How to Write DNP Evidence Synthesis Archives

How to Write Evidence Synthesis for DNP

There’s enough inbox requests on how to write evidence synthesis for DNP this past year to patch this article. Seems faculty heads are rolling eyes behind badly-scripted DNP literature, integrative, and scoping reviews more than any other annual averages. Before another instructor cusses, I’ll save your hide with this comprehensive, evidence-based practice information synthesis guide.

The Best Evidence Synthesis Methodologies (2025)

An evidence synthesis for DNP capstone papers refer to a succinctly distilled summary of appraised empirical literature, whether quantitative or qualitative. Its main purpose, according to Terri A. and Karen H’s 2018 paper, is to guide recommendations for practice improvement. Although content clarity is emphasized, nurse students should also outline and present their review in an easy-to-follow format.

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There’s a whole list of ways to organize and structure key findings from research studies methodically such as the Critical Interpretive Synthesis. In this article, I’ll expose final-year DNP students to 3 major methodologies, namely:

★ Cochrane’s ‘Summary of Findings’ Table

The 2023 Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice evaluation table expands Cochrane’s concept of a DNP project’s ‘summary of findings’ evidence table. However, most DNP students undertaking evidence-based practices using the Cochrane library raise concerns with its comprehension and result presentation. Yet others squawk about the imbalance of precision and simplicity.

Many scholars format Cochrane’s presentation summary either as a traditional abstract, infographics, a podcast, plain-language summaries, or podcast transcriptions. Each format suits different DNP projects and results in the individual audience’s best understanding of the literature review.

A summary of findings table has debatable differences in measures of acceptability (reading experience and user-friendliness) for different med schools.

★ V. R. Bowden’s (2022) DNP Literature Review Strategy

If you closely read the Literature Review section of Pediatric Nursing, 48(2) at pages 97~98, you’ll find 3 distinct DNP-EBP project evidence synthesis styles namely:

Scoping Reviews
Literature Review Summaries, And
Integrative Reviews.

DNP academia isn’t clear on the best evidence summary format from the above three styles. This is because choosing a guideline development heavily depends on the target audience for the individual capstone project report.

★ Mixed Method Systematic Reviews

Lastly, I recommend the mixed methods systematic reviews (MMSR) approach. This is a personal favorite since it offers a deeper understanding of the pre-study findings. Also, a researcher can easily catch evidence discrepancies while using a variety of methods rather than a singular synthesis technique.

Further, mixed method systematic reviews pinpoint how quantitative randomised controlled trials (such as cluster, parallel, stepped-wedge, and crossover) or qualitative research will focus on particular areas of interest in the final report.

11 Golden Steps You Shouldn’t Miss While Writing a DNP Evidence Synthesis

To make things super-easy for you, I’ve chronicled 11 golden steps you shouldn’t miss while writing a DNP evidence synthesis.

Step 0: Start with Developing a Solid Protocol

At this stage, rationalize the hypothesis and lay down a methodology framework plan. A planning worksheet for structured literature reviews ensures empirical transparency, reproducibility, and reduction of bias. Include a protocol template and checklist in the first few pages of your DNP project paper such as PRISMA framework for systematic literature review.

A 27-item Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist ideally covers the title, abstract, methods, results, discussion, and funding.

See Also: PRISMA Extension for Scoping Reviews (PRISMA-ScR) and PRISMA Extension for Network Meta-Analysis (PRISMA-NMA).

Step 1: Design and Develop Practical Project Research Question(s)

After identifying a knowledge gap in your DNP specialty, the next step is formulating a clear, well-defined research question. From a practical research question, identify 2~5 possible search concepts for the strategy discussed under (Step 3).

Use a research question framework to structure your evidence synthesis question. Here are 4 most common DNP project research question development frameworks:

❖ PICO for a Quantitative DNP Project

The research question is based on these metrics:

P (Population / Problem)

I (Intervention / Exposure)

C (Comparison)

O (Outcome).

For example, “Is gabapentin (Intervention) better at decreasing pain symptoms (Outcome) than placebo (Comparison) in middle-aged male amputees suffering phantom limb pain (Population)?”

❖ PICO for Qualitative DNP Projects

Contrary to quantitative studies, PICO for qualitative DNP projects stands for:

P – Population / Problem.

I – Phenomenon of Interest.

Co – Context.

Sample DNP project research question: “What are the experiences (Phenomenon of interest) of American (Context) caregivers providing home-based nurse services to Alzheimer’s patients (Population)?”

❖ SPIDER

This strategy covers 5 major elements of a DNP project evidence synthesis, namely:

S: Sample.

PI: Phenomenon of Interest.

D: Design.

E: Evaluation.

R: Study Type.

Example of a SPIDER-founded practical research question: “Evaluating the experiences (Evaluation) of Caucasian women (Sample) undergoing IVF treatment (Phenomenon of Interest) as assessed in Canada.”

❖ SPICE

Lastly, the 5-way SPICE model wholesomely addresses the project question under these components: Setting, Perspective, Intervention/Exposure, Comparison, and Evaluation.

Example: “What are the benefits (Evaluation) of a doula (Intervention) for low income mothers (Perspective) in the developed world (Setting) compared to complete non-support (Comparison)?”

Step 2: Pick Out All the Grey Literature

Although not peer-reviewed, gray literature presents valuable information that’s critical when synthesizing and evaluating available research evidence. You may consider non-academic or not-for-money literature published by organizations or individuals.

Any clinical literature from graduate dissertations, newsletters, government / NGO reports, conference proceedings, and unpublished clinical trials makes for gray literature. The following are some databases where a DNP student can source gray literature:

OpenGrey
Conference proceedings like CINAHL
Thesis databasesg EThOS
Other open sources such as Overton and trade magazine editorials.

Whenever you include gray literature in your evidence synthesis, document where you’re searching including the resource name, search strategies, specific URL, search terms, and the date. Also, strictly adhere to inclusion and exclusion criteria when selecting gray sources.

Step 3: Note Down a Workable Search Strategy

Writing down a workable search strategy takes intimate knowledge of bibliographic databases equivalent to our expert writers. We use the Boolean logic as an important component of writing your DNP project’s search strategy. When you Order DNP project evidence synthesis, we help you design a comprehensive search strategy across a variety of healthcare databases.

An Example of an Evidence Synthesis Search Strategy

Research Question: What are the health benefits and safety of folic acid fortification of wheat and maize flour (i.e. alone or in combination with other micronutrients) on folate status and health outcomes in the overall population, compared to wheat or maize flour without folic acid (or no intervention)?

Search Strategy: Key concepts from the question combined with AND: (folic acid) AND (fortification).

Protocol on PROSPERO.

Published systematic review for this question with search strategies used in 14 databases.

Step 4: Translate the Search Strategy

The DNP project paper requires the nurse student to search multiple databases, but not all research vaults accept the same search syntax. Every database has inbuilt, specialized search languages. Therefore, keywords for a DNP project evidence synthesis search strategy should be translated to pull similar empirical evidence between databases.

For example, a research question like “What is the effectiveness of Vitamin B12 supplements in reducing morbidity in pregnant women with HIV infection?” can have the following ‘searchable’ terms:

Key Concept 1 Distilled Terms: B12, Cobalamin, B 12.
Key Concept 2 Distilled Terms: Pregnancy, Pregnant, Gestate, Gestation, Gestational.
Key Concept 3 Distilled Terms: HIV, Human Immunodeficiency Virus.

Distilled Search Strategy: (B12 OR “B 12” OR cobalamin) AND (pregnan* OR gestat*) AND (HIV OR “human immunodeficiency virus”)

Examples of Search Syntax Translation Resources

Polyglot (translates search strings across multiple databases).
MEDLINE Transpose for translating MEDLINE (PubMed) searches to / from MEDLINE (Ovid)
Cochrane’s Database Syntax Guide for multiple database keyword translation.

Step 5: Register the Framework Protocol

Prior to conducting the full-blown DNP project evidence synthesis, first register your protocol. Registration improves research reproducibility and transparency, reduces bias, and ensures other project teams don’t duplicate your research efforts. Online protocol registration collaborates, documents, archives, registers, and shares your DNP research project, data extraction forms, and study materials.

Some software tools to connect and support research workflow includes:

Open Science Framework (OSF) connects and supports multidisciplinary research workflow. You can also pre-register a systematic review protocol and share Zotero library documents.

PROSPERO, an international database of prospectively registered systematic reviews in health and social care, doesn’t accept scoping reviews. The protocol records key DNP project review features and maintains a permanent online record. PROSPERO works best with Public Health, Education, Health and Social Care, Welfare, Crime, International Development, and Justice.

Step 6: Explain the Evidence Synthesis Citation Management Procedures

Once you’ve finished translating the DNP project search strategy to conform with each database’s syntax, the next step is to run the search. Next, export and save the search results in BibTeX, MEDLINE, RIS, or XML file format. Lastly, import the file information into a citation management program such as Endnote, Zotero or Mendeley.

A citation management software organizes and stores and all quoted evidence during screening. It further duplicates results and automatically formats in-text citations and bibliographies ready for your manuscript.

Step 7: Data Extraction

Establish a regimented data extraction approach / tools depending on the type and amount of DNP empirical evidence needed for your project. Most nurse student researchers we assist often prefer a table or a form to capture data for later analysis or summary.

Data extraction methodologies use electronic databases such as:

The most common data extraction tools in 2024 are:

Systematic Review Toolbox
Excel
RevMan
JBI Sumari (Joanna Briggs Institute System for the United Management, Assessment and Review of Information)
DistillerSR
Covidence

Step 8: Screen your DNP Project Evidence Synthesis Article

Article screening plucks unrelated studies from your DNP project topic and research question by using your abstract’s inclusion or exclusion criteria. Once you’re through screening the title and abstract, retrieve the full text and definitely decide whether your DNP-EBP fits the eligibility criteria of the draft synthesis.

Here, you may use tools such as:

Covidence
Rayyan, and
Excel

Step 9: Address the Risk of Bias Assessment

A DNP project evidence synthesis’s quality assessment (aka the critical appraisal) helps researchers to establish the transparency of evidence synthesis findings and results. Conduct a risk of bias assessment for every included study in your review. This eliminates individual study findings’ conclusion bias, for example design flaws that trigger ‘overestimation of intervention effect’ questions.

Important Note!

Scoping reviews DON’T include a risk of bias assessment according to the Cochrane Handbook.

You may present the risk of bias assessment in a table format, clearly depicting the strengths of each study and how it relates to multiple quality criteria. If a high percentage of reviewed studies have a high bias risk, be cautious when interpreting or using those results for your DNP evidence synthesis!

Step 10: Finally, Map, Synthesize, and Describe the Literature Review Results

You may present the main findings of your DNP project evidence synthesis through a number of ways including:

Use meta-analysis for homogenous evidence synthesis studies.
Narrative (descriptive) synthesis is the best approach to format literature review results where a student uses dissimilar studies.
Recently, major med schools prefer meta-synthesis for qualitative DNP project research. This is mostly due to the rigid processes underpinning meta-analysis and the likelihood of descriptive synthesis bias from its subjective nature.

Whether a DNP project evidence synthesis is qualitative or quantitative, I recommend you use a PRISMA Flow Diagram. The many adaptations in this evidence synthesis method is handy for audiences struggling with meta-analysis or systematic review components.

Still Can’t Make Head or Tail of DNP Evidence Synthesis Writing?

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