Critical Journal Appraisal of Literature Reviews in Midwifery: A Practical Guide for Midwifery Students

Abstract

The ability to perform a critical journal appraisal (CJA) is an essential competency for undergraduate midwifery students in understanding and applying evidence-based midwifery practice. This article aims to provide a practical guide for conducting CJA, particularly on literature review journals in the field of midwifery, with an emphasis on the accuracy of topic selection. The method used is a literature study and synthesis of various appraisal guidelines from JBI and Cochrane. The discussion shows that the accuracy of the topic in a midwifery literature review must be assessed based on five main criteria: (1) relevance to midwifery practice, (2) recency and comprehensiveness of literature coverage, (3) clarity of the research question using the PICO framework, (4) representativeness of the database sources, and (5) consistency between the title, content, and conclusions. This article presents practical appraisal steps in a table format as well as a case example relevant to student learning. It is concluded that mastering CJA on literature reviews not only improves students’ academic skills in English courses but also equips future midwives with the ability to critically filter scientific information before applying it in midwifery care.

Keywords: critical journal appraisal, midwifery, literature review, topic accuracy, midwifery students

Introduction

In evidence-based midwifery, students are required not only to read journals but also to critically assess the quality and relevance of a research study. One of the fundamental skills in the English course for midwifery is Critical Journal Appraisal (CJA), which is a systematic process of evaluating the strengths and weaknesses of a scientific article.

This article aims to guide undergraduate midwifery students in performing CJA appropriately, focusing on literature review journals. The accuracy of the topic selection in a literature review is the main determinant of whether a review article is suitable to be used as a basis for midwifery practice.

Why Is a Literature Review Important in Midwifery?

A literature review presents a synthesis of various primary studies on a specific topic. In midwifery, topics such as “the effect of prenatal education on anxiety in pregnant women” or “the effectiveness of acupressure for labor pain” are often reviewed in the form of a literature review. The advantage of a review is its ability to provide a comprehensive overview without requiring the reader to read dozens of original articles.

However, not all literature reviews are of good quality. A midwife or midwifery student must be able to assess the accuracy of the topic and the methodology of the review.

Criteria for Topic Accuracy in a Midwifery Literature Review

Topic accuracy is the foundation of a good critical appraisal. Below are the aspects that must be assessed.

1. Relevance to Midwifery Practice

The selected topic must address a real clinical question. An example of a good topic is: “Non-pharmacological interventions to reduce nausea and vomiting in the first trimester of pregnancy.” This topic is specific, has a direct impact on midwifery care, and is based on common patient complaints.

2. Recency and Comprehensiveness of Coverage

A good literature review should include publications from the last 5–10 years. In midwifery, practice guidelines change rapidly, for example regarding labor management or early initiation of breastfeeding. An article that uses outdated literature (more than 15 years old) without justification should be questioned for its validity.

3. Clarity of the Research Question

A precise topic will generate a research question using the PICO format (Population, Intervention, Comparison, Outcome). Example:

• P (Population): Third-trimester pregnant women
• I (Intervention): Pregnancy exercise
• C (Comparison): No pregnancy exercise
• O (Outcome): Duration of the first stage of labor

Without a PICO framework, the topic is often too broad or vague.

4. Representativeness of Database Sources

Does the author use only one database, such as Google Scholar? Or have they used PubMed, CINAHL, and the Cochrane Library? For midwifery topics, the use of at least two reputable databases is an indicator of topic accuracy because it ensures that the literature coverage is not biased.

5. Consistency Between Title, Content, and Conclusions

It is common to find journals with promising titles, but the content of the review discusses a different topic. For example, the title mentions “the effect of oxytocin massage on breast milk production,” but the content is dominated by lactation physiology without any intervention data. This is a failure of topic selection.

Practical Steps for Critical Appraisal for Midwifery Students

The following is a simple guide that can be used when reading a literature review journal for coursework or scientific writing. Step Key Questions 1. Initial screening Does the title reflect the content and is it relevant to midwifery? 2. Research objective Is the aim of the review stated explicitly? 3. Search strategy Which databases were used? What keywords, and do they match PICO? 4. Inclusion/exclusion criteria Are the publication year, study types, and language clearly stated? 5. Quality assessment of sources Did the author critically appraise the summarized articles? 6. Synthesis of results Are the results presented narratively or statistically (meta-analysis)? 7. Conclusion and recommendations Are the conclusions not exaggerated compared to the available evidence?

Case Example: Assessing Topic Accuracy

Article title (fictional):
“Literature Review: The Use of Hypnobirthing to Reduce Anxiety Levels in Primigravida Mothers”

Appraisal questions:

1. Is the topic relevant to modern midwifery practice?
   → Yes, because anxiety in pregnant women is a common problem.
2. Is the research question clear?
   → Fairly clear, but the PICO format is not explicitly used.
3. Did the author limit the publication year?
   → The article only uses literature from 2010–2015, while the article was written in 2024. → This is a weakness.
4. Was only one database used (Google Scholar)?
   → Yes, so there is a risk of bias.

Appraisal conclusion:
The topic of this article is actually good and relevant, but the accuracy in selecting the literature is outdated and the search is not comprehensive. Students should not recommend this article as a main reference; instead, they should look for a more recent review indexed in PubMed or Cochrane.

Conclusion

Critical journal appraisal of literature reviews in midwifery requires thoroughness, especially in assessing the accuracy of the topic. A precise topic must be relevant to midwifery practice, based on a clear research question, supported by quality databases, and consistently reflected from the title to the conclusions. For undergraduate midwifery students, this skill is not only important for passing the English course but also serves as a foundation for evidence-based clinical decision-making in the future.

By practicing reading and critically appraising, students will avoid predatory journals or misleading literature reviews, and will be able to propose midwifery interventions that are safe, effective, and appropriate to patient conditions.

References

Aromataris, E., & Munn, Z. (2020). JBI Manual for Evidence Synthesis. JBI Global.

Harden, A., & Thomas, J. (2018). Cochrane Handbook for Systematic Reviews of Interventions (6th ed.). Cochrane.

Polit, D. F., & Beck, C. T. (2021). Nursing Research: Generating and Assessing Evidence for Nursing Practice (11th ed.). Wolters Kluwer.