Milestone map
Milestone map
3 milestones
Conduct a structured literature search on a clinical question
2–3 weeks
Choose a clinical question relevant to your training area (using PICO format). Conduct a structured literature search across at least two databases (PubMed, Cochrane Library, CINAHL, or equivalent). Document your search strategy: databases searched, search terms used (including Boolean operators and MeSH terms where applicable), inclusion and exclusion criteria, and the number of results at each stage. Produce a PRISMA-style flow diagram showing how you arrived at your final set of included studies.
Proof required
Submit your PICO question, documented search strategy, PRISMA flow diagram, and a list of your final included studies (minimum 5 primary studies or 2 systematic reviews).
What gets checked
- Search strategy includes Boolean operators and controlled vocabulary (MeSH or equivalent) — simple keyword searches are not sufficient for a structured literature search.
- Inclusion and exclusion criteria are defined before the search, not applied retrospectively to prefer certain results.
- PRISMA diagram shows the screening stages accurately — number at each stage must be traceable from the search results.
Common mistakes
- Single database search — two databases are required to avoid bias from one source's coverage.
- Inclusion criteria that are vague ('relevant studies') rather than specific (study type, population, language, date range).
- PRISMA diagram produced retrospectively without actually conducting the screening stages — common when the studies are chosen first and the flow is drawn to match.
Resources
Foundationstart here
Depthgo deeper
Masteryfor the dedicated
What a verifier looks for
- Ask the student to demonstrate one step of the literature search in real time — shows they understand the process, not just the output.
- Check that the PRISMA diagram numbers are traceable — ask them to explain the number at the 'records after duplicates removed' stage.
- Ask what MeSH term they used for their exposure or intervention.
Critically appraise 3 included studies
2–3 weeks
Using a recognised critical appraisal tool (CASP, Joanna Briggs, or SIGN), appraise 3 of your included studies. For each, assess: study design appropriateness for the question, risk of bias, outcome measurement validity, sample size adequacy, and applicability to your clinical context. Produce a one-page appraisal summary per study. Compare the quality of the three studies and summarise the overall level of evidence.
Proof required
Submit 3 critical appraisal summaries (1 page each), each using a named and consistently applied appraisal tool. Include a comparative quality summary showing which study you judge most reliable and why.
What gets checked
- Appraisal tool is named and consistently applied across all 3 studies — switching tools mid-portfolio defeats the comparison.
- Risk of bias assessment is specific — identifies the specific bias risk in each study, not just states 'some bias may be present'.
- Comparative quality summary gives a clear recommendation on which study provides the strongest evidence, with specific reasoning.
Common mistakes
- Appraisal that rates all three studies as high quality — critical appraisal should identify genuine weaknesses, not just validate.
- Risk of bias assessment that is generic ('small sample size is a common limitation') without applying to the specific study.
- Comparative summary that avoids ranking the studies — the purpose of appraisal is to judge evidence quality, not describe it.
Resources
Foundationstart here
Depthgo deeper
What a verifier looks for
- Ask the student to identify the single greatest methodological limitation across the three studies they appraised.
- Check that the CASP or equivalent tool is applied correctly — not just used as a checklist with all boxes ticked 'yes'.
- Ask which study they would cite if they were writing a clinical guideline and why.
Produce an evidence summary and present to peers or a clinical team
1–2 weeks (synthesis + presentation)
Synthesise your literature search and critical appraisal into a 2-page clinical evidence summary: what the evidence shows, how strong it is, what the clinical implications are for practice in your setting, and what remaining uncertainties exist. Present the summary in a structured 10-minute presentation to at least 3 peers, a journal club, or a clinical team member. Collect feedback on both content and presentation quality.
Proof required
Submit your evidence summary (2 pages), a brief description of who you presented to and in what setting, written feedback from at least 2 attendees, and a one-paragraph reflection on what you'd change in the summary based on the feedback.
What gets checked
- Evidence summary states the strength of evidence explicitly (e.g. 'moderate-quality evidence from 2 RCTs and 1 cohort study') — not just 'the evidence suggests'.
- Clinical implications section is specific to your setting — not a generic 'this evidence should inform practice'.
- Feedback is from people with clinical or research context — not from personal acquaintances without relevant knowledge.
Common mistakes
- Evidence summary that summarises the studies without synthesising the evidence — a summary of three papers is not a synthesis.
- Presentation to peers who have no clinical or research context — feedback is only useful if the audience can evaluate the content.
- Reflection that is positive without naming a specific change — 'the feedback was good' is not a reflection.
Resources
Foundationstart here
Depthgo deeper
What a verifier looks for
- Ask the student to state the strength of evidence for their question in one sentence — if they can't, the synthesis hasn't been completed.
- Check that feedback is from people with relevant clinical or research context.
- Ask what the single most important clinical implication from the evidence is — the answer shows whether the synthesis was actionable.
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