# Welcome to SMIRK Unit
4 - Writing a critical
review

- What is a critical review?
- Develop a search strategy
- Organising your search results
- What does critically evaluating the literature mean?
- A critical reviewing example
- Tips for evaluation
- Critical reviewing flowchart
- An example of good writing
- Critically evaluate the literature
- Structuring your crtitical review
- A second example of good writing
- Dos and don'ts of critical reviewing
- Final tips
- What is synthesis?
- Final tips
- Back to main index

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SMIRK - Writing a critical review by Steve Draper, Glasgow University, Dr Jane McKay, GCU modified by Marion Kelt, Glasgow Caledonian University is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://www.psy.gla.ac.uk/~steve/resources/crs.html.

# General pointers

Critical reviews are essays based on scholarship. You will be asked to find and read the literature on a topic and add your own considered arguments and judgements about it. This involves both reviewing an area, and using critical thought and judgement. It is quite a good idea to write with fellow students as your imagined audience, this will help you to avoid assuming that the reader knows everything so you needn't explain much. You need to show that you understand the topic. If you write clearly enough so that a fellow student both understands and is interested by your paper, then it should look good your lecturer.

Your goal is:

- To show that you can critically analyse the literature
- To show that you can synthesise (put together) the key findings and present them in a logical way
- To show that you can pass on the findings to your profession

The first step is to find relevent literature to review. Your lecturer will give you guidance on your topic and what type of literature to include.

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SMIRK - Writing a critical review by Steve Draper, Glasgow University, Dr Jane McKay, GCU modified by Marion Kelt, Glasgow Caledonian University is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://www.psy.gla.ac.uk/~steve/resources/crs.html.

# Develop a search
strategy

Decide on how much and what type of information you need to –

- develop exclusion and inclusion criteria, such as:
  - will you reject (exclude) certain types of interventions? If so, WHY?
  - will you reject studies with certain types of research design? If so, WHY?
  - will you reject studies with certain types of participants? If so, WHY?
- decide on what databases you are going to use
- decide on what your search terms will be, but be flexible – these may change as you progress
- sift through your search results and decide whether to keep or discard based on exclusion and inclusion criteria
- keep a note of what you do – use our literature search template This is a word document so you can download and edit it.
- you can then download the PRISMA flow chart and fill in the details using the information on your template

You can find more detailed information in our systematic reviewing pages.
We have some examples of successful search strategies on GCULearn:

- Topic: the influence of psychosocial factors on low back pain. The search is repeated in 3 databases; Cinahl, Medline and AMED. Have a look at the use of Boolean terms, truncation and MeSH.
- Topic: the role of control beliefs in the levels of distress in family members of people with dementia. This was part of a PhD study.
- Topic: the management of ankle sprains. This systematic review compares a variety of interventions, which you do not have to do, as you at most will compare 2 interventions. It was published in the Australian Journal of Physiotherapy.
- This literature search strategy is part of a systematic review was published in the Child and Adolescent Social Work Journal.
- Topic: interventions to prevent falls in the elderly in the community published by the Cochrane Collaboration, who represent the gold standard for systematic reviews of randomised controlled trial studies. It includes both the description and the actual literature search strategy.

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SMIRK - Writing a critical review by Steve Draper, Glasgow University, Dr Jane McKay, GCU modified by Marion Kelt, Glasgow Caledonian University is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://www.psy.gla.ac.uk/~steve/resources/crs.html.

# Organising your search
results

This video resource from the University of Plymouth, Learning from WOeRk project helps summarise the main points of critical thinking and reflection. You may need to adjust the sound levels from time to time.

#### Read and take notes

- Read the article and highlight the key points, thinking about how they might be used in your review. Key points will include:
  - Contextual information that could be used in your introductory section
  - Method used
  - Results
  - Strengths and weaknesses of the research
- Bullet the key points on a post-it note and stick it to the front of the article for quick reference

#### Organise your notes in a structured way

- Sort your notes into categories by, for example, research design, sample size, results and so on
- This allows you to get an overall picture of the research findings and prevents you feeling overwhelmed
- Allows you to see findings at a glance so will help with pulling together (synthesising) key points

######
SMIRK - Writing a critical review by Steve Draper, Glasgow University, Dr Jane McKay, GCU modified by Marion Kelt, Glasgow Caledonian University is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://www.psy.gla.ac.uk/~steve/resources/crs.html.

# What does critically
evaluating the
literature mean?

- Asking the ‘whys’ and ‘hows’, not the ‘whats’
- This means being analytical, not just descriptive. You need to:
  - Consider how valid and reliable the research is
  - What are its strengths and weaknesses?
  - Consider how applicable to your research question the research is
  - Draw comparisons with other research findings
- Ask the ‘why’ questions, like:
  - Why do the results differ from findings of other similar research?
  - What explanations have the authors suggested and are there alternatives?
  - Make links with practice and wider populations where appropriate

We have a checklist of questions to ask which will help you.

#### A helpful diagram outlining the stages of critical thinking

###### Image: Model to generate critical thinking by John Hilsdon, Learning at Woerk project, University of Plymouth. http://technologyenhancedlearning.net/blog/category/casestudies-projectreports/page/2/

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SMIRK - Writing a critical review by Steve Draper, Glasgow University, Dr Jane McKay, GCU modified by Marion Kelt, Glasgow Caledonian University is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://www.psy.gla.ac.uk/~steve/resources/crs.html.

# A critical reviewing
example

#### Look at this example:

A study by Daniels (1998) found that group exercise was more effective than a control (n=21) in significantly reducing anxiety symptoms among 22 middle-aged men. The participants were randomly assigned to groups and effects were maintained at 6 month follow-up. Beck (2005) reported that anxiety symptoms decreased in a group of 42 middle-aged men and women in comparison to a control. No follow-up measures were taken.

#### What is the problem with this as a piece of critical writing?

Consider the questions raised over the next few pages, then we will show how they can be applied to this paragraph to improve it.

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SMIRK - Writing a critical review by Steve Draper, Glasgow University, Dr Jane McKay, GCU modified by Marion Kelt, Glasgow Caledonian University is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://www.psy.gla.ac.uk/~steve/resources/crs.html.

# Tips for evaluation

Don't just describe - evaluate! Avoid simple description; you must evaluate if you are to be critical (though some description will still be required to ‘set the scene’, otherwise the reader won’t understand the context).

Here are some further tips:

- Write out explicit definitions of central technical terms. Often,doing this (perhaps in the introduction) will lead you into making criticisms - maybe of studies that used different definitions for no good reason, or that included subjects who don't fit the usual definition. It can also lead to criticising papers that failed to explain how they defined crucial terms. It can help you explain how you selected your papers.
- Criticise the technique used. Criticise the method of each paper, and distinguish serious from marginal criticisms of the method.
- Could or should techniques not used have been applied? Offer constructive suggestions about better methods or approaches. Discuss what you would do to improve research in the area. Consider whether techniques from other areas could be imported into this one. If you think one line of work has led to no clear conclusion, what would you recommend? Simply more detailed methods but the same kind of study, or a different kind of study? You might decide that, in a given area, the issues have been adequately resolved and there is no great need for further work. But giving your own view (and reasons for it) in addition to what published papers say, adds value.
- Criticise for failure to look at other established approaches to the problem. In some areas, there may be whole approaches with different research methods that should be considered, yet many papers stay within one approach and fail even to mention the other. One standard approach to criticism is to comment on such one-sidedness.

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SMIRK - Writing a critical review by Steve Draper, Glasgow University, Dr Jane McKay, GCU modified by Marion Kelt, Glasgow Caledonian University is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://www.psy.gla.ac.uk/~steve/resources/crs.html.

# Critical reviewing
flowchart

###### Image: Critical thinking flowchart by Learning at Woerk project, University of Plymouth. http://technologyenhancedlearning.net/blog/category/casestudies-projectreports/page/2/

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SMIRK - Writing a critical review by Steve Draper, Glasgow University, Dr Jane McKay, GCU modified by Marion Kelt, Glasgow Caledonian University is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://www.psy.gla.ac.uk/~steve/resources/crs.html.

# An example of good
writing

A study by Daniels (2002) found that group exercise was more effective than a control (n=24) in significantly reducing anxiety symptoms among 28 middle-aged men. The participants were randomly assigned to groups and effects were maintained at 6 month follow-up. A strength of Daniel’s study was the randomisation of participants to groups and the incorporation of a follow-up anxiety measure. However, the study is limited due to the relatively small sample size and anxiety measure which has been shown to have poor reliability (ref).

#### Why?

The lowest approach to a critical review just summarises the contents of some papers. A better approach also collects and presents criticisms, but is still essentially reacting to the papers one by one and bit by bit. But what is best is when thecritical review as a whole has a clear structure invented by the student, not just directly reflecting the papers being reviewed.

This cannot be planned in advance. One student decided to review the literature on personality and binge drinking, and noticed on his first pass through the papers that most studies had only reported on one or two of the main personality dimensions. This became his chief criticism and also offered a structure for his whole review: beginning with a summary of personality theory, and discussing the studies under each of the 5 personality dimensions in turn. Another concerned CBT therapies for certain mental illnesses. This student began with an introduction about the relevant general issues of clinical study methods, including references to papers on what is desirable. He then applied those standards to the particular papers he was reviewing: again imposing a pre-selected set of standards which he had independently justified and laid out in advance.

This kind of approach usually cannot be decided on until after reading the set of papers through for the first time, making notes of points, and eventually coming to a decision about the most important overall issue. By imposing their own standards and structure, these students demonstrated they were not just taking the literature uncritically; and this gave their whole critical reviews a coherence that the students, not the papers, had come up with.

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SMIRK - Writing a critical review by Steve Draper, Glasgow University, Dr Jane McKay, GCU modified by Marion Kelt, Glasgow Caledonian University is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://www.psy.gla.ac.uk/~steve/resources/crs.html.

# Critically evaluate
the literature

- Have confidence – the more you read and understand, the more you are becoming an expert in the area and able to critique what you read.
- Remember, just because an article is published doesn't mean that it’s perfect – there will be strengths but also limitations. *TIP* you will usually find these at the end of the discussion section.
- You will need a strong understanding of what makes sound or weak research. Revisit this if necessary.

#### Questions to ask:

- Was the sample size big enough to allow findings to generalise to other populations?
- Did attrition affect the results?
- Were the inclusion criteria too wide or narrow?
- Were there flaws in the research design?
- Quantitative research: were participants randomly assigned to groups in a double blinded fashion? Was there a control group?
- Qualitative research: Were interview guides piloted? Were measures taken to enhance the credibility of data analyses? Do the researchers declare any personal biases that may have influenced their interpretation of results?
- Is the source credible? Is it a peer-reviewed journal or unknown website?
- When was the article published? Is it recent?
- Does the study explain the results (or simply just describe)?
- Has the author(s) considered how the results apply to wider populations or practice settings?
- Has the study addressed a ‘gap’ in the literature?
- Are the conclusions final or preliminary? What further research is required?
- Overall how good do you think the article is?
- Check out our full listing of questions for more suggestions.

####

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SMIRK - Writing a critical review by Steve Draper, Glasgow University, Dr Jane McKay, GCU modified by Marion Kelt, Glasgow Caledonian University is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://www.psy.gla.ac.uk/~steve/resources/crs.html.

# Structuring your
critical review

- Introduction - set the scene (relevant background information, such as why it is important to your discipline, scale of problem, relevant policy and so on)
- Methods - How did you locate the literature? (databases searched, inclusion and exclusion criteria, criteria used to judge papers, key terms used) Remember - Justify, don’t just describe
- Findings - this is the hard bit - there is no standard way to structure this
  - Here markers are looking for synthesis - you need to pull together results and compare and contrast
  - Your summary table will really help here
  - Avoid describing each piece of literature in a list – discuss studies in groups and themes to help you structure (such as intervention type, method, outcomes and so on)
  - Critique - you should then discuss the strengths and limitations of the studies
- You might start this section by saying something like:
  - For the purposes of this section of the review, research will be discussed thematically by research approach. Of the 15 studies reviewed, seven adopted a qualitative methodology….(you could then go on to compare and contrast findings of these 7 studies and strengths and limitations)
  - Once you have discussed each of these categories, compared findings, and considered strengths and limitations, you can provide an overall summary to tie up the section.
- See the next page for an example

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SMIRK - Writing a critical review by Steve Draper, Glasgow University, Dr Jane McKay, GCU modified by Marion Kelt, Glasgow Caledonian University is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://www.psy.gla.ac.uk/~steve/resources/crs.html.

# A second example of
good writing

The results of the studies reviewed suggest that exercise can have beneficial effects on alleviating anxiety symptoms. The vast majority of studies reviewed employed robust research designs, with seven studies using RCTs. Given the power of RCTs for identifying causal effects, the evidence for the beneficial effects of exercise on anxiety can be considered strong. However, several limitations should be noted. Firstly, some studies have been hampered by weak anxiety measures and high attrition rates. Secondly, as some studies have failed to consider follow-ups, the sustainability of the effects of exercise on anxiety is not fully understood. Finally, the lack of qualitative studies prevents an understanding of the mechanisms that explain how exercise reduces patients’ experiences of anxiety.

#### Structuring your critical review:

- Discussion:
  - What are the implications of what you have found for your profession and other professions, in other words, what can practitioners do with the results that your review has highlighted?
  - What are the limitations of the review itself?
  - What are the ‘gaps’ in the literature and recommendations for further research?
- Conclusion:
  - Statement of key findings from the review and what the review has added to the body of knowledge in this area

####

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SMIRK - Writing a critical review by Steve Draper, Glasgow University, Dr Jane McKay, GCU modified by Marion Kelt, Glasgow Caledonian University is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://www.psy.gla.ac.uk/~steve/resources/crs.html.

# Dos and don'ts of
critical reviewing

- Don’t simply provide a list of past studies – ensure you analyse and synthesise to provide an overall picture
- Make sure you have identified the best sources of literature and given each source the due weight it deserves
- Make sure you have demonstrated how your literature relates to the relevant wider picture
- Don’t uncritically accept the results of existing literature – critically evaluate!
- Make sure you have considered contrary findings and offered explanation

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SMIRK - Writing a critical review by Steve Draper, Glasgow University, Dr Jane McKay, GCU modified by Marion Kelt, Glasgow Caledonian University is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://www.psy.gla.ac.uk/~steve/resources/crs.html.

# Final tips

- Justify the selection of the papers you chose: otherwise it looks random. Briefly say why you chose them. A short listing of the papers you have chosen in your introduction helps the reader be clear about the scope and structure of your review.
- The introduction should manage the readers' expectations; in particular tell them how you have structured the rest of the review: by paper, by theme, by critical point, and so on.
- Provide explicit definitions of technical terms and categories wherever this is central to the criticisms you will discuss, or to how the topic is defined and the papers selected. It's surprising how simply writing out an exact defintion immediately leads you to making some critical comments.
- Be very careful about citations: do not cite papers you haven't personally read. Even if you think it's OK to cite papers you haven't read in other writing, in a review the whole essay is about your personal discussion of what others have written.
- Tell the reader which criticisms are your own thoughts, and which you are repeating from others (such as an author's self-criticism). Both are interesting, but tell the reader which is which.

#### Revising your critical review:

- If you want to improve quality, revise what you write. When you think that it is finished, get someone else to read it and comment on it. This is easily the single biggest thing you can do to improve quality, but you have to allow some time for it - plan ahead.
- You only get the best out of any reader the first time, when the document is new to them. So if you are serious about quality, line up more than one reader, and revise it after each set of comments before using your next reader. If you think one reader is more expert than another for this piece of work, save the best reader till last (get the first one to find the worst of the spelling mistakes and so on first).
- It is probably a good idea to think of fellow students as your audience: this will encourage you to be interesting, and not to assume too much, which will then lead to you writing more clearly and impressing everyone - especially staff.

#### Finally - good luck!

####

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SMIRK - Writing a critical review by Steve Draper, Glasgow University, Dr Jane McKay, GCU modified by Marion Kelt, Glasgow Caledonian University is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://www.psy.gla.ac.uk/~steve/resources/crs.html.

# What is synthesis?

When writing up your review, you need to give a synthesis of the research papers that you have identified. This isn't just a summary of each paper, but it investigates the themes across the papers. It critically evaluates the methods and findings of papers, and identifies relevant similarities and discrepancies between papers. This is a critical investigation of an intervention or service used within a health or social care setting, with a specific client group or area of performance. It is best to focus on one intervention or service if possible.

Here is a diagram showing the process of synthesis:

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SMIRK - Writing a critical review by Steve Draper, Glasgow University, Dr Jane McKay, GCU modified by Marion Kelt, Glasgow Caledonian University is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://www.psy.gla.ac.uk/~steve/resources/crs.html.