title: Do Cochrane summaries help student midwives understand the findings of Cochrane systematic reviews: the BRIEF randomised trial.
abstract: BACKGROUND
  Abstracts and plain language summaries (PLS) are often the first, and sometimes the only, point of contact between readers and systematic reviews. It is important to identify how these summaries are used and to know the impact of different elements, including the authors' conclusions. The trial aims to assess whether (a) the abstract or the PLS of a Cochrane Review is a better aid for midwifery students in assessing the evidence, (b) inclusion of authors' conclusions helps them and (c) there is an interaction between the type of summary and the presence or absence of the conclusions.
  
  
  METHODS
  Eight hundred thirteen midwifery students from nine universities in the UK and Ireland were recruited to this 2 × 2 factorial trial (abstract versus PLS, conclusions versus no conclusions). They were randomly allocated to one of four groups and asked to recall knowledge after reading one of four summary formats of two Cochrane Reviews, one with clear findings and one with uncertain findings. The primary outcome was the proportion of students who identified the appropriate statement to describe the main findings of the two reviews as assessed by an expert panel.
  
  
  RESULTS
  There was no statistically significant difference in correct response between the abstract and PLS groups in the clear finding example (abstract, 59.6 %; PLS, 64.2 %; risk difference 4.6 %; CI -0.2 to 11.3) or the uncertain finding example (42.7 %, 39.3 %, -3.4 %, -10.1 to 3.4). There was no significant difference between the conclusion and no conclusion groups in the example with clear findings (conclusions, 63.3 %; no conclusions, 60.5 %; 2.8 %; -3.9 to 9.5), but there was a significant difference in the example with uncertain findings (44.7 %; 37.3 %; 7.3 %; 0.6 to 14.1, p = 0.03). PLS without conclusions in the uncertain finding review had the lowest proportion of correct responses (32.5 %). Prior knowledge and belief predicted student response to the clear finding review, while years of midwifery education predicted response to the uncertain finding review.
  
  
  CONCLUSIONS
  Abstracts with and without conclusions generated similar student responses. PLS with conclusions gave similar results to abstracts with and without conclusions. Removing the conclusions from a PLS with uncertain findings led to more problems with interpretation.
authors.affiliation: School of Nursing and Midwifery, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7BL, UK. f.a.alderdice@qub.ac.uk.
authors.forename: Fiona
authors.initials: F
authors.lastname: Alderdice
authors.affiliation: School of Nursing and Midwifery, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7BL, UK. j.mcneill@qub.ac.uk.
authors.forename: Jenny
authors.initials: J
authors.lastname: McNeill
authors.affiliation: Cochrane Editorial Unit, St Albans House, 57-59 Haymarket, London, SW1Y 4QX, UK. tlasserson@cochane.org.
authors.forename: Toby
authors.initials: T
authors.lastname: Lasserson
authors.affiliation: Bond University Queensland, Robina, QLD, 4229, Australia. ebeller@bond.edu.au.
authors.forename: Elaine
authors.initials: E
authors.lastname: Beller
authors.affiliation: School of Nursing, Trinity College Dublin, 24 D`Olier Street, Dublin, Ireland. carolol@tcd.ie.
authors.forename: Margaret
authors.initials: M
authors.lastname: Carroll
authors.affiliation: School of Health and Social Care, Bournemouth University, Royal London House R118, Christchurch Road, Bournemouth, BH1 3LT, UK. vhundley@bournemouth.ac.uk.
authors.forename: Vanora
authors.initials: V
authors.lastname: Hundley
authors.affiliation: School of Health Sciences, City University London, Northampton Square, London, EC1V 0HB, UK. J.sunderland@city.ac.uk.
authors.forename: Judith
authors.initials: J
authors.lastname: Sunderland
authors.affiliation: Nursing & Midwifery Studies, Aras Moyola, National University of Ireland Galway, Galway, Ireland. Declan.devane@nuigalway.ie.
authors.forename: Declan
authors.initials: D
authors.lastname: Devane
authors.affiliation: School of Social Sciences, Bangor University, Bangor, LL57 2DG, Gwynedd, UK. jane.noyes@bangor.ac.uk.
authors.forename: Jane
authors.initials: J
authors.lastname: Noyes
authors.affiliation: School of Nursing and Midwifery and Social Care, Faculty of Health Sciences and Medicine, Edinburgh Napier University, Sighthill Court, Edinburgh, EH11 4BN, UK. S.Key@napier.ac.uk.
authors.forename: Susan
authors.initials: S
authors.lastname: Key
authors.affiliation: Department of Interprofessional Health Studies, College of Human and Health Sciences, Swansea University, Swansea, SA2 8PP, UK. S.E.Norris@swansea.ac.uk.
authors.forename: Sarah
authors.initials: S
authors.lastname: Norris
authors.affiliation: Faculty of Health Sport and Science, University of South Wales, Pontypridd, South Wales, CF3 71DL, UK. Janine.wyn-davies@southwales.ac.uk.
authors.forename: Janine
authors.initials: J
authors.lastname: Wyn-Davies
authors.affiliation: School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK. m.clarke@qub.ac.uk.
authors.forename: Mike
authors.initials: M
authors.lastname: Clarke
mesh_terms: D000043:Abstracting and Indexing; D000328:Adult; D032882:Comprehension; D004506:Education, Nursing / Q000379:methods*; D005260:Female; D006801:Humans; D007494:Ireland; D008297:Male; D011939:Mental Recall; D008880:Midwifery / Q000193:education*; D011897:Random Allocation; D012196:Review Literature as Topic; D013338:Students, Nursing; D006113:United Kingdom; D055815:Young Adult