Large scoping reviews: managing volume and potential chaos in a pool of evidence sources.

Scoping reviews can identify a large number of evidence sources. This commentary describes and provides guidance on planning, conducting, and reporting large scoping reviews. This guidance is informed by experts in scoping review methodology, including JBI (formerly Joanna Briggs Institute) Scoping Review Methodology group members, who have also conducted and reported large scoping reviews. We propose a working definition for large scoping reviews that includes approximately 100 sources of evidence but must also consider the volume of data to be extracted, the complexity of the analyses, and purpose. We pose 6 core questions for scoping review authors to consider when planning, developing, conducting, and reporting large scoping reviews. By considering and addressing these questions, scoping review authors might better streamline and manage the conduct and reporting of large scoping reviews from the planning to publishing stage.

Effectiveness of intrathecal dexmedetomidine vs fentanyl as additives to hyperbaric bupivacaine for postoperative analgesia in women undergoing cesarean section: a systematic review protocol.

OBJECTIVE: The aim of this review is to compare the effectiveness of intrathecal dexmedetomidine vs fentanyl as additives to hyperbaric bupivacaine in providing postoperative analgesia in patients undergoing cesarean section. INTRODUCTION: Pain following cesarean section remains a challenge, with limited treatment options due to potential undesirable parturient and neonatal side effects. Intrathecal dexmedetomidine has emerged as a favorable alternative to opioid additives to hyperbaric bupivacaine in prolonging postoperative analgesia, but its effectiveness requires further investigation. INCLUSION CRITERIA: The review will evaluate studies of patients who underwent cesarean section under spinal anesthesia where dexmedetomidine and fentanyl were compared as intrathecal additives to hyperbaric bupivacaine for postoperative analgesia. This review will consider randomized controlled trials, non-randomized controlled trials, and prospective cohort studies for inclusion. No limits regarding publication date or language will be applied. METHODS: A preliminary search of PubMed and Cochrane Central Register of Controlled Trials has been conducted to identify relevant index terms and keywords, which will be applied in a second search across PubMed, Cochrane CENTRAL, Scopus, and Embase. Google Scholar, National Library of Medicine (Clinicaltrials.gov), and the World Health Organization International Clinical Trial Registry Platform will be searched to identify unpublished literature. Full-text studies will be subjected to an assessment of methodological quality, and data extraction will be performed independently by 2 reviewers. The results will be presented in both tabular and narrative format and, where possible, pooled into a meta-analysis. A Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Summary of Findings will be created to grade the certainty of evidence of the reported outcomes. REVIEW REGISTRATION: PROSPERO CRD42022364815.

A content analysis of two african medical schools' antibiotic stewardship curricula.

Background: Antibiotics are precious substances that have saved millions of lives since their discovery, resulting in significant advances in modern medicine. However, antibiotic resistance and a slowdown in the discovery of new antibiotics with novel mechanisms of action are affecting the sustainability of antibiotics. The objective of this study was to describe the content of South African and Nigerian medical students' curricula with respect to prudent antimicrobial prescribing. Methods: A content analysis framework was used to identify, describe, and count the keywords, key phrases, and sentences relevant to the teaching of prudent antimicrobial prescribing in the complete curricula content of two African countries' medical schools. The courses are taught in the Graduate Entry Medical Programme (GEMP) curriculum (years 3-6) of the South African medical school and years 4-6 of the Nigerian medical school. The frequency of keywords/key phrases relevant to prudent antibiotic prescribing such as antimicrobial stewardship, mechanisms of bacterial resistance, and principles of antibiotic therapy was determined. Results: The two curricula reviewed were found to be different. While the South African medical school uses an integrated curriculum in the GEMP (a stream where candidates with undergraduate degrees are enrolled into the 3rd year of medical school and spend 4 years), the Nigerian medical school operates a traditional (discipline based) curriculum from MBBS 1-6. A greater number of keywords and key phrases were found in the South African curriculum compared to the Nigerian curriculum in relation to prudent antibiotic prescribing and antimicrobial stewardship. The key phrase "antimicrobial stewardship" or "antibiotic stewardship" was absent in the Nigerian curriculum but appeared four times in the South African curriculum. Discussion: The findings of this curriculum review suggest a need for revision of the medical curricula of the two countries, to one that will better prepare learners for antimicrobial stewardship.

Recommendations for the extraction, analysis, and presentation of results in scoping reviews.

Scoping reviewers often face challenges in the extraction, analysis, and presentation of scoping review results. Using best-practice examples and drawing on the expertise of the JBI Scoping Review Methodology Group and an editor of a journal that publishes scoping reviews, this paper expands on existing JBI scoping review guidance. The aim of this article is to clarify the process of extracting data from different sources of evidence; discuss what data should be extracted (and what should not); outline how to analyze extracted data, including an explanation of basic qualitative content analysis; and offer suggestions for the presentation of results in scoping reviews.

The role of scoping reviews in reducing research waste.

OBJECTIVES: Scoping reviews and evidence map methodologies are increasingly being used by researchers. The objective of this article is to examine how scoping reviews can reduce research waste. STUDY DESIGN AND SETTING: This article summarizes the key issues facing the research community regarding research waste and how scoping reviews can make an important contribution to the reduction of research waste in both primary and secondary research. RESULTS: The problem of research waste is an enduring challenge for global health, leading to a waste of human and financial resources and producing research outputs that do not provide answers to the most pressing research questions. Research waste occurs within primary research but also in secondary research such as evidence syntheses. The focus of scoping reviews on characterizing the nature of existing evidence on a topic and including all types of evidence, potentially reduces research waste in five ways: (1) identifying key research gaps on a topic, (2) determining appropriate outcome measures, (3) mapping existing methodological approaches, (4) developing a consistent understanding of terms and concepts used in existing evidence, and (5) ensuring scoping reviews do not exacerbate the issue of research waste. CONCLUSION: To ensure that scoping reviews do not themselves end up contributing to research waste, it is important to register the scoping review and to ensure that international reporting standards and methodological guidance are followed.

A phenomenographic study exploring the conceptions of stakeholders on their teaching and learning roles in nursing education.

BACKGROUND: Nursing education involves a number of stakeholders in the teaching and learning process, and these are student nurses, lecturers, clinical instructors and nurses. The role that each of these parties play in the teaching and learning process is dependent on each other and is key to the development of competence among student nurses. However, there is scanty literature on the discourse of how these stakeholders conceptualise their roles to maximise student learning. The objective of this study was to explore the conceptions of stakeholders on their teaching and learning roles in nursing education. METHODS: Thirty-eight semi-structured interviews and three focus group discussions were conducted with nursing students, lecturers, clinical educators at a Namibian nursing college and nurses at teaching hospitals. Phenomenographic data analysis approach was applied. RESULTS: Four conceptions were constructed that described the level of involvement of the different parties in teaching and learning. These were initiating, supporting, becoming part of and owning the teaching and learning role. Three dimensions of variation marked the differences among the conceptions: responsibility and accountability, priorities and level of collaboration. CONCLUSIONS: The parties involved in the teaching and learning in nursing education have qualitatively different understating of their roles and those of others. There is a pattern transcending from being at the periphery of teaching and learning to taking ownership of teaching and learning. And a movement from limited responsibility and collaboration to that of being responsible, accountable and high level of collaboration in the teaching and learning of nursing students. The conceptions in this study add more ways of enhancing collaboration between theoretical and clinical sites in nursing education, by ensuring that those involved are aware of their role and that of others and work collaboratively at the micro-level.

JBI series paper 4: the role of collaborative evidence networks in promoting and supporting evidence-based health care globally: reflections from 25 years across 38 countries.

Evidence-based health care (EBHC) is a worldwide movement with hundreds of organizations and thousands of individuals working to ensure that health care practice, policy, and decision-making are informed by rigorous research evidence, to improve health outcomes. The success of this global agenda, however, depends on individuals and organizations working together within a functioning evidence ecosystem. Collaborative evidence networks are a key mechanism to facilitate the synthesis, transfer, and implementation of evidence into health care policy and practice. Using the network functions approach as a framework for review, this paper explores the strategic functions and form of the JBI Collaboration to illustrate the role of a collaborative evidence network in promoting and supporting EBHC globally. It illustrates how the functions of a collaborative evidence network enable the development, exchange, and dissemination of knowledge, the building of social capital, mobilization of resources, and amplification and advocacy of members work and ideas, which increase the capacity and effectiveness of members in achieving their unified purpose. Effective and sustainable collaborative evidence networks have innovative ways of relating and mobilizing energy for action and combine formal and informal structures and relationships to successfully work together to address complex global health issues and drive the EBHC agenda forward.

Moving from consultation to co-creation with knowledge users in scoping reviews: guidance from the JBI Scoping Review Methodology Group.

ABSTRACT: Knowledge user consultation is often limited or omitted in the conduct of scoping reviews. Not including knowledge users within the conduct and reporting of scoping reviews could be due to a lack of guidance or understanding about what consultation requires and the subsequent benefits. Knowledge user engagement in evidence synthesis, including consultation approaches, has many associated benefits, including improved relevance of the research and better dissemination and implementation of research findings. Scoping reviews, however, have not been specifically focused on in terms of research into knowledge user consultation and evidence syntheses. In this paper, we will present JBI's guidance for knowledge user engagement in scoping reviews based on the expert opinion of the JBI Scoping Review Methodology Group. We offer specific guidance on how this can occur and provide information regarding how to report and evaluate knowledge user engagement within scoping reviews. We believe that scoping review authors should embed knowledge user engagement into all scoping reviews and strive towards a co-creation model.

Best practice guidance and reporting items for the development of scoping review protocols.

OBJECTIVE: The purpose of this article is to clearly describe how to develop a robust and detailed scoping review protocol, which is the first stage of the scoping review process. This paper provides detailed guidance and a checklist for prospective authors to ensure that their protocols adequately inform both the conduct of the ensuing review and their readership. INTRODUCTION: Scoping reviews are a common approach to evidence synthesis for researchers, clinicians, and policymakers across a variety of fields. Scoping reviews are not concerned with making analytical comparisons based on pooling results data from multiple primary sources of evidence, but rather on collating and describing the evidence and presenting the summation in a clearly illustrated format. Methods for undertaking and reporting scoping reviews continue to be refined. Some prospective reviewers may be uncertain how to plan, structure, and report scoping review protocols, as there is little or no specific guidance for scoping review protocols yet available. METHODS: This guidance was developed by members of the JBI Scoping Review Methodology Group based on previous experience and expertise in developing scoping review and evidence synthesis methodologies, protocols, and reviews, as well as through experiences working with and guiding authors to develop scoping review protocols. Elements of a comprehensive scoping review protocol are outlined and explained in detail. CONCLUSION: Knowledge users of evidence syntheses rely on clear and transparent reporting to understand and use the results of published work to drive evidence-based improvements within health care and beyond. It is hoped that readers will be able to use this guidance when developing protocols to assist them in planning future scoping reviews and to carry them out with a high degree of transparency.

Rapid reviews and the methodological rigor of evidence synthesis: a JBI position statement.

ABSTRACT: The demand for rapid reviews has exploded in recent years. A rapid review is an approach to evidence synthesis that provides timely information to decision-makers (eg, health care planners, providers, policymakers, patients) by simplifying the evidence synthesis process. A rapid review is particularly appealing for urgent decisions. JBI is a world-renowned international collaboration for evidence synthesis and implementation methodologies. The principles for JBI evidence synthesis include comprehensiveness, rigor, transparency, and a focus on applicability to clinical practice. As such, JBI has not yet endorsed a specific approach for rapid reviews. In this paper, we compare rapid reviews versus other types of evidence synthesis, provide a range of rapid evidence products, outline how to appraise the quality of rapid reviews, and present the JBI position on rapid reviews. JBI Collaborating Centers conduct rapid reviews for decision-makers in specific circumstances, such as limited time or funding constraints. A standardized approach is not used for these cases;instead, the evidence synthesis methods are tailored to the needs of the decision-maker. The urgent need to deliver timely evidence to decision-makers poses challenges to JBI's mission to produce high-quality, trustworthy evidence. However, JBI recognizes the value of rapid reviews as part of the evidence synthesis ecosystem. As such, it is recommended that rapid reviews be conducted with the same methodological rigor and transparency expected of JBI reviews. Most importantly, transparency is essential, and the rapid review should clearly report where any simplification in the steps of the evidence synthesis process has been taken.

Practical guide to undertaking scoping reviews for pharmacy clinicians, researchers and policymakers.

WHAT IS KNOWN AND OBJECTIVE: Scoping reviews are a valuable evidence synthesis methodology. They can be used to map the evidence related to any topic to allow examination of practice, methods, policy and where (and how) future research could be undertaken. As such, they are a useful form of evidence synthesis for pharmacy clinicians, researchers and policymakers to review a broad range of evidence sources. COMMENT: This commentary presents the most comprehensive and up to date methodology for scoping reviews published by Joanna Briggs Institute (JBI). This approach builds upon two older approaches by Arksey and O'Malley, and Levac. To assist reviewers working in the field of pharmacy with planning and conducting scoping reviews, this paper describes how to undertake scoping reviews from inception to publication with specific examples related to pharmacy topics. WHAT IS NEW AND CONCLUSION: The JBI scoping review methodology is a valuable evidence synthesis approach to the field of pharmacy and therapeutics. This approach can assist pharmacy clinicians, researchers and policymakers to gain an understanding of the extant literature, to identify gaps, to explore concepts, characteristics and to examine current practice.

Educational antimicrobial stewardship programs in medical schools: a scoping review.

OBJECTIVE: The objective of this scoping review was to identify the available evidence on antimicrobial stewardship programs for teaching medical students about rational antimicrobial use, including the content taught and the method of instruction used. INTRODUCTION: Antibiotics are a precious resource whose discovery have saved millions of lives. They are used extensively in surgical procedures, cancer chemotherapy, and in the treatment of infectious diseases. However, the development of antimicrobial resistance and the slow rate of discovery of new agents with novel mechanisms of actions represent a threat to modern medicine. INCLUSION CRITERIA: This scoping review considered papers that described medical school curricula that focused on the teaching and learning of the prescription of antimicrobial medication. Studies that described this concept in the curricula of other health profession students, such as nursing, pharmacy, or dentistry students, were excluded. METHODS: The JBI three-step process was followed and conducted by two reviewers. The scoping review followed an a priori published protocol. Eight databases were searched for both published and unpublished literature and gray literature. Only studies published in English from 1996 onwards were included. Full texts of selected citations were assessed against the inclusion criteria by two independent reviewers. Data were independently extracted by two reviewers. Disagreements were resolved through discussion, and the need for a third reviewer was not required. Data extraction was undertaken using a modified charting table developed for the review objectives. The findings are presented using the narrative synthesis. RESULTS: Thirteen studies were included in the review, with most of the papers originating from the United States of America and Europe, with one from developing countries. Didactic lectures and web-based distance learning were the most common modes of instruction used in the included papers. Six of the included papers presented the outcomes of their interventions; different methods of assessment were used to evaluate students, which included baseline and post-instruction assessment or a series of short exams. Some of the concepts in the teaching material included the use of antimicrobial agents, prevention of antimicrobial resistance, antimicrobial stewardship, and infection prevention control. The programs (ranging from 75 minutes to 100 hours) were implemented from second to fourth year of study. CONCLUSIONS: A wide range of interventions were used to teach the principles of antimicrobial stewardship to medical students. There is a need to further evaluate these programs through follow-up of students after graduation to determine whether the skills learned are retained.

Knowledge and perceptions about antibiotic resistance and prudent antibiotic prescribing among final year medical students in two African countries.

OBJECTIVES: The objectives of this study were to assess the knowledge and perceptions of final year medical students about antibiotic resistance and antibiotic use to assist in the development of an antibiotic stewardship curriculum for teaching medical students in South Africa and Nigeria and the principles of prudent antibiotic prescribing. METHODS: A cross-sectional study was conducted to determine the knowledge and perceptions of final year medical students in one South African and three Nigerian universities about prudent antibiotic use, antibiotic resistance and antibiotic stewardship. A 26-item questionnaire was administered electronically to students in three medical schools and a paper-based copy in the fourth. KEY FINDINGS: A difference in the gap in knowledge between the two countries was identified; however, respondents from both countries had a similar understanding of antibiotic use and antibiotic resistance. Most respondents in South Africa (94.8%) and Nigeria (91.4%) agreed that antibiotics are overused in their countries. There was a significant difference between the number of respondents in the two countries who thought that there are new antibiotics available to treat resistant pathogens; 45.4% of Nigerian respondents agreed with the statement as compared to 9.6% of the South African respondents. Of the 10 vignettes answered correctly, South African respondents scored an average of 62.4% in the knowledge segment compared to 31.9% scored by the Nigerian respondents (P = 0.001). All of the South African (100%) and 98.3% of the Nigerian respondents indicated their desire for more education on appropriate antibiotic use. CONCLUSIONS: Although students from both countries had the same perception of antibiotic resistance, there was, however, a difference in their level of knowledge, which could have been improved in both countries. This should be addressed at an undergraduate curriculum level; as well as with continued education to reinforce antibiotic knowledge.

Nursing students' conceptions of competence and the learning processes that support the development of competence: a phenomenographic study.

The development of competence among student nurses is important to nurse educators, nursing regulatory bodies, employers and patients. Several teaching and learning strategies support the development of competence among student nurses, but the level of competence at the point of graduation remains below expected standards. Therefore, more research is needed to find strategies that can enhance the development of competence among students. The study explored students' conceptions of competence and the learning processes that support the development of competence in nursing practice. Gaining an understanding of learning and competence from the student's perspective can improve our current understanding of the development of competence. Utilising a phenomenographic approach, in-depth interviews and focus group discussions were conducted among purposively sampled groups of nursing students. The analysis of data was managed through ATLAS. ti 8.1 and followed the process of familiarisation, condensation, comparison, grouping, articulating labelling and contrasting of excerpts to generate the students' conceptions of learning. Five categories of description emerged and showed that the development of competence involves students increasing their understanding of what competence is, hence changing their learning strategies to meet the level of competence, as they understood it. In order of hierarchy from the lowest, the categories of description were: competence is understood as task completion; competence is understood as passing assessments /satisfying facilitators; competence is understood as applying theory to practice; competence is understood as performance of nursing according to clinical standards/guidelines; and competence is understood as performance that yields positive health outcomes.

Updated methodological guidance for the conduct of scoping reviews.

OBJECTIVE: The objective of this paper is to describe the updated methodological guidance for conducting a JBI scoping review, with a focus on new updates to the approach and development of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (the PRISMA-ScR). INTRODUCTION: Scoping reviews are an increasingly common approach to informing decision-making and research based on the identification and examination of the literature on a given topic or issue. Scoping reviews draw on evidence from any research methodology and may also include evidence from non-research sources, such as policy. In this manner, scoping reviews provide a comprehensive overview to address broader review questions than traditionally more specific systematic reviews of effectiveness or qualitative evidence. The increasing popularity of scoping reviews has been accompanied by the development of a reporting guideline: the PRISMA-ScR. In 2014, the JBI Scoping Review Methodology Group developed guidance for scoping reviews that received minor updates in 2017 and was most recently updated in 2020. The updates reflect ongoing and substantial developments in approaches to scoping review conduct and reporting. As such, the JBI Scoping Review Methodology Group recognized the need to revise the guidance to align with the current state of knowledge and reporting standards in evidence synthesis. METHODS: Between 2015 and 2020, the JBI Scoping Review Methodology Group expanded its membership; extensively reviewed the literature; engaged via annual face-to-face meetings, regular teleconferences, and email correspondence; sought advice from methodological experts; facilitated workshops; and presented at scientific conferences. This process led to updated guidance for scoping reviews published in the JBI Manual for Evidence Synthesis. The updated chapter was endorsed by JBI's International Scientific Committee in 2020. RESULTS: The updated JBI guidance for scoping reviews includes additional guidance on several methodological issues, such as when a scoping review is (or is not) appropriate, and how to extract, analyze, and present results, and provides clarification for implications for practice and research. Furthermore, it is aligned with the PRISMA-ScR to ensure consistent reporting. CONCLUSIONS: The latest JBI guidance for scoping reviews provides up-to-date guidance that can be used by authors when conducting a scoping review. Furthermore, it aligns with the PRISMA-ScR, which can be used to report the conduct of a scoping review. A series of ongoing and future methodological projects identified by the JBI Scoping Review Methodology Group to further refine the methodology are planned.

Undertaking a scoping review: A practical guide for nursing and midwifery students, clinicians, researchers, and academics.

AIM: The aim of this study is to discuss the available methodological resources and best-practice guidelines for the development and completion of scoping reviews relevant to nursing and midwifery policy, practice, and research. DESIGN: Discussion Paper. DATA SOURCES: Scoping reviews that exemplify best practice are explored with reference to the recently updated JBI scoping review guide (2020) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review extension (PRISMA-ScR). IMPLICATIONS FOR NURSING AND MIDWIFERY: Scoping reviews are an increasingly common form of evidence synthesis. They are used to address broad research questions and to map evidence from a variety of sources. Scoping reviews are a useful form of evidence synthesis for those in nursing and midwifery and present opportunities for researchers to review a broad array of evidence and resources. However, scoping reviews still need to be conducted with rigour and transparency. CONCLUSION: This study provides guidance and advice for researchers and clinicians who are preparing to undertake an evidence synthesis and are considering a scoping review methodology in the field of nursing and midwifery. IMPACT: With the increasing popularity of scoping reviews, criticism of the rigour, transparency, and appropriateness of the methodology have been raised across multiple academic and clinical disciplines, including nursing and midwifery. This discussion paper provides a unique contribution by discussing each component of a scoping review, including: developing research questions and objectives; protocol development; developing eligibility criteria and the planned search approach; searching and selecting the evidence; extracting and analysing evidence; presenting results; and summarizing the evidence specifically for the fields of nursing and midwifery. Considerations for when to select this methodology and how to prepare a review for publication are also discussed. This approach is applied to the disciplines of nursing and midwifery to assist nursing and/or midwifery students, clinicians, researchers, and academics.

Conducting high quality scoping reviews-challenges and solutions.

OBJECTIVES: Scoping reviews are being increasingly used by researchers. The objective of this article was to outline some challenges and potential solutions to improve the conduct and reporting of scoping reviews. STUDY DESIGN AND SETTING: The JBI scoping review methodology group consists of 9 experts in the field of scoping reviews. This article summarizes the key issues facing reviewers who conduct scoping reviews and those who use the results from scoping reviews and may engage in consultations during their development. RESULTS: Several key issues have been identified for reviewers as challenges in conducting scoping reviews. Challenges may be faced throughout the conduct of the review, from developing the a priori protocol to finalizing the review report for publication and developing implications or recommendations for research, policy, and practice from the results of the review. Challenges to publishing scoping reviews may stem from a lack of understanding of scoping reviews by journal editors, authors, and peer reviewers to extending the conclusion drawn from these reviews to generate recommendations for practice and policy. CONCLUSION: By identifying and overcoming challenges to the conduct and reporting of scoping reviews, reviewers may better ensure that scoping reviews are effective in meeting the objectives of scoping reviews.

Updated methodological guidance for the conduct of scoping reviews.

OBJECTIVE: The objective of this paper is to describe the updated methodological guidance for conducting a JBI scoping review, with a focus on new updates to the approach and development of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (the PRISMA-ScR). INTRODUCTION: Scoping reviews are an increasingly common approach to informing decision-making and research based on the identification and examination of the literature on a given topic or issue. Scoping reviews draw on evidence from any research methodology and may also include evidence from non-research sources, such as policy. In this manner, scoping reviews provide a comprehensive overview to address broader review questions than traditionally more specific systematic reviews of effectiveness or qualitative evidence. The increasing popularity of scoping reviews has been accompanied by the development of a reporting guideline: the PRISMA-ScR. In 2014, the JBI Scoping Review Methodology Group developed guidance for scoping reviews that received minor updates in 2017 and was most recently updated in 2020. The updates reflect ongoing and substantial developments in approaches to scoping review conduct and reporting. As such, the JBI Scoping Review Methodology Group recognized the need to revise the guidance to align with the current state of knowledge and reporting standards in evidence synthesis. METHODS: Between 2015 and 2020, the JBI Scoping Review Methodology Group expanded its membership; extensively reviewed the literature; engaged via annual face-to-face meetings, regular teleconferences, and email correspondence; sought advice from methodological experts; facilitated workshops; and presented at scientific conferences. This process led to updated guidance for scoping reviews published in the JBI Manual for Evidence Synthesis. The updated chapter was endorsed by JBI's International Scientific Committee in 2020. RESULTS: The updated JBI guidance for scoping reviews includes additional guidance on several methodological issues, such as when a scoping review is (or is not) appropriate, and how to extract, analyze, and present results, and provides clarification for implications for practice and research. Furthermore, it is aligned with the PRISMA-ScR to ensure consistent reporting. CONCLUSIONS: The latest JBI guidance for scoping reviews provides up-to-date guidance that can be used by authors when conducting a scoping review. Furthermore, it aligns with the PRISMA-ScR, which can be used to report the conduct of a scoping review. A series of ongoing and future methodological projects identified by the JBI Scoping Review Methodology Group to further refine the methodology are planned.

Educational antimicrobial stewardship programs in medical schools: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to identify the available evidence on antimicrobial stewardship programs for teaching medical students about rational antimicrobial use, including the content taught and the method of instruction used. INTRODUCTION: Antibiotics are life-saving drugs and their discovery is one of the most important advances of the 20th century. They have transformed modern medicine by playing a critical role in the management of infectious diseases. However, the rapid development of resistance of pathogens to antibiotics is gradually affecting this initial success. Antimicrobial stewardship programs have been shown to reduce the burden of antimicrobial resistance in hospitals. INCLUSION CRITERIA: This scoping review will consider papers conducted in medical school curricula to improve the prescribing of antimicrobial medication. Studies that include other health profession students, such as nursing, pharmacy, or dentistry students, will be excluded. Studies published in English from 1996 onwards will be included. METHODS: Databases to be searched are PubMed, Wiley Online library, CINAHL Complete, Web of Knowledge, Scopus and Education Resources Information Center. Unpublished studies and gray literature will be included. Searching will follow a three-step process and will be conducted by two reviewers. Data will be extracted by two independent reviewers. Any disagreements that arise between the reviewers during the study selection process or data extraction will be resolved through discussion, or with a third reviewer. Results will be presented in tabular or diagrammatic form, together with a narrative summary.