SCHOLARS’ CORNER

Understanding scoping reviews: Definition, purpose, and process

Jessica Peterson, PhD, RN (Assistant Professor), Patricia F. Pearce, MPH, PhD, FNP-BC, FAANP, FNAP (Associate
Professor and Interim Director), Laurie Anne Ferguson, DNP, APRN, FNP-C, FAANP, FNAP (Associate Professor and
DNP Program Coordinator), & Cynthia A. Langford, PhD, APRN-BC, FNP (Associate Professor)
School of Nursing, Loyola University New Orleans, New Orleans, Louisiana

Keywords
Scoping review; research methods; review;
concept mapping; evidence base.
Correspondence
Patricia F. Pearce, PhD, FNP-BC, FAANP, FNAP,
School of Nursing, Loyola University
New Orleans, 6363 St. Charles Avenue,
New Orleans, LA 70118.
Tel: 504-865-2795; Fax: 504-865-3254;
E-mail: ppearce@loyno.edu
Received: 3 March 2016;
accepted: 5 April 2016
doi: 10.1002/2327-6924.12380
Abstract
Background/purpose: Scoping review design represents a methodology that
allows assessment of emerging evidence, as well as a first step in research de-
velopment. Despite its increasing use, to date no article reflecting use of scoping
review methodology has been submitted for review at JAANP. The purpose of
this article is to provide detailed information on scoping reviews, including def-
inition, related processes, and uses, and discuss the relationship to nurse prac-
titioner (NP) practice, policy, education, and research. The longer-term goal is
that NPs will understand the related techniques, consider the methodology as a
viable one for NP scholarship, and bring related reports to the forefront of NP
publications.
Methods: This manuscript represents a brief report. Processes to develop the
brief include detailed search and review of scoping review literature in CINAHL
and PubMed. Both methodologic reports and reviews were included. Definitions
and uses of scoping reviews were reviewed.
Conclusion: The definition and process of scoping review are evolving. Al-
though there is controversy regarding the methodology, there is increasing vis-
ibility of scoping review methodology in the published literature since the year
2000, with over 500 published reviews currently available.
Implications for practice: A well-executed scoping review has potential to
inform NP practice, policy, education, and research.

Purpose and background
The purpose of this report is to provide an introduction
for nurse practitioners (NPs) regarding the definition, pro-
cesses, and uses of a scoping review, and to discuss the rela-
tionship of scoping reviews to NP practice, policy, education,
and research. Ultimately, the goal is to enable NPs to lever-
age the methodology, generate scoping reviews in relevant
areas, and disseminate the information to other NPs in or-
der to support practice, education, policy, and research.
A systematic approach to reviewing scientific literature is
critical to informing practice and improving patient out-
comes based on the most current evidence. The synthesis
of current knowledge always should be approached with
a rigor that is systematic, reproducible, and accountable
in manner (Polit & Beck, 2012). Although conceptually
evolving, a scoping review is one form of review scholarship
based on a framework for synthesizing available published
and gray literature on a given topic (Arksey & O’Malley,
2005; Gough, Thomas, & Oliver, 2012; Levac, Colquhoun,
& O’Brien, 2010).
Scoping review—definition
There is no universally accepted definition or purpose
for a scoping review (Daudt, van Mossel, & Scott, 2013;
Levac et al., 2010; Pham et al., 2014; Rumrill, Fitzgerald, &
Merchant, 2010); however, the main characteristic of this
method is that it provides an overview of a broad topic
(Moher, Stewart, & Shekelle, 2015; Pham et al., 2014).
There are several major differences between a scoping re-
view and a traditional systematic review with a meta-
analysis. Both meta-analyses and scoping reviews begin
with a primary question on which inquiry is focused. How-
ever, a scoping review allows for a more general question

12 Journal of the American Association of Nurse Practitioners 29 (2017) 12–16


C 2016 American Association of Nurse Practitioners
J. Peterson et al.
and exploration of the related literature, rather than fo-
cusing on providing answers to a more limited question
(Moher et al., 2015). For a systematic review, investiga-
tors generally start with a clearly defined question and ex-
plore and analyze high-level research studies focused on
narrow parameters. Conversely, a scoping review has less
depth but a broader conceptual range (Arksey & O’Malley,
2005). Within the framework of research methods, a well-
done scoping review is considered at a higher level than
a straightforward review of literature or an integrative
review, but not as in depth as a Cochrane or Johanna
Briggs model systematic review (Arksey & O’Malley, 2005;
Gough et al., 2012; Levac et al., 2010).
A scoping review also provides for more flexibility than
traditional systematic review and meta-analysis. It is able
to account for a diversity of relevant literature and stud-
ies using different methodologies, which is not feasible
in a traditional review (Arksey & O’Malley, 2005; Levac
et al., 2010; Pham et al., 2014). Theoretical and narra-
tive reviews, gray literature, as well as both qualitative
and quantitative research are all included within a scop-
ing review. Thus, a scoping review is an appropriate al-
ternative to a systematic review when literature is vast
and complex (Arksey & O’Malley, 2005; Grimshaw, 2008).
Current knowledge regarding the identified topic, clinical
problems, and research questions posed may influence the
breadth of a scoping review and therefore makes it a per-
fect methodological technique to explore new topics or
rapidly evolving science to guide a more in-depth system-
atic review or other scholarly endeavor.
The end product of a scoping review is typically a narra-
tive presentation, with minimal or limited statistical infor-
mation. The intent is to synthesize the research in the top-
ical area, by mapping or articulating what is known about
key concepts, derived from an array of sources, such as
results from research studies, gray literature, and expert
opinion. The process of mapping or diagraming informa-
tion about the topic illustrates what is known and points
at which there are gaps in knowledge. A completed scop-
ing review can be viewed as scholarship in itself (Arksey
& O’Malley, 2005; Levac et al., 2010; Whittemore, Chao,
Jang, Minges, & Park, 2014) and can serve as a richly in-
formed starting point for further investigations to under-
stand and contribute to research, education, practice, and
policy.
Interest in scoping reviews in nursing is not new. A
number of scoping reviews have been completed in nurs-
ing, or by interdisciplinary investigative teams that include
nurses and NPs as authors. Davis, Drey, and Gould (2009)
completed a status update of scoping reviews in nursing,
and determined that use of scoping reviews in nursing
was in “embryonic” stage, but developing well (p. 1386).
Davis et al. revealed a sample of 262 reports was reduced
Understanding scoping reviews
through systematic inclusion/exclusion criteria application
to a concluding sample of 24 reports. The reports illus-
trated the flexibility of the method in numerous topical
areas, and the reports were categorized into four major ar-
eas, as well as categorization by depth of the results of the
reviews. Davis et al. identified that the power of scoping
reviews lies in the process that includes development and
intellectual creativity.
Structure of a scoping review
Just as there is no universally accepted definition of a
scoping review, neither is there an exacting set of proce-
dures. In 2005, Arksey and O’Malley published the first
framework detailing the purpose of this method and in-
cluded detailed steps to guide researchers. They outlined
four purposes for scoping reviews. The first is to provide a
quick overview of a field of research, examining the extent
of research done on a particular topic or area. The second
purpose is to determine the feasibility, relevance, and/or
costs of conducting a full systematic review. The third pur-
pose detailed by Arksey and O’Malley (2005) is to pro-
vide focused synthesis, potentially with more speed, as was
originally discussed in Antman, Lau, Kupelnick, Mosteller,
and Chalmers (1992) in their synthesis of articles, text-
books, and guidelines regarding myocardial infarction and
its treatment. Arksey and O’Malley (2005) delineate the
fourth purpose to be for drawing conclusions and identify-
ing gaps in the existing literature. Arksey and O’Malley’s
(2005) delineation of these four purposes reinforces that
a scoping review might be conducted as a first step in a
larger project, such as a systematic review, descriptive re-
search endeavor, or randomized trial, or it can serve as a
stand-alone initiative.
The methodology for a scoping review comprised sim-
ilar systematic activities completed in any review, includ-
ing: focus on a specific topical area, a well-defined research
question, rationale regarding inclusion and exclusion crite-
ria, and clearly defined procedures and responsibilities for
all researchers. Of note, the phrase umbrella review as used
in Whittemore et al. (2014) is a term that reflects meta-
synthesis procedures as well; however, metasynthesis pro-
cedures are not a required component of a scoping review.
Documentation of processes is critical. Most reviews are
reported in a format such as PRISMA, the Preferred Re-
porting Items for Systematic Reviews and Meta-Analysis,
and a table of the information reviewed is typically in-
cluded in the published work (Liberati et al., 2009; Moher,
Liberati, Tetzlaff, Altman, & Group, 2009), as are included
in the author guidelines for JAANP (JAANP, 2015).
In their summary of scoping reviews published in a va-
riety of disciplines, Pham et al. (2014) found that the
majority of researchers who reported using a framework
13
Understanding scoping reviews
to guide the review used the six-step methodological ap-
proach defined by Arksey and O’Malley (2005). These
steps include:
1. Identifying the research question(s);
2. Identifying the relevant studies;
3. Study selection;
4. Charting the data;
5. Collating, summarizing, and reporting the data;
6. Consultation (optional stage; Arksey & O’Malley,
2005, pp. 22–23).
It should be noted that Arksey and O’Malley (2005) in-
vited other researchers to contribute to their discussion to
enhance the development of methods for scoping reviews,
and since that time, other investigators have published re-
ports of their recommendations related to the method. Re-
sources such as Levac et al. (2010) and Daudt et al. (2013)
provide additional procedural clarification and details. For
example, a comprehensive table of related definitions with
procedures can be found in Levac et al. (2010), and Whit-
temore et al. (2014) provide a detailed description and
comparison of designs. These reports have built on Arksey
and O’Malley’s (2005) original work.
Uptake of scoping review methodology
The number of scoping reviews indexed located in
PubMed and CINAHL has increased substantially, from
a single report in 2000 to 151 in 2015 (see Figure 1).
There are approximately 500 total reviews indexed since
2000. These reviews were published in 493 unique jour-
nals, and represent reviews completed within and across
multiple health disciplines, including nursing, medicine,
nutrition, public health, dentistry, physical therapy, social
work, and others. The preponderance of these reports re-
flects multiple authors, with some reports authored with
formal groups or organizations.
Controversies and challenges
As is common with a “new” technique, scoping review
methodology is not without controversy. A sustained crit-
icism regarding scoping review procedures is the inatten-
tion to the quality of the studies being included and then
reported in the scoping review (Daudt et al., 2013; Levac
et al., 2010). Unlike in the more traditional systematic
reviews, the parameters for scoping reviews do not call
typically for a critique of the methodological quality of
the studies included within the review. Whittemore et al.
(2014) detail the varying types of reviews, including pur-
poses, details, and emphasis on quality. Levac et al. (2010)
question whether the purposes for a scoping review set
out by Arksey and O’Malley (2005), particularly determin-
14
J. Peterson et al.
ing the feasibility for a systematic review or determining
the gaps in research knowledge, can be met without as-
sessing the quality of the evidence. There is also concern
about the usefulness to practice or policy making if qual-
ity is not considered and the scoping review is done as a
stand-alone project, rather than the first step in a larger
endeavor (Daudt et al., 2013).
A second issue is that of the time required to complete
a scoping review. While Arksey and O’Malley (2005) sug-
gested that scoping reviews could be completed relatively
quickly, this claim has since been challenged. Thorough,
thoughtful scoping reviews take time (Daudt et al., 2013).
Authors have reported that this type of review has taken
up to 20 months to complete (Pham et al., 2014).
As the method gains use and exposure, recent reviews of
scoping reviews have added additional clarity to the pur-
pose and methods of scoping reviews (Davis et al., 2009;
Pham et al., 2014). While definitions and methods con-
tinue to vary, scoping reviews should not be considered
a less rigorous version of systematic reviews; rather scop-
ing reviews have a different purpose and objectives (Pham
et al., 2014). Indeed, Davis et al. (2009) found that well-
done scoping reviews contained depth of analysis and rein-
terpretation of original evidence, contributing to concep-
tual clarification and definitions. “[A]ll literature review
methods offer a set of tools that researchers need to use
appropriately. To that end the scoping study is one method
amongst many that might be used to review literature”
(Arksey & O’Malley, 2005, p. 20).
Recommendations
A scoping review can be leveraged for NPs in relevant
areas of practice, education, research, and policy. Those
areas are included below, and a list of helpful hints is listed
in Table 1.
Practice
A scoping review can be used in almost any area, but
is especially relevant to patient care. An example of rel-
evance to nursing is a review emphasizing health liter-
acy, patient decision making, with conclusion of the ne-
cessity of learning aids for patients (Malloy-Weir, Charles,
Gafni, & Entwistle, 2015). A scoping review can provide a
broad overview of the evidence and controversies before a
clinical practice guideline is available. Additionally, a scop-
ing review can serve as one source of information in the
development of practice guidelines.
Education
Utilizing published scoping reviews to understand a topic
can be useful both for students and others. Further, a
J. Peterson et al.
Figure 1 Frequency of scoping reviews in PubMed and CINAHL (2000–2015).
Table 1 Helpful hints for conducting a scoping review
The success of any scholarly initiative is dependent of systematic
processes and knowledgeable individuals. Recommendations for
completing a scoping review include systematic, but flexible,
processes, including:
• Gather a good team.
• Follow steps detailed in available guidelines (e.g., Arksey & O’Malley,
2005).
• Delineate the parameters of topic to explore, and refine the research
question.
• Assure that procedures are projected in terms of individual
responsibilities, deliverable dates, and overall timeline.
• Maximize search terms, and use of electronic databases and electronic
bibliographic reference managers, including shared web-based sites to
expedite working collaboratively (George, Ferguson, & Pearce, 2014).
• Engage consultants who have expertise in the topical area or process
(Arksey & O’Malley, 2005; Levac et al., 2010).
• A reference librarian is always a best choice to assure appropriate
resource identification (George et al., 2014).
• One of the intentions of scoping reviews is to map the available
research, thus data display and reporting are critical factors. Each
review will be sufficiently different that there is no one best way to
display the mapping. In their review of evidence-use in decision making
by nurses and nurse practitioners, Yost and colleagues (2014) provide
a comprehensive array of displays for mapping review materials in
terms of research designs, knowledge, skills, attitudes, and behaviors,
clinical areas and outcomes, and knowledge translation techniques.
scoping review can provide a useful tool for students to un-
derstand a topic overall, from baccalaureate through DNP
or PhD levels of education. For students themselves, with
development of skill in critique procedures, a student or
group of students potentially could complete a scoping re-
view on a given topic. However, without understanding
Understanding scoping reviews
electronic database search techniques, critique parameters,
and level of evidence, students would be highly challenged
to complete the processes required for a successful scoping
review. Completing a scoping review can also help stu-
dents to hone their knowledge regarding the diversity and
complexity of clinical problems.
Policy
Scoping review outcomes are often more narrative in
nature, and include tables of information that are not
overly endowed with p-values and statistical language.
Generally, this more narrative type of information is help-
ful for policy makers at any level. Examples include a re-
view done specifically to explore research related to public
deliberation and public health, and policy research specific
(Degeling, Carter, & Rychetnik, 2015). These authors com-
pleted a scoping review targeting reports that reflected de-
liberate integration in the research of citizens, consumers
experienced with the topic (e.g., particular diagnosis), or
advocates (e.g., individuals with special expertise in the
area of interest). Another example is that of authors who
completed a mixed method design study exploring the
concept of empowerment, with scoping review as one
form of the mixed method research (Bravo et al., 2015).
Research
A synthesized report of current research, especially if
a gap in knowledge is identified, provides an excellent
foundation for developing additional research or related
projects. For example, future research was recommended
as an outcome in relationship to a review focused on
15
Understanding scoping reviews
swallowing difficulties and the autonomic nervous system
in patients with Alzheimer’s disease (Affoo, Foley, Rosen-
bek, Kevin Shoemaker, & Martin, 2013). This is a good
example of a scoping review providing foundational infor-
mation necessary for proceeding with future research.
The use of scoping review methodology is well suited
to the practice, education, policy, and research issues rel-
evant to NPs. There is increasing use of this methodology
in nursing and other disciplines. Scoping review method-
ology is one of many methods available for NP scholarly
work. JAANP seeks to serve NPs and patient-centered care,
through sharing information to guide clinical practice and
improve quality of care by publishing articles covering a
wide array of topics and methods (JAANP, 2015). System-
atic reviews, such as what could be included in a scop-
ing review, would be an appropriate submission. Author
guidelines provide detailed instructions for inclusion of the
required information (JAANP, 2015).
Acknowledgments
All authors contributed substantially to this manuscript.
Conceptualization, development, and outline were com-
pleted by Drs. Pearce and Peterson. Search, retrieval, and
review of relevant literature, manuscript generation, edit-
ing and refining, and finalization and approval were com-
pleted by Drs. Peterson, Pearce, Ferguson, and Langford.
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