EDITORIAL

Purpose, Insight, and the Review ofLiterature

Let me assure readers that this is not a tutorial inwriting reviews of literature. What this is, instead,is a commentary on the importance of knowingwhat purpose a review is to serve before it iswritten.

Essential QuestionsThe elements of a literature search, the criteria usedto rate evidence, and the varied methods and formatsfor presentation are mechanics discussed in textsand papers easily found with a good search engine.Increasing the utility of a literature review is the sub-ject of numerous critiques and methods papers. Metaanalyses still are the gold standard for quantitativestudies, particularly comparing results of well-designed RCTs. Meta-syntheses, integrative, critical,and scoping literature reviews may be used for sub-sets of literature to address different types of ques-tions. Rating systems differ according to the methodand level of evidence. As a reviewer and reader ofother publications, and particularly as co-Editor ofPublic Health Nursing, the question I am compelledto ask is, “So what?” By that I mean, has the authorcut through to the answers that have been found andidentified the questions that remain? Does thisreview help me distinguish between quality andmediocrity? Does this literature enhance my knowl-edge of a new topic? Has the author of the reviewfound and communicated new insights as a result ofsifting through multiple studies?

Why write a review unless you (1) mean todemonstrate that you know what’s been writtenregarding a topic; (2) want to illustrate how theexisting literature either adequately or inadequatelyaddresses a question of interest; or (3) have had a“Eureka!” moment of insight based on an aggrega-tion of published literature that no one has yet puttogether? In my view, these purposes representstages of development in scholarship. Obviously,the first condition is one that applies primarily tostudents who must prove their readiness to under-take independent inquiry in a field in which others

have worked. Many readers of this journal havecreated some form of literature review to pass com-prehensive examinations and defend proposals fortheses or dissertations, all legitimate reasons forwriting a review but seldom sufficient rationales forpublication.

Clarity of PurposeItem (2) characterizes the majority of reviews sub-mitted for publication; the review provides the justi-fication for the inquiry being reported. Done well,these help situate the research in the landscape ofexisting literature and set the stage for the kinds ofreviews described below. They lead readers logicallyto the research questions which, presumably, havenot already been answered. Occasionally, a review issubmitted that describes the state of the literaturewithout an attendant research question. While nov-ices may benefit from an introduction to a field ofwork, seasoned professionals need focused reviewsthat move them forward. If the criteria for inclusionof studies are missing or if the purpose of a review isnot well-defined, the review fails everyone.

Familiarity with the TerrainIt is the third purpose, item (3), that is the leastlikely to be submitted or found in published form.Like flawless diamonds, unique insights occurrarely. They sometimes do not occur until aresearcher has spent years of searching for exactlythe right location to drill down to the most preciousstuff and, finding it, studies it for a while to pro-duce the insight. You have to know a diamond inthe rough when you see one in order to bring apotentially perfect specimen to light; knowingwhere to position the mine in the first place is criti-cal to finding any diamonds at all. If you do notknow, you may emerge with a perfectly lovely butnot very valuable bit of quartz.

At the risk of overworking my metaphor, dia-monds almost never are found lying in the dust ofthe earth’s surface, unless someone has carelessly

189

Public Health Nursing Vol. 29 No. 3, pp. 189–190

0737-1209/© 2012 Wiley Periodicals, Inc.doi: 10.1111/j.1525-1446.2012.01025.x

dropped one. The rarest insights, too, are foundafter much preparation and consideration. IsaacNewton may have had his gravitational “Aha!”moment under an apple tree, but probably notbefore he had put some effort into understandingthe laws of the physical world using inductive rea-soning. In an effort to find gems of knowledge withfacets so complex that they draw us toward newunderstandings, novice investigators often movefrom study to study skipping across the landscapeamassing great amounts of data of varying quality.Some has potential; much is the dust that lies nearthe surface. Systematic study of low quality resultsis more likely to introduce bias than to reduce it;this leads us down dead-end paths. The results failto yield value. Experienced scientists survey thepublication landscape systematically, but withoutthe coordinates for where there is the greatestpromise of value, they miss the mark. Systematicreviews of literature that are not situated correctlycan yield useful information, but they do not movethe science forward. In the worst case, they leaveperfect diamonds in the dust for someone else tofind. Quality work takes time; insight takes only amoment—after years of preparation.

PerseveranceIt is the capacity for insight that takes time togrow. Aside from savants whose neuronal capacityexceeds what the rest of us possess, most humanbeings slowly develop appreciation for the nature

of inquiry and for the complexity of whatever phe-nomena we study. That is normal, and fine. Dia-monds are diamonds precisely because of thepressure placed on them over time. Knowing theterrain of a discipline takes exposure; creating amind map of the most productive areas ofresearch can take a lifetime. Does this mean weare consigned to wait until we are ready to retirebefore we publish? Of course not. The purpose ofinquiry remains constant, to answer the questionsthat lead to better understanding. I believe allscholars aim to find those flawless gems in theirown research or by connecting the work of othersin newly meaningful ways. When we designresearch or write reviews of others’ work we mustknow why we are doing it, and take care with itspresentation. Select the most promising specimensbut let the dust slip back to earth. This is not tosay that less than brilliant results do not contrib-ute to the development of understanding. Stepsforward get us somewhere new. New vantagepoints bring new perspectives.

Diamonds, natural brilliance, and uniquenesshave at least one conceptual link—rarity. Suchresults are not assured. Aiming for the best, how-ever, we may deliver high quality in any case. Withperseverance, there will be insight, and with time,new diamonds to mine. But, if you find a flawlessdiamond in the dust, pick it up!

Sarah E. AbramsBurlington VT

190 Public Health Nursing Volume 29 Number 3 May/June 2012