Getting to know the Knowledge and Evidence Specialists

Get to know your Knowledge and Evidence Specialists:

Maria- Maria has worked in Library and Knowledge Services for over 13 years, beginning her career as a Library Assistant at institutions including The British Library, the London School of Economics, and University College London. She joined Maidstone and Tunbridge Wells NHS Library and Knowledge Services in 2018. Her experience spans acute, public health, and mental health settings, including outreach work with the Public Health Team at Kent County Council and time as a Mental Health Librarian with Kent and Medway NHS and Social Care Partnership Trust. Maria has a particular interest in the use of artificial intelligence in healthcare and how emerging technologies can support evidence-based practice.

Nikki- Before joining MTW in 2024 Nikki worked as an Evidence Support Information Specialist at the British Medical Association in the Library and Archives team doing literature reviews and systematic review searches.  Prior to that she worked in a Ministry of Defence scientific research organisation as a Knowledge and Information Agent doing literature searches, database/Information Management/Knowledge Management training, looking after the MoD reports repository, editor of the organisation's wiki and managing communities of practice. Nikki has a particular interest in current awareness tools to help people keep up to date with the latest evidence. She is also keen to improve knowledge sharing across the organisation using the Knowledge Mobilisation framework and launched the inaugural Coffee Connect round at the end of last year. 

Mary- Mary completed her initial library training at the University of Oxford’s Bodleian Social Science library. After graduating from UCL with a Master’s degree in Library & Information Studies, she worked at the Templeman library at the University of Kent. She joined the NHS in 2022, working in the Library & Knowledge Services at East Kent Hospitals University NHS Foundation Trust, before coming to MTW in 2024. Her current professional interests include the impact of climate change on the NHS and the ways in which library services can support sustainability.

1. What is a Knowledge and Evidence Specialist?

From 1st April the Clinical Librarians will be changing job titles to Knowledge and Evidence Specialists. The core service will continue, but with a clearer evidence-focused identity. The services that we provide are all designed to support evidence-based decision making across the Trust. We also help with the acquisition of knowledge through services and resources provided through the Library and Knowledge Services.

More about why we have library services within healthcare settings can be found in the national NHS Knowledge & Library Services strategy.

2. How do we support evidence-based decision making?

We carry out literature and evidence searches for staff and learners across the Trust, whether clinical, managerial, research, business or operational decisions. Most decisions need an evidence base and that’s what we provide. Here are some examples of searches we have completed recently:

•     How organisations can mitigate the impact of cuts, mergers, and similar disruptions
•     How artificial intelligence is being used in recruitment processes
•     The use of Zoomorphic robots for mental health and wellbeing
•     Forensic service models and interventions for autism
•     Laboratory predictors of venous thromboembolism in high-risk cancers
•     The use of AI tools for sleep disturbances 

Having high-quality evidence can support decisions by ensuring that changes are effective, safe and cost-effective. Whilst staff often don’t have the time to gather and sift through evidence themselves, the Knowledge and Evidence Specialists can present a report with high-quality, available evidence to support decisions. We can also help identify evidence gaps to support research applications.

If you would like to request an evidence search, please fill out our online form

3. Who can use this service?

We support all staff groups—clinical, non-clinical, corporate, trainees, AHPs, nursing, medical, students and learners.

No prior knowledge of research or searching is needed.

5. How can you work with us to save you time?

The Knowledge and Evidence Specialists have expert searching skills which speeds up the gathering of evidence. The Evidence Specialists know how to navigate complex medical databases and where to look for the right information for your query. We also have expertise in developing robust search strategies. Search quality improves the decision-making process. 

An average search can take up to 4 hours, whilst a more complex search can take days to gather all relevant evidence. This is a big time saving for staff.

6. What training do we offer?

We also offer a range of training sessions to support with information literacy skills and staff development. These include:

• Evidence Searching
• Critical Appraisal
• Study Skills
• Health Literacy
• Beyond the Databases
• Getting Research Published
• An Introduction to AI in Healthcare

Getting started with Copilot

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Sessions are bookable on MTW Learning or iLearn (for KMMH staff). Or we also can provide 1-1 training or training delivered to a team.

7. What else do we provide?

Evidence searches and training sessions are a large part of what we deliver, but it’s not all we do. Here are some other services that we provide:

• Current awareness and evidence updates
• Knowledge mobilisation support
• Staff research repository 
• Help with referencing, research design or publication processes
• Journal club support

For more information on Knowledge and Evidence Specialists, please see our website Knowledge and evidence specialist services | Website 

To contact us, email mtw-tr.evidence.specialists@nhs.net 

 

Access BMJ Best Practice with your NHS email

 

Is is now easier than ever for you to access BMJ Best Practice.

You can log in instantly using your NHS email, giving you fast, reliable access to evidence based answers whenever you need them

Why this matters?

• Offline access: Use the app anywhere, even with limited connectivity
• Trusted guidance: Clear, evidence‑based recommendations
• Practical support: Short videos, microcontent and podcasts

How to access the app

All NHS staff and learners have free access to BMJ Best Practice

1. Download the 'BMJ Best Practice' app.

2. Select 'Access through your institution' button.

3. Create your profile: Enter your NHS email address, set a password for your account and verify your email address (if you already have a profile with this email, you will be redirected to log in)

4. Stay on screen until the download completes — you're ready to go!

Important notes:

Verification: You must have access to your NHS inbox to complete the registration

What's included in your subscription?

• Differential diagnosis tables and treatment algorithms
• Videos of the most common clinical procedures
• Offline access
• More than 250 integrated medical calculators
• 380+ patient leaflets
• Ability to download CME/CPD certificates

Want to get the most out of BMJ Best Practice? Book onto one of their free 30 minute training sessions 

Subject Headings explained: Unlock the secret language of the databases

 

We have all been there. You type a perfectly reasonable search into one of the medical databases, hit enter, and find yourself overwhelmed by thousands of irrelevant database results — or frustrated that a search returns almost nothing. Something is going wrong — but what?

The answer is that you're speaking a different language from the database. Medical databases aren't like Google. They aren't built to interpret natural language and guess what you mean. They're built around a precise, controlled vocabulary — and unless you know how to use it, you can leave the best evidence buried.

This post will walk you through subject headings: what they are, why they exist, how to find the right ones, and how to use them to make your searches more comprehensive.

What Are Subject Headings?

Every article indexed in a medical database is read by a trained indexer — a human expert who assigns standardised labels to describe what that article is about. These labels are called subject headings, and they come from a fixed, carefully maintained list of approved terms.

Different databases use different systems:

Think of it like a library catalogue. If every librarian labelled books differently — one calling it "heart attack," another "myocardial infarction," another "MI" — finding everything on the topic would be more difficult. Subject headings solve this by insisting that every article about a heart attack gets the same tag, no matter what term the authors use.

All those terms — heart attack, MI, coronary thrombosis, cardiac infarction — feed into a single subject heading. Search the heading, and you capture them all.

Subject Headings vs. Keywords: What's the Difference?

A keyword search asks: "does this word appear somewhere in the article?"
A subject heading search asks: "was this article tagged as being about this concept?" These are very different questions.

Keywords (sometimes called free-text or text words) search for the word you type — in the title, abstract, or sometimes the full text. They are flexible and can pick up new terminology, but if you miss a synonym, you miss the evidence.

Subject headings search the controlled vocabulary tags assigned by the indexer. They're consistent, precise, and enormously powerful — but they require you to know the right heading to use.

***TOP TIP*** For a thorough search — especially a systematic review or comprehensive literature review — always use both subject headings and keywords together. Subject headings give you comprehensiveness; keywords catch what the subject headings miss. Combining both in a single search is the gold standard approach recommended and practiced by Information Specialists.

How to Find the Right Subject Heading

The good news: you don't have to memorise every single subject heading. Every database has a built-in thesaurus tool to help you find the right heading for your concept.

Step 1: Use the thesaurus or index tool

In Ovid MEDLINE or Ovid Embase, there's a dedicated Map Term to Subject Heading feature, or you can use the Term Finder tool.

                  

In CINAHL via EBSCOhost, use the CINAHL Headings browser. In PubMed, go to the MeSH Database (found under "Explore" in the menu). Type your concept in plain language and let the system suggest headings.

Step 2: Read the scope note

Every subject heading comes with a scope note — a brief definition explaining exactly what it covers and, crucially, what it does not cover. Always read this. It tells you whether a heading matches your concept or whether you need a different one (or several). It is also a good place to find alternative keywords

Step 3: Check the entry terms

Entry terms (sometimes called "see also" terms) are all the synonyms and variant terms that map onto this heading. If you can see your keyword in the entry terms list, you know you've found the right heading.

Step 4: Look at the tree structure

Subject headings exist within a hierarchy — a branching tree from the very broad down to the very specific. Viewing the tree shows you what sits above your heading (broader concepts) and below it (more specific ones). This is invaluable for deciding how wide or narrow you want your search to be.

Step 5: Test with a known article

If you have a highly relevant article already, look at its subject headings in the database record. This is an excellent way to verify you have the right heading and often reveals additional headings you hadn't considered.

Broadening and Narrowing Your Search

One of the most powerful features of subject headings is the ability to control the scope of your search with surgical precision. You can deliberately cast a wider or narrower net depending on what your research question demands.

Exploding a heading — to broaden

Most databases allow you to "explode" a subject heading, which means your search automatically includes that heading and all the narrower terms beneath it in the hierarchy. This is enormously useful when you want to be comprehensive.

By exploding "Antidepressant Agent," a single subject heading retrieves articles about all antidepressants — including specific drugs — without you needing to list them individually. This is far more reliable than trying to think of every synonym yourself.

Focusing a heading — to narrow further

In some databases, particularly those using the Ovid interface, you can "focus" a subject heading (often marked with an asterisk, e.g. *Hypertension). This restricts results to articles where that heading is considered a major topic — meaning the article is primarily about that concept, rather than merely mentioning it in passing. This is useful when precision matters more than comprehensiveness.

Subheadings (qualifiers) — to narrow

Subject headings can be refined using subheadings (also called qualifiers) — these are standard modifiers that specify a particular aspect of the topic. When you select a subject heading, the database will typically offer you a menu of relevant subheadings to apply.

Common subheadings include:

• /drug therapy - treatment with medications, e.g. Hypertension/drug therapy retrieves only articles about treating hypertension with drugs
• /diagnosis - diagnostic aspects, e.g. Depression/diagnosis focuses on identifying and diagnosing depression

• /surgery - surgical treatment, e.g. Breast Neoplasms/surgery limits to surgical management of breast cancer
• /prevention & control – preventive measures
• /epidemiology - incidence, prevalence, distribution
• /adverse effects - unwanted effects of an intervention

Applying a subheading dramatically reduces noise while retaining highly relevant results.

The tree structure works in both directions. If your search is returning too little, move up the tree to a broader heading and explode it. If you're drowning in results, move down the tree to a more specific heading, or add a subheading to constrain the aspect you care about.

 

Differences Between Databases 

It's tempting, once you've learned MeSH, to assume the same headings will work in Embase or CINAHL. They won't — not exactly. Each database has its own vocabulary, and the headings, though often similar in concept, differ in terminology, hierarchy, and scope.

Embase's Emtree tends to have more granular terms for drugs and pharmacological interventions — useful if your search involves specific medications. CINAHL Headings include terms specific to nursing practice, patient care, and allied health that don't always exist in MeSH. If you are using multiple databases, you will need to translate your strategy into each database's own vocabulary. This can take some time but is a mark of a rigorous, comprehensive search.

Where to get help

if you need help contact the Clinical Librarians for help – we know the quirks of each thesaurus and can translate strategies reliably between databases.

Email: mtw-tr.clinical.librarians@nhs.net