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How to Conclude a Literature Review

By Laura Brown on 6th March 2019

The conclusion of the dissertation literature review focuses on a few critical points,

  • Highlight the essential parts of the existing body of literature in a concise way.
  • Next, you should analyse the current state of the reviewed literature .
  • Explain the research gap for your chosen topic/existing knowledge.
  • Now, outline the areas for future study by mentioning main agreements and disagreements in the literature.
  • Finally, link the research to existing knowledge .

Now, any of you who have been into research would agree that literature review is a very exhausting process and may stress you during your academic career. It is tougher because it requires you to be organised. We have seen many students asking does a literature review need a conclusion.

Well, the answer is simple, a good literature review will always have a proper ending. But there is nothing to worry about how to write a conclusion for a literature review. Here is a complete guide for you in “four” simple yet convenient steps. These steps can really be valuable in providing an excellent presentation to your literature review help . Furthermore, you can ask us for literature review conclusion examples anytime using our live chat or email option.

Now, without further ado, let’s move towards the steps.

How To Write A Literature Review Conclusion

Simple Steps To Conclude A Literature Review

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Here are four major steps which can help you with how to conclude a literature review with ease.

1. Enlist Key Points

The conclusion can also be said as judgement because it gives a clear view of your work, whether you achieved your targeted objectives or not. Typically, it is not too difficult to conclude a review, but it can be challenging as well if not carried out properly.

It is crucial to find key features which should be engaging and useful as well for a reader. So at first, draft or enlist key factors before moving forward towards initialising your summary.

2. Summarise The Key Features Briefly

This is a most sensitive and important step of a dissertation literature review conclusion, where you should stick to the following things to get the job done efficiently.

  • Once you are done drafting the important points , here you should mention them briefly.
  • You can also take the liberty to agree or disagree with whatever literature you have gone through.
  • Make sure you don’t drag your arguments while counter-arguing. Keeping your points specific is key.
  • Describe, in one to two lines, how you addressed the previously identified gap .
  • It is also important to point out the lapses you have noticed in previous authors’ work. Those lapses could be a misquotation of figures, a wrong pattern of research and so on.
  • Alongside this, discuss existing theories and methods to build a framework for your research.

3. Educational Implications Of The Reviewed Literature

After mentioning the key factors, it is suggested to put implications to the already reviewed research. Like, as identifying problems in the already done research and giving recommendations on how these problems can be resolved.

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4. Indicating Room For Future Research

After completing the whole analysis of the particular research, you will be capable of identifying the work which can be done in future. You can also leave some gaps for future researchers so others can extend your work. This will be the final step, and this is how to end a literature review.

Tips That Can Enlighten Your Conclusion

Tips That Can Make A Good Literature Review Conclusion

We hope that things are very clear to you on how to write a conclusion for a literature review. If you want it to be even better and more meaningful, then you should keep the below points in mind.

  • It should not be burdened with an unnecessary chain of details.
  • It should be as precise and easy to understand as possible.
  • You should mention important key points and findings .
  • Make sure to put all points in a flow so the reader can understand your research in one go.
  • Do not add anything from your own.

“Simply put, touch the prominent factors and leave them unexplained here”.

Get Help to Conclude Your Literature Review

If you are able to keep your focus around these steps and mentioned points, believe us, you will never ask anyone how to conclude literature review.

Looking At Literature Review Conclusion Example

Below are three examples which will help you understand how to conclude a literature review.

1. Firstly, you should summarise the important aspects and evaluate the current state of the existing literature.

Overall, the findings from this literature review highlight the need for further research to address the gaps in knowledge on the effectiveness of mindfulness-based interventions for reducing symptoms of anxiety and depression in college students.

2. Now, along with mentioning the gaps, come up with your approach to future study.

Therefore, to address this gap in the literature, we incorporated larger and more diverse samples, used standardised measures of mindfulness and mental health outcomes, and included longer follow-up periods to assess the long-term effects of mindfulness-based interventions on anxiety and depression.

3. Now summarise on how your findings will contribute to the particular field by linking it to the existing knowledge.

The findings from the study will provide important insights for researchers, clinicians, and educators interested in developing and implementing effective interventions to promote mental health and well-being among college students, and highlight the need for further research to establish the effectiveness of mindfulness-based interventions in this population.

We hope that these examples will bring in more clarification and you can have a better idea about the literature review conclusion.

What basically is a literature review?

What are the 3 primary parts of a literature review, what are the goals of writing a literature review.

There are four primary objectives of writing a literature review:

1. Determining the background from the previous scholarly literature related to the topic.

2. Identifying the gaps between literature to boost further research.

3. Analysing if the theory is applicable and associating a suitable methodology.

Why is a literature review conclusion necessary?

  • https://azhin.org/cummings/basiclitreview/conclusions
  • https://www.citewrite.qut.edu.au/write/writing-well/litreview.html
  • https://psychology.ucsd.edu/undergraduate-program/undergraduate-resources/academic-writing-resources/writing-research-papers/writing-lit-review.html
  • https://students.unimelb.edu.au/academic-skills/resources/report-writing/reviewing-the-literature

Laura Brown

Laura Brown, a senior content writer who writes actionable blogs at Crowd Writer.

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  • How to Write a Literature Review | Guide, Examples, & Templates

How to Write a Literature Review | Guide, Examples, & Templates

Published on January 2, 2023 by Shona McCombes . Revised on September 11, 2023.

What is a literature review? A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research that you can later apply to your paper, thesis, or dissertation topic .

There are five key steps to writing a literature review:

  • Search for relevant literature
  • Evaluate sources
  • Identify themes, debates, and gaps
  • Outline the structure
  • Write your literature review

A good literature review doesn’t just summarize sources—it analyzes, synthesizes , and critically evaluates to give a clear picture of the state of knowledge on the subject.

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Table of contents

What is the purpose of a literature review, examples of literature reviews, step 1 – search for relevant literature, step 2 – evaluate and select sources, step 3 – identify themes, debates, and gaps, step 4 – outline your literature review’s structure, step 5 – write your literature review, free lecture slides, other interesting articles, frequently asked questions, introduction.

  • Quick Run-through
  • Step 1 & 2

When you write a thesis , dissertation , or research paper , you will likely have to conduct a literature review to situate your research within existing knowledge. The literature review gives you a chance to:

  • Demonstrate your familiarity with the topic and its scholarly context
  • Develop a theoretical framework and methodology for your research
  • Position your work in relation to other researchers and theorists
  • Show how your research addresses a gap or contributes to a debate
  • Evaluate the current state of research and demonstrate your knowledge of the scholarly debates around your topic.

Writing literature reviews is a particularly important skill if you want to apply for graduate school or pursue a career in research. We’ve written a step-by-step guide that you can follow below.

Literature review guide

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Writing literature reviews can be quite challenging! A good starting point could be to look at some examples, depending on what kind of literature review you’d like to write.

  • Example literature review #1: “Why Do People Migrate? A Review of the Theoretical Literature” ( Theoretical literature review about the development of economic migration theory from the 1950s to today.)
  • Example literature review #2: “Literature review as a research methodology: An overview and guidelines” ( Methodological literature review about interdisciplinary knowledge acquisition and production.)
  • Example literature review #3: “The Use of Technology in English Language Learning: A Literature Review” ( Thematic literature review about the effects of technology on language acquisition.)
  • Example literature review #4: “Learners’ Listening Comprehension Difficulties in English Language Learning: A Literature Review” ( Chronological literature review about how the concept of listening skills has changed over time.)

You can also check out our templates with literature review examples and sample outlines at the links below.

Download Word doc Download Google doc

Before you begin searching for literature, you need a clearly defined topic .

If you are writing the literature review section of a dissertation or research paper, you will search for literature related to your research problem and questions .

Make a list of keywords

Start by creating a list of keywords related to your research question. Include each of the key concepts or variables you’re interested in, and list any synonyms and related terms. You can add to this list as you discover new keywords in the process of your literature search.

  • Social media, Facebook, Instagram, Twitter, Snapchat, TikTok
  • Body image, self-perception, self-esteem, mental health
  • Generation Z, teenagers, adolescents, youth

Search for relevant sources

Use your keywords to begin searching for sources. Some useful databases to search for journals and articles include:

  • Your university’s library catalogue
  • Google Scholar
  • Project Muse (humanities and social sciences)
  • Medline (life sciences and biomedicine)
  • EconLit (economics)
  • Inspec (physics, engineering and computer science)

You can also use boolean operators to help narrow down your search.

Make sure to read the abstract to find out whether an article is relevant to your question. When you find a useful book or article, you can check the bibliography to find other relevant sources.

You likely won’t be able to read absolutely everything that has been written on your topic, so it will be necessary to evaluate which sources are most relevant to your research question.

For each publication, ask yourself:

  • What question or problem is the author addressing?
  • What are the key concepts and how are they defined?
  • What are the key theories, models, and methods?
  • Does the research use established frameworks or take an innovative approach?
  • What are the results and conclusions of the study?
  • How does the publication relate to other literature in the field? Does it confirm, add to, or challenge established knowledge?
  • What are the strengths and weaknesses of the research?

Make sure the sources you use are credible , and make sure you read any landmark studies and major theories in your field of research.

You can use our template to summarize and evaluate sources you’re thinking about using. Click on either button below to download.

Take notes and cite your sources

As you read, you should also begin the writing process. Take notes that you can later incorporate into the text of your literature review.

It is important to keep track of your sources with citations to avoid plagiarism . It can be helpful to make an annotated bibliography , where you compile full citation information and write a paragraph of summary and analysis for each source. This helps you remember what you read and saves time later in the process.

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To begin organizing your literature review’s argument and structure, be sure you understand the connections and relationships between the sources you’ve read. Based on your reading and notes, you can look for:

  • Trends and patterns (in theory, method or results): do certain approaches become more or less popular over time?
  • Themes: what questions or concepts recur across the literature?
  • Debates, conflicts and contradictions: where do sources disagree?
  • Pivotal publications: are there any influential theories or studies that changed the direction of the field?
  • Gaps: what is missing from the literature? Are there weaknesses that need to be addressed?

This step will help you work out the structure of your literature review and (if applicable) show how your own research will contribute to existing knowledge.

  • Most research has focused on young women.
  • There is an increasing interest in the visual aspects of social media.
  • But there is still a lack of robust research on highly visual platforms like Instagram and Snapchat—this is a gap that you could address in your own research.

There are various approaches to organizing the body of a literature review. Depending on the length of your literature review, you can combine several of these strategies (for example, your overall structure might be thematic, but each theme is discussed chronologically).

Chronological

The simplest approach is to trace the development of the topic over time. However, if you choose this strategy, be careful to avoid simply listing and summarizing sources in order.

Try to analyze patterns, turning points and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred.

If you have found some recurring central themes, you can organize your literature review into subsections that address different aspects of the topic.

For example, if you are reviewing literature about inequalities in migrant health outcomes, key themes might include healthcare policy, language barriers, cultural attitudes, legal status, and economic access.

Methodological

If you draw your sources from different disciplines or fields that use a variety of research methods , you might want to compare the results and conclusions that emerge from different approaches. For example:

  • Look at what results have emerged in qualitative versus quantitative research
  • Discuss how the topic has been approached by empirical versus theoretical scholarship
  • Divide the literature into sociological, historical, and cultural sources

Theoretical

A literature review is often the foundation for a theoretical framework . You can use it to discuss various theories, models, and definitions of key concepts.

You might argue for the relevance of a specific theoretical approach, or combine various theoretical concepts to create a framework for your research.

Like any other academic text , your literature review should have an introduction , a main body, and a conclusion . What you include in each depends on the objective of your literature review.

The introduction should clearly establish the focus and purpose of the literature review.

Depending on the length of your literature review, you might want to divide the body into subsections. You can use a subheading for each theme, time period, or methodological approach.

As you write, you can follow these tips:

  • Summarize and synthesize: give an overview of the main points of each source and combine them into a coherent whole
  • Analyze and interpret: don’t just paraphrase other researchers — add your own interpretations where possible, discussing the significance of findings in relation to the literature as a whole
  • Critically evaluate: mention the strengths and weaknesses of your sources
  • Write in well-structured paragraphs: use transition words and topic sentences to draw connections, comparisons and contrasts

In the conclusion, you should summarize the key findings you have taken from the literature and emphasize their significance.

When you’ve finished writing and revising your literature review, don’t forget to proofread thoroughly before submitting. Not a language expert? Check out Scribbr’s professional proofreading services !

This article has been adapted into lecture slides that you can use to teach your students about writing a literature review.

Scribbr slides are free to use, customize, and distribute for educational purposes.

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If you want to know more about the research process , methodology , research bias , or statistics , make sure to check out some of our other articles with explanations and examples.

  • Sampling methods
  • Simple random sampling
  • Stratified sampling
  • Cluster sampling
  • Likert scales
  • Reproducibility

 Statistics

  • Null hypothesis
  • Statistical power
  • Probability distribution
  • Effect size
  • Poisson distribution

Research bias

  • Optimism bias
  • Cognitive bias
  • Implicit bias
  • Hawthorne effect
  • Anchoring bias
  • Explicit bias

A literature review is a survey of scholarly sources (such as books, journal articles, and theses) related to a specific topic or research question .

It is often written as part of a thesis, dissertation , or research paper , in order to situate your work in relation to existing knowledge.

There are several reasons to conduct a literature review at the beginning of a research project:

  • To familiarize yourself with the current state of knowledge on your topic
  • To ensure that you’re not just repeating what others have already done
  • To identify gaps in knowledge and unresolved problems that your research can address
  • To develop your theoretical framework and methodology
  • To provide an overview of the key findings and debates on the topic

Writing the literature review shows your reader how your work relates to existing research and what new insights it will contribute.

The literature review usually comes near the beginning of your thesis or dissertation . After the introduction , it grounds your research in a scholarly field and leads directly to your theoretical framework or methodology .

A literature review is a survey of credible sources on a topic, often used in dissertations , theses, and research papers . Literature reviews give an overview of knowledge on a subject, helping you identify relevant theories and methods, as well as gaps in existing research. Literature reviews are set up similarly to other  academic texts , with an introduction , a main body, and a conclusion .

An  annotated bibliography is a list of  source references that has a short description (called an annotation ) for each of the sources. It is often assigned as part of the research process for a  paper .  

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Concluding Your Literature Review

conclusion of literature review

In the previous blogs, we talked about  searching and assessing reference papers for your literature review , and shared  tips on organising and writing the content . Let’s look now at how to conclude your literature review.

One of the aims of writing the literature review is to define the purpose and contribution of your own study. Your review should therefore cover the points listed below to provide the rationale or justification for your study:

⦁ gaps in the research

⦁ limitations of previous studies

⦁ weaknesses or lack of support for existing theories

conclusion of literature review

Quick Takeaways:

  • et al.' means 'and others'.
  • Use 'et al.' to cite works with three or more authors.
  • The presentation (et al., et al., or rarely et al) depends on the style guide or journal guidelines

The English language has a rich history of borrowing words from other languages, especially from Latin. Latin abbreviations such as ‘a.m.’, ‘p.m.’ and ‘CV’ have become part of our everyday vocabulary. Such abbreviations are also frequently used in academic writing, from the ‘Ph.D.’ in the affiliation section to the ‘i.e.’, ‘e.g.’, ‘et al.’, and ‘QED’ in the rest of the paper.

This guide explains when and how to correctly use ‘et al.’ in a research paper.

In this guide:

  • 1) Meaning of ‘et al.’
  • a) Table: Correct use of ‘et al.’ by style guide
  • b) Unusual scenarios

Filling a Gap is Not a Rationale in itself

You need to state clearly what your study intends to achieve and why it is important.

It is not sufficient to simply say something like, “there is a gap in the research or literature”.  Your readers might think that the gap exists only because there is no reason to fill such gap.

Then what should you consider including in the conclusion of your literature review?

1. Purpose or Objective of Your Study

First, you must be clear about what the purpose or objective of your study is. For example, you need to make it clear whether your study:

⦁ is designed to answer a specific  question  or solve a specific  problem

⦁ is an experimental study looking for a  cause and effect  relationship

⦁ is a correlational study looking for  relationships between variables

⦁ compares different clinical or psychological  treatments or interventions

⦁ presents a  new technique  or an adaptation of an existing one

⦁ is a  meta-analysis  or  review  of previous studies

2. Significance of your Study

Try to be specific about the significance of your study and have a clear idea about what or who will benefit from it.

To give you some examples, a benefit might include:

⦁ advancing an existing theory or developing a new one

⦁ providing a new technique that will benefit future researchers

⦁ presenting a new material or product, or refining an existing one that will benefit industry

⦁ proposing a treatment or intervention that will aid clinicians and patients

⦁ providing evidence that can be used to improve government policy-making

Steps to Writing your Literature Review Conclusion

It is important to remember that the conclusion only needs to be a few sentences long. So, do not write too much.

You can follow the steps and adapt the sample expressions listed below:

Step #1: Start with a sentence to highlight the research gap

You may consider using one of these examples:

Despite the aforementioned theoretical inferences, no study to date has provided empirical support for the hypothesized effects

Step #2: State what you did to address the problem

Try using a sentence similar to one of these:

Therefore, in a series of experiments, we explored the direct effects of a on b and c, and tested whether m had a moderating influence on these effects

Step #3: Summarise how the findings will contribute to theory and/or practice

You may consider writing in one of these ways:

The results not only provide support for the theory, but also have practical implications for industry and government decision makers

Confirmation of the suitability of the intervention in this population will provide an alternative choice of treatment for this condition, which will benefit both patients and clinicians.

Putting those sample expressions together, we have the following example literature review conclusions.

“Given the lack of evidence for the applicability of this psychological intervention in Asian populations, we conducted a randomised control trial with a sample of patients who attended the clinic at ABC Hospital. Confirmation of the suitability of the intervention in this population will provide an alternative choice of treatment for this condition, which will benefit both patients and clinicians.”

But, always remember that the wording you use will differ depending on the nature of your study.

And no matter how different the wording you use is, the fundamental elements of this summary should not change, you must cover the following:

⦁ make clear the research gap

⦁ explain how you set out to address the problem

⦁ and why it was important to do so

QUICK ASIDE

Wondering why some abbreviations such as ‘et al.’ and ‘e.g.’ use periods, whereas others such as CV and AD don’t? Periods are typically used if the abbreviations include lowercase or mixed-case letters. They’re usually not used with abbreviations containing only uppercase letters.

Unusual Scenarios

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The response to our workshop, which included a constructive and insightful Q&A session, was very positive.Drawing on our extensive experience working with hundreds of Hong Kong researchers targeting the GRF and ECS every year, we used examples of poor and subsequently improved proposals to show the attendees how they can make their applications stand out. The response to our workshop, which included a constructive and insightful Q&A session, was very positive.Drawing on our extensive experience working with hundreds of Hong Kong researchers targeting the GRF and ECS every year, we used examples of poor and subsequently improved proposals to show the attendees how they can make their applications stand out. The response to our workshop, which included a constructive and insightful Q&A session, was very positive.Drawing on our extensive experience working with hundreds of Hong Kong researchers targeting the GRF and ECS every year, we used examples of poor and subsequently improved proposals to show the attendees how they can make their applications stand out.

conclusion of literature review

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Writing a Literature Review

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A literature review is a document or section of a document that collects key sources on a topic and discusses those sources in conversation with each other (also called synthesis ). The lit review is an important genre in many disciplines, not just literature (i.e., the study of works of literature such as novels and plays). When we say “literature review” or refer to “the literature,” we are talking about the research ( scholarship ) in a given field. You will often see the terms “the research,” “the scholarship,” and “the literature” used mostly interchangeably.

Where, when, and why would I write a lit review?

There are a number of different situations where you might write a literature review, each with slightly different expectations; different disciplines, too, have field-specific expectations for what a literature review is and does. For instance, in the humanities, authors might include more overt argumentation and interpretation of source material in their literature reviews, whereas in the sciences, authors are more likely to report study designs and results in their literature reviews; these differences reflect these disciplines’ purposes and conventions in scholarship. You should always look at examples from your own discipline and talk to professors or mentors in your field to be sure you understand your discipline’s conventions, for literature reviews as well as for any other genre.

A literature review can be a part of a research paper or scholarly article, usually falling after the introduction and before the research methods sections. In these cases, the lit review just needs to cover scholarship that is important to the issue you are writing about; sometimes it will also cover key sources that informed your research methodology.

Lit reviews can also be standalone pieces, either as assignments in a class or as publications. In a class, a lit review may be assigned to help students familiarize themselves with a topic and with scholarship in their field, get an idea of the other researchers working on the topic they’re interested in, find gaps in existing research in order to propose new projects, and/or develop a theoretical framework and methodology for later research. As a publication, a lit review usually is meant to help make other scholars’ lives easier by collecting and summarizing, synthesizing, and analyzing existing research on a topic. This can be especially helpful for students or scholars getting into a new research area, or for directing an entire community of scholars toward questions that have not yet been answered.

What are the parts of a lit review?

Most lit reviews use a basic introduction-body-conclusion structure; if your lit review is part of a larger paper, the introduction and conclusion pieces may be just a few sentences while you focus most of your attention on the body. If your lit review is a standalone piece, the introduction and conclusion take up more space and give you a place to discuss your goals, research methods, and conclusions separately from where you discuss the literature itself.

Introduction:

  • An introductory paragraph that explains what your working topic and thesis is
  • A forecast of key topics or texts that will appear in the review
  • Potentially, a description of how you found sources and how you analyzed them for inclusion and discussion in the review (more often found in published, standalone literature reviews than in lit review sections in an article or research paper)
  • Summarize and synthesize: Give an overview of the main points of each source and combine them into a coherent whole
  • Analyze and interpret: Don’t just paraphrase other researchers – add your own interpretations where possible, discussing the significance of findings in relation to the literature as a whole
  • Critically Evaluate: Mention the strengths and weaknesses of your sources
  • Write in well-structured paragraphs: Use transition words and topic sentence to draw connections, comparisons, and contrasts.

Conclusion:

  • Summarize the key findings you have taken from the literature and emphasize their significance
  • Connect it back to your primary research question

How should I organize my lit review?

Lit reviews can take many different organizational patterns depending on what you are trying to accomplish with the review. Here are some examples:

  • Chronological : The simplest approach is to trace the development of the topic over time, which helps familiarize the audience with the topic (for instance if you are introducing something that is not commonly known in your field). If you choose this strategy, be careful to avoid simply listing and summarizing sources in order. Try to analyze the patterns, turning points, and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred (as mentioned previously, this may not be appropriate in your discipline — check with a teacher or mentor if you’re unsure).
  • Thematic : If you have found some recurring central themes that you will continue working with throughout your piece, you can organize your literature review into subsections that address different aspects of the topic. For example, if you are reviewing literature about women and religion, key themes can include the role of women in churches and the religious attitude towards women.
  • Qualitative versus quantitative research
  • Empirical versus theoretical scholarship
  • Divide the research by sociological, historical, or cultural sources
  • Theoretical : In many humanities articles, the literature review is the foundation for the theoretical framework. You can use it to discuss various theories, models, and definitions of key concepts. You can argue for the relevance of a specific theoretical approach or combine various theorical concepts to create a framework for your research.

What are some strategies or tips I can use while writing my lit review?

Any lit review is only as good as the research it discusses; make sure your sources are well-chosen and your research is thorough. Don’t be afraid to do more research if you discover a new thread as you’re writing. More info on the research process is available in our "Conducting Research" resources .

As you’re doing your research, create an annotated bibliography ( see our page on the this type of document ). Much of the information used in an annotated bibliography can be used also in a literature review, so you’ll be not only partially drafting your lit review as you research, but also developing your sense of the larger conversation going on among scholars, professionals, and any other stakeholders in your topic.

Usually you will need to synthesize research rather than just summarizing it. This means drawing connections between sources to create a picture of the scholarly conversation on a topic over time. Many student writers struggle to synthesize because they feel they don’t have anything to add to the scholars they are citing; here are some strategies to help you:

  • It often helps to remember that the point of these kinds of syntheses is to show your readers how you understand your research, to help them read the rest of your paper.
  • Writing teachers often say synthesis is like hosting a dinner party: imagine all your sources are together in a room, discussing your topic. What are they saying to each other?
  • Look at the in-text citations in each paragraph. Are you citing just one source for each paragraph? This usually indicates summary only. When you have multiple sources cited in a paragraph, you are more likely to be synthesizing them (not always, but often
  • Read more about synthesis here.

The most interesting literature reviews are often written as arguments (again, as mentioned at the beginning of the page, this is discipline-specific and doesn’t work for all situations). Often, the literature review is where you can establish your research as filling a particular gap or as relevant in a particular way. You have some chance to do this in your introduction in an article, but the literature review section gives a more extended opportunity to establish the conversation in the way you would like your readers to see it. You can choose the intellectual lineage you would like to be part of and whose definitions matter most to your thinking (mostly humanities-specific, but this goes for sciences as well). In addressing these points, you argue for your place in the conversation, which tends to make the lit review more compelling than a simple reporting of other sources.

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Writing: Literature Review Basics

  • What is Synthesis?
  • Organizing Your Research
  • Paraphrasing, Summary, or Direct Quotation?
  • Introductions
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The Job of the Conclusion

The job of the conclusion is, quite literally, to conclude ... or to wrap things up so the reader feels a sense of closure.  It accomplishes this by stepping back from the specifics in order to view the bigger picture of the document. In other words, it is reminding the reader of the main argument.

Whereas an introduction started out generally and moved towards discussion of a specific focus, the conclusion takes the opposite approach.  It starts by reminding the reader of the contents and importance of your findings and then moves out gradually to more general topics.

For most written assignments, the conclusion is a single paragraph.  It does not introduce any new information; rather, it succinctly restates your chief conclusions and places the importance of your findings within your field.  Depending upon the purpose of the literature review, you may also include a brief statement of future directions or self-reflection.

Here is an easy checklist for writing a conclusion:

 Is the main argument of the paper accurately restated as the first sentence (but is not copied verbatim?

In a literature review, you basicaly want to answer the question, "What did I find out? What conclusions did I come to?"   Giving the reader a one-sentence answer to this question that provides a summary of your findings is a solid way to begin a conclusion.

  What recommendations do you have?

Here you may offer the reader your suggestions on what you think should happen next.  You can make recommendations that are specific to the evidence you have uncovered, or you can make recommendations for future research.  When this area is well done, it links to previous conclusions you have already made and gives the conclusion a finished feeling.

 Did you remind the reader of the importance of the topic and how it can contribute to the knowledge in the field?

Make sure that the paper places its findings in the context of some kind of needed change, relevance, or solution.  If you addressed why the topic was interesting, important, or relevant in your introduction, you can loop back to that here.  Other ways that can be done are to remind the reader of other research you have discussed and how your work builds upon theirs, or what gaps there may yet be to explore.

Keep these items in mind as "what not to do":

 Is there a sense of closure without using words such as "In conclusion?"

If you have to use the words "In conclusion" or similar ones to launch your conclusion so the reader knows the end is near, you've got a problem.  Make sure the reader has a distinct sense that the paper has come to an end without telling them it is ending. It is important to not leave the reader hanging. 

 Did you avoid presenting any new information?

No new ideas should be introduced in the conclusion. It is simply a review of the material that is already present in the paper. The only new idea would be the suggesting of a direction for future research.

Stigmatization of the mentally ill is caused by the public’s belief in myths about the dangerousness of the mentally ill and exposing those myths can reduce stigmatization. At least one-third of the people sampled in one study said that they would both reject socially and fear violence from someone displaying behaviors associated with different mentally illnesses. Other research discovered that this rejection is associated to lack of contact with the mentally ill and that as contact increased, fear of the mentally ill decreased. The direction of the relationship between fear and rejection seems to be that fear (possibly based upon myths about mental illness) causes rejection. Taken as a whole, it appears that exposing these myths as myths increases the acceptance of the mentally ill and that staged contact with a mentally person to expose myths has an even more powerful effect. Caution must be advised, though; Martin et al.’s (2002) and Alexander and Link’s (2003) studies and the first study of Corrigan et al. (2002) were based upon paper and pencil methodologies. And while Corrigan et al.’s (2002) second study involved staged Myths of violence 6 presentations, it was conducted in a college setting with a college sample. Future research should replicate these findings in more natural settings with different populations.

Now let's break that down.

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How do I Write a Literature Review?: #5 Writing the Review

  • Step #1: Choosing a Topic
  • Step #2: Finding Information
  • Step #3: Evaluating Content
  • Step #4: Synthesizing Content
  • #5 Writing the Review
  • Citing Your Sources

WRITING THE REVIEW 

You've done the research and now you're ready to put your findings down on paper. When preparing to write your review, first consider how will you organize your review.

The actual review generally has 5 components:

Abstract  -  An abstract is a summary of your literature review. It is made up of the following parts:

  • A contextual sentence about your motivation behind your research topic
  • Your thesis statement
  • A descriptive statement about the types of literature used in the review
  • Summarize your findings
  • Conclusion(s) based upon your findings

Introduction :   Like a typical research paper introduction, provide the reader with a quick idea of the topic of the literature review:

  • Define or identify the general topic, issue, or area of concern. This provides the reader with context for reviewing the literature.
  • Identify related trends in what has already been published about the topic; or conflicts in theory, methodology, evidence, and conclusions; or gaps in research and scholarship; or a single problem or new perspective of immediate interest.
  • Establish your reason (point of view) for reviewing the literature; explain the criteria to be used in analyzing and comparing literature and the organization of the review (sequence); and, when necessary, state why certain literature is or is not included (scope)  - 

Body :  The body of a literature review contains your discussion of sources and can be organized in 3 ways-

  • Chronological -  by publication or by trend
  • Thematic -  organized around a topic or issue, rather than the progression of time
  • Methodical -  the focusing factor usually does not have to do with the content of the material. Instead, it focuses on the "methods" of the literature's researcher or writer that you are reviewing

You may also want to include a section on "questions for further research" and discuss what questions the review has sparked about the topic/field or offer suggestions for future studies/examinations that build on your current findings.

Conclusion :  In the conclusion, you should:

Conclude your paper by providing your reader with some perspective on the relationship between your literature review's specific topic and how it's related to it's parent discipline, scientific endeavor, or profession.

Bibliography :   Since a literature review is composed of pieces of research, it is very important that your correctly cite the literature you are reviewing, both in the reviews body as well as in a bibliography/works cited. To learn more about different citation styles, visit the " Citing Your Sources " tab.

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conclusion of literature review

The Writing Center • University of North Carolina at Chapel Hill

Literature Reviews

What this handout is about.

This handout will explain what literature reviews are and offer insights into the form and construction of literature reviews in the humanities, social sciences, and sciences.

Introduction

OK. You’ve got to write a literature review. You dust off a novel and a book of poetry, settle down in your chair, and get ready to issue a “thumbs up” or “thumbs down” as you leaf through the pages. “Literature review” done. Right?

Wrong! The “literature” of a literature review refers to any collection of materials on a topic, not necessarily the great literary texts of the world. “Literature” could be anything from a set of government pamphlets on British colonial methods in Africa to scholarly articles on the treatment of a torn ACL. And a review does not necessarily mean that your reader wants you to give your personal opinion on whether or not you liked these sources.

What is a literature review, then?

A literature review discusses published information in a particular subject area, and sometimes information in a particular subject area within a certain time period.

A literature review can be just a simple summary of the sources, but it usually has an organizational pattern and combines both summary and synthesis. A summary is a recap of the important information of the source, but a synthesis is a re-organization, or a reshuffling, of that information. It might give a new interpretation of old material or combine new with old interpretations. Or it might trace the intellectual progression of the field, including major debates. And depending on the situation, the literature review may evaluate the sources and advise the reader on the most pertinent or relevant.

But how is a literature review different from an academic research paper?

The main focus of an academic research paper is to develop a new argument, and a research paper is likely to contain a literature review as one of its parts. In a research paper, you use the literature as a foundation and as support for a new insight that you contribute. The focus of a literature review, however, is to summarize and synthesize the arguments and ideas of others without adding new contributions.

Why do we write literature reviews?

Literature reviews provide you with a handy guide to a particular topic. If you have limited time to conduct research, literature reviews can give you an overview or act as a stepping stone. For professionals, they are useful reports that keep them up to date with what is current in the field. For scholars, the depth and breadth of the literature review emphasizes the credibility of the writer in his or her field. Literature reviews also provide a solid background for a research paper’s investigation. Comprehensive knowledge of the literature of the field is essential to most research papers.

Who writes these things, anyway?

Literature reviews are written occasionally in the humanities, but mostly in the sciences and social sciences; in experiment and lab reports, they constitute a section of the paper. Sometimes a literature review is written as a paper in itself.

Let’s get to it! What should I do before writing the literature review?

If your assignment is not very specific, seek clarification from your instructor:

  • Roughly how many sources should you include?
  • What types of sources (books, journal articles, websites)?
  • Should you summarize, synthesize, or critique your sources by discussing a common theme or issue?
  • Should you evaluate your sources?
  • Should you provide subheadings and other background information, such as definitions and/or a history?

Find models

Look for other literature reviews in your area of interest or in the discipline and read them to get a sense of the types of themes you might want to look for in your own research or ways to organize your final review. You can simply put the word “review” in your search engine along with your other topic terms to find articles of this type on the Internet or in an electronic database. The bibliography or reference section of sources you’ve already read are also excellent entry points into your own research.

Narrow your topic

There are hundreds or even thousands of articles and books on most areas of study. The narrower your topic, the easier it will be to limit the number of sources you need to read in order to get a good survey of the material. Your instructor will probably not expect you to read everything that’s out there on the topic, but you’ll make your job easier if you first limit your scope.

Keep in mind that UNC Libraries have research guides and to databases relevant to many fields of study. You can reach out to the subject librarian for a consultation: https://library.unc.edu/support/consultations/ .

And don’t forget to tap into your professor’s (or other professors’) knowledge in the field. Ask your professor questions such as: “If you had to read only one book from the 90’s on topic X, what would it be?” Questions such as this help you to find and determine quickly the most seminal pieces in the field.

Consider whether your sources are current

Some disciplines require that you use information that is as current as possible. In the sciences, for instance, treatments for medical problems are constantly changing according to the latest studies. Information even two years old could be obsolete. However, if you are writing a review in the humanities, history, or social sciences, a survey of the history of the literature may be what is needed, because what is important is how perspectives have changed through the years or within a certain time period. Try sorting through some other current bibliographies or literature reviews in the field to get a sense of what your discipline expects. You can also use this method to consider what is currently of interest to scholars in this field and what is not.

Strategies for writing the literature review

Find a focus.

A literature review, like a term paper, is usually organized around ideas, not the sources themselves as an annotated bibliography would be organized. This means that you will not just simply list your sources and go into detail about each one of them, one at a time. No. As you read widely but selectively in your topic area, consider instead what themes or issues connect your sources together. Do they present one or different solutions? Is there an aspect of the field that is missing? How well do they present the material and do they portray it according to an appropriate theory? Do they reveal a trend in the field? A raging debate? Pick one of these themes to focus the organization of your review.

Convey it to your reader

A literature review may not have a traditional thesis statement (one that makes an argument), but you do need to tell readers what to expect. Try writing a simple statement that lets the reader know what is your main organizing principle. Here are a couple of examples:

The current trend in treatment for congestive heart failure combines surgery and medicine. More and more cultural studies scholars are accepting popular media as a subject worthy of academic consideration.

Consider organization

You’ve got a focus, and you’ve stated it clearly and directly. Now what is the most effective way of presenting the information? What are the most important topics, subtopics, etc., that your review needs to include? And in what order should you present them? Develop an organization for your review at both a global and local level:

First, cover the basic categories

Just like most academic papers, literature reviews also must contain at least three basic elements: an introduction or background information section; the body of the review containing the discussion of sources; and, finally, a conclusion and/or recommendations section to end the paper. The following provides a brief description of the content of each:

  • Introduction: Gives a quick idea of the topic of the literature review, such as the central theme or organizational pattern.
  • Body: Contains your discussion of sources and is organized either chronologically, thematically, or methodologically (see below for more information on each).
  • Conclusions/Recommendations: Discuss what you have drawn from reviewing literature so far. Where might the discussion proceed?

Organizing the body

Once you have the basic categories in place, then you must consider how you will present the sources themselves within the body of your paper. Create an organizational method to focus this section even further.

To help you come up with an overall organizational framework for your review, consider the following scenario:

You’ve decided to focus your literature review on materials dealing with sperm whales. This is because you’ve just finished reading Moby Dick, and you wonder if that whale’s portrayal is really real. You start with some articles about the physiology of sperm whales in biology journals written in the 1980’s. But these articles refer to some British biological studies performed on whales in the early 18th century. So you check those out. Then you look up a book written in 1968 with information on how sperm whales have been portrayed in other forms of art, such as in Alaskan poetry, in French painting, or on whale bone, as the whale hunters in the late 19th century used to do. This makes you wonder about American whaling methods during the time portrayed in Moby Dick, so you find some academic articles published in the last five years on how accurately Herman Melville portrayed the whaling scene in his novel.

Now consider some typical ways of organizing the sources into a review:

  • Chronological: If your review follows the chronological method, you could write about the materials above according to when they were published. For instance, first you would talk about the British biological studies of the 18th century, then about Moby Dick, published in 1851, then the book on sperm whales in other art (1968), and finally the biology articles (1980s) and the recent articles on American whaling of the 19th century. But there is relatively no continuity among subjects here. And notice that even though the sources on sperm whales in other art and on American whaling are written recently, they are about other subjects/objects that were created much earlier. Thus, the review loses its chronological focus.
  • By publication: Order your sources by publication chronology, then, only if the order demonstrates a more important trend. For instance, you could order a review of literature on biological studies of sperm whales if the progression revealed a change in dissection practices of the researchers who wrote and/or conducted the studies.
  • By trend: A better way to organize the above sources chronologically is to examine the sources under another trend, such as the history of whaling. Then your review would have subsections according to eras within this period. For instance, the review might examine whaling from pre-1600-1699, 1700-1799, and 1800-1899. Under this method, you would combine the recent studies on American whaling in the 19th century with Moby Dick itself in the 1800-1899 category, even though the authors wrote a century apart.
  • Thematic: Thematic reviews of literature are organized around a topic or issue, rather than the progression of time. However, progression of time may still be an important factor in a thematic review. For instance, the sperm whale review could focus on the development of the harpoon for whale hunting. While the study focuses on one topic, harpoon technology, it will still be organized chronologically. The only difference here between a “chronological” and a “thematic” approach is what is emphasized the most: the development of the harpoon or the harpoon technology.But more authentic thematic reviews tend to break away from chronological order. For instance, a thematic review of material on sperm whales might examine how they are portrayed as “evil” in cultural documents. The subsections might include how they are personified, how their proportions are exaggerated, and their behaviors misunderstood. A review organized in this manner would shift between time periods within each section according to the point made.
  • Methodological: A methodological approach differs from the two above in that the focusing factor usually does not have to do with the content of the material. Instead, it focuses on the “methods” of the researcher or writer. For the sperm whale project, one methodological approach would be to look at cultural differences between the portrayal of whales in American, British, and French art work. Or the review might focus on the economic impact of whaling on a community. A methodological scope will influence either the types of documents in the review or the way in which these documents are discussed. Once you’ve decided on the organizational method for the body of the review, the sections you need to include in the paper should be easy to figure out. They should arise out of your organizational strategy. In other words, a chronological review would have subsections for each vital time period. A thematic review would have subtopics based upon factors that relate to the theme or issue.

Sometimes, though, you might need to add additional sections that are necessary for your study, but do not fit in the organizational strategy of the body. What other sections you include in the body is up to you. Put in only what is necessary. Here are a few other sections you might want to consider:

  • Current Situation: Information necessary to understand the topic or focus of the literature review.
  • History: The chronological progression of the field, the literature, or an idea that is necessary to understand the literature review, if the body of the literature review is not already a chronology.
  • Methods and/or Standards: The criteria you used to select the sources in your literature review or the way in which you present your information. For instance, you might explain that your review includes only peer-reviewed articles and journals.

Questions for Further Research: What questions about the field has the review sparked? How will you further your research as a result of the review?

Begin composing

Once you’ve settled on a general pattern of organization, you’re ready to write each section. There are a few guidelines you should follow during the writing stage as well. Here is a sample paragraph from a literature review about sexism and language to illuminate the following discussion:

However, other studies have shown that even gender-neutral antecedents are more likely to produce masculine images than feminine ones (Gastil, 1990). Hamilton (1988) asked students to complete sentences that required them to fill in pronouns that agreed with gender-neutral antecedents such as “writer,” “pedestrian,” and “persons.” The students were asked to describe any image they had when writing the sentence. Hamilton found that people imagined 3.3 men to each woman in the masculine “generic” condition and 1.5 men per woman in the unbiased condition. Thus, while ambient sexism accounted for some of the masculine bias, sexist language amplified the effect. (Source: Erika Falk and Jordan Mills, “Why Sexist Language Affects Persuasion: The Role of Homophily, Intended Audience, and Offense,” Women and Language19:2).

Use evidence

In the example above, the writers refer to several other sources when making their point. A literature review in this sense is just like any other academic research paper. Your interpretation of the available sources must be backed up with evidence to show that what you are saying is valid.

Be selective

Select only the most important points in each source to highlight in the review. The type of information you choose to mention should relate directly to the review’s focus, whether it is thematic, methodological, or chronological.

Use quotes sparingly

Falk and Mills do not use any direct quotes. That is because the survey nature of the literature review does not allow for in-depth discussion or detailed quotes from the text. Some short quotes here and there are okay, though, if you want to emphasize a point, or if what the author said just cannot be rewritten in your own words. Notice that Falk and Mills do quote certain terms that were coined by the author, not common knowledge, or taken directly from the study. But if you find yourself wanting to put in more quotes, check with your instructor.

Summarize and synthesize

Remember to summarize and synthesize your sources within each paragraph as well as throughout the review. The authors here recapitulate important features of Hamilton’s study, but then synthesize it by rephrasing the study’s significance and relating it to their own work.

Keep your own voice

While the literature review presents others’ ideas, your voice (the writer’s) should remain front and center. Notice that Falk and Mills weave references to other sources into their own text, but they still maintain their own voice by starting and ending the paragraph with their own ideas and their own words. The sources support what Falk and Mills are saying.

Use caution when paraphrasing

When paraphrasing a source that is not your own, be sure to represent the author’s information or opinions accurately and in your own words. In the preceding example, Falk and Mills either directly refer in the text to the author of their source, such as Hamilton, or they provide ample notation in the text when the ideas they are mentioning are not their own, for example, Gastil’s. For more information, please see our handout on plagiarism .

Revise, revise, revise

Draft in hand? Now you’re ready to revise. Spending a lot of time revising is a wise idea, because your main objective is to present the material, not the argument. So check over your review again to make sure it follows the assignment and/or your outline. Then, just as you would for most other academic forms of writing, rewrite or rework the language of your review so that you’ve presented your information in the most concise manner possible. Be sure to use terminology familiar to your audience; get rid of unnecessary jargon or slang. Finally, double check that you’ve documented your sources and formatted the review appropriately for your discipline. For tips on the revising and editing process, see our handout on revising drafts .

Works consulted

We consulted these works while writing this handout. This is not a comprehensive list of resources on the handout’s topic, and we encourage you to do your own research to find additional publications. Please do not use this list as a model for the format of your own reference list, as it may not match the citation style you are using. For guidance on formatting citations, please see the UNC Libraries citation tutorial . We revise these tips periodically and welcome feedback.

Anson, Chris M., and Robert A. Schwegler. 2010. The Longman Handbook for Writers and Readers , 6th ed. New York: Longman.

Jones, Robert, Patrick Bizzaro, and Cynthia Selfe. 1997. The Harcourt Brace Guide to Writing in the Disciplines . New York: Harcourt Brace.

Lamb, Sandra E. 1998. How to Write It: A Complete Guide to Everything You’ll Ever Write . Berkeley: Ten Speed Press.

Rosen, Leonard J., and Laurence Behrens. 2003. The Allyn & Bacon Handbook , 5th ed. New York: Longman.

Troyka, Lynn Quittman, and Doug Hesse. 2016. Simon and Schuster Handbook for Writers , 11th ed. London: Pearson.

You may reproduce it for non-commercial use if you use the entire handout and attribute the source: The Writing Center, University of North Carolina at Chapel Hill

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How To Structure Your Literature Review

3 options to help structure your chapter.

By: Amy Rommelspacher (PhD) | Reviewer: Dr Eunice Rautenbach | November 2020 (Updated May 2023)

Writing the literature review chapter can seem pretty daunting when you’re piecing together your dissertation or thesis. As  we’ve discussed before , a good literature review needs to achieve a few very important objectives – it should:

  • Demonstrate your knowledge of the research topic
  • Identify the gaps in the literature and show how your research links to these
  • Provide the foundation for your conceptual framework (if you have one)
  • Inform your own  methodology and research design

To achieve this, your literature review needs a well-thought-out structure . Get the structure of your literature review chapter wrong and you’ll struggle to achieve these objectives. Don’t worry though – in this post, we’ll look at how to structure your literature review for maximum impact (and marks!).

The function of the lit review

But wait – is this the right time?

Deciding on the structure of your literature review should come towards the end of the literature review process – after you have collected and digested the literature, but before you start writing the chapter. 

In other words, you need to first develop a rich understanding of the literature before you even attempt to map out a structure. There’s no use trying to develop a structure before you’ve fully wrapped your head around the existing research.

Equally importantly, you need to have a structure in place before you start writing , or your literature review will most likely end up a rambling, disjointed mess. 

Importantly, don’t feel that once you’ve defined a structure you can’t iterate on it. It’s perfectly natural to adjust as you engage in the writing process. As we’ve discussed before , writing is a way of developing your thinking, so it’s quite common for your thinking to change – and therefore, for your chapter structure to change – as you write. 

Need a helping hand?

conclusion of literature review

Like any other chapter in your thesis or dissertation, your literature review needs to have a clear, logical structure. At a minimum, it should have three essential components – an  introduction , a  body   and a  conclusion . 

Let’s take a closer look at each of these.

1: The Introduction Section

Just like any good introduction, the introduction section of your literature review should introduce the purpose and layout (organisation) of the chapter. In other words, your introduction needs to give the reader a taste of what’s to come, and how you’re going to lay that out. Essentially, you should provide the reader with a high-level roadmap of your chapter to give them a taste of the journey that lies ahead.

Here’s an example of the layout visualised in a literature review introduction:

Example of literature review outline structure

Your introduction should also outline your topic (including any tricky terminology or jargon) and provide an explanation of the scope of your literature review – in other words, what you  will   and  won’t   be covering (the delimitations ). This helps ringfence your review and achieve a clear focus . The clearer and narrower your focus, the deeper you can dive into the topic (which is typically where the magic lies). 

Depending on the nature of your project, you could also present your stance or point of view at this stage. In other words, after grappling with the literature you’ll have an opinion about what the trends and concerns are in the field as well as what’s lacking. The introduction section can then present these ideas so that it is clear to examiners that you’re aware of how your research connects with existing knowledge .

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2: The Body Section

The body of your literature review is the centre of your work. This is where you’ll present, analyse, evaluate and synthesise the existing research. In other words, this is where you’re going to earn (or lose) the most marks. Therefore, it’s important to carefully think about how you will organise your discussion to present it in a clear way. 

The body of your literature review should do just as the description of this chapter suggests. It should “review” the literature – in other words, identify, analyse, and synthesise it. So, when thinking about structuring your literature review, you need to think about which structural approach will provide the best “review” for your specific type of research and objectives (we’ll get to this shortly).

There are (broadly speaking)  three options  for organising your literature review.

The body section of your literature review is the where you'll present, analyse, evaluate and synthesise the existing research.

Option 1: Chronological (according to date)

Organising the literature chronologically is one of the simplest ways to structure your literature review. You start with what was published first and work your way through the literature until you reach the work published most recently. Pretty straightforward.

The benefit of this option is that it makes it easy to discuss the developments and debates in the field as they emerged over time. Organising your literature chronologically also allows you to highlight how specific articles or pieces of work might have changed the course of the field – in other words, which research has had the most impact . Therefore, this approach is very useful when your research is aimed at understanding how the topic has unfolded over time and is often used by scholars in the field of history. That said, this approach can be utilised by anyone that wants to explore change over time .

Adopting the chronological structure allows you to discuss the developments and debates in the field as they emerged over time.

For example , if a student of politics is investigating how the understanding of democracy has evolved over time, they could use the chronological approach to provide a narrative that demonstrates how this understanding has changed through the ages.

Here are some questions you can ask yourself to help you structure your literature review chronologically.

  • What is the earliest literature published relating to this topic?
  • How has the field changed over time? Why?
  • What are the most recent discoveries/theories?

In some ways, chronology plays a part whichever way you decide to structure your literature review, because you will always, to a certain extent, be analysing how the literature has developed. However, with the chronological approach, the emphasis is very firmly on how the discussion has evolved over time , as opposed to how all the literature links together (which we’ll discuss next ).

Option 2: Thematic (grouped by theme)

The thematic approach to structuring a literature review means organising your literature by theme or category – for example, by independent variables (i.e. factors that have an impact on a specific outcome).

As you’ve been collecting and synthesising literature , you’ll likely have started seeing some themes or patterns emerging. You can then use these themes or patterns as a structure for your body discussion. The thematic approach is the most common approach and is useful for structuring literature reviews in most fields.

For example, if you were researching which factors contributed towards people trusting an organisation, you might find themes such as consumers’ perceptions of an organisation’s competence, benevolence and integrity. Structuring your literature review thematically would mean structuring your literature review’s body section to discuss each of these themes, one section at a time.

The thematic structure allows you to organise your literature by theme or category  – e.g. by independent variables.

Here are some questions to ask yourself when structuring your literature review by themes:

  • Are there any patterns that have come to light in the literature?
  • What are the central themes and categories used by the researchers?
  • Do I have enough evidence of these themes?

PS – you can see an example of a thematically structured literature review in our literature review sample walkthrough video here.

Option 3: Methodological

The methodological option is a way of structuring your literature review by the research methodologies used . In other words, organising your discussion based on the angle from which each piece of research was approached – for example, qualitative , quantitative or mixed  methodologies.

Structuring your literature review by methodology can be useful if you are drawing research from a variety of disciplines and are critiquing different methodologies. The point of this approach is to question  how  existing research has been conducted, as opposed to  what  the conclusions and/or findings the research were.

The methodological structure allows you to organise your chapter by the analysis method  used - e.g. qual, quant or mixed.

For example, a sociologist might centre their research around critiquing specific fieldwork practices. Their literature review will then be a summary of the fieldwork methodologies used by different studies.

Here are some questions you can ask yourself when structuring your literature review according to methodology:

  • Which methodologies have been utilised in this field?
  • Which methodology is the most popular (and why)?
  • What are the strengths and weaknesses of the various methodologies?
  • How can the existing methodologies inform my own methodology?

3: The Conclusion Section

Once you’ve completed the body section of your literature review using one of the structural approaches we discussed above, you’ll need to “wrap up” your literature review and pull all the pieces together to set the direction for the rest of your dissertation or thesis.

The conclusion is where you’ll present the key findings of your literature review. In this section, you should emphasise the research that is especially important to your research questions and highlight the gaps that exist in the literature. Based on this, you need to make it clear what you will add to the literature – in other words, justify your own research by showing how it will help fill one or more of the gaps you just identified.

Last but not least, if it’s your intention to develop a conceptual framework for your dissertation or thesis, the conclusion section is a good place to present this.

In the conclusion section, you’ll need to present the key findings of your literature review and highlight the gaps that exist in the literature. Based on this, you'll  need to make it clear what your study will add  to the literature.

Example: Thematically Structured Review

In the video below, we unpack a literature review chapter so that you can see an example of a thematically structure review in practice.

Let’s Recap

In this article, we’ve  discussed how to structure your literature review for maximum impact. Here’s a quick recap of what  you need to keep in mind when deciding on your literature review structure:

  • Just like other chapters, your literature review needs a clear introduction , body and conclusion .
  • The introduction section should provide an overview of what you will discuss in your literature review.
  • The body section of your literature review can be organised by chronology , theme or methodology . The right structural approach depends on what you’re trying to achieve with your research.
  • The conclusion section should draw together the key findings of your literature review and link them to your research questions.

If you’re ready to get started, be sure to download our free literature review template to fast-track your chapter outline.

Literature Review Course

Psst… there’s more!

This post is an extract from our bestselling Udemy Course, Literature Review Bootcamp . If you want to work smart, you don't want to miss this .

You Might Also Like:

Literature review 101 - how to find articles

27 Comments

Marin

Great work. This is exactly what I was looking for and helps a lot together with your previous post on literature review. One last thing is missing: a link to a great literature chapter of an journal article (maybe with comments of the different sections in this review chapter). Do you know any great literature review chapters?

ISHAYA JEREMIAH AYOCK

I agree with you Marin… A great piece

Qaiser

I agree with Marin. This would be quite helpful if you annotate a nicely structured literature from previously published research articles.

Maurice Kagwi

Awesome article for my research.

Ache Roland Ndifor

I thank you immensely for this wonderful guide

Malik Imtiaz Ahmad

It is indeed thought and supportive work for the futurist researcher and students

Franklin Zon

Very educative and good time to get guide. Thank you

Dozie

Great work, very insightful. Thank you.

KAWU ALHASSAN

Thanks for this wonderful presentation. My question is that do I put all the variables into a single conceptual framework or each hypothesis will have it own conceptual framework?

CYRUS ODUAH

Thank you very much, very helpful

Michael Sanya Oluyede

This is very educative and precise . Thank you very much for dropping this kind of write up .

Karla Buchanan

Pheeww, so damn helpful, thank you for this informative piece.

Enang Lazarus

I’m doing a research project topic ; stool analysis for parasitic worm (enteric) worm, how do I structure it, thanks.

Biswadeb Dasgupta

comprehensive explanation. Help us by pasting the URL of some good “literature review” for better understanding.

Vik

great piece. thanks for the awesome explanation. it is really worth sharing. I have a little question, if anyone can help me out, which of the options in the body of literature can be best fit if you are writing an architectural thesis that deals with design?

S Dlamini

I am doing a research on nanofluids how can l structure it?

PATRICK MACKARNESS

Beautifully clear.nThank you!

Lucid! Thankyou!

Abraham

Brilliant work, well understood, many thanks

Nour

I like how this was so clear with simple language 😊😊 thank you so much 😊 for these information 😊

Lindiey

Insightful. I was struggling to come up with a sensible literature review but this has been really helpful. Thank you!

NAGARAJU K

You have given thought-provoking information about the review of the literature.

Vakaloloma

Thank you. It has made my own research better and to impart your work to students I teach

Alphonse NSHIMIYIMANA

I learnt a lot from this teaching. It’s a great piece.

Resa

I am doing research on EFL teacher motivation for his/her job. How Can I structure it? Is there any detailed template, additional to this?

Gerald Gormanous

You are so cool! I do not think I’ve read through something like this before. So nice to find somebody with some genuine thoughts on this issue. Seriously.. thank you for starting this up. This site is one thing that is required on the internet, someone with a little originality!

kan

I’m asked to do conceptual, theoretical and empirical literature, and i just don’t know how to structure it

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  • What is a Literature Review? | Guide, Template, & Examples

What is a Literature Review? | Guide, Template, & Examples

Published on 22 February 2022 by Shona McCombes . Revised on 7 June 2022.

What is a literature review? A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research.

There are five key steps to writing a literature review:

  • Search for relevant literature
  • Evaluate sources
  • Identify themes, debates and gaps
  • Outline the structure
  • Write your literature review

A good literature review doesn’t just summarise sources – it analyses, synthesises, and critically evaluates to give a clear picture of the state of knowledge on the subject.

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Table of contents

Why write a literature review, examples of literature reviews, step 1: search for relevant literature, step 2: evaluate and select sources, step 3: identify themes, debates and gaps, step 4: outline your literature review’s structure, step 5: write your literature review, frequently asked questions about literature reviews, introduction.

  • Quick Run-through
  • Step 1 & 2

When you write a dissertation or thesis, you will have to conduct a literature review to situate your research within existing knowledge. The literature review gives you a chance to:

  • Demonstrate your familiarity with the topic and scholarly context
  • Develop a theoretical framework and methodology for your research
  • Position yourself in relation to other researchers and theorists
  • Show how your dissertation addresses a gap or contributes to a debate

You might also have to write a literature review as a stand-alone assignment. In this case, the purpose is to evaluate the current state of research and demonstrate your knowledge of scholarly debates around a topic.

The content will look slightly different in each case, but the process of conducting a literature review follows the same steps. We’ve written a step-by-step guide that you can follow below.

Literature review guide

Prevent plagiarism, run a free check.

Writing literature reviews can be quite challenging! A good starting point could be to look at some examples, depending on what kind of literature review you’d like to write.

  • Example literature review #1: “Why Do People Migrate? A Review of the Theoretical Literature” ( Theoretical literature review about the development of economic migration theory from the 1950s to today.)
  • Example literature review #2: “Literature review as a research methodology: An overview and guidelines” ( Methodological literature review about interdisciplinary knowledge acquisition and production.)
  • Example literature review #3: “The Use of Technology in English Language Learning: A Literature Review” ( Thematic literature review about the effects of technology on language acquisition.)
  • Example literature review #4: “Learners’ Listening Comprehension Difficulties in English Language Learning: A Literature Review” ( Chronological literature review about how the concept of listening skills has changed over time.)

You can also check out our templates with literature review examples and sample outlines at the links below.

Download Word doc Download Google doc

Before you begin searching for literature, you need a clearly defined topic .

If you are writing the literature review section of a dissertation or research paper, you will search for literature related to your research objectives and questions .

If you are writing a literature review as a stand-alone assignment, you will have to choose a focus and develop a central question to direct your search. Unlike a dissertation research question, this question has to be answerable without collecting original data. You should be able to answer it based only on a review of existing publications.

Make a list of keywords

Start by creating a list of keywords related to your research topic. Include each of the key concepts or variables you’re interested in, and list any synonyms and related terms. You can add to this list if you discover new keywords in the process of your literature search.

  • Social media, Facebook, Instagram, Twitter, Snapchat, TikTok
  • Body image, self-perception, self-esteem, mental health
  • Generation Z, teenagers, adolescents, youth

Search for relevant sources

Use your keywords to begin searching for sources. Some databases to search for journals and articles include:

  • Your university’s library catalogue
  • Google Scholar
  • Project Muse (humanities and social sciences)
  • Medline (life sciences and biomedicine)
  • EconLit (economics)
  • Inspec (physics, engineering and computer science)

You can use boolean operators to help narrow down your search:

Read the abstract to find out whether an article is relevant to your question. When you find a useful book or article, you can check the bibliography to find other relevant sources.

To identify the most important publications on your topic, take note of recurring citations. If the same authors, books or articles keep appearing in your reading, make sure to seek them out.

You probably won’t be able to read absolutely everything that has been written on the topic – you’ll have to evaluate which sources are most relevant to your questions.

For each publication, ask yourself:

  • What question or problem is the author addressing?
  • What are the key concepts and how are they defined?
  • What are the key theories, models and methods? Does the research use established frameworks or take an innovative approach?
  • What are the results and conclusions of the study?
  • How does the publication relate to other literature in the field? Does it confirm, add to, or challenge established knowledge?
  • How does the publication contribute to your understanding of the topic? What are its key insights and arguments?
  • What are the strengths and weaknesses of the research?

Make sure the sources you use are credible, and make sure you read any landmark studies and major theories in your field of research.

You can find out how many times an article has been cited on Google Scholar – a high citation count means the article has been influential in the field, and should certainly be included in your literature review.

The scope of your review will depend on your topic and discipline: in the sciences you usually only review recent literature, but in the humanities you might take a long historical perspective (for example, to trace how a concept has changed in meaning over time).

Remember that you can use our template to summarise and evaluate sources you’re thinking about using!

Take notes and cite your sources

As you read, you should also begin the writing process. Take notes that you can later incorporate into the text of your literature review.

It’s important to keep track of your sources with references to avoid plagiarism . It can be helpful to make an annotated bibliography, where you compile full reference information and write a paragraph of summary and analysis for each source. This helps you remember what you read and saves time later in the process.

You can use our free APA Reference Generator for quick, correct, consistent citations.

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To begin organising your literature review’s argument and structure, you need to understand the connections and relationships between the sources you’ve read. Based on your reading and notes, you can look for:

  • Trends and patterns (in theory, method or results): do certain approaches become more or less popular over time?
  • Themes: what questions or concepts recur across the literature?
  • Debates, conflicts and contradictions: where do sources disagree?
  • Pivotal publications: are there any influential theories or studies that changed the direction of the field?
  • Gaps: what is missing from the literature? Are there weaknesses that need to be addressed?

This step will help you work out the structure of your literature review and (if applicable) show how your own research will contribute to existing knowledge.

  • Most research has focused on young women.
  • There is an increasing interest in the visual aspects of social media.
  • But there is still a lack of robust research on highly-visual platforms like Instagram and Snapchat – this is a gap that you could address in your own research.

There are various approaches to organising the body of a literature review. You should have a rough idea of your strategy before you start writing.

Depending on the length of your literature review, you can combine several of these strategies (for example, your overall structure might be thematic, but each theme is discussed chronologically).

Chronological

The simplest approach is to trace the development of the topic over time. However, if you choose this strategy, be careful to avoid simply listing and summarising sources in order.

Try to analyse patterns, turning points and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred.

If you have found some recurring central themes, you can organise your literature review into subsections that address different aspects of the topic.

For example, if you are reviewing literature about inequalities in migrant health outcomes, key themes might include healthcare policy, language barriers, cultural attitudes, legal status, and economic access.

Methodological

If you draw your sources from different disciplines or fields that use a variety of research methods , you might want to compare the results and conclusions that emerge from different approaches. For example:

  • Look at what results have emerged in qualitative versus quantitative research
  • Discuss how the topic has been approached by empirical versus theoretical scholarship
  • Divide the literature into sociological, historical, and cultural sources

Theoretical

A literature review is often the foundation for a theoretical framework . You can use it to discuss various theories, models, and definitions of key concepts.

You might argue for the relevance of a specific theoretical approach, or combine various theoretical concepts to create a framework for your research.

Like any other academic text, your literature review should have an introduction , a main body, and a conclusion . What you include in each depends on the objective of your literature review.

The introduction should clearly establish the focus and purpose of the literature review.

If you are writing the literature review as part of your dissertation or thesis, reiterate your central problem or research question and give a brief summary of the scholarly context. You can emphasise the timeliness of the topic (“many recent studies have focused on the problem of x”) or highlight a gap in the literature (“while there has been much research on x, few researchers have taken y into consideration”).

Depending on the length of your literature review, you might want to divide the body into subsections. You can use a subheading for each theme, time period, or methodological approach.

As you write, make sure to follow these tips:

  • Summarise and synthesise: give an overview of the main points of each source and combine them into a coherent whole.
  • Analyse and interpret: don’t just paraphrase other researchers – add your own interpretations, discussing the significance of findings in relation to the literature as a whole.
  • Critically evaluate: mention the strengths and weaknesses of your sources.
  • Write in well-structured paragraphs: use transitions and topic sentences to draw connections, comparisons and contrasts.

In the conclusion, you should summarise the key findings you have taken from the literature and emphasise their significance.

If the literature review is part of your dissertation or thesis, reiterate how your research addresses gaps and contributes new knowledge, or discuss how you have drawn on existing theories and methods to build a framework for your research. This can lead directly into your methodology section.

A literature review is a survey of scholarly sources (such as books, journal articles, and theses) related to a specific topic or research question .

It is often written as part of a dissertation , thesis, research paper , or proposal .

There are several reasons to conduct a literature review at the beginning of a research project:

  • To familiarise yourself with the current state of knowledge on your topic
  • To ensure that you’re not just repeating what others have already done
  • To identify gaps in knowledge and unresolved problems that your research can address
  • To develop your theoretical framework and methodology
  • To provide an overview of the key findings and debates on the topic

Writing the literature review shows your reader how your work relates to existing research and what new insights it will contribute.

The literature review usually comes near the beginning of your  dissertation . After the introduction , it grounds your research in a scholarly field and leads directly to your theoretical framework or methodology .

Cite this Scribbr article

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McCombes, S. (2022, June 07). What is a Literature Review? | Guide, Template, & Examples. Scribbr. Retrieved 15 February 2024, from https://www.scribbr.co.uk/thesis-dissertation/literature-review/

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  • 04 December 2020
  • Correction 09 December 2020

How to write a superb literature review

Andy Tay is a freelance writer based in Singapore.

You can also search for this author in PubMed   Google Scholar

Literature reviews are important resources for scientists. They provide historical context for a field while offering opinions on its future trajectory. Creating them can provide inspiration for one’s own research, as well as some practice in writing. But few scientists are trained in how to write a review — or in what constitutes an excellent one. Even picking the appropriate software to use can be an involved decision (see ‘Tools and techniques’). So Nature asked editors and working scientists with well-cited reviews for their tips.

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doi: https://doi.org/10.1038/d41586-020-03422-x

Interviews have been edited for length and clarity.

Updates & Corrections

Correction 09 December 2020 : An earlier version of the tables in this article included some incorrect details about the programs Zotero, Endnote and Manubot. These have now been corrected.

Hsing, I.-M., Xu, Y. & Zhao, W. Electroanalysis 19 , 755–768 (2007).

Article   Google Scholar  

Ledesma, H. A. et al. Nature Nanotechnol. 14 , 645–657 (2019).

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Brahlek, M., Koirala, N., Bansal, N. & Oh, S. Solid State Commun. 215–216 , 54–62 (2015).

Choi, Y. & Lee, S. Y. Nature Rev. Chem . https://doi.org/10.1038/s41570-020-00221-w (2020).

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The structure of a literature review

A literature review should be structured like any other essay: it should have an introduction, a middle or main body, and a conclusion.

Introduction

The introduction should:

  • define your topic and provide an appropriate context for reviewing the literature;
  • establish your reasons – i.e. point of view – for
  • reviewing the literature;
  • explain the organisation – i.e. sequence – of the review;
  • state the scope of the review – i.e. what is included and what isn’t included. For example, if you were reviewing the literature on obesity in children you might say something like: There are a large number of studies of obesity trends in the general population. However, since the focus of this research is on obesity in children, these will not be reviewed in detail and will only be referred to as appropriate.

The middle or main body should:

  • organise the literature according to common themes;
  • provide insight into the relation between your chosen topic and the wider subject area e.g. between obesity in children and obesity in general;
  • move from a general, wider view of the literature being reviewed to the specific focus of your research.

The conclusion should:

  • summarise the important aspects of the existing body of literature;
  • evaluate the current state of the literature reviewed;
  • identify significant flaws or gaps in existing knowledge;
  • outline areas for future study;
  • link your research to existing knowledge.

Privacy Overview

Learn how to write a review of literature

What is a review of literature.

The format of a review of literature may vary from discipline to discipline and from assignment to assignment.

A review may be a self-contained unit — an end in itself — or a preface to and rationale for engaging in primary research. A review is a required part of grant and research proposals and often a chapter in theses and dissertations.

Generally, the purpose of a review is to analyze critically a segment of a published body of knowledge through summary, classification, and comparison of prior research studies, reviews of literature, and theoretical articles.

Writing the introduction

In the introduction, you should:

Define or identify the general topic, issue, or area of concern, thus providing an appropriate context for reviewing the literature.

Point out overall trends in what has been published about the topic; or conflicts in theory, methodology, evidence, and conclusions; or gaps in research and scholarship; or a single problem or new perspective of immediate interest.

Establish the writer’s reason (point of view) for reviewing the literature; explain the criteria to be used in analyzing and comparing literature and the organization of the review (sequence); and, when necessary, state why certain literature is or is not included (scope).

Writing the body

In the body, you should:

Group research studies and other types of literature (reviews, theoretical articles, case studies, etc.) according to common denominators such as qualitative versus quantitative approaches, conclusions of authors, specific purpose or objective, chronology, etc.

Summarize individual studies or articles with as much or as little detail as each merits according to its comparative importance in the literature, remembering that space (length) denotes significance.

Provide the reader with strong “umbrella” sentences at beginnings of paragraphs, “signposts” throughout, and brief “so what” summary sentences at intermediate points in the review to aid in understanding comparisons and analyses.

Writing the conclusion

In the conclusion, you should:

Summarize major contributions of significant studies and articles to the body of knowledge under review, maintaining the focus established in the introduction.

Evaluate the current “state of the art” for the body of knowledge reviewed, pointing out major methodological flaws or gaps in research, inconsistencies in theory and findings, and areas or issues pertinent to future study.

Conclude by providing some insight into the relationship between the central topic of the literature review and a larger area of study such as a discipline, a scientific endeavor, or a profession.

For further information see our handouts on Writing a Critical Review of a Nonfiction Book or Article or Reading a Book to Review It .

To learn more about literature reviews, take a look at our workshop on Writing Literature Reviews of Published Research.

Sample Literature Reviews

An important strategy for learning how to compose literature reviews in your field or within a specific genre is to locate and analyze representative examples. The following collection of annotated sample literature reviews written and co-written by colleagues associated with UW-Madison showcases how these reviews can do different kind of work for different purposes. Use these successful examples as a starting point for understanding how other writers have approached the challenging and important task of situating their idea in the context of established research.

  • Sample 1 (PDF) A brief literature review within a political scientists’  National Science Foundation Graduate Research Fellowship  grant
  • Sample 2 (PDF) A several-page literature review at the beginning of a published, academic article about philosophy
  • Sample 3 (PDF) A brief literature review at the beginning of a published, academic article about photochemistry

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  • UConn Library
  • Literature Review: The What, Why and How-to Guide
  • Introduction

Literature Review: The What, Why and How-to Guide — Introduction

  • Getting Started
  • How to Pick a Topic
  • Strategies to Find Sources
  • Evaluating Sources & Lit. Reviews
  • Tips for Writing Literature Reviews
  • Writing Literature Review: Useful Sites
  • Citation Resources
  • Other Academic Writings

What are Literature Reviews?

So, what is a literature review? "A literature review is an account of what has been published on a topic by accredited scholars and researchers. In writing the literature review, your purpose is to convey to your reader what knowledge and ideas have been established on a topic, and what their strengths and weaknesses are. As a piece of writing, the literature review must be defined by a guiding concept (e.g., your research objective, the problem or issue you are discussing, or your argumentative thesis). It is not just a descriptive list of the material available, or a set of summaries." Taylor, D.  The literature review: A few tips on conducting it . University of Toronto Health Sciences Writing Centre.

Goals of Literature Reviews

What are the goals of creating a Literature Review?  A literature could be written to accomplish different aims:

  • To develop a theory or evaluate an existing theory
  • To summarize the historical or existing state of a research topic
  • Identify a problem in a field of research 

Baumeister, R. F., & Leary, M. R. (1997). Writing narrative literature reviews .  Review of General Psychology , 1 (3), 311-320.

What kinds of sources require a Literature Review?

  • A research paper assigned in a course
  • A thesis or dissertation
  • A grant proposal
  • An article intended for publication in a journal

All these instances require you to collect what has been written about your research topic so that you can demonstrate how your own research sheds new light on the topic.

Types of Literature Reviews

What kinds of literature reviews are written?

Narrative review: The purpose of this type of review is to describe the current state of the research on a specific topic/research and to offer a critical analysis of the literature reviewed. Studies are grouped by research/theoretical categories, and themes and trends, strengths and weakness, and gaps are identified. The review ends with a conclusion section which summarizes the findings regarding the state of the research of the specific study, the gaps identify and if applicable, explains how the author's research will address gaps identify in the review and expand the knowledge on the topic reviewed.

  • Example : Predictors and Outcomes of U.S. Quality Maternity Leave: A Review and Conceptual Framework:  10.1177/08948453211037398  

Systematic review : "The authors of a systematic review use a specific procedure to search the research literature, select the studies to include in their review, and critically evaluate the studies they find." (p. 139). Nelson, L. K. (2013). Research in Communication Sciences and Disorders . Plural Publishing.

  • Example : The effect of leave policies on increasing fertility: a systematic review:  10.1057/s41599-022-01270-w

Meta-analysis : "Meta-analysis is a method of reviewing research findings in a quantitative fashion by transforming the data from individual studies into what is called an effect size and then pooling and analyzing this information. The basic goal in meta-analysis is to explain why different outcomes have occurred in different studies." (p. 197). Roberts, M. C., & Ilardi, S. S. (2003). Handbook of Research Methods in Clinical Psychology . Blackwell Publishing.

  • Example : Employment Instability and Fertility in Europe: A Meta-Analysis:  10.1215/00703370-9164737

Meta-synthesis : "Qualitative meta-synthesis is a type of qualitative study that uses as data the findings from other qualitative studies linked by the same or related topic." (p.312). Zimmer, L. (2006). Qualitative meta-synthesis: A question of dialoguing with texts .  Journal of Advanced Nursing , 53 (3), 311-318.

  • Example : Women’s perspectives on career successes and barriers: A qualitative meta-synthesis:  10.1177/05390184221113735

Literature Reviews in the Health Sciences

  • UConn Health subject guide on systematic reviews Explanation of the different review types used in health sciences literature as well as tools to help you find the right review type
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How to Write a Literature Review

What is a literature review.

  • What Is the Literature
  • Writing the Review

A literature review is much more than an annotated bibliography or a list of separate reviews of articles and books. It is a critical, analytical summary and synthesis of the current knowledge of a topic. Thus it should compare and relate different theories, findings, etc, rather than just summarize them individually. In addition, it should have a particular focus or theme to organize the review. It does not have to be an exhaustive account of everything published on the topic, but it should discuss all the significant academic literature and other relevant sources important for that focus.

This is meant to be a general guide to writing a literature review: ways to structure one, what to include, how it supplements other research. For more specific help on writing a review, and especially for help on finding the literature to review, sign up for a Personal Research Session .

The specific organization of a literature review depends on the type and purpose of the review, as well as on the specific field or topic being reviewed. But in general, it is a relatively brief but thorough exploration of past and current work on a topic. Rather than a chronological listing of previous work, though, literature reviews are usually organized thematically, such as different theoretical approaches, methodologies, or specific issues or concepts involved in the topic. A thematic organization makes it much easier to examine contrasting perspectives, theoretical approaches, methodologies, findings, etc, and to analyze the strengths and weaknesses of, and point out any gaps in, previous research. And this is the heart of what a literature review is about. A literature review may offer new interpretations, theoretical approaches, or other ideas; if it is part of a research proposal or report it should demonstrate the relationship of the proposed or reported research to others' work; but whatever else it does, it must provide a critical overview of the current state of research efforts. 

Literature reviews are common and very important in the sciences and social sciences. They are less common and have a less important role in the humanities, but they do have a place, especially stand-alone reviews.

Types of Literature Reviews

There are different types of literature reviews, and different purposes for writing a review, but the most common are:

  • Stand-alone literature review articles . These provide an overview and analysis of the current state of research on a topic or question. The goal is to evaluate and compare previous research on a topic to provide an analysis of what is currently known, and also to reveal controversies, weaknesses, and gaps in current work, thus pointing to directions for future research. You can find examples published in any number of academic journals, but there is a series of Annual Reviews of *Subject* which are specifically devoted to literature review articles. Writing a stand-alone review is often an effective way to get a good handle on a topic and to develop ideas for your own research program. For example, contrasting theoretical approaches or conflicting interpretations of findings can be the basis of your research project: can you find evidence supporting one interpretation against another, or can you propose an alternative interpretation that overcomes their limitations?
  • Part of a research proposal . This could be a proposal for a PhD dissertation, a senior thesis, or a class project. It could also be a submission for a grant. The literature review, by pointing out the current issues and questions concerning a topic, is a crucial part of demonstrating how your proposed research will contribute to the field, and thus of convincing your thesis committee to allow you to pursue the topic of your interest or a funding agency to pay for your research efforts.
  • Part of a research report . When you finish your research and write your thesis or paper to present your findings, it should include a literature review to provide the context to which your work is a contribution. Your report, in addition to detailing the methods, results, etc. of your research, should show how your work relates to others' work.

A literature review for a research report is often a revision of the review for a research proposal, which can be a revision of a stand-alone review. Each revision should be a fairly extensive revision. With the increased knowledge of and experience in the topic as you proceed, your understanding of the topic will increase. Thus, you will be in a better position to analyze and critique the literature. In addition, your focus will change as you proceed in your research. Some areas of the literature you initially reviewed will be marginal or irrelevant for your eventual research, and you will need to explore other areas more thoroughly. 

Examples of Literature Reviews

See the series of Annual Reviews of *Subject* which are specifically devoted to literature review articles to find many examples of stand-alone literature reviews in the biomedical, physical, and social sciences. 

Research report articles vary in how they are organized, but a common general structure is to have sections such as:

  • Abstract - Brief summary of the contents of the article
  • Introduction - A explanation of the purpose of the study, a statement of the research question(s) the study intends to address
  • Literature review - A critical assessment of the work done so far on this topic, to show how the current study relates to what has already been done
  • Methods - How the study was carried out (e.g. instruments or equipment, procedures, methods to gather and analyze data)
  • Results - What was found in the course of the study
  • Discussion - What do the results mean
  • Conclusion - State the conclusions and implications of the results, and discuss how it relates to the work reviewed in the literature review; also, point to directions for further work in the area

Here are some articles that illustrate variations on this theme. There is no need to read the entire articles (unless the contents interest you); just quickly browse through to see the sections, and see how each section is introduced and what is contained in them.

The Determinants of Undergraduate Grade Point Average: The Relative Importance of Family Background, High School Resources, and Peer Group Effects , in The Journal of Human Resources , v. 34 no. 2 (Spring 1999), p. 268-293.

This article has a standard breakdown of sections:

  • Introduction
  • Literature Review
  • Some discussion sections

First Encounters of the Bureaucratic Kind: Early Freshman Experiences with a Campus Bureaucracy , in The Journal of Higher Education , v. 67 no. 6 (Nov-Dec 1996), p. 660-691.

This one does not have a section specifically labeled as a "literature review" or "review of the literature," but the first few sections cite a long list of other sources discussing previous research in the area before the authors present their own study they are reporting.

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A literature review surveys prior research published in books, scholarly articles, and any other sources relevant to a particular issue, area of research, or theory, and by so doing, provides a description, summary, and critical evaluation of these works in relation to the research problem being investigated. Literature reviews are designed to provide an overview of sources you have used in researching a particular topic and to demonstrate to your readers how your research fits within existing scholarship about the topic.

Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . Fourth edition. Thousand Oaks, CA: SAGE, 2014.

Importance of a Good Literature Review

A literature review may consist of simply a summary of key sources, but in the social sciences, a literature review usually has an organizational pattern and combines both summary and synthesis, often within specific conceptual categories . A summary is a recap of the important information of the source, but a synthesis is a re-organization, or a reshuffling, of that information in a way that informs how you are planning to investigate a research problem. The analytical features of a literature review might:

  • Give a new interpretation of old material or combine new with old interpretations,
  • Trace the intellectual progression of the field, including major debates,
  • Depending on the situation, evaluate the sources and advise the reader on the most pertinent or relevant research, or
  • Usually in the conclusion of a literature review, identify where gaps exist in how a problem has been researched to date.

Given this, the purpose of a literature review is to:

  • Place each work in the context of its contribution to understanding the research problem being studied.
  • Describe the relationship of each work to the others under consideration.
  • Identify new ways to interpret prior research.
  • Reveal any gaps that exist in the literature.
  • Resolve conflicts amongst seemingly contradictory previous studies.
  • Identify areas of prior scholarship to prevent duplication of effort.
  • Point the way in fulfilling a need for additional research.
  • Locate your own research within the context of existing literature [very important].

Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper. 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Jesson, Jill. Doing Your Literature Review: Traditional and Systematic Techniques . Los Angeles, CA: SAGE, 2011; Knopf, Jeffrey W. "Doing a Literature Review." PS: Political Science and Politics 39 (January 2006): 127-132; Ridley, Diana. The Literature Review: A Step-by-Step Guide for Students . 2nd ed. Los Angeles, CA: SAGE, 2012.

Types of Literature Reviews

It is important to think of knowledge in a given field as consisting of three layers. First, there are the primary studies that researchers conduct and publish. Second are the reviews of those studies that summarize and offer new interpretations built from and often extending beyond the primary studies. Third, there are the perceptions, conclusions, opinion, and interpretations that are shared informally among scholars that become part of the body of epistemological traditions within the field.

In composing a literature review, it is important to note that it is often this third layer of knowledge that is cited as "true" even though it often has only a loose relationship to the primary studies and secondary literature reviews. Given this, while literature reviews are designed to provide an overview and synthesis of pertinent sources you have explored, there are a number of approaches you could adopt depending upon the type of analysis underpinning your study.

Argumentative Review This form examines literature selectively in order to support or refute an argument, deeply embedded assumption, or philosophical problem already established in the literature. The purpose is to develop a body of literature that establishes a contrarian viewpoint. Given the value-laden nature of some social science research [e.g., educational reform; immigration control], argumentative approaches to analyzing the literature can be a legitimate and important form of discourse. However, note that they can also introduce problems of bias when they are used to make summary claims of the sort found in systematic reviews [see below].

Integrative Review Considered a form of research that reviews, critiques, and synthesizes representative literature on a topic in an integrated way such that new frameworks and perspectives on the topic are generated. The body of literature includes all studies that address related or identical hypotheses or research problems. A well-done integrative review meets the same standards as primary research in regard to clarity, rigor, and replication. This is the most common form of review in the social sciences.

Historical Review Few things rest in isolation from historical precedent. Historical literature reviews focus on examining research throughout a period of time, often starting with the first time an issue, concept, theory, phenomena emerged in the literature, then tracing its evolution within the scholarship of a discipline. The purpose is to place research in a historical context to show familiarity with state-of-the-art developments and to identify the likely directions for future research.

Methodological Review A review does not always focus on what someone said [findings], but how they came about saying what they say [method of analysis]. Reviewing methods of analysis provides a framework of understanding at different levels [i.e. those of theory, substantive fields, research approaches, and data collection and analysis techniques], how researchers draw upon a wide variety of knowledge ranging from the conceptual level to practical documents for use in fieldwork in the areas of ontological and epistemological consideration, quantitative and qualitative integration, sampling, interviewing, data collection, and data analysis. This approach helps highlight ethical issues which you should be aware of and consider as you go through your own study.

Systematic Review This form consists of an overview of existing evidence pertinent to a clearly formulated research question, which uses pre-specified and standardized methods to identify and critically appraise relevant research, and to collect, report, and analyze data from the studies that are included in the review. The goal is to deliberately document, critically evaluate, and summarize scientifically all of the research about a clearly defined research problem . Typically it focuses on a very specific empirical question, often posed in a cause-and-effect form, such as "To what extent does A contribute to B?" This type of literature review is primarily applied to examining prior research studies in clinical medicine and allied health fields, but it is increasingly being used in the social sciences.

Theoretical Review The purpose of this form is to examine the corpus of theory that has accumulated in regard to an issue, concept, theory, phenomena. The theoretical literature review helps to establish what theories already exist, the relationships between them, to what degree the existing theories have been investigated, and to develop new hypotheses to be tested. Often this form is used to help establish a lack of appropriate theories or reveal that current theories are inadequate for explaining new or emerging research problems. The unit of analysis can focus on a theoretical concept or a whole theory or framework.

NOTE : Most often the literature review will incorporate some combination of types. For example, a review that examines literature supporting or refuting an argument, assumption, or philosophical problem related to the research problem will also need to include writing supported by sources that establish the history of these arguments in the literature.

Baumeister, Roy F. and Mark R. Leary. "Writing Narrative Literature Reviews."  Review of General Psychology 1 (September 1997): 311-320; Mark R. Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Kennedy, Mary M. "Defining a Literature." Educational Researcher 36 (April 2007): 139-147; Petticrew, Mark and Helen Roberts. Systematic Reviews in the Social Sciences: A Practical Guide . Malden, MA: Blackwell Publishers, 2006; Torracro, Richard. "Writing Integrative Literature Reviews: Guidelines and Examples." Human Resource Development Review 4 (September 2005): 356-367; Rocco, Tonette S. and Maria S. Plakhotnik. "Literature Reviews, Conceptual Frameworks, and Theoretical Frameworks: Terms, Functions, and Distinctions." Human Ressource Development Review 8 (March 2008): 120-130; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016.

Structure and Writing Style

I.  Thinking About Your Literature Review

The structure of a literature review should include the following in support of understanding the research problem :

  • An overview of the subject, issue, or theory under consideration, along with the objectives of the literature review,
  • Division of works under review into themes or categories [e.g. works that support a particular position, those against, and those offering alternative approaches entirely],
  • An explanation of how each work is similar to and how it varies from the others,
  • Conclusions as to which pieces are best considered in their argument, are most convincing of their opinions, and make the greatest contribution to the understanding and development of their area of research.

The critical evaluation of each work should consider :

  • Provenance -- what are the author's credentials? Are the author's arguments supported by evidence [e.g. primary historical material, case studies, narratives, statistics, recent scientific findings]?
  • Methodology -- were the techniques used to identify, gather, and analyze the data appropriate to addressing the research problem? Was the sample size appropriate? Were the results effectively interpreted and reported?
  • Objectivity -- is the author's perspective even-handed or prejudicial? Is contrary data considered or is certain pertinent information ignored to prove the author's point?
  • Persuasiveness -- which of the author's theses are most convincing or least convincing?
  • Validity -- are the author's arguments and conclusions convincing? Does the work ultimately contribute in any significant way to an understanding of the subject?

II.  Development of the Literature Review

Four Basic Stages of Writing 1.  Problem formulation -- which topic or field is being examined and what are its component issues? 2.  Literature search -- finding materials relevant to the subject being explored. 3.  Data evaluation -- determining which literature makes a significant contribution to the understanding of the topic. 4.  Analysis and interpretation -- discussing the findings and conclusions of pertinent literature.

Consider the following issues before writing the literature review: Clarify If your assignment is not specific about what form your literature review should take, seek clarification from your professor by asking these questions: 1.  Roughly how many sources would be appropriate to include? 2.  What types of sources should I review (books, journal articles, websites; scholarly versus popular sources)? 3.  Should I summarize, synthesize, or critique sources by discussing a common theme or issue? 4.  Should I evaluate the sources in any way beyond evaluating how they relate to understanding the research problem? 5.  Should I provide subheadings and other background information, such as definitions and/or a history? Find Models Use the exercise of reviewing the literature to examine how authors in your discipline or area of interest have composed their literature review sections. Read them to get a sense of the types of themes you might want to look for in your own research or to identify ways to organize your final review. The bibliography or reference section of sources you've already read, such as required readings in the course syllabus, are also excellent entry points into your own research. Narrow the Topic The narrower your topic, the easier it will be to limit the number of sources you need to read in order to obtain a good survey of relevant resources. Your professor will probably not expect you to read everything that's available about the topic, but you'll make the act of reviewing easier if you first limit scope of the research problem. A good strategy is to begin by searching the USC Libraries Catalog for recent books about the topic and review the table of contents for chapters that focuses on specific issues. You can also review the indexes of books to find references to specific issues that can serve as the focus of your research. For example, a book surveying the history of the Israeli-Palestinian conflict may include a chapter on the role Egypt has played in mediating the conflict, or look in the index for the pages where Egypt is mentioned in the text. Consider Whether Your Sources are Current Some disciplines require that you use information that is as current as possible. This is particularly true in disciplines in medicine and the sciences where research conducted becomes obsolete very quickly as new discoveries are made. However, when writing a review in the social sciences, a survey of the history of the literature may be required. In other words, a complete understanding the research problem requires you to deliberately examine how knowledge and perspectives have changed over time. Sort through other current bibliographies or literature reviews in the field to get a sense of what your discipline expects. You can also use this method to explore what is considered by scholars to be a "hot topic" and what is not.

III.  Ways to Organize Your Literature Review

Chronology of Events If your review follows the chronological method, you could write about the materials according to when they were published. This approach should only be followed if a clear path of research building on previous research can be identified and that these trends follow a clear chronological order of development. For example, a literature review that focuses on continuing research about the emergence of German economic power after the fall of the Soviet Union. By Publication Order your sources by publication chronology, then, only if the order demonstrates a more important trend. For instance, you could order a review of literature on environmental studies of brown fields if the progression revealed, for example, a change in the soil collection practices of the researchers who wrote and/or conducted the studies. Thematic [“conceptual categories”] A thematic literature review is the most common approach to summarizing prior research in the social and behavioral sciences. Thematic reviews are organized around a topic or issue, rather than the progression of time, although the progression of time may still be incorporated into a thematic review. For example, a review of the Internet’s impact on American presidential politics could focus on the development of online political satire. While the study focuses on one topic, the Internet’s impact on American presidential politics, it would still be organized chronologically reflecting technological developments in media. The difference in this example between a "chronological" and a "thematic" approach is what is emphasized the most: themes related to the role of the Internet in presidential politics. Note that more authentic thematic reviews tend to break away from chronological order. A review organized in this manner would shift between time periods within each section according to the point being made. Methodological A methodological approach focuses on the methods utilized by the researcher. For the Internet in American presidential politics project, one methodological approach would be to look at cultural differences between the portrayal of American presidents on American, British, and French websites. Or the review might focus on the fundraising impact of the Internet on a particular political party. A methodological scope will influence either the types of documents in the review or the way in which these documents are discussed.

Other Sections of Your Literature Review Once you've decided on the organizational method for your literature review, the sections you need to include in the paper should be easy to figure out because they arise from your organizational strategy. In other words, a chronological review would have subsections for each vital time period; a thematic review would have subtopics based upon factors that relate to the theme or issue. However, sometimes you may need to add additional sections that are necessary for your study, but do not fit in the organizational strategy of the body. What other sections you include in the body is up to you. However, only include what is necessary for the reader to locate your study within the larger scholarship about the research problem.

Here are examples of other sections, usually in the form of a single paragraph, you may need to include depending on the type of review you write:

  • Current Situation : Information necessary to understand the current topic or focus of the literature review.
  • Sources Used : Describes the methods and resources [e.g., databases] you used to identify the literature you reviewed.
  • History : The chronological progression of the field, the research literature, or an idea that is necessary to understand the literature review, if the body of the literature review is not already a chronology.
  • Selection Methods : Criteria you used to select (and perhaps exclude) sources in your literature review. For instance, you might explain that your review includes only peer-reviewed [i.e., scholarly] sources.
  • Standards : Description of the way in which you present your information.
  • Questions for Further Research : What questions about the field has the review sparked? How will you further your research as a result of the review?

IV.  Writing Your Literature Review

Once you've settled on how to organize your literature review, you're ready to write each section. When writing your review, keep in mind these issues.

Use Evidence A literature review section is, in this sense, just like any other academic research paper. Your interpretation of the available sources must be backed up with evidence [citations] that demonstrates that what you are saying is valid. Be Selective Select only the most important points in each source to highlight in the review. The type of information you choose to mention should relate directly to the research problem, whether it is thematic, methodological, or chronological. Related items that provide additional information, but that are not key to understanding the research problem, can be included in a list of further readings . Use Quotes Sparingly Some short quotes are appropriate if you want to emphasize a point, or if what an author stated cannot be easily paraphrased. Sometimes you may need to quote certain terminology that was coined by the author, is not common knowledge, or taken directly from the study. Do not use extensive quotes as a substitute for using your own words in reviewing the literature. Summarize and Synthesize Remember to summarize and synthesize your sources within each thematic paragraph as well as throughout the review. Recapitulate important features of a research study, but then synthesize it by rephrasing the study's significance and relating it to your own work and the work of others. Keep Your Own Voice While the literature review presents others' ideas, your voice [the writer's] should remain front and center. For example, weave references to other sources into what you are writing but maintain your own voice by starting and ending the paragraph with your own ideas and wording. Use Caution When Paraphrasing When paraphrasing a source that is not your own, be sure to represent the author's information or opinions accurately and in your own words. Even when paraphrasing an author’s work, you still must provide a citation to that work.

V.  Common Mistakes to Avoid

These are the most common mistakes made in reviewing social science research literature.

  • Sources in your literature review do not clearly relate to the research problem;
  • You do not take sufficient time to define and identify the most relevant sources to use in the literature review related to the research problem;
  • Relies exclusively on secondary analytical sources rather than including relevant primary research studies or data;
  • Uncritically accepts another researcher's findings and interpretations as valid, rather than examining critically all aspects of the research design and analysis;
  • Does not describe the search procedures that were used in identifying the literature to review;
  • Reports isolated statistical results rather than synthesizing them in chi-squared or meta-analytic methods; and,
  • Only includes research that validates assumptions and does not consider contrary findings and alternative interpretations found in the literature.

Cook, Kathleen E. and Elise Murowchick. “Do Literature Review Skills Transfer from One Course to Another?” Psychology Learning and Teaching 13 (March 2014): 3-11; Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Jesson, Jill. Doing Your Literature Review: Traditional and Systematic Techniques . London: SAGE, 2011; Literature Review Handout. Online Writing Center. Liberty University; Literature Reviews. The Writing Center. University of North Carolina; Onwuegbuzie, Anthony J. and Rebecca Frels. Seven Steps to a Comprehensive Literature Review: A Multimodal and Cultural Approach . Los Angeles, CA: SAGE, 2016; Ridley, Diana. The Literature Review: A Step-by-Step Guide for Students . 2nd ed. Los Angeles, CA: SAGE, 2012; Randolph, Justus J. “A Guide to Writing the Dissertation Literature Review." Practical Assessment, Research, and Evaluation. vol. 14, June 2009; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016; Taylor, Dena. The Literature Review: A Few Tips On Conducting It. University College Writing Centre. University of Toronto; Writing a Literature Review. Academic Skills Centre. University of Canberra.

Writing Tip

Break Out of Your Disciplinary Box!

Thinking interdisciplinarily about a research problem can be a rewarding exercise in applying new ideas, theories, or concepts to an old problem. For example, what might cultural anthropologists say about the continuing conflict in the Middle East? In what ways might geographers view the need for better distribution of social service agencies in large cities than how social workers might study the issue? You don’t want to substitute a thorough review of core research literature in your discipline for studies conducted in other fields of study. However, particularly in the social sciences, thinking about research problems from multiple vectors is a key strategy for finding new solutions to a problem or gaining a new perspective. Consult with a librarian about identifying research databases in other disciplines; almost every field of study has at least one comprehensive database devoted to indexing its research literature.

Frodeman, Robert. The Oxford Handbook of Interdisciplinarity . New York: Oxford University Press, 2010.

Another Writing Tip

Don't Just Review for Content!

While conducting a review of the literature, maximize the time you devote to writing this part of your paper by thinking broadly about what you should be looking for and evaluating. Review not just what scholars are saying, but how are they saying it. Some questions to ask:

  • How are they organizing their ideas?
  • What methods have they used to study the problem?
  • What theories have been used to explain, predict, or understand their research problem?
  • What sources have they cited to support their conclusions?
  • How have they used non-textual elements [e.g., charts, graphs, figures, etc.] to illustrate key points?

When you begin to write your literature review section, you'll be glad you dug deeper into how the research was designed and constructed because it establishes a means for developing more substantial analysis and interpretation of the research problem.

Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1 998.

Yet Another Writing Tip

When Do I Know I Can Stop Looking and Move On?

Here are several strategies you can utilize to assess whether you've thoroughly reviewed the literature:

  • Look for repeating patterns in the research findings . If the same thing is being said, just by different people, then this likely demonstrates that the research problem has hit a conceptual dead end. At this point consider: Does your study extend current research?  Does it forge a new path? Or, does is merely add more of the same thing being said?
  • Look at sources the authors cite to in their work . If you begin to see the same researchers cited again and again, then this is often an indication that no new ideas have been generated to address the research problem.
  • Search Google Scholar to identify who has subsequently cited leading scholars already identified in your literature review [see next sub-tab]. This is called citation tracking and there are a number of sources that can help you identify who has cited whom, particularly scholars from outside of your discipline. Here again, if the same authors are being cited again and again, this may indicate no new literature has been written on the topic.

Onwuegbuzie, Anthony J. and Rebecca Frels. Seven Steps to a Comprehensive Literature Review: A Multimodal and Cultural Approach . Los Angeles, CA: Sage, 2016; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016.

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When you began looking through this book, you may have already been an accomplished researcher and writer.  As a student, you may have had both research and writing experiences as an undergraduate that prepared you for your first graduate-level literature review.  For most graduate students, however, many of the concepts and skills needed to successfully complete this high-stakes document will be new.  And, while developing these skills is not always a linear process, the effort put into acquiring them will serve you throughout both your academic and professional life.

Here is a quick review of the main points from each of the chapters in this book:

  • The purpose of a literature review is to survey the current state of knowledge in the area of inquiry; to identify key authors, articles, theories, and findings in that area; and to identify gaps in knowledge in that research area. (Chapter 1)
  • Accepts another researcher’s finding as valid without evaluating methodology and data
  • Neglects to consider or mention contrary findings and alternative interpretations
  • Findings are not clearly related to one’s own study or findings are too general.
  • Allows insufficient time to define best search strategies and writing
  • Simply reports individual studies rather than synthesizing the results
  • Problems with selecting and using most relevant keywords and descriptors are evident.
  • Relies too heavily on secondary sources
  • Does not record or report search procedures
  • Summarizes rather than synthesizes (Chapter 1)
  • By understanding what the literature in your field is, as well as how and when it is generated, you begin to know what is available and where to look for it. (Chapter 2)
  • Most graduate-level literature reviews begin with choosing a relevant, appropriate, interesting topic and then changing it. (Chapter 3)
  • Search and discovery of the literature is an iterative process.  There are many places to look and many tools and techniques to use to find resources.  Advanced researchers master this skill early on and refine it with each project. (Chapter 4)
  • You searched the literature and found lots of relevant resources. How do you now determine whether each item is an appropriate fit for your own review? (Chapter 5)
  • How will your resources be organized (alphabetically or chronologically)?  By broad general theme or theory?  Based on a type of methodology or population?  What citation management program or software are you going to use to keep track of all your references? (Chapter 6)
  • Your literature review is not a summary of all the articles you read but rather a synthesis that demonstrates a critical analysis of the papers you collected as well as your ability to integrate the results of your analysis into your own literature review. (Chapter 7)
  • Like any effective argument, the literature review is about both content and form.  It should have logical and smooth flow, a clear introduction and conclusion, and use a consistent citation style throughout. (Chapter 8)

Remember: Writing a good literature review takes time.  Start early.  Begin thinking about your topic and collect references even while you work on other tasks.  Write a first draft and then revise.  Go over the language, style, and form.  Focus, sharpen, clarify, and search again.  When you are satisfied with the result, you’re done.

How is the literature review evaluated?

It is usually judged in three main areas:

  • Have you clearly indicated the scope and purpose of the review?
  • Have you included a balanced coverage of what is available?
  • Have you included the most recent and relevant studies?
  • Have you included enough material to show the development and limitations in this area?
  • Have you indicated the source of the literature by referencing accurately?
  • Have you used mostly primary sources or appropriate secondary sources?
  • Have you clearly (and logically) ordered and sorted the research, focusing on themes or ideas rather than the authors?
  • Does the review move from broader concepts to a more specific focus?
  • Is there adequate critique of research limitations, including design and methodology?
  • How do the studies compare or contrast with debates or controversies highlighted?
  • Is the relevance to your problem clear?
  • Have you made an overall interpretation of what is available?
  • Do the implications provide theoretical or empirical justification for your own research questions/hypothesis?
  • Do the implications provide a rationale for your research design? (RMIT University)

Many instructors use rubrics to evaluate literature reviews.  For a sample of a literature review rubric that may also serve as a checklist for evaluating your own review before submitting, see Holmlund (2019)   also listed in the Additional Resources section for this chapter.

We hope that this discussion about literature reviews is useful.  After reading this guide, and reviewing the additional resources and activities in each chapter, we hope you have a better understanding of the research and writing process.  What conclusions have you reached regarding the content and structure of a literature review that can answer the question, “How do I write a graduate-level literature review?”

Additional Resources

Bell, J. (2005).   Doing Your Research Project: A Guide for First-Time Researchers in Education, Health and Social Science (4th ed.). New York: Open University Press.

Booth, A., Sutton, Anthea, & Papaioannou, Diana. (2016). Systematic Approaches to a Successful Literature Review (2nd ed.). Los Angeles: Sage Publications.

Collins, S. (2016). Professional Writing in the Health Disciplines .   http://epub-fhd.athabascau.ca/professionalwriting/   CC-BY-NC-SA 4.0

Coughlan, M., & Cronin, Patricia. (2017). Doing a Literature Review in Nursing, Health and Social Care (2nd ed.). Los Angeles: Sage Publications.

Fink, A. (2014). Conducting Research Literature Reviews (4th ed.). Los Angeles, CA: Sage Publications.

Galvan, J.L. (2009). Writing Literature Reviews: A Guide for Students of the Social and Behavioral Sciences .  Glendale, CA : Pyrczak

Garrard, J. (2017). Health Sciences Literature Review Made Easy: The Matrix Method .  Burlington, MA: Jones & Bartlett Learning.

Holmlund, T. (2019).   Sample Literature Review .   Washington State University Vancouver.  CC-BY-NC 4.0

Machi, L.A., & McEvoy, B.T. (2012). The Literature Review: Six Steps to Success .  Thousand Oaks, CA: Corwin.

Milardo, R.M. (2015). Crafting Scholarship in the Behavioral and Social Sciences: Writing, Reviewing, and Editing .  New York: Routledge.

Pautasso M. (2013). Ten simple rules for writing a literature review. PLoS Computational Biology 9(7): e1003149. https://doi.org/10.1371/journal.pcbi.1003149

Petticrew, M., & Roberts, H. (2006). Systematic Reviews in the Social Sciences .  Malden, MA: Blackwell Publishing.

Wallace, M., & Wray, A. (2016). Critical Reading and Writing for Postgraduates  (3rd ed.).  Los Angeles, CA: Sage Publications.

RMIT University (n.d.). Writing the literature review/Using the literature.   https://www.dlsweb.rmit.edu.au/lsu/content/2_assessmenttasks/assess_pdf/PG%20lit%20review.pdf

Literature Reviews for Education and Nursing Graduate Students Copyright © by Linda Frederiksen is licensed under a Creative Commons Attribution 4.0 International License , except where otherwise noted.

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Lau F, Kuziemsky C, editors. Handbook of eHealth Evaluation: An Evidence-based Approach [Internet]. Victoria (BC): University of Victoria; 2017 Feb 27.

Cover of Handbook of eHealth Evaluation: An Evidence-based Approach

Handbook of eHealth Evaluation: An Evidence-based Approach [Internet].

Chapter 9 methods for literature reviews.

Guy Paré and Spyros Kitsiou .

9.1. Introduction

Literature reviews play a critical role in scholarship because science remains, first and foremost, a cumulative endeavour ( vom Brocke et al., 2009 ). As in any academic discipline, rigorous knowledge syntheses are becoming indispensable in keeping up with an exponentially growing eHealth literature, assisting practitioners, academics, and graduate students in finding, evaluating, and synthesizing the contents of many empirical and conceptual papers. Among other methods, literature reviews are essential for: (a) identifying what has been written on a subject or topic; (b) determining the extent to which a specific research area reveals any interpretable trends or patterns; (c) aggregating empirical findings related to a narrow research question to support evidence-based practice; (d) generating new frameworks and theories; and (e) identifying topics or questions requiring more investigation ( Paré, Trudel, Jaana, & Kitsiou, 2015 ).

Literature reviews can take two major forms. The most prevalent one is the “literature review” or “background” section within a journal paper or a chapter in a graduate thesis. This section synthesizes the extant literature and usually identifies the gaps in knowledge that the empirical study addresses ( Sylvester, Tate, & Johnstone, 2013 ). It may also provide a theoretical foundation for the proposed study, substantiate the presence of the research problem, justify the research as one that contributes something new to the cumulated knowledge, or validate the methods and approaches for the proposed study ( Hart, 1998 ; Levy & Ellis, 2006 ).

The second form of literature review, which is the focus of this chapter, constitutes an original and valuable work of research in and of itself ( Paré et al., 2015 ). Rather than providing a base for a researcher’s own work, it creates a solid starting point for all members of the community interested in a particular area or topic ( Mulrow, 1987 ). The so-called “review article” is a journal-length paper which has an overarching purpose to synthesize the literature in a field, without collecting or analyzing any primary data ( Green, Johnson, & Adams, 2006 ).

When appropriately conducted, review articles represent powerful information sources for practitioners looking for state-of-the art evidence to guide their decision-making and work practices ( Paré et al., 2015 ). Further, high-quality reviews become frequently cited pieces of work which researchers seek out as a first clear outline of the literature when undertaking empirical studies ( Cooper, 1988 ; Rowe, 2014 ). Scholars who track and gauge the impact of articles have found that review papers are cited and downloaded more often than any other type of published article ( Cronin, Ryan, & Coughlan, 2008 ; Montori, Wilczynski, Morgan, Haynes, & Hedges, 2003 ; Patsopoulos, Analatos, & Ioannidis, 2005 ). The reason for their popularity may be the fact that reading the review enables one to have an overview, if not a detailed knowledge of the area in question, as well as references to the most useful primary sources ( Cronin et al., 2008 ). Although they are not easy to conduct, the commitment to complete a review article provides a tremendous service to one’s academic community ( Paré et al., 2015 ; Petticrew & Roberts, 2006 ). Most, if not all, peer-reviewed journals in the fields of medical informatics publish review articles of some type.

The main objectives of this chapter are fourfold: (a) to provide an overview of the major steps and activities involved in conducting a stand-alone literature review; (b) to describe and contrast the different types of review articles that can contribute to the eHealth knowledge base; (c) to illustrate each review type with one or two examples from the eHealth literature; and (d) to provide a series of recommendations for prospective authors of review articles in this domain.

9.2. Overview of the Literature Review Process and Steps

As explained in Templier and Paré (2015) , there are six generic steps involved in conducting a review article:

  • formulating the research question(s) and objective(s),
  • searching the extant literature,
  • screening for inclusion,
  • assessing the quality of primary studies,
  • extracting data, and
  • analyzing data.

Although these steps are presented here in sequential order, one must keep in mind that the review process can be iterative and that many activities can be initiated during the planning stage and later refined during subsequent phases ( Finfgeld-Connett & Johnson, 2013 ; Kitchenham & Charters, 2007 ).

Formulating the research question(s) and objective(s): As a first step, members of the review team must appropriately justify the need for the review itself ( Petticrew & Roberts, 2006 ), identify the review’s main objective(s) ( Okoli & Schabram, 2010 ), and define the concepts or variables at the heart of their synthesis ( Cooper & Hedges, 2009 ; Webster & Watson, 2002 ). Importantly, they also need to articulate the research question(s) they propose to investigate ( Kitchenham & Charters, 2007 ). In this regard, we concur with Jesson, Matheson, and Lacey (2011) that clearly articulated research questions are key ingredients that guide the entire review methodology; they underscore the type of information that is needed, inform the search for and selection of relevant literature, and guide or orient the subsequent analysis. Searching the extant literature: The next step consists of searching the literature and making decisions about the suitability of material to be considered in the review ( Cooper, 1988 ). There exist three main coverage strategies. First, exhaustive coverage means an effort is made to be as comprehensive as possible in order to ensure that all relevant studies, published and unpublished, are included in the review and, thus, conclusions are based on this all-inclusive knowledge base. The second type of coverage consists of presenting materials that are representative of most other works in a given field or area. Often authors who adopt this strategy will search for relevant articles in a small number of top-tier journals in a field ( Paré et al., 2015 ). In the third strategy, the review team concentrates on prior works that have been central or pivotal to a particular topic. This may include empirical studies or conceptual papers that initiated a line of investigation, changed how problems or questions were framed, introduced new methods or concepts, or engendered important debate ( Cooper, 1988 ). Screening for inclusion: The following step consists of evaluating the applicability of the material identified in the preceding step ( Levy & Ellis, 2006 ; vom Brocke et al., 2009 ). Once a group of potential studies has been identified, members of the review team must screen them to determine their relevance ( Petticrew & Roberts, 2006 ). A set of predetermined rules provides a basis for including or excluding certain studies. This exercise requires a significant investment on the part of researchers, who must ensure enhanced objectivity and avoid biases or mistakes. As discussed later in this chapter, for certain types of reviews there must be at least two independent reviewers involved in the screening process and a procedure to resolve disagreements must also be in place ( Liberati et al., 2009 ; Shea et al., 2009 ). Assessing the quality of primary studies: In addition to screening material for inclusion, members of the review team may need to assess the scientific quality of the selected studies, that is, appraise the rigour of the research design and methods. Such formal assessment, which is usually conducted independently by at least two coders, helps members of the review team refine which studies to include in the final sample, determine whether or not the differences in quality may affect their conclusions, or guide how they analyze the data and interpret the findings ( Petticrew & Roberts, 2006 ). Ascribing quality scores to each primary study or considering through domain-based evaluations which study components have or have not been designed and executed appropriately makes it possible to reflect on the extent to which the selected study addresses possible biases and maximizes validity ( Shea et al., 2009 ). Extracting data: The following step involves gathering or extracting applicable information from each primary study included in the sample and deciding what is relevant to the problem of interest ( Cooper & Hedges, 2009 ). Indeed, the type of data that should be recorded mainly depends on the initial research questions ( Okoli & Schabram, 2010 ). However, important information may also be gathered about how, when, where and by whom the primary study was conducted, the research design and methods, or qualitative/quantitative results ( Cooper & Hedges, 2009 ). Analyzing and synthesizing data : As a final step, members of the review team must collate, summarize, aggregate, organize, and compare the evidence extracted from the included studies. The extracted data must be presented in a meaningful way that suggests a new contribution to the extant literature ( Jesson et al., 2011 ). Webster and Watson (2002) warn researchers that literature reviews should be much more than lists of papers and should provide a coherent lens to make sense of extant knowledge on a given topic. There exist several methods and techniques for synthesizing quantitative (e.g., frequency analysis, meta-analysis) and qualitative (e.g., grounded theory, narrative analysis, meta-ethnography) evidence ( Dixon-Woods, Agarwal, Jones, Young, & Sutton, 2005 ; Thomas & Harden, 2008 ).

9.3. Types of Review Articles and Brief Illustrations

EHealth researchers have at their disposal a number of approaches and methods for making sense out of existing literature, all with the purpose of casting current research findings into historical contexts or explaining contradictions that might exist among a set of primary research studies conducted on a particular topic. Our classification scheme is largely inspired from Paré and colleagues’ (2015) typology. Below we present and illustrate those review types that we feel are central to the growth and development of the eHealth domain.

9.3.1. Narrative Reviews

The narrative review is the “traditional” way of reviewing the extant literature and is skewed towards a qualitative interpretation of prior knowledge ( Sylvester et al., 2013 ). Put simply, a narrative review attempts to summarize or synthesize what has been written on a particular topic but does not seek generalization or cumulative knowledge from what is reviewed ( Davies, 2000 ; Green et al., 2006 ). Instead, the review team often undertakes the task of accumulating and synthesizing the literature to demonstrate the value of a particular point of view ( Baumeister & Leary, 1997 ). As such, reviewers may selectively ignore or limit the attention paid to certain studies in order to make a point. In this rather unsystematic approach, the selection of information from primary articles is subjective, lacks explicit criteria for inclusion and can lead to biased interpretations or inferences ( Green et al., 2006 ). There are several narrative reviews in the particular eHealth domain, as in all fields, which follow such an unstructured approach ( Silva et al., 2015 ; Paul et al., 2015 ).

Despite these criticisms, this type of review can be very useful in gathering together a volume of literature in a specific subject area and synthesizing it. As mentioned above, its primary purpose is to provide the reader with a comprehensive background for understanding current knowledge and highlighting the significance of new research ( Cronin et al., 2008 ). Faculty like to use narrative reviews in the classroom because they are often more up to date than textbooks, provide a single source for students to reference, and expose students to peer-reviewed literature ( Green et al., 2006 ). For researchers, narrative reviews can inspire research ideas by identifying gaps or inconsistencies in a body of knowledge, thus helping researchers to determine research questions or formulate hypotheses. Importantly, narrative reviews can also be used as educational articles to bring practitioners up to date with certain topics of issues ( Green et al., 2006 ).

Recently, there have been several efforts to introduce more rigour in narrative reviews that will elucidate common pitfalls and bring changes into their publication standards. Information systems researchers, among others, have contributed to advancing knowledge on how to structure a “traditional” review. For instance, Levy and Ellis (2006) proposed a generic framework for conducting such reviews. Their model follows the systematic data processing approach comprised of three steps, namely: (a) literature search and screening; (b) data extraction and analysis; and (c) writing the literature review. They provide detailed and very helpful instructions on how to conduct each step of the review process. As another methodological contribution, vom Brocke et al. (2009) offered a series of guidelines for conducting literature reviews, with a particular focus on how to search and extract the relevant body of knowledge. Last, Bandara, Miskon, and Fielt (2011) proposed a structured, predefined and tool-supported method to identify primary studies within a feasible scope, extract relevant content from identified articles, synthesize and analyze the findings, and effectively write and present the results of the literature review. We highly recommend that prospective authors of narrative reviews consult these useful sources before embarking on their work.

Darlow and Wen (2015) provide a good example of a highly structured narrative review in the eHealth field. These authors synthesized published articles that describe the development process of mobile health ( m-health ) interventions for patients’ cancer care self-management. As in most narrative reviews, the scope of the research questions being investigated is broad: (a) how development of these systems are carried out; (b) which methods are used to investigate these systems; and (c) what conclusions can be drawn as a result of the development of these systems. To provide clear answers to these questions, a literature search was conducted on six electronic databases and Google Scholar . The search was performed using several terms and free text words, combining them in an appropriate manner. Four inclusion and three exclusion criteria were utilized during the screening process. Both authors independently reviewed each of the identified articles to determine eligibility and extract study information. A flow diagram shows the number of studies identified, screened, and included or excluded at each stage of study selection. In terms of contributions, this review provides a series of practical recommendations for m-health intervention development.

9.3.2. Descriptive or Mapping Reviews

The primary goal of a descriptive review is to determine the extent to which a body of knowledge in a particular research topic reveals any interpretable pattern or trend with respect to pre-existing propositions, theories, methodologies or findings ( King & He, 2005 ; Paré et al., 2015 ). In contrast with narrative reviews, descriptive reviews follow a systematic and transparent procedure, including searching, screening and classifying studies ( Petersen, Vakkalanka, & Kuzniarz, 2015 ). Indeed, structured search methods are used to form a representative sample of a larger group of published works ( Paré et al., 2015 ). Further, authors of descriptive reviews extract from each study certain characteristics of interest, such as publication year, research methods, data collection techniques, and direction or strength of research outcomes (e.g., positive, negative, or non-significant) in the form of frequency analysis to produce quantitative results ( Sylvester et al., 2013 ). In essence, each study included in a descriptive review is treated as the unit of analysis and the published literature as a whole provides a database from which the authors attempt to identify any interpretable trends or draw overall conclusions about the merits of existing conceptualizations, propositions, methods or findings ( Paré et al., 2015 ). In doing so, a descriptive review may claim that its findings represent the state of the art in a particular domain ( King & He, 2005 ).

In the fields of health sciences and medical informatics, reviews that focus on examining the range, nature and evolution of a topic area are described by Anderson, Allen, Peckham, and Goodwin (2008) as mapping reviews . Like descriptive reviews, the research questions are generic and usually relate to publication patterns and trends. There is no preconceived plan to systematically review all of the literature although this can be done. Instead, researchers often present studies that are representative of most works published in a particular area and they consider a specific time frame to be mapped.

An example of this approach in the eHealth domain is offered by DeShazo, Lavallie, and Wolf (2009). The purpose of this descriptive or mapping review was to characterize publication trends in the medical informatics literature over a 20-year period (1987 to 2006). To achieve this ambitious objective, the authors performed a bibliometric analysis of medical informatics citations indexed in medline using publication trends, journal frequencies, impact factors, Medical Subject Headings (MeSH) term frequencies, and characteristics of citations. Findings revealed that there were over 77,000 medical informatics articles published during the covered period in numerous journals and that the average annual growth rate was 12%. The MeSH term analysis also suggested a strong interdisciplinary trend. Finally, average impact scores increased over time with two notable growth periods. Overall, patterns in research outputs that seem to characterize the historic trends and current components of the field of medical informatics suggest it may be a maturing discipline (DeShazo et al., 2009).

9.3.3. Scoping Reviews

Scoping reviews attempt to provide an initial indication of the potential size and nature of the extant literature on an emergent topic (Arksey & O’Malley, 2005; Daudt, van Mossel, & Scott, 2013 ; Levac, Colquhoun, & O’Brien, 2010). A scoping review may be conducted to examine the extent, range and nature of research activities in a particular area, determine the value of undertaking a full systematic review (discussed next), or identify research gaps in the extant literature ( Paré et al., 2015 ). In line with their main objective, scoping reviews usually conclude with the presentation of a detailed research agenda for future works along with potential implications for both practice and research.

Unlike narrative and descriptive reviews, the whole point of scoping the field is to be as comprehensive as possible, including grey literature (Arksey & O’Malley, 2005). Inclusion and exclusion criteria must be established to help researchers eliminate studies that are not aligned with the research questions. It is also recommended that at least two independent coders review abstracts yielded from the search strategy and then the full articles for study selection ( Daudt et al., 2013 ). The synthesized evidence from content or thematic analysis is relatively easy to present in tabular form (Arksey & O’Malley, 2005; Thomas & Harden, 2008 ).

One of the most highly cited scoping reviews in the eHealth domain was published by Archer, Fevrier-Thomas, Lokker, McKibbon, and Straus (2011) . These authors reviewed the existing literature on personal health record ( phr ) systems including design, functionality, implementation, applications, outcomes, and benefits. Seven databases were searched from 1985 to March 2010. Several search terms relating to phr s were used during this process. Two authors independently screened titles and abstracts to determine inclusion status. A second screen of full-text articles, again by two independent members of the research team, ensured that the studies described phr s. All in all, 130 articles met the criteria and their data were extracted manually into a database. The authors concluded that although there is a large amount of survey, observational, cohort/panel, and anecdotal evidence of phr benefits and satisfaction for patients, more research is needed to evaluate the results of phr implementations. Their in-depth analysis of the literature signalled that there is little solid evidence from randomized controlled trials or other studies through the use of phr s. Hence, they suggested that more research is needed that addresses the current lack of understanding of optimal functionality and usability of these systems, and how they can play a beneficial role in supporting patient self-management ( Archer et al., 2011 ).

9.3.4. Forms of Aggregative Reviews

Healthcare providers, practitioners, and policy-makers are nowadays overwhelmed with large volumes of information, including research-based evidence from numerous clinical trials and evaluation studies, assessing the effectiveness of health information technologies and interventions ( Ammenwerth & de Keizer, 2004 ; Deshazo et al., 2009 ). It is unrealistic to expect that all these disparate actors will have the time, skills, and necessary resources to identify the available evidence in the area of their expertise and consider it when making decisions. Systematic reviews that involve the rigorous application of scientific strategies aimed at limiting subjectivity and bias (i.e., systematic and random errors) can respond to this challenge.

Systematic reviews attempt to aggregate, appraise, and synthesize in a single source all empirical evidence that meet a set of previously specified eligibility criteria in order to answer a clearly formulated and often narrow research question on a particular topic of interest to support evidence-based practice ( Liberati et al., 2009 ). They adhere closely to explicit scientific principles ( Liberati et al., 2009 ) and rigorous methodological guidelines (Higgins & Green, 2008) aimed at reducing random and systematic errors that can lead to deviations from the truth in results or inferences. The use of explicit methods allows systematic reviews to aggregate a large body of research evidence, assess whether effects or relationships are in the same direction and of the same general magnitude, explain possible inconsistencies between study results, and determine the strength of the overall evidence for every outcome of interest based on the quality of included studies and the general consistency among them ( Cook, Mulrow, & Haynes, 1997 ). The main procedures of a systematic review involve:

  • Formulating a review question and developing a search strategy based on explicit inclusion criteria for the identification of eligible studies (usually described in the context of a detailed review protocol).
  • Searching for eligible studies using multiple databases and information sources, including grey literature sources, without any language restrictions.
  • Selecting studies, extracting data, and assessing risk of bias in a duplicate manner using two independent reviewers to avoid random or systematic errors in the process.
  • Analyzing data using quantitative or qualitative methods.
  • Presenting results in summary of findings tables.
  • Interpreting results and drawing conclusions.

Many systematic reviews, but not all, use statistical methods to combine the results of independent studies into a single quantitative estimate or summary effect size. Known as meta-analyses , these reviews use specific data extraction and statistical techniques (e.g., network, frequentist, or Bayesian meta-analyses) to calculate from each study by outcome of interest an effect size along with a confidence interval that reflects the degree of uncertainty behind the point estimate of effect ( Borenstein, Hedges, Higgins, & Rothstein, 2009 ; Deeks, Higgins, & Altman, 2008 ). Subsequently, they use fixed or random-effects analysis models to combine the results of the included studies, assess statistical heterogeneity, and calculate a weighted average of the effect estimates from the different studies, taking into account their sample sizes. The summary effect size is a value that reflects the average magnitude of the intervention effect for a particular outcome of interest or, more generally, the strength of a relationship between two variables across all studies included in the systematic review. By statistically combining data from multiple studies, meta-analyses can create more precise and reliable estimates of intervention effects than those derived from individual studies alone, when these are examined independently as discrete sources of information.

The review by Gurol-Urganci, de Jongh, Vodopivec-Jamsek, Atun, and Car (2013) on the effects of mobile phone messaging reminders for attendance at healthcare appointments is an illustrative example of a high-quality systematic review with meta-analysis. Missed appointments are a major cause of inefficiency in healthcare delivery with substantial monetary costs to health systems. These authors sought to assess whether mobile phone-based appointment reminders delivered through Short Message Service ( sms ) or Multimedia Messaging Service ( mms ) are effective in improving rates of patient attendance and reducing overall costs. To this end, they conducted a comprehensive search on multiple databases using highly sensitive search strategies without language or publication-type restrictions to identify all rct s that are eligible for inclusion. In order to minimize the risk of omitting eligible studies not captured by the original search, they supplemented all electronic searches with manual screening of trial registers and references contained in the included studies. Study selection, data extraction, and risk of bias assessments were performed inde­­pen­dently by two coders using standardized methods to ensure consistency and to eliminate potential errors. Findings from eight rct s involving 6,615 participants were pooled into meta-analyses to calculate the magnitude of effects that mobile text message reminders have on the rate of attendance at healthcare appointments compared to no reminders and phone call reminders.

Meta-analyses are regarded as powerful tools for deriving meaningful conclusions. However, there are situations in which it is neither reasonable nor appropriate to pool studies together using meta-analytic methods simply because there is extensive clinical heterogeneity between the included studies or variation in measurement tools, comparisons, or outcomes of interest. In these cases, systematic reviews can use qualitative synthesis methods such as vote counting, content analysis, classification schemes and tabulations, as an alternative approach to narratively synthesize the results of the independent studies included in the review. This form of review is known as qualitative systematic review.

A rigorous example of one such review in the eHealth domain is presented by Mickan, Atherton, Roberts, Heneghan, and Tilson (2014) on the use of handheld computers by healthcare professionals and their impact on access to information and clinical decision-making. In line with the methodological guide­lines for systematic reviews, these authors: (a) developed and registered with prospero ( www.crd.york.ac.uk/ prospero / ) an a priori review protocol; (b) conducted comprehensive searches for eligible studies using multiple databases and other supplementary strategies (e.g., forward searches); and (c) subsequently carried out study selection, data extraction, and risk of bias assessments in a duplicate manner to eliminate potential errors in the review process. Heterogeneity between the included studies in terms of reported outcomes and measures precluded the use of meta-analytic methods. To this end, the authors resorted to using narrative analysis and synthesis to describe the effectiveness of handheld computers on accessing information for clinical knowledge, adherence to safety and clinical quality guidelines, and diagnostic decision-making.

In recent years, the number of systematic reviews in the field of health informatics has increased considerably. Systematic reviews with discordant findings can cause great confusion and make it difficult for decision-makers to interpret the review-level evidence ( Moher, 2013 ). Therefore, there is a growing need for appraisal and synthesis of prior systematic reviews to ensure that decision-making is constantly informed by the best available accumulated evidence. Umbrella reviews , also known as overviews of systematic reviews, are tertiary types of evidence synthesis that aim to accomplish this; that is, they aim to compare and contrast findings from multiple systematic reviews and meta-analyses ( Becker & Oxman, 2008 ). Umbrella reviews generally adhere to the same principles and rigorous methodological guidelines used in systematic reviews. However, the unit of analysis in umbrella reviews is the systematic review rather than the primary study ( Becker & Oxman, 2008 ). Unlike systematic reviews that have a narrow focus of inquiry, umbrella reviews focus on broader research topics for which there are several potential interventions ( Smith, Devane, Begley, & Clarke, 2011 ). A recent umbrella review on the effects of home telemonitoring interventions for patients with heart failure critically appraised, compared, and synthesized evidence from 15 systematic reviews to investigate which types of home telemonitoring technologies and forms of interventions are more effective in reducing mortality and hospital admissions ( Kitsiou, Paré, & Jaana, 2015 ).

9.3.5. Realist Reviews

Realist reviews are theory-driven interpretative reviews developed to inform, enhance, or supplement conventional systematic reviews by making sense of heterogeneous evidence about complex interventions applied in diverse contexts in a way that informs policy decision-making ( Greenhalgh, Wong, Westhorp, & Pawson, 2011 ). They originated from criticisms of positivist systematic reviews which centre on their “simplistic” underlying assumptions ( Oates, 2011 ). As explained above, systematic reviews seek to identify causation. Such logic is appropriate for fields like medicine and education where findings of randomized controlled trials can be aggregated to see whether a new treatment or intervention does improve outcomes. However, many argue that it is not possible to establish such direct causal links between interventions and outcomes in fields such as social policy, management, and information systems where for any intervention there is unlikely to be a regular or consistent outcome ( Oates, 2011 ; Pawson, 2006 ; Rousseau, Manning, & Denyer, 2008 ).

To circumvent these limitations, Pawson, Greenhalgh, Harvey, and Walshe (2005) have proposed a new approach for synthesizing knowledge that seeks to unpack the mechanism of how “complex interventions” work in particular contexts. The basic research question — what works? — which is usually associated with systematic reviews changes to: what is it about this intervention that works, for whom, in what circumstances, in what respects and why? Realist reviews have no particular preference for either quantitative or qualitative evidence. As a theory-building approach, a realist review usually starts by articulating likely underlying mechanisms and then scrutinizes available evidence to find out whether and where these mechanisms are applicable ( Shepperd et al., 2009 ). Primary studies found in the extant literature are viewed as case studies which can test and modify the initial theories ( Rousseau et al., 2008 ).

The main objective pursued in the realist review conducted by Otte-Trojel, de Bont, Rundall, and van de Klundert (2014) was to examine how patient portals contribute to health service delivery and patient outcomes. The specific goals were to investigate how outcomes are produced and, most importantly, how variations in outcomes can be explained. The research team started with an exploratory review of background documents and research studies to identify ways in which patient portals may contribute to health service delivery and patient outcomes. The authors identified six main ways which represent “educated guesses” to be tested against the data in the evaluation studies. These studies were identified through a formal and systematic search in four databases between 2003 and 2013. Two members of the research team selected the articles using a pre-established list of inclusion and exclusion criteria and following a two-step procedure. The authors then extracted data from the selected articles and created several tables, one for each outcome category. They organized information to bring forward those mechanisms where patient portals contribute to outcomes and the variation in outcomes across different contexts.

9.3.6. Critical Reviews

Lastly, critical reviews aim to provide a critical evaluation and interpretive analysis of existing literature on a particular topic of interest to reveal strengths, weaknesses, contradictions, controversies, inconsistencies, and/or other important issues with respect to theories, hypotheses, research methods or results ( Baumeister & Leary, 1997 ; Kirkevold, 1997 ). Unlike other review types, critical reviews attempt to take a reflective account of the research that has been done in a particular area of interest, and assess its credibility by using appraisal instruments or critical interpretive methods. In this way, critical reviews attempt to constructively inform other scholars about the weaknesses of prior research and strengthen knowledge development by giving focus and direction to studies for further improvement ( Kirkevold, 1997 ).

Kitsiou, Paré, and Jaana (2013) provide an example of a critical review that assessed the methodological quality of prior systematic reviews of home telemonitoring studies for chronic patients. The authors conducted a comprehensive search on multiple databases to identify eligible reviews and subsequently used a validated instrument to conduct an in-depth quality appraisal. Results indicate that the majority of systematic reviews in this particular area suffer from important methodological flaws and biases that impair their internal validity and limit their usefulness for clinical and decision-making purposes. To this end, they provide a number of recommendations to strengthen knowledge development towards improving the design and execution of future reviews on home telemonitoring.

9.4. Summary

Table 9.1 outlines the main types of literature reviews that were described in the previous sub-sections and summarizes the main characteristics that distinguish one review type from another. It also includes key references to methodological guidelines and useful sources that can be used by eHealth scholars and researchers for planning and developing reviews.

Table 9.1. Typology of Literature Reviews (adapted from Paré et al., 2015).

Typology of Literature Reviews (adapted from Paré et al., 2015).

As shown in Table 9.1 , each review type addresses different kinds of research questions or objectives, which subsequently define and dictate the methods and approaches that need to be used to achieve the overarching goal(s) of the review. For example, in the case of narrative reviews, there is greater flexibility in searching and synthesizing articles ( Green et al., 2006 ). Researchers are often relatively free to use a diversity of approaches to search, identify, and select relevant scientific articles, describe their operational characteristics, present how the individual studies fit together, and formulate conclusions. On the other hand, systematic reviews are characterized by their high level of systematicity, rigour, and use of explicit methods, based on an “a priori” review plan that aims to minimize bias in the analysis and synthesis process (Higgins & Green, 2008). Some reviews are exploratory in nature (e.g., scoping/mapping reviews), whereas others may be conducted to discover patterns (e.g., descriptive reviews) or involve a synthesis approach that may include the critical analysis of prior research ( Paré et al., 2015 ). Hence, in order to select the most appropriate type of review, it is critical to know before embarking on a review project, why the research synthesis is conducted and what type of methods are best aligned with the pursued goals.

9.5. Concluding Remarks

In light of the increased use of evidence-based practice and research generating stronger evidence ( Grady et al., 2011 ; Lyden et al., 2013 ), review articles have become essential tools for summarizing, synthesizing, integrating or critically appraising prior knowledge in the eHealth field. As mentioned earlier, when rigorously conducted review articles represent powerful information sources for eHealth scholars and practitioners looking for state-of-the-art evidence. The typology of literature reviews we used herein will allow eHealth researchers, graduate students and practitioners to gain a better understanding of the similarities and differences between review types.

We must stress that this classification scheme does not privilege any specific type of review as being of higher quality than another ( Paré et al., 2015 ). As explained above, each type of review has its own strengths and limitations. Having said that, we realize that the methodological rigour of any review — be it qualitative, quantitative or mixed — is a critical aspect that should be considered seriously by prospective authors. In the present context, the notion of rigour refers to the reliability and validity of the review process described in section 9.2. For one thing, reliability is related to the reproducibility of the review process and steps, which is facilitated by a comprehensive documentation of the literature search process, extraction, coding and analysis performed in the review. Whether the search is comprehensive or not, whether it involves a methodical approach for data extraction and synthesis or not, it is important that the review documents in an explicit and transparent manner the steps and approach that were used in the process of its development. Next, validity characterizes the degree to which the review process was conducted appropriately. It goes beyond documentation and reflects decisions related to the selection of the sources, the search terms used, the period of time covered, the articles selected in the search, and the application of backward and forward searches ( vom Brocke et al., 2009 ). In short, the rigour of any review article is reflected by the explicitness of its methods (i.e., transparency) and the soundness of the approach used. We refer those interested in the concepts of rigour and quality to the work of Templier and Paré (2015) which offers a detailed set of methodological guidelines for conducting and evaluating various types of review articles.

To conclude, our main objective in this chapter was to demystify the various types of literature reviews that are central to the continuous development of the eHealth field. It is our hope that our descriptive account will serve as a valuable source for those conducting, evaluating or using reviews in this important and growing domain.

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  • Cite this Page Paré G, Kitsiou S. Chapter 9 Methods for Literature Reviews. In: Lau F, Kuziemsky C, editors. Handbook of eHealth Evaluation: An Evidence-based Approach [Internet]. Victoria (BC): University of Victoria; 2017 Feb 27.
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Definition: A literature review is a systematic examination and synthesis of existing scholarly research on a specific topic or subject.

Purpose: It serves to provide a comprehensive overview of the current state of knowledge within a particular field.

Analysis: Involves critically evaluating and summarizing key findings, methodologies, and debates found in academic literature.

Identifying Gaps: Aims to pinpoint areas where there is a lack of research or unresolved questions, highlighting opportunities for further investigation.

Contextualization: Enables researchers to understand how their work fits into the broader academic conversation and contributes to the existing body of knowledge.

conclusion of literature review

tl;dr  A literature review critically examines and synthesizes existing scholarly research and publications on a specific topic to provide a comprehensive understanding of the current state of knowledge in the field.

What is a literature review NOT?

❌ An annotated bibliography

❌ Original research

❌ A summary

❌ Something to be conducted at the end of your research

❌ An opinion piece

❌ A chronological compilation of studies

The reason for conducting a literature review is to:

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How to write a literature review introduction (+ examples)

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The introduction to a literature review serves as your reader’s guide through your academic work and thought process. Explore the significance of literature review introductions in review papers, academic papers, essays, theses, and dissertations. We delve into the purpose and necessity of these introductions, explore the essential components of literature review introductions, and provide step-by-step guidance on how to craft your own, along with examples.

Why you need an introduction for a literature review

When you need an introduction for a literature review, what to include in a literature review introduction, examples of literature review introductions, steps to write your own literature review introduction.

A literature review is a comprehensive examination of the international academic literature concerning a particular topic. It involves summarizing published works, theories, and concepts while also highlighting gaps and offering critical reflections.

In academic writing , the introduction for a literature review is an indispensable component. Effective academic writing requires proper paragraph structuring to guide your reader through your argumentation. This includes providing an introduction to your literature review.

It is imperative to remember that you should never start sharing your findings abruptly. Even if there isn’t a dedicated introduction section .

Instead, you should always offer some form of introduction to orient the reader and clarify what they can expect.

There are three main scenarios in which you need an introduction for a literature review:

  • Academic literature review papers: When your literature review constitutes the entirety of an academic review paper, a more substantial introduction is necessary. This introduction should resemble the standard introduction found in regular academic papers.
  • Literature review section in an academic paper or essay: While this section tends to be brief, it’s important to precede the detailed literature review with a few introductory sentences. This helps orient the reader before delving into the literature itself.
  • Literature review chapter or section in your thesis/dissertation: Every thesis and dissertation includes a literature review component, which also requires a concise introduction to set the stage for the subsequent review.

You may also like: How to write a fantastic thesis introduction (+15 examples)

It is crucial to customize the content and depth of your literature review introduction according to the specific format of your academic work.

In practical terms, this implies, for instance, that the introduction in an academic literature review paper, especially one derived from a systematic literature review , is quite comprehensive. Particularly compared to the rather brief one or two introductory sentences that are often found at the beginning of a literature review section in a standard academic paper. The introduction to the literature review chapter in a thesis or dissertation again adheres to different standards.

Here’s a structured breakdown based on length and the necessary information:

Academic literature review paper

The introduction of an academic literature review paper, which does not rely on empirical data, often necessitates a more extensive introduction than the brief literature review introductions typically found in empirical papers. It should encompass:

  • The research problem: Clearly articulate the problem or question that your literature review aims to address.
  • The research gap: Highlight the existing gaps, limitations, or unresolved aspects within the current body of literature related to the research problem.
  • The research relevance: Explain why the chosen research problem and its subsequent investigation through a literature review are significant and relevant in your academic field.
  • The literature review method: If applicable, describe the methodology employed in your literature review, especially if it is a systematic review or follows a specific research framework.
  • The main findings or insights of the literature review: Summarize the key discoveries, insights, or trends that have emerged from your comprehensive review of the literature.
  • The main argument of the literature review: Conclude the introduction by outlining the primary argument or statement that your literature review will substantiate, linking it to the research problem and relevance you’ve established.
  • Preview of the literature review’s structure: Offer a glimpse into the organization of the literature review paper, acting as a guide for the reader. This overview outlines the subsequent sections of the paper and provides an understanding of what to anticipate.

By addressing these elements, your introduction will provide a clear and structured overview of what readers can expect in your literature review paper.

Regular literature review section in an academic article or essay

Most academic articles or essays incorporate regular literature review sections, often placed after the introduction. These sections serve to establish a scholarly basis for the research or discussion within the paper.

In a standard 8000-word journal article, the literature review section typically spans between 750 and 1250 words. The first few sentences or the first paragraph within this section often serve as an introduction. It should encompass:

  • An introduction to the topic: When delving into the academic literature on a specific topic, it’s important to provide a smooth transition that aids the reader in comprehending why certain aspects will be discussed within your literature review.
  • The core argument: While literature review sections primarily synthesize the work of other scholars, they should consistently connect to your central argument. This central argument serves as the crux of your message or the key takeaway you want your readers to retain. By positioning it at the outset of the literature review section and systematically substantiating it with evidence, you not only enhance reader comprehension but also elevate overall readability. This primary argument can typically be distilled into 1-2 succinct sentences.

In some cases, you might include:

  • Methodology: Details about the methodology used, but only if your literature review employed a specialized method. If your approach involved a broader overview without a systematic methodology, you can omit this section, thereby conserving word count.

By addressing these elements, your introduction will effectively integrate your literature review into the broader context of your academic paper or essay. This will, in turn, assist your reader in seamlessly following your overarching line of argumentation.

Introduction to a literature review chapter in thesis or dissertation

The literature review typically constitutes a distinct chapter within a thesis or dissertation. Often, it is Chapter 2 of a thesis or dissertation.

Some students choose to incorporate a brief introductory section at the beginning of each chapter, including the literature review chapter. Alternatively, others opt to seamlessly integrate the introduction into the initial sentences of the literature review itself. Both approaches are acceptable, provided that you incorporate the following elements:

  • Purpose of the literature review and its relevance to the thesis/dissertation research: Explain the broader objectives of the literature review within the context of your research and how it contributes to your thesis or dissertation. Essentially, you’re telling the reader why this literature review is important and how it fits into the larger scope of your academic work.
  • Primary argument: Succinctly communicate what you aim to prove, explain, or explore through the review of existing literature. This statement helps guide the reader’s understanding of the review’s purpose and what to expect from it.
  • Preview of the literature review’s content: Provide a brief overview of the topics or themes that your literature review will cover. It’s like a roadmap for the reader, outlining the main areas of focus within the review. This preview can help the reader anticipate the structure and organization of your literature review.
  • Methodology: If your literature review involved a specific research method, such as a systematic review or meta-analysis, you should briefly describe that methodology. However, this is not always necessary, especially if your literature review is more of a narrative synthesis without a distinct research method.

By addressing these elements, your introduction will empower your literature review to play a pivotal role in your thesis or dissertation research. It will accomplish this by integrating your research into the broader academic literature and providing a solid theoretical foundation for your work.

Comprehending the art of crafting your own literature review introduction becomes significantly more accessible when you have concrete examples to examine. Here, you will find several examples that meet, or in most cases, adhere to the criteria described earlier.

Example 1: An effective introduction for an academic literature review paper

To begin, let’s delve into the introduction of an academic literature review paper. We will examine the paper “How does culture influence innovation? A systematic literature review”, which was published in 2018 in the journal Management Decision.

conclusion of literature review

The entire introduction spans 611 words and is divided into five paragraphs. In this introduction, the authors accomplish the following:

  • In the first paragraph, the authors introduce the broader topic of the literature review, which focuses on innovation and its significance in the context of economic competition. They underscore the importance of this topic, highlighting its relevance for both researchers and policymakers.
  • In the second paragraph, the authors narrow down their focus to emphasize the specific role of culture in relation to innovation.
  • In the third paragraph, the authors identify research gaps, noting that existing studies are often fragmented and disconnected. They then emphasize the value of conducting a systematic literature review to enhance our understanding of the topic.
  • In the fourth paragraph, the authors introduce their specific objectives and explain how their insights can benefit other researchers and business practitioners.
  • In the fifth and final paragraph, the authors provide an overview of the paper’s organization and structure.

In summary, this introduction stands as a solid example. While the authors deviate from previewing their key findings (which is a common practice at least in the social sciences), they do effectively cover all the other previously mentioned points.

Example 2: An effective introduction to a literature review section in an academic paper

The second example represents a typical academic paper, encompassing not only a literature review section but also empirical data, a case study, and other elements. We will closely examine the introduction to the literature review section in the paper “The environmentalism of the subalterns: a case study of environmental activism in Eastern Kurdistan/Rojhelat”, which was published in 2021 in the journal Local Environment.

conclusion of literature review

The paper begins with a general introduction and then proceeds to the literature review, designated by the authors as their conceptual framework. Of particular interest is the first paragraph of this conceptual framework, comprising 142 words across five sentences:

“ A peripheral and marginalised nationality within a multinational though-Persian dominated Iranian society, the Kurdish people of Iranian Kurdistan (a region referred by the Kurds as Rojhelat/Eastern Kurdi-stan) have since the early twentieth century been subject to multifaceted and systematic discriminatory and exclusionary state policy in Iran. This condition has left a population of 12–15 million Kurds in Iran suffering from structural inequalities, disenfranchisement and deprivation. Mismanagement of Kurdistan’s natural resources and the degradation of its natural environmental are among examples of this disenfranchisement. As asserted by Julian Agyeman (2005), structural inequalities that sustain the domination of political and economic elites often simultaneously result in environmental degradation, injustice and discrimination against subaltern communities. This study argues that the environmental struggle in Eastern Kurdistan can be asserted as a (sub)element of the Kurdish liberation movement in Iran. Conceptually this research is inspired by and has been conducted through the lens of ‘subalternity’ ” ( Hassaniyan, 2021, p. 931 ).

In this first paragraph, the author is doing the following:

  • The author contextualises the research
  • The author links the research focus to the international literature on structural inequalities
  • The author clearly presents the argument of the research
  • The author clarifies how the research is inspired by and uses the concept of ‘subalternity’.

Thus, the author successfully introduces the literature review, from which point onward it dives into the main concept (‘subalternity’) of the research, and reviews the literature on socio-economic justice and environmental degradation.

While introductions to a literature review section aren’t always required to offer the same level of study context detail as demonstrated here, this introduction serves as a commendable model for orienting the reader within the literature review. It effectively underscores the literature review’s significance within the context of the study being conducted.

Examples 3-5: Effective introductions to literature review chapters

The introduction to a literature review chapter can vary in length, depending largely on the overall length of the literature review chapter itself. For example, a master’s thesis typically features a more concise literature review, thus necessitating a shorter introduction. In contrast, a Ph.D. thesis, with its more extensive literature review, often includes a more detailed introduction.

Numerous universities offer online repositories where you can access theses and dissertations from previous years, serving as valuable sources of reference. Many of these repositories, however, may require you to log in through your university account. Nevertheless, a few open-access repositories are accessible to anyone, such as the one by the University of Manchester . It’s important to note though that copyright restrictions apply to these resources, just as they would with published papers.

Master’s thesis literature review introduction

The first example is “Benchmarking Asymmetrical Heating Models of Spider Pulsar Companions” by P. Sun, a master’s thesis completed at the University of Manchester on January 9, 2024. The author, P. Sun, introduces the literature review chapter very briefly but effectively:

conclusion of literature review

PhD thesis literature review chapter introduction

The second example is Deep Learning on Semi-Structured Data and its Applications to Video-Game AI, Woof, W. (Author). 31 Dec 2020, a PhD thesis completed at the University of Manchester . In Chapter 2, the author offers a comprehensive introduction to the topic in four paragraphs, with the final paragraph serving as an overview of the chapter’s structure:

conclusion of literature review

PhD thesis literature review introduction

The last example is the doctoral thesis Metacognitive strategies and beliefs: Child correlates and early experiences Chan, K. Y. M. (Author). 31 Dec 2020 . The author clearly conducted a systematic literature review, commencing the review section with a discussion of the methodology and approach employed in locating and analyzing the selected records.

conclusion of literature review

Having absorbed all of this information, let’s recap the essential steps and offer a succinct guide on how to proceed with creating your literature review introduction:

  • Contextualize your review : Begin by clearly identifying the academic context in which your literature review resides and determining the necessary information to include.
  • Outline your structure : Develop a structured outline for your literature review, highlighting the essential information you plan to incorporate in your introduction.
  • Literature review process : Conduct a rigorous literature review, reviewing and analyzing relevant sources.
  • Summarize and abstract : After completing the review, synthesize the findings and abstract key insights, trends, and knowledge gaps from the literature.
  • Craft the introduction : Write your literature review introduction with meticulous attention to the seamless integration of your review into the larger context of your work. Ensure that your introduction effectively elucidates your rationale for the chosen review topics and the underlying reasons guiding your selection.

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Minor revisions: Sample peer review comments and examples

  • Open access
  • Published: 06 February 2024

What are the learning objectives in surgical training – a systematic literature review of the surgical competence framework

  • Niklas Pakkasjärvi 1 , 2 ,
  • Henrika Anttila 3 &
  • Kirsi Pyhältö 3 , 4  

BMC Medical Education volume  24 , Article number:  119 ( 2024 ) Cite this article

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To map the landscape of contemporary surgical education through a competence framework by conducting a systematic literature review on learning outcomes of surgical education and the instructional methods applied to attain the outcomes.

Surgical education has seen a paradigm shift towards competence-based training. However, a gap remains in the literature regarding the specific components of competency taught and the instructional methods employed to achieve these outcomes. This paper aims to bridge this gap by conducting a systematic review on the learning outcomes of surgical education within a competence framework and the instructional methods applied. The primary outcome measure was to elucidate the components of competency emphasized by modern surgical curricula. The secondary outcome measure was to discern the instructional methods proven effective in achieving these competencies.

A search was conducted across PubMed, Medline, ProQuest Eric, and Cochrane databases, adhering to PRISMA guidelines, limited to 2017–2021. Keywords included terms related to surgical education and training. Inclusion criteria mandated original empirical studies that described learning outcomes and methods, and targeted both medical students and surgical residents.

Out of 42 studies involving 2097 participants, most concentrated on technical skills within competency-based training, with a lesser emphasis on non-technical competencies. The effect on clinical outcomes was infrequently explored.

The shift towards competency in surgical training is evident. However, further studies on its ramifications on clinical outcomes are needed. The transition from technical to clinical competence and the creation of validated assessments are crucial for establishing a foundation for lifelong surgical learning.

Peer Review reports

Introduction

Surgery requires a highly specialized set of surgical knowledge, skills, and attitudes that will allow a surgeon to perform the requisite procedures in collaboration with the patient and the multi-professional team. These competencies are fundamental to a surgeon’s ability to function effectively, necessitating flexibility, adaptability, and continuous professional development. In the field of learning sciences, the term competence is used to refer to the combination of knowledge, skills, and attitudes that allows an individual to solve the job-related task or a problem at hand and act professionally [ 1 , 2 , 3 , 4 ]. Accordingly, it can be claimed that cultivating a set of surgical competencies organically integrating knowledge, skills, and attitudes needed in surgeons’ work is imperative for high-quality surgical education. This calls for the understanding of both the range of competencies acquired in surgery training and the kinds of instructional methods that are effective in adopting them. Interestingly, many studies in surgical education, including systematic literature reviews, appear to often focus on a single learning outcome. This typically involves exploring either a specific technical skill or content knowledge in a surgical area, along with assessing the effectiveness of a particular instructional method [ 5 , 6 , 7 , 8 , 9 ].

The traditional Halstedian methods, with their focus on incremental responsibility and volume-based exposure, have been foundational in surgical training. Over the past few decades, the approach has been complemented with more tailored instructional methods [ 10 , 11 ]. For example, technical skills are often contemplated with models and simulators [ 12 , 13 ], thus increasing patient safety during surgery, and allowing the training surgeon to focus on the operation without feeling pressured to execute technical tasks [ 11 ]. Simulation training has demonstrated positive effects, especially in technical skills [ 14 , 15 , 16 ], but also in the longitudinal transfer of skills [ 17 ]. Much of the research on simulation has focused on training assessment with validated programs becoming more widely available [ 18 , 19 , 20 , 21 , 22 ]. Procedure-specific assessment has become common in evaluating surgical learning outcomes and has resulted in a set of validated task-specific assessment tools, such as OSATS (Objective Structured Assessment of Technical Skills) [ 23 ]. However, reducing surgery to separated technical tasks infers risks related to developing surgical competence, mainly a lack of integration in the learning of surgical skills, knowledge, and attitudes, further compromising continuous professional development, and thus potentially occupational wellbeing. There is also contradictory evidence on the effectiveness of the surgical training method in achieving the desired learning outcomes, but this may be more related to the unrealized potential of evidence-based training methods [ 24 ]. Further, the implementation of modern surgical training is lagging [ 25 ]. To sum up, while research on surgical education has significantly advanced our understanding of more tailored methods for cultivating surgical learning, it has also typically adapted a single ingredient approach [ 10 , 11 ]. A problem with this approach is that it neglects the complexity of surgical competence development and, without coherence building, bears the inherent risk of reducing surgery into mastering a series of technical tasks rather than providing tools for cultivating surgical competencies. Moreover, only a few prior systematic reviews on surgical education have studied surgical learning across the fields of surgery or among both medical students and surgical residents. Our study aims to comprehensively analyze the competencies targeted in contemporary surgical education, as revealed through a systematic literature review. We seek to elucidate the nature of these competencies—including skills, knowledge, and attitudes—and the instructional methods employed to develop them in medical students and surgical residents. This approach will highlight how competencies are defined, integrated, and cultivated in surgical education according to existing literature. Specifically, our primary outcome is to identify and detail the competencies (skills, knowledge, and attitudes) emphasized in the existing research on surgical education. We aim to understand how these competencies are conceptualized, taught, and developed, providing insights into the current focus of surgical training programs. As a secondary objective, we will examine the instructional methods discussed in the literature for teaching these competencies. This involves analyzing the effectiveness and application of different teaching strategies in nurturing a comprehensive set of surgical competencies, focusing on integrating technical and non-technical skills. To our knowledge, this is the first published effort within surgery to review the literature comprehensively on surgical competencies development and instructional methods across the fields of surgery, with studies conducted with both medical students and surgical residents.

We conducted a systematic literature review by using the guidelines of the Preferred Reporting Item for Systematic Reviews and Meta-analysis statement (PRISMA) [ 26 ].

Research strategy and data sources

We searched four electronic databases: PubMed, Medline, ProQuest Eric, and Cochrane databases on 18 February 2021. Only articles in English were considered, and the search was limited to years 2017–2021. This restriction was based on a pilot search, which identified a high volume of review articles before 2017 and a significant increase in the quantity and relevance of primary research studies on the surgical competence framework beginning in 2017. The search string consisted of the following keywords: “Surgical Education”, “Surgical Training”, “Surgical Intern*”, “surgical resident” OR “surgical apprentice” AND “learning”. The detailed syntax of the search was: (“surgical intern” AND learning) OR (“surgical training” AND learning) OR (“surgical intern*” AND learning) OR (“surgical resident” AND learning) OR (“surgical apprentice” AND learning). The database search resulted 1305 articles (1297 from PubMed/Medline, 6 from Cochrane databases, and 2 from ProQuest Eric).

Inclusion criteria and study selection

We applied five inclusion criteria for the data. To be included in the review, the articles had to fulfil the following criteria:

be original empirical studies.

be published in a peer-reviewed journal between 2017 and 2021.

be written in English, although the study could have been conducted in any country.

include surgical residents and/or medical students as participants.

include descriptions of learning outcomes and methods of learning in the results of the study.

Data were extracted manually in several increments. Two of the authors (NP) and (HA) independently reviewed the titles and abstracts of all articles identified by the search and marked potentially relevant articles for full-text retrieval (see Fig.  1 for the PRISMA diagram for the review flow). After reading the titles and abstracts, and removing the duplicates, 1236 articles were excluded as they did not meet the inclusion criteria. This also included 13 literature reviews that were excluded from the study as they were not empirical. However, the references of the reviews were reviewed by using a snowball method to detect additional references. This resulted in 16 studies being added to the full-text analysis. After this, the two authors independently examined the full texts of the remaining 85 articles with the inclusion criteria and selected the studies eligible for inclusion in the review. At this point, 43 articles were excluded as they did not explain learning outcomes or learning activities. Disagreements between the two authors were minimal and were resolved through a joint review of the full-text articles and discussion with the third co-author (KP). All articles that matched the inclusion criteria were included in the review, resulting in 42 articles being included in the review.

figure 1

The PRISMA diagram depicts the flow of the systematic review, from the initial identification of 1305 database hits to the ultimate inclusion of 42 articles

Data extraction

Two of the authors (NP) and (HA) extracted and documented information about 11 factors of each study into the Excel file to create a data sheet for the analysis. The following characteristics of the studies were recorded: country, participants, field of surgery, study design, use of a control group, tool, outcome measure, core finding, results on surgical learning outcomes, instructional design applied and clinical setting. Learning outcomes were categorized according to the three components of surgical competence: (a) knowledge , (b) skills (including both technical and non-technical skills), and (c) attitudes [ 22 ]. Surgical knowledge included results concerning training surgeons’ theoretical and practical knowledge about surgery, procedure, or medicine in more general. Surgical skills entailed results on their technical and non-technical skills, strategies, reflection, and self-regulation. Surgical attitudes involved results on training surgeons about their attitudes to their work and views about themselves as surgeons. The instructional design reported in the studies was coded into seven categories according to the mode of instruction applied in the study for training surgeons: (a) learning by doing , including (b) learning through reflection , including instructions where the training surgeons reflected their own learning (c) learning by modelling , (d) learning by direct instruction , (e) learning by self-directed study , (f) learning by mentoring or teaching , and (g) learning by gaming.

The “ Learning by doing ” category included instructional situations in which medical students and surgeons learned while working as surgeons, for example, by completing surgical tasks and procedures. “ Learning through reflection ” included situations in which they learned by reflecting on their prior experiences, thoughts, own development, and performance in specific tasks.

In the “ Learning by modeling ” category, learning occurred by observing or copying the behaviors of their peers or more experienced surgeons. “ Learning by direct instruction ” included situations in which they learned while attending formal education, lectures, or seminars and by receiving tips or practical guidance from others.

The “ Learning by self-directed study ” category encompassed situations where training surgeons learned through self-directed study, such as reading, seeking information, and independently watching procedure videos, without any external intervention.

In the “ Learning by mentoring or teaching ” category, training surgeons learned while they taught or mentored their peers. “ Learning by gaming ” included situations where training surgeons played games to improve their competence.

Regarding categorization, each of the studies included in the review could belong to one or more of these categories. However, to be included in a category, the article needed to clearly explain that the instructional method in question was used in the study. For example, even though performing surgical procedures might also involve self-reflection, the article was categorized under “ learning by doing ” and not additionally under “ learning by self-reflection ” unless the reflection was explicitly mentioned in the article.

We included 42 empirical studies involving 2097 medical students and surgeons in training in this systematic review. The studies on surgical learning were geographically distributed across ten countries. Most of the studies were conducted in the USA ( n  = 22), and Canada ( n  = 12), however studies from the UK, the Netherlands, Austria, Chile, Germany, Finland, and Switzerland were also present. Surgical learning was typically explored with small-scale studies with a median of 28 participants, interquartile range 46 (see Table  1 ). Most of the studies focused on surgical residents’ learning ( n  = 29), whereas medical students’ surgical learning was explored in 11 studies. One study had both residents and medical students as participants. Twenty-seven studies investigated surgical learning in general surgery, with the remaining 16 in various other surgical specialties (including gynecology, cardiology, urology, pediatrics, neurosurgery, microsurgery, orthopedics, vascular surgery, gastro surgery and otolaryngology). The study design of the empirical studies varied from simulation (including bench models, animals, human cadavers, and virtual reality (VR)), operating room (OR) procedures, interviews, surveys, writing tasks, to knowledge tests and the resident report card. Most of the studies employed multimodal designs. Eighteen of the studies were controlled; 13 studies were randomized controlled trials (RCT), and five were controlled trials (CT). The core finding was discussed in all studies and where applicable, statistical tests were applied to highlight the significance. Almost half of the studies ( n  = 18) were conducted in clinical settings.

Primary outcome measures: learning objectives of surgeons in training and competency components

Most of the included studies on surgical learning focused on surgical skills and their attainment ( n  = 36) (See Table  1 ). Training surgeons commonly learned technical skills such as knot tying, distinct surgical procedures, and robotic skills ( n  = 25). In contrast, learning of non-technical skills ( n  = 11), such as communication, patient management, reflection, self-regulation, and decision-making skills, were less often reported. Twenty-two studies focused on the acquisition of surgical knowledge, such as general medical or surgical knowledge or more specific knowledge of certain procedures. Some of the studies ( n  = 10) reported attitudinal learning outcomes including confidence, resilience, and self-efficacy. Most of the studies ( n  = 26) had a single focus on surgical competence, i.e., they focused on learning of skills, knowledge, or attitudes. However, in 19 studies, the training surgeons’ learning was a combination of several skills, knowledge, and attitudes, most typically technical skills, and surgical knowledge. Empirical studies relied on performance assessment ( n  = 15), including studies in which the performance assessment was utilized by other reports, such as senior surgeons assessing the performance of the training surgeons, and self-reporting of the learning outcomes ( n  = 11). Sixteen studies combined both performance assessment and self-report of learning.

Learning was measured with validated objective tools in half of the studies. Most studies utilized either the OSATS global evaluation tool or a derivative optimized for the given conditions. These derivatives included ABSITE (The American Board of Surgery In-Service Training Exam) [ 69 ]; OSA-LS (OSATS salpingectomy-specific form) [ 70 ]; ASSET (Arthroscopic Surgical Skill Evaluation Tool) [ 71 ]; SP-CAT (Simulation Participants-Communication Assessment Tool) [ 72 ]; UWOMSA (University of Western Ontario Microsurgical Acquisition/assessment instrument) [ 73 ], and NRS (Numeric Rating Scale). Cognitive task analysis (CTA) was utilized in only two studies. In both studies, CTA improved scores in outcome testing [ 62 , 64 ]. CTA-based training was considered suitable for expediting learning but based on our study cohort, it is scarcely applied.

Secondary outcome measures: what kind of instructional designs do surgeons in training learn through?

The included studies in the present review employed various instructional methods ranging from learning by doing to mentoring and teaching fellow residents. Learning by doing , including technical training (of specific procedures, knot tying, etc.) both in OR settings and in simulation (e.g., VR, robotic, bench model, human cadaver, and animal), was most typically applied as the primary instructional method ( n  = 26), especially in teaching technical skills and non-technical surgical skills both for surgical residents and medical students. Partly mixed resulted in terms of the effectiveness of the method for novice and more advanced surgical students. For example, while Feins et al. showed that residents’ performance in component tasks and complete cardiac surgical procedures improved by simulation, Korte et al. reported, that especially more novice surgeons benefitted from simulations more than those who had more experience [ 29 , 37 ]. Most skill curricula improved assessment scores, but surgical outcomes may remain unaffected by similar interventions as shown by Jokinen et al. [ 43 ]. Also, learning through reflection , through which training surgeons reflecting on their own learning experiences and development, such as by participating in debriefing after operations or via video-based guided reflection ( n  = 13) was a commonly emphasized instructional method. Engaging in reflection was shown to be effective in promoting the learning of non-technical skills and attitudes. Trickey et al. showed that reflecting on positive learning experiences increased residents’ confidence and improved their communication skills, while Soucisse et al. and Naik et al. reported that self-reflecting on surgical tasks performed improved technical skills as well [ 55 , 57 , 65 ]. Ranney et al. furthermore showed that residents, who can reflect on their learning and thought processes are more in control and proceed to autonomy more quickly [ 56 ].

Commonly used instructional methods for enhancing surgical learning include modeling ( n  = 5), particularly observing more experienced surgeons performing surgical procedures, s elf-directed study ( n  = 6), such as preparing for surgery, reading, and self-studying and direct instruction ( n  = 7). The latter included participating in contact teaching and lectures, watching videos, and getting practical advice from senior surgeons, and these were frequently used in teaching future surgeons. Raiche et al. showed that observing and modelling, have their limitations, as residents have challenges in identifying where to focus their attention and in understanding what it is teaching them [ 52 ]. To be effective, such a form of instruction seems to call for explanation and support from senior surgeons. Naik et al. showed that receiving feedback during technical skill learning had a significant impact on residents’ performance in technical skills [ 57 ]. The results also emphasized the importance of pre-preparation for the OR for learning gains. For example, Logishetty et al. showed that residents preparing for arthroplasty with a CTA tool improved operative times and reduced mistakes and were taught both decision-making skills as well as technical skills [ 64 ].

On the other hand, learning through gaming (including playing escape rooms, jeopardy, and other quiz games) ( n  = 4) and mentoring or teaching fellow training surgeons ( N  = 1) were seldomly applied in the teaching of future surgeons. The empirical evidence still implies that such instructional methods can enhance surgical learning. Hancock et al., Chon et al., Kinio et al. and Amer et al., all showed that gaming improved surgical knowledge [ 40 , 42 , 54 , 61 ]. Zundel et al. found that peers are an extremely important source of instruction for training surgeons and that they both acquire knowledge and learn technical skills every day from each other [ 44 ]. Unfortunately, they receive little educational training in peer mentoring and thus the resource of peers as learning support is not exploited to its full potential [ 44 ].

To sum up, the results indicate that multimodal instructional designs are more commonly applied in studies exploring surgical learning and means to enhance it. In just over half of the studies ( n  = 23) participants were engaged in a combination of two to three different instructional activities.

Our results show that studies on surgical residents and medical students’ surgical learning focus heavily on learning surgical skills, particularly technical skills, and acquiring knowledge on how to perform specific procedures or surgical tasks. This indicates that, at least implicitly, quite a few studies on surgical learning are drawing on a competence framework by combining the learning of surgical skills and knowledge acquisition. However, the scope of such studies typically remains very specific.

Learning surgical soft skills such as communication and teamwork, learning skills, and adaptability were rarely investigated. Interestingly, none of the studies address learning skills such as self- or co-regulated learning as part of surgical learning. However, they are fundamental for flexible and adaptive professional behaviors and engagement in continuous professional development [ 74 , 75 ]. In addition, the studies included in the review rarely addressed learning of attitudes such as self- or co-efficacy or resilience as part of surgical learning, though self-efficacy has shown to be one of the main predictors of learning outcomes and good performance [ 76 , 77 ]. This may imply that such skills and attitudes are not considered to be at the core of surgical learning or that they are expected to result as by-product of other surgical learning activities. This can be considered to be a gap in the literature on surgical learning. The lack of knowledge on developing soft skills and attitudes among future surgeons also has practical implications since they play a central role in patient safety and a surgeon’s recovery from adverse events [ 78 , 79 ]. The importance of these non-technical skills is further supported by research from Galayia et al. and Gleason et al. [ 80 , 81 ]. Their studies highlight how factors like workload, emotional intelligence, and resilience are crucial in managing burnout, with a clear correlation shown between these skills, job resources, and burnout rates among surgical trainees.

Surgeons’ lack of familiarity with non-technical skills and insufficient training for handling adverse events [ 82 , 83 ] exacerbate this issue. In our review, systematic approaches to address adverse events were notably absent. The fact that soft skills and attitudes are often overlooked in surgical competencies poses a challenge for both research on surgical learning and the development of informed surgical education.

Recently, high incidences of burnout among surgery residents have been reported [ 84 ]. This concerning trend underscores the need for a holistic approach to surgical education. Addressing stressors in surgical education is not solely an individual concern but a systemic issue, necessitating substantial transformations in healthcare delivery and success measurement [ 85 ]. Fortunately, there has been a noticeable increase in publications emphasizing the acquisition of non-technical skills, reflecting a growing awareness of their importance in surgical training [ 86 ]. However, it is essential to note that most literature on simulation-based surgical training still predominantly focuses on technical skills [ 86 ]. This ongoing emphasis suggests that while strides are being made towards a more comprehensive educational approach, there remains a significant skew towards technical proficiency in current training paradigms.

The studies we reviewed applied various validated assessment tools. In this systematic review, learning was most focused on technical skills and evaluated by OSATS or a derivative. OSATS is a validated evaluation tool used for technical skill assessment [ 87 ]. While it is the gold standard in evaluation, it has limitations. The use of OSATS is limited in clinical operating room settings. Hence many studies have attempted to optimize and modify it according to their specific needs [ 32 , 88 , 89 ]. An assessment tool must meet the following requirements: (1) the inter-rater reliability must exceed 0.90, and (2) this reliability should be based on the amount of agreement between the observers [ 90 ]. Based on Groenier et al.’s systematic review and meta-analysis, considerable caution is required with the use of assessment tools, especially when high-stake decision-making is required [ 91 ]. Advancing proficiency in technical skills with progression toward clinical application poses many issues. Surgeons gaining false self-confidence through inadequate testing may increase the risks of adverse events in clinical applications. Thus, competence testing protocols must be validated, and must be evidence based. In addition to technical proficiency, a surgical intervention requires vast competence and robust, validated assessment tools for surgical soft skills, including learning and interpersonal skills and attitudes.

The results showed that learning by doing, typically simulation, and learning through guided reflection were the most used instructional methods to promote surgical residents’ and medical students’ surgical learning. Both methods effectively promote acquiring knowledge about performing surgical tasks and surgical skills. For instance, simulation training has been shown to enhance fluency in technical performance of specific surgical procedures and patient safety and in increasing a surgeon’s confidence [ 17 , 51 , 91 ]. While building confidence is essential for progression, self-reflection to maintain competence awareness is needed. Hence, self-assessment is fundamental to surgical learning and can be used in many forms [ 92 ]. Also, modeling, particularly observing more experienced surgeons performing surgical procedures, self-directed study, and direct instruction were commonly applied to enhance surgical learning. In turn, learning by gaming and mentoring or teaching fellow training surgeons was rarely applied in the studies as forms of instruction in cultivating surgical learning. The result indicates that gaming and peer learning are still both under-studied and under-utilized resources for systematically promoting the learning of future surgeons. The quality and quantity of social interactions with peers, senior surgeons, and patients are fundamental for surgical learning. Learning of all higher-order competencies proceeds from an inter-individual to an intra-individual sphere [ 93 , 94 , 95 ]. Moreover, since no surgeon works alone, the surgeon must be trained to work with and within the team. Accordingly, systematic use of peer learning would be essential not only for enhancing specific surgical knowledge and skills, but also for cultivating much-needed surgical soft skills. Nevertheless, emerging qualitative evidence suggests that peer learning is being increasingly implemented in medical education [ 96 ]. This trend underscores the growing recognition of the value of collaborative learning environments, where peers can share knowledge, challenge each other, and collectively develop the comprehensive skill set required in modern surgical practice.

Half of the studies we reviewed applied multimodal instruction to enhance surgical learning. This reflects a more modern understanding of learning in which varied instructional methods should be used depending on the object of learning, participants, and context. It also implies that traditional surgical teaching methods of incremental responsibility, with increasing volume-based exposure during residency, will gradually complement more varied research-informed instructional practices. However, it is essential to recall that learning always depends on our actions. This means that if we want to educate reflective practitioners who are good at solving complex problems [ 36 ], able to work in teams and engaged in continuous professional development, the instructional designs must systematically engage the future surgeons in such activities [ 97 ].

However, based on our review, many questions remain unanswered. The most fundamental of these is related to the transfer of surgical learning from a learning setting to other settings and across the competence ingredients. Firstly, further studies are needed on the extent and how surgical competencies, particularly beyond the technical skills attained in simulation (for instance), transfer into clinical work. This is also connected with the optimal length of the interval between preparation and execution, which was not analyzed thoroughly in most articles, nor was the time for initiation of skill waning explicitly stated. Feins et al. observed a transient decline from the end of one session to the beginning of the next, which was subsequently recovered and improved [ 37 ]. Green et al. showed that technical skills attained during preparatory courses are maintained into residency without additional interventions, with similar results from Maertens et al. and Lee-Riddle et al., who recorded proficiency levels to be maintained for at least three months [ 41 , 51 , 60 ]. Secondly, based on our review, studies addressing the learning and training of surgical competencies were highly task specific. Accordingly, further studies on the interrelation between competence ingredients, including surgical knowledge, technical and soft skills, and attitudes, are needed to promote the development of comprehensive surgical competencies among future surgeons. Thirdly, while simulation has proven essential for technical training, many operative interventions contain elements that cannot be simulated with current systems. The preparation for such interventions demands a multimodal approach, including preparatory discussions and visualization, until further methods become available.

Surgical residency is demanding in many aspects, not the least timewise. Among surgeons, mini-fellowships are uncommon as a learning method as opposed to traditional learning-by-doing approaches. While more effective methods are acknowledged, they are not applied due to time concerns [ 98 ]. As shown by Bohl et al., dedicated synthetic model training may alleviate time demands, allowing residents to recover better and thus improving preparedness for subsequent tasks [ 45 ]. Cognitive task analysis-based training is a valuable adjunct to the modern surgical curriculum, especially considering the global reduction in operating times and volumes during training [ 99 , 100 ]. CTA-based training improves procedural knowledge and technical performance [ 99 ]. However, it was applied in only a few of the studies analyzed here. Interestingly, CTA seems more effective in the later stages of surgical education, with less impact on medical students [ 101 ]. In addition, CTA-based training is suitable for electronic delivery, utilization through web-based tools, and gaming applications, all of which are accessible and provide opportunities for frequent revisits without personnel or resource investments [ 102 , 103 ]. Learning through gaming was also rarely applied in teaching situations in the studies analyzed here. While serious gaming in medical education is beneficial, validating each application for a specific purpose is mandatory [ 104 ].

Postgraduate medical education has recently moved towards competency-based education in many countries. Entrusted professional activities (EPA) are utilized as milestones in many competency frameworks [ 105 ]. Although EPAs have been applied to and gained rapid acceptance in postgraduate medical education, their potential within undergraduate education remains unverified [ 106 ]. In addition, while EPAs are becoming more prominent in surgical education, their widespread adoption and dissemination remain challenging [ 107 ]. We advocate for using all tools that collectively embrace a holistic approach to all competency components within surgical learning.

Our study is not without limitations. While we attempted to acquire a comprehensive picture of the pedagogical surgical landscape, we may have yet to detect some reports. Although geographical coverage was acceptable, all the studies we identified were from Western countries. Thus, the actual coverage of multimodal surgical learning warrants further studies. One potential limitation of our study is the decision to restrict our literature search to studies published from 2017 onwards. While this approach allowed us to focus on the most recent and relevant developments in surgical training and competence, it may have excluded earlier studies that could provide additional historical context or foundational insights into the evolution of surgical education practices. Finally, although we limited our study population to students and residents, learning continues through a surgeon’s career and evolves depending on the learner’s situation. Competence-based learning applies equally to all stages of surgical learning and should be incorporated, irrespective of career stage.

Advancing proficiency through adequate competency assessment is crucial for effective surgical learning. As we observe, contemporary surgical education is high quality and continuously evolves. Most studies focused on objective assessments, yet the measurement and assurance of the transition from technical to clinical proficiency remain areas for further exploration. Defining competency and creating validated assessments are fundamental to lifelong surgical learning.

While acquiring operational skills, decision-making knowledge, and confidence in performing technical tasks are teachable, the ultimate success in learning also hinges on the learner’s attitude and willingness to learn. Therefore, it is vital to incorporate non-technical skills alongside technical aptitude testing and academic achievements in designing modern surgical curricula.

To optimize learning outcomes, learners must adopt an approach encompassing the full spectrum of surgical education. This means integrating technical and non-technical skills to create a learning environment that nurtures a broad range of competencies essential for comprehensive surgical expertise.

Availability of data and materials

The dataset supporting the conclusions of the current study is available from the corresponding author on reasonable request.

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Pakkasjärvi, N., Anttila, H. & Pyhältö, K. What are the learning objectives in surgical training – a systematic literature review of the surgical competence framework. BMC Med Educ 24 , 119 (2024). https://doi.org/10.1186/s12909-024-05068-z

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Differentiated instruction (DI) is a beneficial approach to addressing students’ diverse learning needs, abilities, and interests to ensure that each student has the opportunity to make academic progress. To answer the question of how teachers utilize DI in K-12 classrooms, this systematic review was based on 61 empirical studies on DI published between 2000 and 2022. It examined the current status and trends of implementing DI in K-12 education and integrated various factors involved in the process of DI, including educational levels, subjects, student difference analysis, instructional methods, content, tools, assessment methods, and instructional effectiveness. The findings indicated that (1) DI was most commonly used in primary school mathematics and language classrooms, with the majority of studies having sample sizes exceeding 100 and lasting for more than 6 months; (2) The most frequently employed form of DI was ability grouping, often grouped based on academic achievement; (3) Information technology tools and resources can empower differentiated instruction; (4) Most studies utilized standardized tests, questionnaires, and scales as evaluation tools, with a focus on the impact of DI on students’ academic achievement and skills; and (5) The effectiveness of DI was controversial and influenced by multiple factors, such as may be associated with the instructional methods. In response to these findings, the study introduces a comprehensive DI model. This model, rooted in the perspective of instructional design, elucidates the interconnected factors of DI. It serves as a valuable reference for the future design and implementation of DI, offering a practical guide for educators aiming to create inclusive and effective learning environments.

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Acknowledgements

This work was supported by (The National Social Science Foundation's “14th five-year Plan” 2021 Pedagogy General Project) under Grant (Number BCA210083). At the same time, I would like to thank the experts who helped complete the literature screening and coding.

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Hu, L. Utilization of differentiated instruction in K-12 classrooms: a systematic literature review (2000–2022). Asia Pacific Educ. Rev. (2024). https://doi.org/10.1007/s12564-024-09931-y

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Management of vesicoenteric fistulas arising from perforated Meckel’s diverticulum: a report of a case and review of the literature

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Dimitrios Diamantidis, Nikolaos Papatheodorou, Panagiotis Kostoglou, Georgios Tsakaldimis, Sotirios Botaitis, Management of vesicoenteric fistulas arising from perforated Meckel’s diverticulum: a report of a case and review of the literature, Oxford Medical Case Reports , Volume 2024, Issue 2, February 2024, omad155, https://doi.org/10.1093/omcr/omad155

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Vesicoenteric fistulas are rare, with an incidence of 0.1%–0.2% in the general population, and Meckel’s diverticulum is a rare cause, accounting for less than 5% of cases with challenging diagnosis due to atypical symptoms at the admission. This article presents a case of a vesicoenteric fistula formation between Meckel’s diverticulum perforated by a foreign body and urinary bladder in a 38-years-old Caucasian male admitted to emergency department due to colicky abdominal pain located in the lower abdomen. An extensive review of the literature was conducted referring all the cases of vesicoenteric fistula incorporating Meckel’s diverticulum to elucidate the clinical characteristics, explore the diagnostic yield, and to summarize the therapeutic approach.

Meckel’s diverticulum is a rare entity that affects the gastrointestinal tract and characterized by a blind pouch protruding from the wall of the small intestine approximately two inches long. It is usually caused by failure of the omphalomesenteric duct to obliterate, and usually being found within two feet from ileocecal valve. Although it is usually asymptomatic, it can lead to complications such as ulceration, bleeding, and even vesicoenteric fistula formation. Vesicoenteric fistulas are abnormal connections between the urinary bladder and an intestinal (small bowel) segment that could cause the leakage of urine into the intestine [ 1–4 ]. They pose a scarce pathology throughout the literature, with an incidence rate of 0.1%–0.2% in general population. They develop between Meckel’s diverticulum and urinary bladder, in less than 5% of cases [ 2 ]. Symptoms of vesicoenteric fistulas can include abdominal pain, fever, urinary retention, and vomiting [ 5 ]. These conditions can be diagnosed further through a combination of clinical examination, laboratory, and imaging tests. Treatment of vesicoenteric fistulas due to Meckel’s diverticulum typically involves the resection of the affected intestinal portion and repair of the fistula [ 6 ]. In some cases, laparoscopic surgery can be used successfully to treat these fistulas [ 5 , 7 ]. This article reports a rare case of a male patient suffering from an unknown until the point of the admission vesicoenteric fistula developed between the perforated by foreign body Meckel’s diverticulum and urinary bladder. Additionally, an extensive review of the literature using PubMed library was conducted using the keywords ‘enterovesical AND fistula AND meckel AND diverticulum’, ‘foreign AND body AND fistula AND meckel AND diverticulum AND vesicoenteric OR enterovesical’, ‘foreign AND body AND fistula AND meckel AND diverticulum’ and ‘vesicoenteric AND fistula AND meckel AND diverticulum’ in the title and abstract on June 2023. Moreover, the reference lists of the eligible studies and relevant review articles were cross-checked to identify all prior reported case reports of vesicoenteric fistula from Meckel diverticulum, and to determine the set of symptoms, the different diagnostic tools, and the surgical approach.

A 38-year-old Caucasian male patient was admitted to the emergency department of the University Hospital of Alexandroupolis with colicky abdominal pain, ongoing for three weeks. The patient reported slight remission of the symptoms the last two weeks and exacerbation of them two days before his admission. No active bleeding, history of hematochezia, faecaluria or pneumaturia was reported by the patient. The patient was afebrile, without accompanying nausea or vomiting. Vital parameters were recorded: blood pressure measurement 125/80 mm Hg, oxygen saturation rate 97% and pulse rate of 87 beats per minute. During the clinical examination, the abdomen was distended and tympanic, with intense tenderness in the hypogastrium and right and left iliac fossa. Positive McBurney and Rovsing signs were found, as well as decreased bowel sounds during auscultation. The laboratory tests results revealed leukocytosis, with a polymorphonuclear type, and increased inflammation indices. Table 1 summarizes the results of the laboratory tests. The emergent abdominal computed tomography (CT) revealed a thin elongated radiopaque formation about 2 cm long, that could be a foreign body, protruding from a blind small bowel loop (attributed to Meckel’s diverticulum, Fig. 1 ) into the pelvic cavity ( Fig. 2 ). Focal thickening as well as edema of the intestinal wall and the surrounding mesenterial fat was revealed, without any extraluminal air bubbles or intra-abdominal fluid collections ( Fig. 1 ).

Laboratory test results

Computed Tomography of the abdomen: a blind intestinal loop (thin arrow) was attributed to Meckel’s diverticulum. Concomitant focal thickening as well as edema of the intestinal wall and the surrounding mesenterial fat (thick arrow).

Computed Tomography of the abdomen: a blind intestinal loop (thin arrow) was attributed to Meckel’s diverticulum. Concomitant focal thickening as well as edema of the intestinal wall and the surrounding mesenterial fat (thick arrow).

Computed Tomography of the abdomen: a thin elongated hyperdense nodule about 2 cm long perforating the intestinal wall, attributed to a foreign body (fish-bone).

Computed Tomography of the abdomen: a thin elongated hyperdense nodule about 2 cm long perforating the intestinal wall, attributed to a foreign body (fish-bone).

The patient underwent an emergent exploratory laparotomy. Intraoperatively, distended small bowel coils and a hypertrophic but non-inflammatory appendix vermiformis were discovered. During the small bowel examination, adhesions as well as a large about one and a half inches long, inflammatory, and perforated by a fishbone Meckel’s diverticulum was observed about 80 cm from the ileocecal valve ( Fig. 3 ), solidly attached to the urinary bladder. Adhesiolysis, segmental small bowel resection incorporating the Meckel’s diverticulum, and a side-to-side small bowel anastomosis were carried out ( Fig. 4 ). Urinary bladder leakage was discovered during the Douglas pouch examination, and the bladder wall deficit was then closed via a double-layer suture pattern. A drainage tube inserted and positioned in Douglas’s pouch to detect any early postoperative leakage. The patient’s postoperative course was uneventful and the patient discharged home on the sixth postoperative day, and the Foley catheter was removed on the tenth postoperative day.

Postoperative specimen from small bowel segmental resection including the perforated by a fish bone Meckel’s diverticulum.

Postoperative specimen from small bowel segmental resection including the perforated by a fish bone Meckel’s diverticulum.

Postoperative specimen from small bowel segmental resection including the perforated by a fish bone Meckel’s diverticulum.

Meckel’s diverticulum is the most common congenital anomaly of gastrointestinal tract characterized by a blind pouch protruding from the wall of the small intestine [ 2 , 4 ]. It is a rare condition, occurring in approximately 2% of the population [ 3 ]. While Meckel’s diverticulum is usually asymptomatic, it can cause various complications such as intussusception, intestinal obstruction, ulceration, bleeding, diverticulitis, perforation and, very rarely, neoplasms and vesicoenteric fistulas [ 1 , 4 ].

Vesicoenteric fistulas (VEFs) are abnormal connections between the urinary bladder and the intestine that can result in the leakage of urine into the intestinal lumen. These fistulas are rare complications, with an incidence of 0.1%–0.2% in the general population [ 2 ]. Meckel’s diverticulum is a rare cause of vesicoenteric fistulas, accounting for less than 5% of all cases while most commonly occur secondary to diverticulitis, Crohn’s disease, colon and bladder malignancies [ 6 ]. Recent literature has documented eleven similar cases, with Table 2 offering a comprehensive summary encompassing their symptoms, the diagnostic imaging techniques employed, and the surgical interventions performed. The cause of the formation of vesicointestinal fistulas to the reported cases included the following: unknown etiology—idiopathic in seven cases [ 2 , 3 , 5 , 7–10 ], Crohn disease [ 11 ], enterolith, adenocarcinoma of ectopic pancreatic tissue, and foreign body [ 12–14 ].

Eleven similar studies have been documented reporting vesicoenteric fistulas formation between Meckel’s diverticulum and urinary bladder

VEFs can be difficult to diagnose, as symptoms may be nonspecific and the condition is rare [ 5 ]. Symptoms of vesicoenteric fistulas can include abdominal pain, fever, lower urinary tract symptoms, urinary retention, and vomiting [ 6 , 7 ]. The diagnosis of these conditions can be made through a combination of clinical examination, laboratory tests, and imaging studies, such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), cystoscopy, Tc-99 m DTPA or gastrointestinal (GI) contrast studies [ 6 ]. In some cases, including ours, laparotomy may be necessary to confirm the diagnosis [ 11 ]. In our case, a vesicoenteric fistula could not be seen in the emergent CT examination of the abdomen. The diagnosis was confirmed intraoperatively with the existence of a vesicoenteric fistula developed between the perforated by a foreign body (fishbone) Meckel’s diverticulum and the urinary bladder.

The surgical approach for the treatment of vesicoenteric fistulas incorporating Meckel’s diverticulum typically involves the removal of the affected portion of the intestine and the Meckel’s diverticulum, as well as repair of the fistula [ 7 ]. In some cases, additional procedures such as appendectomy may be necessary [ 2 ]. After surgery, the patient may need to undergo urinary catheterization and may require ongoing monitoring for any complications [ 5 ]. Laparoscopic surgery can successfully be used to treat vesicoenteric fistula due to Meckel’s diverticulum [ 7 ]. Operative management of vesicoenteric fistulas involves resection and reanastomosis of the bowel segment causing the fistula and closing of the bladder [ 6 ].

In conclusion, Meckel’s diverticulum is a rare cause of vesicoenteric fistula formation. It could lead to life-threatening complications due to foreign body ingestion or perforation. The diagnosis of vesicoenteric fistula poses a challenge even for an experienced radiologist. General surgeons should be aware of this scarcity because of the provocative treatment required. Treatment is mainly surgical and involves the removal of the affected portion of the intestine incorporating the Meckel’s diverticulum, as well as repair of the fistula. Further studies should be conducted to evaluate the safety and effectiveness of laparoscopic surgery for the treatment of vesicoenteric fistulas incorporated Meckel’s diverticulum.

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

None declared.

No funding source to declare.

A consent form completed and signed by the patient.

Dimitrios Diamantidis (Author), Nikolaos Papatheodorou (Co-author), Panagiotis Kostoglou (Reviewer), Georgios Tsakaldimis (Reviewer), and Sotirios Botaitis (Supervisor).

Srisajjakul   S , Prapaisilp   P , Bangchokdee   S . Many faces of Meckel’s diverticulum and its complications . Jpn J Radiol   2016 ; 34 : 313 – 20 .

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Hakoda   H , Mishima   H , Habu   T , Murai   S , Maeno   R , Yokomizo   Y . et al.    Laparoscopic treatment of a vesicointestinal fistula due to a Meckel’s diverticulum: a case report and review of the literature . Clin J Gastroenterol   2018 ; 11 : 476 – 80 .

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