The Cumulative Index to Nursing and Allied Health Literature or CINAHL has a substantial history. Originating from a 1940s card index and first becoming available online in the 1980s, it has undergone many metamorphoses. In 2003 it was acquired by EBSCO Publishing, but CINAHL remained available through several commercial interfaces, including OVID and Proquest, until it was made exclusively available on the EBSCOhost Platform in 2006. Today, it is aimed at hospital libraries and healthcare programmes in academic institutions and is available in four versions, two with selected full text. “Plus” versions offer extra content such as Evidence‐Based Care Sheets, Quick Lessons and cited reference functionality. Reviews of these features rate them as useful but purely supplementary. Users are well supported online and through other means. At the time of writing, EBSCO were conducting international WebEx training on searching CINAHL as well as the customisation options and individual account functionalities.
On its web site the CINAHL Criteria tells us little about the content but the site provides title lists with coverage for each version (in PDF, Excel or HTML); these include the “start” and “stop” dates for full text content and should be scrutinised if purchasing considerations include the extent of availability of specific titles. In my experience, the “Full Text” label causes some confusion with users. The maximum proportion of full text content in the “Full Text” versions is around 20 percent. Coverage starts with a scattering of content dating back to 1937. New content is added weekly. CINAHL says it includes a broad spectrum of document types from journal articles to audiovisual material and research instruments. Although this may be the case, when using CINAHL for routine clinical search queries in my library (public hospital) I rarely come across material other than content sourced from journals. The item format is also indexed (e.g. review, letter). The item type is listed with each result along with the citation details (e.g. journal article – research, journal article – case study) and content has been indexed using CINAHL subject headings and topical subheadings. The CINAHL headings follow the structure of the National Library of Medicine's Medical Subject Headings (MeSH).
For libraries that previously had access to CINAHL through the OVID interface, moving to EBSCOhost has caused some frustrations. The general consensus seems to be that searching using CINAHL subject headings is not facilitated by EBSCO's interface. Similar to OVID, the EBSCOhost interface offers basic (word matching) and advanced search options. The advanced search mode allows for complex search building including use of Boolean operators, truncation and proximity searches, as well as a range of limits and filter options. EBSCO has also included a flash‐based visual search option that allows users to manage results interactively through a novel graphic display.
My organization's CINAHL account has the Advanced Search and Suggest Subject Terms activated but otherwise relies on default settings. We access via a statewide subscription with limited customisation options. EBSCOhost does enable individual accounts so that users can set up and customise their own interface but they will have to log in for access. In many cases staff do not know this or find it quicker to search using the main account. Given the opportunity, we would set the search screen default to show the search history. The single most confounding issue for our CINAHL users is the search history not defaulting to Expanded View in Advanced Search mode. Adding to the confusion, the Advanced Search (unlike OVID which presents a single search box in advanced mode) offers three lines of search boxes. It is arguable that this setup allows users to visualise a Boolean search better and to search specific fields using the drop down list for each term. It may also target a more appropriate CINAHL heading. However, this “layered” appearance may trick users into believing they are viewing the search history and frustrate them when they wish to combine CINAHL headings. Other display options that users may wish to manage themselves are all limits options appearing on the initial search screen. The concern here is that users may be tempted to apply them immediately, when they might be better used once initial results have been appraised.
Despite these issues, most people would find it a friendly‐looking screen, with rounded edges and icons in keeping with online trends. EBSCO has also tried to keep search options for subject headings appearing on the same screen, providing a “breadcrumb trail” to help users see where they are in an Advanced Search.
For a multidisciplinary topic or less exhaustive nursing search is my library's preference as there is considerable content overlap with CINAHL. Although I was unable to source exact figures on this, both databases cover the nursing and allied health journal literature; however CINAHL indexes some additional journals and other peripheral content. Other comparable products are OVID's Nursing@OVID and Elsevier's Mosby's Index. Mosby's is the nearest match in terms of titles indexed (CINAHL Plus 4556 to Mosby's 3,000+ and OVID 400+) but the number of peer‐reviewed titles is much higher in CINAHL. Interestingly though, a 2009 comparison I was involved in found that Mosby's included an abstract with 68 percent of entries compared to 33 percent in CINAHL (Shipperlee et al., 2009).
For managing results, EBSCOhost uses a virtual folder system. Individual results or batches of up to 50 can be selected and added to a folder. Folder View then allows further culling before the final selection are exported or saved. Export options are to print, email, save as file or export (to bibliographic management program, XML, BibTeX or MARC21 format). In personal accounts users can create auto‐alerts and save, notate and share search folders. When emailing search results the search history can be included with the result set, but it is sent as an attachment. I prefer OVID's e‐mails which place the search history as an introduction to the results. In terms of providing a demonstration and/or evidence of strategy for reference, the history should clearly visible.
Adding to EBSCO's supporting material, a quick internet search on “searching CINAHL” will reveal links to tutorials, handouts and even YouTube training videos created by hospital and university libraries everywhere. In terms of teaching notes, instructions, etc. there is no equivalent nursing/allied health resource. And as we know, EBSCO has ensured this is also the case for content.
CINAHL is an essential resource for health care and education libraries, but, to be used to its full potential, it does require users to undergo a significant learning curve; as do most databases with advanced search capabilities. Fortunately librarians are (for now) still around to guide this.
