NR-714 Week 1 Protocol Development and Review Scope: How to Write It

What NR-714 Week 1 asks for

A doctoral student working in a long-term acute care hospital wants to review the evidence on early mobility for patients on prolonged ventilator weaning. She starts reading, finds eleven promising papers over a fortnight, and by the time she writes anything down she has quietly excluded three studies she found unconvincing, included one she liked despite its design, and defined mobility differently in her head than any of the authors did. None of that was dishonest. All of it is unrecoverable, because there is no record of what she decided before she looked. The protocol stage exists to make those decisions visible, dated and binding.

A review protocol is a specification document. It names the question in structured form, the eligibility criteria that will admit or exclude a study, the databases and the search approach, the screening process including how many people screen and how disagreements resolve, the data items to be extracted, the risk of bias tool to be applied, the planned approach to synthesis including whether pooling is anticipated, the outcomes with their hierarchy, and the method for rating certainty in the body of evidence. Reporting guidance for systematic reviews and their protocols exists precisely so this list is standard; name the guidance you are following and follow it.

Two decisions in the protocol determine everything downstream. The first is the outcome hierarchy: which single outcome is primary, which are secondary, and whether economic outcomes such as cost per event avoided are inside the review or outside it. A review that treats every reported outcome equally produces a results section nobody can interpret. The second is the eligibility boundary on setting and population, which in post-acute and transitional care work is unusually consequential, because interventions of the same name behave differently in a hospital, in a skilled nursing facility and in the home.

Keep the practice-doctorate frame in view. This is a review conducted to support translation of existing evidence into a change at a real site, not a study generating new knowledge. Expect a written protocol, usually with tables for eligibility criteria and planned data items, and often a discussion post presenting your scope for critique. Present the protocol elements rather than your enthusiasm for the topic, since posts do not reopen once submitted in Canvas.

The NR-714 Week 1 method, step by step

Six moves from a topic you care about to a protocol somebody else could execute.

1. Determination of the review type before anything else

   A full systematic review, a review restricted to a design family, a scoping review mapping what exists: each carries different obligations. Name the type in the first paragraph, because the reader judges every later decision against it.

2. Specification of the question with an outcome hierarchy

   Population, intervention, comparator and outcomes, with one outcome designated primary and the rest ranked. State whether economic outcomes are within scope now rather than discovering the question later.

3. Construction of eligibility criteria as decision rules

   Write each criterion so a second reader applying it to the same abstract would reach your decision: setting, population characteristics, intervention definition, comparator, study design, language, date window and publication type.

4. Declaration of the search and screening process

   Databases with reasons, supplementary sources, how many screeners at each stage, and the rule for resolving disagreement. Naming the process now is what makes the screening stage reportable later.

5. Enumeration of the data items to be extracted

   List every field the extraction form will carry, including the economic and measurement fields you will want in later stages. Fields added after extraction begins force a return to papers already read.

6. Statement of the planned synthesis and certainty approach

   Say in advance whether pooling is anticipated and under what conditions, how heterogeneity will be examined, what subgroups are planned, and which framework will rate certainty in the body of evidence.

A layout and word budget for a review protocol

Our frame for a protocol deliverable, sized for roughly 1,500 to 1,900 words plus the criteria and data item tables. It is our own outline rather than anything the university issues, and your week's rubric outranks it wherever the two disagree.

Evidence craft for protocol writing

Check for existing reviews before proposing a new one. A protocol that does not say whether the question has already been synthesized invites the obvious question. Search the review registries and the review literature first, and if a recent synthesis exists, justify yours by what it adds: a newer window, a different setting, an economic dimension the original omitted.

Write eligibility criteria that two people could apply identically. Adults in post-acute care is a description. Adults aged sixty-five and over admitted to a skilled nursing facility directly from an acute stay is a rule. The test is whether a colleague screening the same abstract would agree with your decision without asking you.

Name the reporting guidance and the appraisal tools by name. Reporting statements for reviews and protocols, and risk of bias instruments matched to each design in scope, all exist and are expected at this level. Cite them with their year and use their terminology consistently.

Define the intervention operationally. Interventions with familiar names vary enormously in what they actually contain. State the components a study must include to count, and the components whose presence would exclude it, or your synthesis will pool things that are not the same thing.

Date the protocol and treat later changes as amendments. If the plan changes after screening begins, record the change, its date and its reason rather than quietly editing the document. Reported amendments are methodologically respectable; silent ones are not.

Five mistakes that cost points in this week's territory

• A protocol written after the reading. Criteria that happen to match the studies already chosen are visible to any experienced reader, and the whole value of the document evaporates.
• No primary outcome. A review with six equally weighted outcomes has no way to reach a conclusion and no basis for a certainty rating.
• Vague eligibility criteria. Criteria that require the author's judgment to apply cannot be reproduced and cannot be reported as a method.
• Intervention left undefined. Without stated components, the review pools studies of different things under one label and the synthesis is uninterpretable.
• Research framing in a translation course. Writing as though the review will generate new knowledge, rather than assemble what is known so a site can act, misreads the degree.

Before you submit

• The review type is named and its obligations acknowledged
• One primary outcome is designated with its unit of measurement
• Every eligibility criterion could be applied by a second reader without asking you
• The intervention is defined by required and disqualifying components
• Databases, screening stages and disagreement rules are all specified
• The synthesis, heterogeneity and certainty plans are stated in advance
• Every reference appears in the text and every in-text citation appears in the list

Questions students ask about this stage

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