Original Article

Scottish Medical Journal

2017, Vol. 62(2) 58–62

A beginner’s guide to the literature search ! The Author(s) 2017

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in medical education DOI: 10.1177/0036933017707163
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S Martin, Z Hussain and JG Boyle

Abstract
Conducting a literature search can be a daunting prospect if you have not done it before. This article aims to provide a
beginner’s guide to searching the medical education literature, by describing how to construct an effective search
strategy, the resources that are available and the basics of how searching works.

Keywords
Literature, search, medical, education

Introduction Creating a search strategy

Conducting a literature search can be a daunting pro- Literature searching is a process that to be done suc-
spect if you have not done it before. Using databases cessfully requires a fair bit of prior planning and
like PubMed or Embase can be confusing to the begin- strategy. It is not a matter of randomly searching
ner despite how innovative they may be. In addition, databases; a good search is one that is carefully con-
with the vast amount of information available in the structed. Haig and Dozier state that there are three
medical literature, it is essential to separate relevant key steps to constructing a search query that must be
material from the irrelevant, and achieving this can be done prior to starting your search.2 These three steps
a skill in itself. This article aims to provide a beginner’s are as follows:
guide to searching the medical education literature, by
describing how to construct an effective search strategy, . Define the search query
the resources that are available and the basics of how . Identify and expand concepts
searching works. . Set the scope of the query

Central to conducting your search is first of all defin-

How to search the literature ing your search query or question – trying to express in
The work of Haig and Dozier, 2003 is a vital source of words what it is you want to find out. This is important
information with regard to conducting a literature because all subsequent stages of your work will stem
search in the field of medical education. These papers from the initial question that you asked. It is generally
(BEME Guide No. 3 – Parts 1 and 2, both 2003)1,2 accepted that it is better to phrase your search query
highlight a number of key points as well as providing into a clear, focussed question. For example, ‘How do
a comprehensive list of sources and a protocol on how medical students know when they have studied
to conduct a literature search. The BEME (best evi- enough?’
dence medical education) collaboration is an inter- You should then study your search query carefully
national research collaboration that is dedicated to and break it down into its component parts. Look at
compiling systematic reviews in the field of medical
education. So far they have published 24 systematic University of Glasgow, UK
reviews (BEME guides 1–24) on a variety of topics,
Corresponding author:
with another 15 in progress. The overall aim of JG Boyle, Wolfson Medical School Building, University Avenue, Glasgow
BEME is for medical education to achieve the same G12 8QQ, UK.
standards of evidence based practice seen in medicine.8 Email: james.boyle@glasgow.ac.uk
Martin et al. 59

these components and compile a list of all the possible Amsterdam, the Netherlands. It has a strong focus on
synonyms, alternative meanings, different spellings and pharmaceutical research and publications from
related words and phrases that may be applicable, and Western Europe, in contrast to Medline, which has
decide if you want these to be included in or excluded more emphasis on North America. Embase boasts a
from your search. In the above example, ‘How do med- database containing over 28 million records indexed
ical students know when they have studied enough?’ from over 8300 journals. It claims to include all the
‘medical students’ could easily be replaced with ‘med- records indexed by Medline plus an additional 6 million
ical undergraduates’, ‘studied’ could be replaced with records from a further 2500 journals that Medline does
‘revised’ or ‘learned’ and ‘enough’ could be replaced not currently index.5 Embase also indexes numerous
with ‘adequately’ and so on. Also think about what key medical education journals that are not covered
your topic can be called in different countries, there anywhere else.1 Access to Embase is only available
may be variations especially between the UK and through subscription.
North America. By going through this systematically
you will be able to compile a list of the keywords that
will be involved in your search, and start to think about
Subject headings
how these keywords relate to each other and how you Subject headings are what make up the structured
might combine them when you start searching. vocabulary of a database. When a journal article is
Finally you also need to set the scope, by choosing added to a database, specific subject headings relating
inclusion and exclusion criteria and setting limitations to the article’s content are chosen by an indexer from a
on the extent of your search. This can mean thinking set list of words, phrases or acronyms and the article
about when articles were published. How many years will be indexed accordingly. The subject headings can
back do you intend to search the literature? Do you then be used to search the databases in a structured way
want to include articles from 5, 10 or 20 years ago for articles relating to those topics, and relevant articles
and where would you draw that line? The geographical will still be found regardless of spelling variations or
location of studies is also another important consider- synonyms being used. Searching databases using sub-
ation. Are you only looking for studies that were car- ject headings is useful because it also ensures that any
ried out in the UK, Europe wide or worldwide? Will articles found will significantly reflect that topic, mean-
you only be looking at articles published in the English ing that you will find results relevant to your search
language? query. Of course, this only works if the subject headings
It may be necessary to go back and refine your used adequately represent the concept you are trying to
search strategy as your project develops, but having search for, which in Medical Education can be more
carried out these steps you will have a definite under- difficult to get right.1,2
standing of what it is you want to search for and will be
well prepared to actually start searching the literature.
Ovid
Ovid is an online search engine system that provides
Medline, PubMed and Embase
access to the bibliographic databases including both
Medline is the bibliographic database of the United Medline and Embase. It is a commercial system that
States National Library of Medicine, based in can only be accessed with a subscription or by affili-
Maryland, USA. It contains over 20 million records ation with an organisation with a subscription, such as
indexed from over 5600 journals dating back to a university, or via an Athens account. Upon opening
1946.3 Access to the Medline database is provided by Ovid, the user is prompted to select, from a list, which
commercial vendors such as Ovid but it can also be database(s) they want to search. The list includes
accessed for free through various websites, the most Embase and Medline, as well as a section dedicated
well known of these being PubMed. solely to the journals with a full-text subscription held
PubMed is a free-to-use website that uses the search by the organisation with which you are affiliated.
engine Entrez to search the academic literature and When searching Ovid the default search page is an
provide free access to Medline. It has over 22 million Advanced Search. The Advanced Search offers the
articles, made up of the entire Medline database plus choice to search for keywords, author, title or journal
additional articles from life science journals that are not as well as being able to set limits such as publication
part of Medline, so it has a slightly wider scope. In year; but the most important feature of the Advanced
addition, new records are added more quickly to Search is the mapping of your search term to subject
PubMed than they are to Medline.4 headings. This is in effect translating your search terms
Embase is the bibliographic database owned and into the controlled vocabulary used by the database. For
operated by the publishing giants Elsevier based in example, searching for the term ‘PBL’ in the context of
60 Scottish Medical Journal 62(2)

medical education brings up the relevant search heading they mention student satisfaction. NOT should
‘Problem-based learning’, as well as ‘Education, be used carefully as it can leave out articles that
Medical’, ‘Curriculum’ and ‘Students, Medical’ some may in fact be useful.
or even all of which may be relevant to the search.
Some of the search headings generated may not be rele-
vant to what you are searching, for example, ‘PBL’ also
generates ‘T-Lymphocytes’, ‘HIV-1’ and ‘Lymphocyte
Truncation and wildcards
Activation’ none of which will be at all useful if we You can search for all the possible variations of a search
were searching for PBL in a medical education context. term by shortening the word and adding in a specific
Once the search term has been mapped into subject ‘truncation symbol’. For example, reflect* will return
headings, you can select as many or as few of the rele- results that contain: reflect, reflection, reflective, reflect-
vant ones as you wish, and combine them with Boolean iveness, etc. You can then take this one step further by
operators such as AND or OR. If none of the subject setting a limit on how many characters can follow the
headings generated are close enough matches to what truncated word. For example, reflect*3 will return items
you want to search for then there is also the option to containing reflection and reflective (three characters) but
use your initial search term as a keyword and search for will not include reflectiveness (seven characters). Most
that instead. This is what happens on the Basic Search databases have their own set truncation symbol,
function of Ovid. It is also possible to combine a key- PubMed uses *, OVID Medline uses * or $ and some
word with a subject heading. It is generally accepted databases use %; but they all do the same thing. If you
that the best way to start a literature search is to find are unfamiliar with the truncation symbol of the data-
the most suitable subject headings relevant to your base you are searching, the information is usually access-
topic. This is because subject headings are thought to ible by clicking on the database’s online help page.
retrieve a higher proportion of relevant returns.1,2 Wildcards work by inserting a specific character (a
wildcard symbol) into the middle of your search term.
Combining search terms – Boolean This allows for words that contain an additional char-
acter at the point of the wildcard symbol to be
algebra retrieved, words that do not contain an additional char-
Boolean algebra, also known as Boolean logic, is a way acter will also still be retrieved. This is particularly
of combining search terms by using the words AND, useful for searching for items with American English
OR and NOT which act as ‘Boolean operators’. Doing and British English spelling variations. For example,
this allows you to refine your search criteria. an?emia will give search results using both the British
spelling anaemia and the American spelling anemia.
AND Using AND will narrow your search by making
sure that only articles that contain all of the
combined terms are retrieved. For example, ‘pro-
Searching by hand
blem-based learning’ AND ‘student satisfaction’ Another option available for searching the literature is
will only return articles relating to both problem- performing a hand-search. This involves sifting through
based learning and student satisfaction together. each volume of a journal one issue at a time to ensure
OR Using OR will greatly expand your search by that no relevant articles are missed. Obviously, this can be
returning any records where any of the combined a very tiresome and time-consuming process and requires
terms are in the article. ‘Problem-based learning’ a lot of dedication and planning. Hand searches are usu-
OR ‘student satisfaction’ will retrieve items con- ally needed for the purposes of large systematic reviews
taining problem-based learning, items containing such as those seen by the Cochrane Collaboration. It has
student satisfaction and items containing both. been shown that hand searches locate records that data-
The use of OR is also useful for connecting syno- bases do not pick up. Therefore, it could be argued that
nyms. For example, ‘problem-based learning’ all literature searches should include the hand-searching
OR ‘PBL’ OR ‘problem-based curriculum’. of journals to ensure that no stone is left unturned. This
NOT Using NOT will restrict your search by eliminat- would of course be ideal; however, in practice it may be
ing a search term and making sure it is not difficult to accomplish.1
included in the results. This can be effective in
narrowing your search by telling the database to Challenges of the medical education
ignore concepts that may be implied by your
literature search
search terms. For example, ‘Problem-based
learning’ NOT ‘student satisfaction’ will return It should be noted that searching the academic litera-
articles on problem-based learning but not if ture for material relating to medical education often
Martin et al. 61

Box 1. Google Scholar.

Google Scholar is an additional resource for literature searching that should not be ignored as it can potentially complement
searching the databases. The world’s number one search engine launched Google Scholar, dedicated to searching the academic
world, in November 2004. It uses search engine technology to find journal articles, abstracts, books and other academic sources of
information directly from the Internet as opposed to from a database. Using Google Scholar is very simple, employing the same
layout of the main search engine that will be familiar to anyone who uses the Internet, the basic search function consists of just a
simple text entry field and a search button, making it extremely user-friendly.
Unlike the other databases, Google Scholar does not use subject headings, and instead all searches are done with free-text or
keyword searches, in the same way as standard Google. However, the Advanced Search option allows the user to specify a
particular author, journal, and to input a range of publication years that they may wish to include as search criteria. Google Scholar,
along with the main Google search engine, also operates with Boolean algebra, meaning that ‘Boolean operators’ like AND or OR
can be used to combine search terms to either narrow or broaden results.
The Google Scholar results page provides links to the full PDF version of the articles if available, a link to all the articles that cite
each result and a further link to articles related to each result. Linking up with bibliography managers is also easy with Google
Scholar providing direct links to import references into BibTeX, EndNote, RefMan and RefWorks, as well as providing a formatted
citation for each result that users can copy and paste into their bibliography by hand.
Some sources recommend the use of Google Scholar as a starting point for any literature review to acquire some background
knowledge on the subject material before conducting a more structured approach when searching the other databases.6 However,
the widespread use of Google Scholar in literature searching is subject to debate. Some studies have concluded that Google
Scholar is not yet robust enough searching tool for projects where stringent methodologies are required, such as large systematic
reviews.7

Box 2. Mendeley.

Mendeley9 is a popular bibliography management system that allows users to manage references, store and manage PDF files,
compile bibliographies and share articles with other Mendeley users. It is available online as a web based desktop program and as an
app for smartphone and tablets. All versions are free to use and download. To use it, one first has to sign up for a personal
Mendeley account. In a clear demonstration of Mendeley embracing the social media age in which we live, the quickest and easiest
way to do this is by linking with your Facebook profile. However, for users without Facebook or who do not wish to link the two, it
is also possible to sign up with a separate account. Once you have an account it is then possible to synchronise your saved
references on every device with which you use Mendeley. For example, if you add references online, they will be immediately
accessible on your laptop, phone or tablet. Mendeley synchronises in this way every time it is opened, meaning that the user has
access to all of their references, anywhere.
When using Mendeley online there is a ‘Save to Mendeley’ button that can be added to the toolbar of the Internet browser. With
this button in place, whenever an article or abstract is being viewed you only need to click on this button and the details of the
article will appear on the right-hand side of the browser. You can then specify whereabouts in the Mendeley Library you want the
article to be saved, in a specific folder or sub-folder, for example. You can then add and save any personal tags or notes to
the article. All the tags that you have assigned to articles in your Mendeley library appear in a box at the left side of the screen.
When you click on a tag, all the articles that have been assigned that tag will be displayed in the library. Tags are a useful way of
organising references especially if you have lots of articles on a variety of unrelated topics.The web importer facility of Mendeley
also gives the user the option to download the PDF version of the article if it is available. The PDF will usually only be available if it is
from an Open-Access source, by subscription, or through affiliation with an organisation with a subscription. If the PDF is available,
then this will be downloaded and saved straight into the Mendeley Library. Once downloaded, the PDF version will then be
available to view on all other devices synchronised with your Mendeley account, whether that be via the app for smartphone or
tablet, or the desktop version. PDFs can be highlighted, annotated and have notes added, which will also be available on all the
other devices synchronised with your account. As well as allowing users to manage bibliography and store PDF files, Mendeley is
also a self-styled ‘academic social network’. The aim is to facilitate greater online collaboration between academics across the
world. Users can join groups with other academics with similar interests, and can have discussions as well as sharing references and
articles with other group members.

meets with difficulties. Haig and Dozier, 2003 (BEME researcher has to turn elsewhere to find evidence, usu-
Guide No. 3 – Part 1), raise a number of key points ally either a medical or an educational database. The
regarding these difficulties. The main issue is that there problem with this is that these databases often do not
is no indexed bibliographic database solely dedicated to gather or index the medical education literature
the field of medical education, which means that the sufficiently.1,2
62 Scottish Medical Journal 62(2)

Medline does have the subject heading ‘Education, References

medical’ which returns over 66,000 results indexed as 1. Haig A and Dozier M. BEME Guide no. 3: systematic
being medical education related. However, even though searching for evidence in medical education – Part 1:
subject headings like these exist in the medical and edu- sources of information. Med Teach 2003; 25: 352–363.
cational databases, there are concerns that they are not 2. Haig A and Dozier M. BEME Guide no. 3: systematic
used properly and are often incomplete. This means searching for evidence in medical education – Part 2: con-
that not all the relevant medical education literature structing searches. Med Teach 2003; 25: 463–484.
is accessible. Therefore, a good well thought out 3. MEDLINE/PubMed and other databases, www.nlm.nih.
gov/services/faqmed.html (accessed 28 January 2016).
search technique such as that described by Haig and
4. Kelly L and St Pierre-Hansen N. So many databases, such
Dozier is important at overcoming these problems.1,2
little clarity: searching the literature for the topic aborigi-
nal. Can Fam Physician 2008; 54: 1572–1573.
Conclusion 5. About Embase, www.elsevier.com/online-tools/embase/
about (accessed 28 January 2016).
This beginner’s guide is intended to outline some basic 6. Younger P. Using Google Scholar to conduct a literature
principles and present an overview of the approach. We search. Nurs Stand 2010; 24: 40–46.
hope the guide will help new scholars in the field of 7. Boeker M, Vach W and Motschall E. Google Scholar as
medical education to dispel the myth that the medical replacement for systematic literature searches: good rela-
education literature search is an insurmountable task. tive recall and precision are not enough. BMC Med Res
Methodol 2013; 13: 131.
8. Best Evidence Medical Education Collaboration, www.
Declaration of Conflicting Interests
bemecollaboration.org (accessed 16 January 2016).
The author(s) declared no potential conflicts of interest with 9. Mendeley, www.mendeley.com (accessed 22 January
respect to the research, authorship, and/or publication of this 2016).
article.

Funding
The author(s) received no financial support for the research,
authorship, and/or publication of this article.