A search in CINAHL follows the general process described on the Search Strategy page of this guide. Briefly, those steps include: topic, searchable questions, in/exclusion criteria, terms and operators, iterations and refinements, documentation, and citation management.
Use the following link to access CINAHL. Our proxied link will grant you access to our library holdings and full text articles.
On this page, we'll discuss how to break your question down into searchable concepts, come up with search terms, execute the search, and document/manage the citations. Here is a worksheet that will help you work through this page:
By now, you've established your topic: nursing orientation programs in acute care settings for new hires. And you've created your searchable question: For newly hired nurses in a hospital system (P), do structured orientation programs (I) improve retention and performance (O) when compared to the current informal staff onboarding process (C)?
The next step is to break that question down into searchable concepts. You won't always search every part of your PICO question. For example:
In this example, your searchable concepts may include:
Once you've broken your question into the searchable concepts, the next step is to come up with search terms. In CINAHL, this means identifying both keywords and subject headings (Need a refresher on subject headings? Check out the Subject Headings page of the guide!).
Start by turning each concept into a list of searchable words or phrases. Then, brainstorm synonyms and alternate spellings (e.g., color vs. colour). Following the new hire orientation example, you might include onboarding, new hire training, and transition to practice in your search. Truncation can help you capture variations of a word. Add an asterisk (*) to the root of a word - for example, type educat* to retrieve educates, education, educator, etc.
Keep an eye on your search results: keywords like orientation can have multiple meanings and may pull in irrelevant results. If that happens, try using quotation marks for an exact phrase (e.g., "staff orientation") or swap in a synonym.
It's considered best practice to include subject headings to your search once you've tackled keywords. CINAHL uses CINAHL Headings, which are functionally similar to PubMed's MeSH terms.
You can search for CINAHL Headings using the "CINAHL Headings" tab on the advanced search interface. Pressing this button brings up a search bar where you enter a keyword to find associated subject headings:
If your keyword doesn't return results, try synonyms, using broader/narrower terms, or rephrasing the concept. It is possible that a subject heading does not exist for some terms. In that case, rely on robust keyword searching.
To add a term to your search:
For more help with CINAHL Headings, visit EBSCO's help page.
Once you've identified your concepts and selected your terms, you're ready to execute the search. Summa's CINAHL Database defaults to the Advanced Search page. If you're not already there, go ahead and switch over. Unlike PubMed, CINAHL allows you to enter multiple lines of search at once. You can either use the different lines to search all concepts at once or search several concepts separately and combine them later using your search history.
After running your search, you'll land on the results page. The initial results may be unwieldy, but you can bring them under control by applying filters and other tools.
As you work on your search, you will likely make adjustments to your terms and filters, especially when there are many irrelevant results. A great technique is reading through the abstracts and keywords of relevant results and adding those to your search. If your results still aren't what you expected after some refinements, it may be a result of how CINAHL interpreted your terms.
Some misinterpretations might be obvious: retention might pull in articles about urinary retention, or orientation might pull in cultural orientation. In this case, try:
Sometimes the problem is less clear. CINAHL uses automatic term mapping, meaning that it tries to identify the subject heading(s) related to your keywords and search using them. In the case of the keyword orientation, CINAHL may map to the general MH "Orientation+" subject heading:
This use of the word orientation is not what we were intending. CINAHL even anticipates this by calling out the potential for confusing this heading with employee orientation! In this instance, we'd do one of two things: swap out the keyword, or turn off automatic term mapping.
To turn off automatic term mapping:
CINAHL and other EBSCO databases recently updated to a new user interface. This change was mandated by EBSCO. Overall, user satisfaction is low with the update. Expect ongoing changes as EBSCO implements feedback and requested enhancements.
As a part of this UI change, the folder functionality, where you could save articles of interest for later, was replaced with projects. Folders from the old UI can be retrieved until 12/31/2025, after which point they'll be deleted by EBSCO. Projects function similarly to folders, but offers some upgrades like saving search strings used for the project.
Formal documentation is often unnecessary for quick searches, but is necessary for many searches that contribute to a research project. Many journals require researchers to document and present their search strategy in their writing. Properly documenting your strategy supports reproducibility and transparency, as well as makes it easier to revise your search for future iterations.
Begin formally documenting your process from the beginning instead of trying to remember and replicate later (spoiler alert: you will not be able to replicate what you did later). It's also helpful to write down your reasoning for the terms you choose, filters you apply, etc. If you are conducting a systematic review, follow the applicable standards in your discipline. At a minimum, you should document the following items from your search:
CINAHL lets you export your search history to various file formats including PDF and .csv. Visit the "Recent Activity" page to see your history. This file contains all of the information you'll need for documentation, so it's a good trick to become familiar with. Be sure that all aspects of the search carry over to the .csv file including filters/limiters - sometimes, those do not export with the search history and must be manually added to the documentation.
When you've finished a search session, you export your search history from the database you're working in. You make sure that the history includes date/time and filters/limiters - if not, you add them to the exported document. If the database does not allow you to export your history, you copy and paste it into a document and add all additional relevant information like the date/time, limits/filters.
After exporting, you also document your reasoning for the choices you made throughout the search. You explained the study type filters you chose (because you wanted high level evidence), eliminating orientation as a keyword on its own (because it was giving too many false hits), etc.
Once you've found the articles, you'll need to keep track of all of them. A great way to do this is to create a folder, collection, or project (different names, same function) in your database of choice to save articles. As you work through your search, click check boxes next to relevant articles to save for later. Once you've completed the search, you can review your saved articles to determine which full-texts you'd like to retrieve. You can also export your results into a file compatible with citation management software, a .csv file, or even a Word document.
For more information and guidance on citation management, visit the Citations guide!
You are doing your search in CINAHL. You've sent relevant articles to your Project folder and are now ready to export the citations to EndNote. You open the Project, select the articles of interest, and send them to a citation manager. You also want the full texts of some of the articles, so you also track those down using the full-text links in each article record, or you request an interlibrary loan of the best articles.