Authors/Title/Reference Study design Size Key Findings Other
Boulvain, M., Irion, O., Dowswell, T., & Thornton, J. G. (2016). Induction of labour at or near term for suspected foetal macrosomia.Cochrane Database of Systematic Reviews,5(5). https://doi.org/10.1002/14651858.CD000938.pub2
IOL reduces the risk of trauma when suspected foetal macrosomia 818 women APGARS, birth injuries, IOL VS expected management and outcomes Even though this study is 7 years old it is relevant and important to my research
Magro-Malosso, E. R., Saccone, G., Chen, M., Navathe, R., Di Tommaso, M., & Berghella, V. (2017). Induction of labour for suspected macrosomia at term in non-diabetic women: a systematic review and meta-analysis of randomized controlled trials.BJOG: An International Journal of Obstetrics & Gynaecology,124(3), 414421. https://doi.org/10.1111/1471-0528.14435Expected management and IOL for macrosomia Four RCTs 1190 women APGARS<7 at 5 minutes, birth weights >4000 grams, birth injuries, IOL reduces the risk of birth risk and APGAR scores Even though this is 6 years old this study had a significant effect on my research and is relevant
Vitner, D., Bleicher, I., Kadour-Peero, E., Borenstein-Levin, L., Kugelman, A., Sagi, S., & Gonen, R. (2020). Induction of labour versus expectant management among women with macrocosmic neonates: a retrospective study.The Journal of Maternal-Foetal & Neonatal Medicine,33(11), 18311839. https://doi.org/10.1080/14767058.2018.1531121IOL vs expected management with macrocosmic neonates Cohort study live neonates 3095 women 795 women had IOL, C-section rates did not reduce, above 39 weeks gestation had compromised neonates and birth injuries Studies included in my research are in the table below:
References
Australian Institute for Health and Welfare. (2022). Australias mothers and babies. https://www.aihw.gov.au/reports/mothers-babies/australias-mothers-babies/contents/about
Booth, A., Sutton, A., Clowes, M., & Martyn-St James, M. (2022).Systematic approaches to a successful literature review(Third). SAGE.
Boulvain, M., Irion, O., Dowswell, T., & Thornton, J. G. (2016). Induction of labour at or near term for suspected foetal macrosomia.Cochrane Database of Systematic Reviews,5(5). https://doi.org/10.1002/14651858.CD000938.pub2
Bowen, J. R., Nippita, T. A., Morris, J. M., & Ford, J. B. (2019). Childhood health and education outcomes following early term induction for large-for-gestational age: a population-based record linkage study.Acta Obstetricia Et Gynecologica Scandinavica,98(4), 423432. https://doi.org/10.1111/aogs.13511Coates, D., Makris, A., Catling, C., Henry, A., Scarf, V., Watts, N., Fox, D., Thirukumar, P., Wong, V., Russell, H., & Homer, C. (2020). A systematic scoping review of clinical indications for induction of labour. Public Library of Science One, 15(1), 1-42. https://doi.org/10.1371/journal.pone.0228196
Dahlen, H. G., Thornton, C., Downe, S., de Jonge, A., Seijmonsbergen-Schermers, A., Tracy, S., Tracy, M., Bisits, A., & Peters, L. (2021). Intrapartum interventions and outcomes for women and children following induction of labour at term in uncomplicated pregnancies: a 16-year population-based linked data study.BMJ Open,11(6). https://doi.org/10.1136/bmjopen-2020-047040
Fugard, A., & Potts, H. W. W. (2020).Thematic analysis. SAGE Publications. https://methods.sagepub.com/foundations/thematic-analysis.
Higgins, J., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J., & Welch, V. A. (Eds.). (2022). Cochrane Handbook for Systematic Reviews of Interventions. https://training.cochrane.org/handbook/current
Joanna Briggs Institute. (2020). Critical Appraisal Checklist for Randomized Controlled Trials. https://jbi.global/critical-appraisal-toolsMagro-Malosso, E. R., Saccone, G., Chen, M., Navathe, R., Di Tommaso, M., & Berghella, V. (2017). Induction of labour for suspected macrosomia at term in non-diabetic women: a systematic review and meta-analysis of randomized controlled trials.BJOG: An International Journal of Obstetrics & Gynaecology,124(3), 414421. https://doi.org/10.1111/1471-0528.14435Middleton, P., Shepherd, E., Morris, J., Crowther, C. A., & Gomersall, J. C. (2020). Induction of labour at or beyond 37 weeks gestation. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD004945.pub5
PRISMA. (n.d.). PRISMA Flow Diagram. http://www.prisma-statement.org/PRISMAStatement/FlowDiagram
Rayane, E., Lara, A. K., Holger, J. S., Assem, M. K., Hector, P.-H., Ibrahim, E. M., Elie, A. A., & Neal, R. H. (2022). Tailored Prisma 2020 flow diagrams for living systematic reviews: a methodological survey and a proposal. 10. https://doi.org/10.12688/f1000research.51723.3Royal Australian and New Zealand College of Obstetricians and Gynaecologists. (2021). Diagnosis and management of suspected foetal macrosomia. https://ranzcog.edu.au/wp-content/uploads/2022/05/Diagnosis-and-management-of-suspected-fetal-macrosomia.pdfRydahl, E., Declercq, E., Juhl, M., Damkjaer Mainmburg, R. (2019). Routine induction in late-term pregnancies: Follow-up of a Danish induction of labour paradigm. BMJ Open, 9(12), 1-9. https://doi.org/10.1136/bmjopen-2019-032815
Seijmonsbergen-Schermers, A. E., Peters, L. L., Goodarzi, B., Bekker, M., Prins, M., Stapert, M., Dahlen, H. G., Downe, S., Franx, A., de Jonge, A. (2020). Which level of risk justifies routine induction of labour for healthy women? Sexual & Reproductive Health, 23, 1-4. https://doi.org/10.1016/100479
Simpson, K. R. (2020). Cervical Ripening and Labour Induction and Augmentation, 5th Edition.JOGNN: Journal of Obstetric, Gynecologic & Neonatal Nursing,49(5), 141. https://doi.org/10.1016/j.jogn.2020.04.005Sinkey, R. G., Blanchard, C. T., Szychowski, J. M., Ausbeck, E., Subramaniam, A., Neely, C. L., Casey, B. M., & Tita, A. T. (2019). Elective induction of labour in the 39th week of gestation compared with expectant management of low-risk multiparous women.Obstetrics and Gynecology,134(2), 282287. https://doi.org/10.1097/0000000000003371
Sohail, A., Muzaffar, T., & Saleem, U. (2022). The outcome of early and late induction of labour in premature rupture of membranes.Pakistan Armed Forces Medical Journal,72(6), 20872087.
Teitler, J. O., Plaza, R., Hegyi, T., Kruse, L., & Reichman, N. E. (2019). Elective deliveries and neonatal outcomes in full-term pregnancies.American Journal of Epidemiology,188(4), 674683. https://doi.org/10.1093/aje/kwz014Vitner, D., Bleicher, I., Kadour-Peero, E., Borenstein-Levin, L., Kugelman, A., Sagi, S., & Gonen, R. (2020). Induction of labour versus expectant management among women with macrosomic neonates: a retrospective study.The Journal of Maternal-Foetal & Neonatal Medicine,33(11), 18311839. https://doi.org/10.1080/14767058.2018.1531121
Template Assignment Two Findings from the systematic review
Review question: A comparison of APGAR scores between term babies whose weight by ultrasound is estimated above the ninety-fifth percentile, where the mothers labour was spontaneous or induced.
3 Papers to be used: Boulvain, M., Irion, O., Dowswell, T., & Thornton, J. G. (2016). Induction of labour at or near term for suspected foetal macrosomia.Cochrane Database of Systematic Reviews,5(5). https://doi.org/10.1002/14651858.CD000938.pub2Magro-Malosso, E. R., Saccone, G., Chen, M., Navathe, R., Di Tommaso, M., & Berghella, V. (2017). Induction of labour for suspected macrosomia at term in non-diabetic women: a systematic review and meta-analysis of randomized controlled trials.BJOG: An International Journal of Obstetrics & Gynaecology,124(3), 414421. https://doi.org/10.1111/1471-0528.14435Vitner, D., Bleicher, I., Kadour-Peero, E., Borenstein-Levin, L., Kugelman, A., Sagi, S., & Gonen, R. (2020). Induction of labour versus expectant management among women with macrocosmic neonates: a retrospective study.The Journal of Maternal-Foetal & Neonatal Medicine,33(11), 18311839. https://doi.org/10.1080/14767058.2018.1531121Data Extraction (quantitative) (300)
Present a table with the main themes of the data extraction. Headings to include:
Author/s
Year of publication
Country of origin Aim/s or Purpose Population and sample size Methods and Methodology Intervention type or comparator and details Key Findings that relate to the original question
Need to have 3 lines ( as have 3 references need to do this for all 3 references
Findings (500)
Present the key findings of your review (ie. the overarching themes that emerged when you analysed each article and then group them together to form meaningful categories).
Each key finding should contribute to answering your review question.
Link to evidence based practiceRelevance to midwifery practice
In this section this is what needs to be included. I found that out and I found the other things out and that's when you go into your discussion section when you're pulling it all apart and you're actually doing what we call an original thought, gosh, I found all of these things out. This is how we can change things. This is what we could do differently, you know? And that's when you would pull in other bits of evidence and reference isn't things.
Discussion (750)
Crafting your discussion section should be guided by the central findings of your review. It should critically examine the significance of your overarching findings in the context of current research, demonstrating how each core finding (or theme) adds to the body of evidence that already exists in your field of research. A discussion should also describe any limitations that emerged from your review and make recommendations for further research. limitations to all articles( paper1 , 2, 3). In a nutshell, a discussion section has a beginning, middle, and an ending:
The beginning: Recap the aim of your review and review question. Present your core findings to the reader.
The middle (unpacking your core findings): Compare your findings with the works of other authors within your field, interpret your findings (what do they mean in practice?), and share the strengths and limitations of your review.
The ending: Conclude your review by restating your key findings. Reiterate the significance of your review and how it fills a gap in knowledge (or highlights other gaps that require further research). Leve the reader feeling inspired!
Conclusion (600)
Provide a concise summation of the outcomes of the systematic review process.
Do not include any new information or references in the conclusion.
Abstract (300)
The last component of this assignment requires you to prepare an abstract (This would usually be presented at the start of your systematic review i.e.at the top of assignment one). It should include:
Background ( few sentences, what you looked at and who )
Aims and objectives ( few sentences, review current literature on the subject and to add to the body of midwifery practice)
Study design ( few sentences , JBI systematic review )
Methods ( few sentences, jbi framework )
Results ( few sentences, 3 articles were found)
Conclusion
Relevance to clinical practice
