Systematic vs Scoping Review: Choose the Method With a Worked Nursing Example

Start with the sentence your review needs to support

A nursing topic is not yet a review question. “Discharge education” could mean cataloguing teaching approaches, estimating an effect on comprehension, or understanding how patients experience instructions. Those tasks can share search terms while requiring different evidence and different conclusions. Selecting a label first makes it easy to collect papers that cannot answer the question you actually care about.

JBI recommends considering both the question and its intended use. Munn and colleagues explain how mapping concepts, research methods, and evidence gaps differs from synthesizing evidence for a particular decision. Their guidance also cautions against choosing a scoping review simply because it appears easier. The distinction is about the planned contribution, not a ranking in which every systematic review is automatically better.

The worked example below follows a fictional student team examining written discharge information for adults leaving hospital. No search has been conducted and the sample records are invented. We will turn the same topic into two defensible proposals, screen four teaching records, and write the conclusions each proposal could support. These examples help plan an assignment; they are not findings about the effectiveness of discharge education.

• JBI: Choosing between evidence synthesis types
• Munn and colleagues: Systematic review or scoping review?

Compare the decisions, not just the definitions

Imagine your supervisor asks what “better discharge education” means. If you cannot yet describe the approaches or the outcomes used in the literature, a map may be useful. If you already need to compare a defined approach with another approach on a defined outcome, a map of publication counts will not answer that question. Write the proposed output before you select the method.

Systematic reviews extend beyond intervention effects. A qualitative evidence synthesis can address experiences or meaning, for example. PICO is useful for the intervention question developed here, but it is not a universal template for every systematic review. Likewise, the broad remit of a scoping review does not excuse an undefined population or an unclear concept.

Route A: Write a scoping question that produces a useful map

For the fictional team, the scoping question is: “What formats of written discharge education for adults leaving acute hospital care have been studied, and how have those studies defined and measured understanding?” The population is adults; the concept is written discharge education and its evaluation; the context is discharge from acute hospital care. The planned output is a table connecting delivery format with the meaning and timing of each outcome.

This question earns its breadth by explaining what the map will resolve. If one paper calls satisfaction “understanding” while another tests recall of warning signs, placing both under a single comprehension heading would hide a useful distinction. The charting form should preserve the authors’ outcome labels and separately record what was actually measured. A map can expose that mismatch without deciding which education method works best.

For this proposal, include empirical studies of written discharge materials used with adults, including paper or digital text. Exclude paediatric-only studies and studies of verbal-only teaching. Include mixed interventions only when the written component is described sufficiently to chart it. This is an example of a defensible boundary, not a required rule for all discharge reviews. A different mapping purpose could justify a different selection.

Before screening, clarify whether emergency-department discharge and translated materials belong in the context, and how mixed adult/child samples will be handled. Decide these points because they affect the question, not after seeing which studies are convenient. A pilot of the form can reveal an ambiguous rule; record any amendment and apply the revised rule consistently.

Route B: Write an effect question and preserve its conditions

The alternative proposal asks: “For adults discharged from acute medical wards, does a plain-language written sheet plus the usual verbal explanation, compared with the existing standard leaflet plus the same usual explanation, improve recall of the discharge instructions within 48 hours?” The intervention and comparison keep the verbal component aligned so that the written-material comparison remains interpretable.

The outcome is deliberately narrow. Recall of specified information is different from confidence, satisfaction, medication adherence, and readmission. Those may be important additional outcomes, but a result for one cannot silently stand in for another. If the team needs a patient-important clinical outcome, it should state that question and plan the review accordingly instead of adding a stronger claim at the end.

For this teaching proposal, start with randomized comparisons that match the question and retain the actual measurement instrument and time point. That design restriction is a proposed choice for this effect question; systematic reviews are not universally restricted to randomized trials. Establish the appropriate eligibility, appraisal, and synthesis approach with methodological input before committing to the protocol.

Cochrane emphasizes prespecified questions and methods, relevant expertise, and a plan to minimize bias. For the fictional project, the protocol would need more than the question below: it would specify search sources and strategies, screening responsibilities, extraction, risk-of-bias assessment, outcome handling, and synthesis. A worksheet is a starting point for that planning, not a completed protocol.

• Cochrane Handbook: Starting a review

Screen the same four records against the two proposals

The following titles and descriptions are invented for a screening exercise. They are not citations and have no sample sizes or findings. Read the reason in each cell: the decision should follow the question and eligibility rules rather than whether a title sounds relevant. Where a report is unclear, retrieve the missing detail before making a final inclusion decision.

Record B demonstrates why a source can be valuable in one review and unsuitable in another. Its interviews could illuminate the accessibility of digital instructions, but they would not estimate the specified leaflet comparison. Excluding it from the effect review does not mean qualitative research is poor evidence. It means that this particular study does not answer this particular effect question.

Plan results that answer the chosen question

For the scoping route, a useful results table would connect formats, study designs, populations, and outcome definitions. A diagram or matrix can show which combinations have been studied, but the accompanying text should explain what those categories mean. “Five papers” is a count of papers, not five independent patient samples or five pieces of equally persuasive evidence. Check whether multiple reports describe the same study before interpreting the map.

For the effect route, begin with the individual studies and their limitations. Record the exact contrast, effect estimate, uncertainty, outcome measure, follow-up, and risk-of-bias findings. A pooled result is appropriate only if the studies and data support a meaningful combined estimate. If pooling would obscure incompatible outcomes or comparisons, use an appropriate synthesis without meta-analysis and explain what can still be learned.

The conclusion must also distinguish “not found in this review” from “does not exist.” Search dates, eligible languages, settings, and information sources define the field you examined. If your review excludes community discharge programmes, an empty cell for those programmes tells readers about the eligibility boundary, not a gap in all nursing research.

Use a short decision memo before starting the full review

Write the memo below in ordinary language and discuss it with the person who will use the result. The completed example chooses the mapping route because the immediate problem is inconsistent descriptions of discharge education and understanding. If the actual decision is whether to replace one leaflet with another, that rationale would be insufficient; the effect question needs its own suitable synthesis.

The blank prompts are intended for reuse. Be specific in the output and conclusion fields: “review the evidence” does not tell a collaborator what will be delivered. If the method is fixed by an assignment, keep that constraint visible and refine a question that the required method can answer. Do not relabel a small literature exercise as a formal systematic review if the required methods were not performed.

Report the method you actually used

Use reporting guidance to make the completed work inspectable. PRISMA-ScR addresses reporting of scoping reviews, including eligibility, search, selection, charting, synthesis, and limitations. Its optional appraisal items allow readers to see whether and how appraisal was performed. Completing a checklist does not supply missing methods or certify that the conclusions are sound.

Before handing over the proposal, read the question, planned tables, and proposed conclusion together. Each should describe the same population, context, and purpose. Then check the practical plan: who can help with searching, who will screen, how disagreements will be handled, and how the work fits available resources. If the planned review is not feasible, revise the scope transparently with the supervisor instead of silently dropping steps.

A successful choice leaves a clear boundary: this review will produce this kind of answer, from these eligible sources, using these planned methods. For the fictional discharge project, the mapping proposal ends with a description of the evidence landscape. The effect proposal aims at an appraisal-informed answer to the specified comparison.

• PRISMA-ScR: Reporting a scoping review