scoping review dissertation example

Scoping Reviews

• Introduction
• Guidelines & procedures
• Management tools
• Define the question
• Check the topic
• Determine inclusion/exclusion criteria
• Develop a protocol
• Identify keywords
• Databases and search strategies
• Grey literature
• Manage and organise
• Screen & Select
• Locate full text
• Extract data

Example reviews

• Examples of scoping reviews
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Please choose the tab below for your discipline to see relevant examples.

For more information about how to conduct and write reviews, please see the Guidelines section of this guide.

• Health & medicine
• Social sciences
• Technologically-enhanced psychological interventions for older adults: A scoping review. (2020).
• The effects of Toxic Early Childhood Experiences on depression according to Young Schema Model: A scoping review. (2019).

Rehab sciences

• Occupational therapists' contributions to fostering older adults' social participation: A scoping review. (2018).
• Physiotherapy interventions for people with dementia and a hip fracture—a scoping review of the literature. (2017).
• Speech, language and swallowing impairments in functional neurological disorder: A scoping review. (2019).

Veterinary sciences

• A scoping review of the evidence for efficacy of acupuncture in companion animals. (2017).
• Scoping review of indicators and methods of measurement used to evaluate the impact of dog population management interventions. (2017).
• Promoting social creativity in science education with digital technology to overcome inequalities: A scoping review. (2019).
• Simulation in social work education: A scoping review. (2020).
• Performance management: A scoping review of the literature and an agenda for future research. (2019).
• A scoping review of feed interventions and livelihoods of small-scale livestock keepers. (2020).
• Ice-jam flood research: A scoping review. (2018).
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• Last Updated: May 13, 2024 11:34 AM
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Cochrane Training

Scoping reviews: what they are and how you can do them.

In these videos from a  Cochrane Learning Live  webinar delivered in partnership with  GESI: the Global Evidence Synthesis Initiative , Dr Andrea C. Tricco presents the definition of a scoping review, examples of scoping reviews, steps of the scoping review process, and methods used in 494 scoping reviews from the literature. In the second video, Kafayat Oboirien presents her experiences of conducting a scoping review on strengthening clinical governance in low and middle income countries.

• Scoping reviews: an overview with examples
• Example: Strengthening clinical governance in low- and middle-income countries
• Examples of non-health related scoping reviews
• Doing scoping reviews
• Polling questions and Q&A session

Presenters Bio

Dr. Andrea C. Tricco (PhD, MSc) holds a Tier 2 Canada Research Chair in Knowledge Synthesis. Her research interests are related to responding to knowledge users (including patients, healthcare providers, and policy-makers) through knowledge synthesis. Her research also focuses on advancing the science of knowledge synthesis and she is leading research projects related to rapid reviews, network meta-analysis, and scoping reviews.

Kafayat Oboirien has a MPH in Health Economics. She has been involved in the analysis of utilisation in South Africa and a cross-country project evaluating reforms towards universal health coverage. Her present research interest lies in knowledge synthesis, specifically in mapping and documenting health systems’ work practices in LMICs.

Part 1: Scoping reviews: an overview with examples

Part 2: Example: Strengthening clinical governance in low- and middle-income countries

Part 3: Examples of non-health related scoping reviews

Part 4: Doing scoping reviews

Part 5: Polling questions and Q&A session

Systematic reviews and other evidence synthesis projects

• Types of Reviews
• Systematic Reviews
• 0. Plan your Review
• 1. Define the Question
• 2. Check for Recent Systematic Reviews and Protocols
• 3. Write and register your protocol
• Developing your Search Terms
• Database Search Tips and Filters
• Grey Literature
• Record and Report your Search Strategy
• Covidence This link opens in a new window
• 6. Appraise the Studies
• 7. Extract Data
• 8. Analyze / Synthesize Data
• 9. Write the Review
• Rapid Reviews

What is a Scoping Review?

Scoping review steps, scoping reviews vs. systematic reviews, the pcc framework, learning resources, guide design credit.

• Equity in Evidence Synthesis
• Automation, AI, and other upcoming review technologies
• Librarian Support

A scoping review is a broad overview of a general topic that maps a large and diverse body of literature to provide forms of evidence. 

Objectives of a Scoping Review

• To identify the types of available evidence in a given field
• To clarify key concepts/ definitions in the literature
• To examine how research is conducted on a certain topic or field
• To identify key characteristics or factors related to a concept
• As a precursor to a systematic review
• To identify and analyze knowledge gaps

Note: The full scoping review methodology is outside the scope of almost all class assignments or dissertation/thesis. If you are considering assigning one, please meet with a librarian about a modified version that will fit your course's needs and limits.

The following are the steps for the scoping review process:

• Determine subject for review and develop some general questions
• Highly recommended to develop a protocol after the first step!
• Use the PCC framework
• Conduct systematic searches
• Determine eligibility of papers from results with a screening process
• Data extraction of relevant information
• Document the evidence
• See also: the JBI scoping review YouTube playlist

Scoping reviews share a lot of the same methodology as systematic reviews, but there are some differences.

Scoping reviews answer different types of questions than systematic reviews. Arksey and O'Malley identified 4 reasons to conduct a scoping review:

• To examine the extent, range and nature of research activity
• To determine the value of undertaking a full systematic review
• To summarize and disseminate research findings
• To identify research gaps in the existing literature

Writing your protocol

The JBI Scoping Review chapter has guidance on writing your protocol. Also, the National Institutes of Health (NIH) Library has developed a Scoping Review Protocol Guidance template and informational document containing goals and requirements for the protocol plus helpful tips and examples.

Registering your protocol

There is not as centralized a location for registering scoping review protocols as there is for systematic reviews, but there are a few ways to do it. You can put it into an open science repository such as:

These have the added features of being a place where you can make any supplemental materials available, such as the full text of your searches, and the advantage of being fast since they don’t require the approval process of the journals below. They have the disadvantage of the protocol only being findable by people searching that repository.

There are also several journals that publish protocols:

• BMC Systematic Reviews  
• JMIR Research Protocols
• JBI Evidence Synthesis

These have the advantage of being included in several databases, but the disadvantage of having to go through the submission and approval process.

The PCC framework stand for the following and include these elements:

This framework can be used for mixed methods of qualitative and quantitative research.

By using this framework, it is also important to surface the varying including and excluding criteria to explicitly guide the scope of what is being investigated. This is helpful to document in your protocol to provide clarity about what information needs to be looked for in supporting your research question. 

• Systematic vs Scoping Review: What's the Difference? A short video from Carrie Price.
• Should I undertake a scoping review or a systematic review? A video from JBI.
• Scoping reviews: What they are and how you can do them on YouTube  or on Cochrane's website   Cochrane video training series.
• Pham MT, Rajić A, Greig JD, Sargeant JM, Papadopoulos A, McEwen SA. A scoping review of scoping reviews: advancing the approach and enhancing the consistency. Res Synth Methods. 2014 Dec;5(4):371-85. doi: 10.1002/jrsm.1123. Epub 2014 Jul 24. PMID: 26052958; PMCID: PMC4491356.
• Levac, Danielle, Heather Colquhoun, and Kelly K. O'Brien. "Scoping studies: advancing the methodology." Implementation Science 5.1 (2010): 1-9. https://doi.org/10.1186/1748-5908-5-69
• Scoping reviews: reinforcing and advancing the methodology and application . Micah D. J. Peters, Casey Marnie, Heather Colquhoun, Chantelle M. Garritty, Susanne Hempel, Tanya Horsley, Etienne V. Langlois, Erin Lillie, Kelly K. O’Brien, Ӧzge Tunçalp, Michael G. Wilson, Wasifa Zarin & Andrea C. Tricco. Systematic Reviews volume 10, Article number: 263 (2021)
• Khalil H, Peters M, Godfrey CM, McInerney P, Soares CB, Parker D. An Evidence-Based Approach to Scoping Reviews. Worldviews Evid Based Nurs. 2016 Apr;13(2):118-23. doi: 10.1111/wvn.12144 . Epub 2016 Jan 28. PMID: 26821833 .
• Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach ; by Zachary Munn, Micah D. J. Peters, Cindy Stern, Catalin Tufanaru, Alexa McArthur & Edoardo Aromataris. BMC Med Res Methodol 18, 143 (2018). https://doi.org/10.1186/s12874-018-0611-x
• Evidence maps - often based on a ScR: Miake-Lye IM, Hempel S, Shanman R, Shekelle PG. What is an evidence map? A systematic review of published evidence maps and their definitions, methods, and products . Syst Rev. 2016;5(1):28.

Reporting Guidelines

• PRISMA Extension for Scoping Reviews The PRISMA extension for scoping reviews, or PRISMA-ScR for short, contains 20 essential reporting items and 2 optional items to include when completing a scoping review.

Dev Wilder UW MLIS Candidate 2023

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• Literature Reviews in the Health Sciences
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When is a Scoping Review methodology appropriate?

Outline of stages, methods and guidance, examples of scoping reviews, supplementary resources.

According to Colquhoun et al. (2014) , a scoping review can be defined as: "a form of knowledge synthesis, which incorporate a range of study designs to comprehensively summarize and synthesize evidence with the aim of informing practice, programs, and policy and providing direction to future research priorities" (p.1291).

Characteristics

• Answers a broad question
• Scoping reviews serve the purpose of identifying the scope and extent of existing research on a topic
• Similar to systematic reviews, scoping reviews follow a step-by-step process and aim to be transparent and replicable in its methods

When to Use It: A scoping review might be right for you if you are interested in:

• Examining the extent, range, and nature of research activity
• Determining the value of undertaking a full systematic review (e.g. Do any studies exist? Have systematic reviews already been conducted?)
• Summarizing the disseminating research findings
• Identifying gaps in an existing body of literature

The following stages of conducting a review of complex interventions are derived from  Peters et al. (2015)  and Levac et al. (2010) .

Timeframe:  12+ months, (same amount of time as a systematic review or longer)

*Varies beyond the type of review. Depends on many factors such as but not limited to: resources available, the quantity and quality of the literature, and the expertise or experience of reviewers" ( Grant & Booth, 2009 ).

Question:  Answers broader and topic focused questions beyond those relating to the effectiveness of treatments or interventions. A priori review protocol is recommended. 

Is your review question a complex intervention? Learn more about  Reviews of Complex Interventions .

Sources and searches:  Comprehensive search-may be limited by time/scope restraints, still aims to be thorough and repeatable of all literature. May involve multiple structured searches rather than a single structured search. This will produce more results than a systematic review. Must include a modified PRISMA flow diagram.

Selection:  Based on inclusion/exclusion criteria, due to the iterative nature of a scoping review some changes may be necessary. May require more time spent screening articles due to the larger volume of results from broader questions.

Appraisal:  Critical appraisal (optional), Risk of Bias assessment (optional) is not applicable for scoping reviews. 

Synthesis:  (Tabular with some narrative) The extraction of data for a scoping review may include a charting table or form but a formal synthesis of findings from individual studies and the generation of a 'summary of findings' (SOF) table is not required. Results may include a logical diagram or table or any descriptive form that aligns with the scope and objectives of the review. May incorporate a numerical summary and qualitative thematic analysis.

Consultation:  (optional) 

The following resources provide methods and guidance in the field of scoping reviews.

Methods & Guidance

• Cochrane Training: Scoping reviews: what they are and how you can do them A series of videos presented by Dr Andrea C. Tricco and Kafayat Oboirien. Learn the about what a scoping review is, see examples, learn the steps involved, and common methods from Dr. Tricco. Oboirien presents her experiences of conducting a scoping review on strengthening clinical governance in low and middle income countries.
• Current Best Practices for the Conduct of Scoping Reviews by Heather Colquhoun An overview on best practices when executing a scoping review.
• Joanna Briggs Institute (JBI) Manual for Evidence Synthesis. Chapter 11: Scoping Reviews An extensive and detailed outline within the JBI Manual for Evidence Synthesis on how to properly conduct a scoping review.

Reporting Guideline

• PRISMA for Scoping Reviews (PRISMA-ScR) Contains a 20-item checklist for proper reporting of a scoping review plus 2 optional items.
• Håkonsen, S. J., Pedersen, P. U., Bjerrum, M., Bygholm, A., & Peters, M. (2018). Nursing minimum data sets for documenting nutritional care for adults in primary healthcare: a scoping review .  JBI database of systematic reviews and implementation reports ,  16 (1), 117–139. doi: 10.11124/JBISRIR-2017-003386
• Kao, S. S., Peters, M., Dharmawardana, N., Stew, B., & Ooi, E. H. (2017). Scoping review of pediatric tonsillectomy quality of life assessment instruments .  The Laryngoscope ,  127 (10), 2399–2406. doi: 10.1002/lary.26522
• Tricco, A. C., Zarin, W., Rios, P., Nincic, V., Khan, P. A., Ghassemi, M., Diaz, S., Pham, B., Straus, S. E., & Langlois, E. V. (2018). Engaging policy-makers, health system managers, and policy analysts in the knowledge synthesis process: a scoping review .  Implementation science: IS ,  13 (1), 31. doi: 10.1186/s13012-018-0717-x

Anderson, S., Allen, P., Peckham, S., & Goodwin, N. (2008). Asking the right questions: scoping studies in the commissioning of research on the organisation and delivery of health services .  Health research policy and systems ,  6 , 7. doi: 10.1186/1478-4505-6-7

Arksey, H., & O'Malley, L. (2005). Scoping studies: towards a methodological framework .  International journal of social research methodology, 8 (1), 19-32. doi: 10.1080/1364557032000119616

Armstrong, R., Hall, B. J., Doyle, J., & Waters, E. (2011). Cochrane Update. 'Scoping the scope' of a cochrane review .  Journal of public health (Oxford, England) ,  33 (1), 147–150. doi: 10.1093/pubmed/fdr015

Colquhoun, H. (2016). Current best practices for the conducting of scoping reviews . Symposium Presentation - Impactful Biomedical Research: Achieving Quality and Transparency . https://www.equator-network.org/wp-content/uploads/2016/06/Gerstein-Library-scoping-reviews_May-12.pdf

Colquhoun, H. L., Levac, D., O'Brien, K. K., Straus, S., Tricco, A. C., Perrier, L., Kastner, M., & Moher, D. (2014). Scoping reviews: time for clarity in definition, methods, and reporting .  Journal of clinical epidemiology ,  67 (12), 1291–1294. doi: 10.1016/j.jclinepi.2014.03.013

Davis, K., Drey, N., & Gould, D. (2009). What are scoping studies? A review of the nursing literature .  International journal of nursing studies ,  46 (10), 1386–1400. doi: 10.1016/j.ijnurstu.2009.02.010

Khalil, H., Peters, M., Godfrey, C. M., McInerney, P., Soares, C. B., & Parker, D. (2016). An evidence-based approach to scoping reviews .  Worldviews on evidence-based nursing ,  13 (2), 118–123. doi: 10.1111/wvn.12144

Levac, D., Colquhoun, H., & O'Brien, K. K. (2010). Scoping studies: advancing the methodology .  Implementation science: IS ,  5 , 69. doi: 10.1186/1748-5908-5-69

Lockwood, C., Dos Santos, K. B., & Pap, R. (2019). Practical guidance for knowledge synthesis: scoping review methods .  Asian nursing research ,  13 (5), 287–294. doi: 10.1016/j.anr.2019.11.002

Morris, M., Boruff, J. T., & Gore, G. C. (2016). Scoping reviews: establishing the role of the librarian .  Journal of the Medical Library Association: JMLA ,  104 (4), 346–354. doi: 10.3163/1536-5050.104.4.020

Munn, Z., Peters, M., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach .  BMC medical research methodology ,  18 (1), 143. doi: 10.1186/s12874-018-0611-x

O'Brien, K. K., Colquhoun, H., Levac, D., Baxter, L., Tricco, A. C., Straus, S., Wickerson, L., Nayar, A., Moher, D., & O'Malley, L. (2016). Advancing scoping study methodology: a web-based survey and consultation of perceptions on terminology, definition and methodological steps .  BMC health services research ,  16 , 305. doi: 10.1186/s12913-016-1579-z

Peters, M. D., Godfrey, C. M., Khalil, H., McInerney, P., Parker, D., & Soares, C. B. (2015). Guidance for conducting systematic scoping reviews .  International journal of evidence-based healthcare ,  13 (3), 141–146. doi: 10.1097/XEB.0000000000000050

Peters, M. D. J., Godfrey, C., McInerney, P., Munn, Z., Tricco, A. C., & Khalil, H. (2020). Chapter 11: Scoping Reviews . In Aromataris, E. & Munn, Z. (Eds.),  JBI Manual for Evidence Synthesis . Joanna Briggs Institute. doi: 10.46658/JBIMES-20-12

Peters, M., Marnie, C., Tricco, A. C., Pollock, D., Munn, Z., Alexander, L., McInerney, P., Godfrey, C. M., & Khalil, H. (2021). Updated methodological guidance for the conduct of scoping reviews .  JBI evidence implementation ,  19 (1), 3–10. doi: 10.1097/XEB.0000000000000277

Pham, M. T., Rajić, A., Greig, J. D., Sargeant, J. M., Papadopoulos, A., & McEwen, S. A. (2014). A scoping review of scoping reviews: advancing the approach and enhancing the consistency .  Research synthesis methods ,  5 (4), 371–385. doi: 10.1002/jrsm.1123

Tricco, A. C., Lillie, E., Zarin, W., O'Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M., Horsley, T., Weeks, L., Hempel, S., Akl, E. A., Chang, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson, M. G., Garritty, C., Lewin, S., … Straus, S. E. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation .  Annals of internal medicine ,  169 (7), 467–473. doi: 10.7326/M18-0850

Tricco, A., Oboirien, K., Lotfi, T., & Sambunjak, D. (2017, August).  Scoping reviews: what they are and how you can do them . Cochrane Training. https://training.cochrane.org/resource/scoping-reviews-what-they-are-and-how-you-can-do-them

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Other Names for a Scoping Review

• Scoping Study
• Systematic Scoping Review
• Scoping Report
• Scope of the Evidence
• Rapid Scoping Review
• Structured Literature Review
• Scoping Project
• Scoping Meta Review

Limitations of a Scoping Review

The following challenges of conducting a scoping review are derived from Grant & Booth (2009) , Peters et al. (2015) , and O'Brien (2016) .

• Is not easier than a systematic review.
• Is not faster than a systematic review; may take longer .
• More citations to screen.
• Different screening criteria/process than a systematic review.
• Often leads to a broader, less defined search.
• Requires multiple structured searches instead of one.
• Increased emphasis for hand searching the literature.
• May require larger teams because of larger volume of literature.
• Inconsistency in the conduct of scoping reviews.

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A scoping review of scoping reviews: advancing the approach and enhancing the consistency

a Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, N1G 2W1, Canada

b Division of Public Health Risk Sciences, Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, 160 Research Lane, Suite 206, Guelph, Ontario, N1G 5B2, Canada

Andrijana Rajić

c Food Safety and Quality Unit, Food and Agriculture Organization of the United Nations, Viale delle Terme di Caracalla, 00153, Rome, Italy

Judy D Greig

Jan m sargeant.

d Centre for Public Health and Zoonoses, Ontario Veterinary College, University of Guelph, Guelph, Ontario, N1G 2W1, Canada

Andrew Papadopoulos

Scott a mcewen, associated data.

The scoping review has become an increasingly popular approach for synthesizing research evidence. It is a relatively new approach for which a universal study definition or definitive procedure has not been established. The purpose of this scoping review was to provide an overview of scoping reviews in the literature.

A scoping review was conducted using the Arksey and O'Malley framework. A search was conducted in four bibliographic databases and the gray literature to identify scoping review studies. Review selection and characterization were performed by two independent reviewers using pretested forms.

The search identified 344 scoping reviews published from 1999 to October 2012. The reviews varied in terms of purpose, methodology, and detail of reporting. Nearly three-quarter of reviews (74.1%) addressed a health topic. Study completion times varied from 2 weeks to 20 months, and 51% utilized a published methodological framework. Quality assessment of included studies was infrequently performed (22.38%).

Conclusions

Scoping reviews are a relatively new but increasingly common approach for mapping broad topics. Because of variability in their conduct, there is a need for their methodological standardization to ensure the utility and strength of evidence. © 2014 The Authors. Research Synthesis Methods published by John Wiley & Sons, Ltd.

1. Background

The scoping review has become an increasingly popular approach for synthesizing research evidence (Davis et al. , 2009 ; Levac et al. , 2010 ; Daudt et al. , 2013 ). It aims to map the existing literature in a field of interest in terms of the volume, nature, and characteristics of the primary research (Arksey and O'Malley, 2005 ). A scoping review of a body of literature can be of particular use when the topic has not yet been extensively reviewed or is of a complex or heterogeneous nature (Mays et al. , 2001 ). They are commonly undertaken to examine the extent, range, and nature of research activity in a topic area; determine the value and potential scope and cost of undertaking a full systematic review; summarize and disseminate research findings; and identify research gaps in the existing literature (Arksey and O'Malley, 2005 ; Levac et al. , 2010 ). As it provides a rigorous and transparent method for mapping areas of research, a scoping review can be used as a standalone project or as a preliminary step to a systematic review (Arksey and O'Malley, 2005 ).

Scoping reviews share a number of the same processes as systematic reviews as they both use rigorous and transparent methods to comprehensively identify and analyze all the relevant literature pertaining to a research question (DiCenso et al. , 2010 ). The key differences between the two review methods can be attributed to their differing purposes and aims. First, the purpose of a scoping review is to map the body of literature on a topic area (Arksey and O'Malley, 2005 ), whereas the purpose of a systematic review is to sum up the best available research on a specific question (Campbell Collaboration, 2013 ). Subsequently, a scoping review seeks to present an overview of a potentially large and diverse body of literature pertaining to a broad topic, whereas a systematic review attempts to collate empirical evidence from a relatively smaller number of studies pertaining to a focused research question (Arksey and O'Malley, 2005 ; Higgins and Green, 2011 ). Second, scoping reviews generally include a greater range of study designs and methodologies than systematic reviews addressing the effectiveness of interventions, which often focus on randomized controlled trials (Arksey and O'Malley, 2005 ). Third, scoping reviews aim to provide a descriptive overview of the reviewed material without critically appraising individual studies or synthesizing evidence from different studies (Arksey and O'Malley, 2005 ; Brien et al. , 2010 ). In contrast, systematic reviews aim to provide a synthesis of evidence from studies assessed for risk of bias (Higgins and Green, 2011 ).

Scoping reviews are a relatively new approach for which there is not yet a universal study definition or definitive procedure (Arksey and O'Malley, 2005 ; Anderson et al. , 2008 ; Davis et al. , 2009 ; Levac et al. , 2010 ; Daudt et al. , 2013 ). In 2005, Arksey and O'Malley published the first methodological framework for conducting scoping reviews with the aims of clarifying when and how one might be undertaken. They proposed an iterative six-stage process: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, (5) collating, summarizing and reporting the results, and (6) an optional consultation exercise (Arksey and O'Malley, 2005 ). Arksey and O'Malley intended for their framework to stimulate discussion about the value of scoping reviews and provide a starting point toward a methodological framework. Since its publication, a few researchers have proposed enhancements to the Arksey and O'Malley framework based on their own experiences with it (Brien et al. , 2010 ; Levac et al. , 2010 ; Daudt et al. , 2013 ) or a review of a selection of scoping reviews (Anderson et al. , 2008 ; Davis et al. , 2009 ).

In recent years, scoping reviews have become an increasingly adopted approach and have been published across a broad range of disciplines and fields of study (Anderson et al. , 2008 ). To date, little has been published of the extent, nature, and use of completed scoping reviews. One study that explored the nature of scoping reviews within the nursing literature found that the included reviews ( N = 24) varied widely in terms of intent, procedure, and methodological rigor (Davis et al. , 2009 ). Another study that examined 24 scoping reviews commissioned by a health research program found that the nature and type of the reports were wide ranging and reported that the value of scoping reviews is ‘increasingly limited by a lack of definition and clarity of purpose’ (Anderson et al. , 2008 ). Given that these studies examined only a small number of scoping reviews from select fields, it is not known to what extent scoping reviews have been undertaken in other fields of research and whether these findings are representative of all scoping reviews as a whole. A review of scoping reviews across the literature can provide a better understanding of how the approach has been used and some of the limitations and challenges encountered by scoping review authors. This information would provide a basis for the development and adoption of a universal definition and methodological framework.

The purpose of this paper is to provide an overview of existing scoping reviews in the literature. The four specific objectives of this scoping review were to (1) conduct a systematic search of the published and gray literature for scoping review papers, (2) map out the characteristics and range of methodologies used in the identified scoping reviews, (3) examine reported challenges and limitations of the scoping review approach, and (4) propose recommendations for advancing the approach and enhancing the consistency with which they are undertaken and reported.

This scoping review began with the establishment of a research team consisting of individuals with expertise in epidemiology and research synthesis (Levac et al. , 2010 ). The team advised on the broad research question to be addressed and the overall study protocol, including identification of search terms and selection of databases to search.

The methodology for this scoping review was based on the framework outlined by Arksey and O'Malley ( 2005 ) and ensuing recommendations made by Levac et al . ( 2010 ). The review included the following five key phases: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, and (5) collating, summarizing, and reporting the results. The optional ‘consultation exercise’ of the framework was not conducted. A detailed review protocol can be obtained from the primary author upon request.

2.1. Research question

This review was guided by the question, ‘What are the characteristics and range of methodologies used in scoping reviews in the literature?’ For the purposes of this study, a scoping review is defined as a type of research synthesis that aims to ‘map the literature on a particular topic or research area and provide an opportunity to identify key concepts; gaps in the research; and types and sources of evidence to inform practice, policymaking, and research’ (Daudt et al. , 2013 ).

2.2. Data sources and search strategy

The initial search was implemented on June 17, 2011, in four electronic databases: MEDLINE/PubMed (biomedical sciences, 1946–present), SciVerse Scopus (multidisciplinary; 1823–present), CINAHL/EBSCO (nursing and allied health; 1981–present) and Current Contents Connect/ISI Web of Knowledge (multidisciplinary current awareness; 1998–present). The databases were selected to be comprehensive and to cover a broad range of disciplines. No limits on date, language, subject or type were placed on the database search. The search query consisted of terms considered by the authors to describe the scoping review and its methodology: scoping review, scoping study, scoping project, literature mapping, scoping exercise, scoping report, evidence mapping, systematic mapping, and rapid review. The search query was tailored to the specific requirements of each database (see Additional file 1).

Applying the same search string that was used for the search in SciVerse Scopus (Elsevier), a web search was conducted in SciVerse Hub (Elsevier) to identify gray literature. The a priori decision was made to screen only the first 100 hits (as sorted by relevance by Scopus Hub) after considering the time required to screen each hit and because it was believed that further screening was unlikely to yield many more relevant articles (Stevinson and Lawlor, 2004 ). The following websites were also searched manually: the Health Services Delivery Research Programme of the National Institute for Health Research ( http://www.netscc.ac.uk/hsdr/ ), the National Co-ordinating Centre for NHS Service Delivery and Organisation ( http://php.york.ac.uk/inst/spru/pubs/main.php ), NHS Evidence by the National Institute for Health and Clinical Excellence ( http://evidence.nhs.uk/ ), the University of York Social Policy Research Unit ( http://php.york.ac.uk/inst/spru/pubs/main.php ), the United Kingdom's Department of Health ( http://www.dh.gov.uk/en/index.htm ), and Google ( http://www.google.com ).

The reference lists of 10 randomly selected relevant articles (Hazel, 2005 ; Vissandjee et al. , 2007 ; Gagliardi et al. , 2009 ; Meredith et al. , 2009 ; Bassi et al. , 2010 ; Ravenek et al. , 2010 ; Sawka et al. , 2010 ; Churchill et al. , 2011 ; Kushki et al. , 2011 ; Spilsbury et al. , 2011 ) and eight review articles on scoping reviews (Arksey and O'Malley, 2005 ; Anderson et al. , 2008 ; Davis et al. , 2009 ; Grant and Booth, 2009 ; Hetrick et al. , 2010 ; Levac et al. , 2010 ; Rumrill et al. , 2010 ; Armstrong et al. , 2011 ) were manually searched to identify any further scoping reviews not yet captured. A ‘snowball’ technique was also adopted in which citations within articles were searched if they appeared relevant to the review (Hepplestone et al. , 2011 ; Jaskiewicz and Tulenko, 2012 ).

A follow-up search of the four bibliographic databases and gray literature sources was conducted on October 1, 2012 to identify any additional scoping reviews published after the initial search [see Additional file 1]. A search of Google with no date restrictions was also conducted at this time; only the first 100 hits (as sorted by relevance by Google) were screened.

2.3. Citation management

All citations were imported into the web-based bibliographic manager RefWorks 2.0 (RefWorks-COS, Bethesda, MD), and duplicate citations were removed manually with further duplicates removed when found later in the process. Citations were then imported into the web-based systematic review software DistillerSR (Evidence Partners Incorporated, Ottawa, ON) for subsequent title and abstract relevance screening and data characterization of full articles.

2.4. Eligibility criteria

A two-stage screening process was used to assess the relevance of studies identified in the search. Studies were eligible for inclusion if they broadly described the use of a scoping review methodology to identify and characterize the existing literature or evidence base on a broad topic. Because of limited resources for translation, articles published in languages other than English, French, or Spanish were excluded. Papers that described the scoping review process without conducting one and reviews of scoping reviews were excluded from the analysis, but their reference list was reviewed to identify additional scoping reviews. When the same data were reported in more than one publication (e.g., in a journal article and electronic report), only the article reporting the most complete data set was used.

2.5. Title and abstract relevance screening

For the first level of screening, only the title and abstract of citations were reviewed to preclude waste of resources in procuring articles that did not meet the minimum inclusion criteria. A title and abstract relevance screening form was developed by the authors and reviewed by the research team (see Additional file 2). The form was pretested by three reviewers (M. P., J. G., I. Y.) using 20 citations to evaluate reviewer agreement. The overall kappa of the pretest was 0.948, where a kappa of greater than 0.8 is considered to represent a high level of agreement (Dohoo et al. , 2012 ). As there were no significant disagreements among reviewers and the reviewers had no revisions to recommend, no changes were made to the form. The title and abstract of each citation were independently screened by two reviewers. Reviewers were not masked to author or journal name. Titles for which an abstract was not available were included for subsequent review of the full article in the data characterization phase. Reviewers met throughout the screening process to resolve conflicts and discuss any uncertainties related to study selection (Levac et al. , 2010 ). The overall kappa was 0.90.

2.6. Data characterization

All citations deemed relevant after title and abstract screening were procured for subsequent review of the full-text article. For articles that could not be obtained through institutional holdings available to the authors, attempts were made to contact the source author or journal for assistance in procuring the article. A form was developed by the authors to confirm relevance and to extract study characteristics such as publication year, publication type, study sector, terminology, use of a published framework, quality assessment of individual studies, types of data sources included, number of reviewers, and reported challenges and limitations (see Additional file 3). This form was reviewed by the research team and pretested by all reviewers (M. P., A. R., J. G., I. Y., K. G.) before implementation, resulting in minor modifications to the form. The characteristics of each full-text article were extracted by two independent reviewers (M. P. and J. G./K. G.). Studies excluded at this phase if they were found to not meet the eligibility criteria. Upon independently reviewing a batch of 20 to 30 articles, the reviewers met to resolve any conflicts and to help ensure consistency between reviewers and with the research question and purpose (Levac et al. , 2010 ).

2.7. Data summary and synthesis

The data were compiled in a single spreadsheet and imported into Microsoft Excel 2010 (Microsoft Corporation, Redmond, WA) for validation and coding. Fields allowing string values were examined for implausible values. The data were then exported into STATA version 12 (StataCorp, College Station, TX) for analyses. Descriptive statistics were calculated to summarize the data. Frequencies and percentages were utilized to describe nominal data.

3.1. Search and selection of scoping reviews

The original search conducted in June 2011 yielded 2528 potentially relevant citations. After deduplication and relevance screening, 238 citations met the eligibility criteria based on title and abstract and the corresponding full-text articles were procured for review. Four articles could not be procured and were thus not included in the review (Levy and Sanghvi, 1986 ; Bhavaraju, 1987 ; Centre for Reviews and Dissemination, 2004 ; Connell et al. , 2006 ). After data characterization of the full-text articles, 182 scoping reviews remained and were included in the analysis. The updated search in October 2012 produced 758 potentially relevant citations and resulted in another 162 scoping reviews being included. In total, 344 scoping reviews were included in the study. The flow of articles through identification to final inclusion is represented in Figure ​ Figure1 1 .

PRISMA flowchart of study selection process.

Many citations were excluded upon screening at the title and abstract level as several terms used in the search algorithm also corresponded to other study designs. For example, the term ‘scoping study’ was also used to describe studies that assessed the chemical composition of samples (e.g., Behrens et al. , 1998 ; Banks and Banks, 2001 ; Forrest et al. , 2011 ) and preliminary mining studies (Butcher, 2002 ; Bhargava et al. , 2008 ). ‘Scoping exercise’ also described studies that scoped an issue using questionnaires, focus groups, and/or interviews (e.g., Malloch and Burgess, 2007 ; Willis et al. , 2011 ; Norwood and Skinner, 2012 ). ‘Rapid review’ was also used to describe the partial rescreening of negative cervical smears as a method of internal quality assurance (e.g., Faraker and Boxer, 1996 ; Frist, 1997 ; Shield and Cox, 1998 ). ‘Systematic mapping’ was also used in studies pertaining to topographic mapping (e.g., Noda and Fujikado, 1987 ; Gunnell, 1997 ; Liu et al. , 2011 ) and mapping of biomolecular structures (e.g., Camargo et al. , 1976 ; Descarries et al. , 1982 ; Betz et al. , 2006 ).

3.2. General characteristics of included scoping reviews

The general characteristics of scoping reviews included in this study are reported in Table ​ Table1. 1 . All included reviews were published between 1999 and October 2012, with 68.9% (237/344) published after 2009. Most reviews did not report the length of time taken to conduct the review; for the 12.8% (44/344) that did, the mean length was approximately 5.2 months with a range of 2 weeks to 20 months. Journal articles (64.8%; 223/344) and government or research station reports (27.6%; 95/344) comprised the majority of documents included in the review. The number of journal articles was slightly underrepresented as 10 were excluded as duplicates because the same scoping review was also reported in greater detail in a report. The included reports ranged greatly in length, from four pages (Healthcare Improvement Scotland, 2012 ) to over 300 pages (Wallace et al. , 2006 ).

General characteristics of included scoping reviews ( n = 344)

The included scoping reviews varied widely in terms of the terminology used to describe the methodology. ‘Scoping review’ was the term most often used, reported in 61.6% (212/344) of included studies. An explicit definition or description of what study authors meant by ‘scoping review’ was reported in 63.1% (217/344) of articles. Most definitions centered around scoping reviews as a type of literature that identifies and characterizes, or maps, the available research on a broad topic. However, there was some divergence in how study authors characterized the rigor of the scoping review methodology. The terms ‘systematic’, ‘rigorous’, ‘replicable’, and ‘transparent’ were frequently used to describe the methodology, and several authors described scoping reviews to be comparable in rigor to systematic reviews (Gagliardi et al. , 2009 ; Liu et al. , 2010 ; Ravenek et al. , 2010 ; Feehan et al. , 2011 ; Heller et al. , 2011 ). In contrast, some studies described the methodology as less rigorous or systematic than a systematic review (Cameron et al. , 2008 ; Levac et al. , 2009 ; Campbell et al. , 2011 ). Brien et al. ( 2010 ) commented that scoping reviews were ‘often misinterpreted to be a less rigorous systematic review, when in actual fact they are a different entity’.

Some reviews were conducted as stand-alone projects while others were undertaken as parts of larger research projects. Study authors reported that a main purpose or objective for the majority of articles (97.4%; 335/344) was to identify, characterize, and summarize research evidence on a topic, including identification of research gaps. Only 6.4% (22/344) of included articles conducted the scoping review methodology to identify questions for a systematic review. As response options were not mutually exclusive, some reviews reported multiple purposes and/or objectives. A commissioning source was reported in 31.4% (108/344) of reviews; some reported that they were specifically commissioned to advise a funding body as to what further research should be undertaken in an area (e.g., Arksey et al. , 2002 ; Carr-Hill et al. , 2003 ; Fotaki et al. , 2005 ; Baxter et al. , 2008 ; Williams et al. , 2008 ; Trivedi et al. , 2009 ; Crilly et al. , 2010 ; Brearley et al. , 2011 ).

The majority of the included scoping reviews addressed a health topic, making up 74.1% (255/344) of reviews. The use of scoping reviews in software engineering—or ‘systematic mapping’ as termed in the sector—has increased in recent years with 92.7% (38/41) published after 2010. The topics examined in the included scoping reviews ranged greatly, spanning from data on multiplayer online role-playing games (Meredith et al. , 2009 ), to factors that influence antibiotic prophylaxis administration (Gagliardi et al. , 2009 ). The topics investigated were generally broad in nature, such as ‘what is known about the diagnosis, treatment and management of obesity in older adults’ (Decaria et al. , 2012 ). Some reviews that were conducted under short time frames (e.g., 1 month) addressed more specific questions such as ‘what is the published evidence of an association between hospital volume and operative mortality for surgical repair (open and endovascular) of unruptured and ruptured abdominal aortic aneurysms?’ (Healthcare Improvement Scotland, 2011 ).

3.3. Methodological characteristics of included scoping reviews

The methodological characteristics of included scoping reviews are reported in Table ​ Table2. 2 . Approximately half of the reviews (50.6%; 174/344) reported using one or more methodological frameworks for carrying out the scoping review. Framework use varied greatly between reviews from different sectors, such as in 85.4% (35/41) of reviews from the software engineering sector and in 44.0% (89/202) of health sector reviews. Overall, the Arksey and O'Malley ( 2005 ) framework was the most frequently used, reported in 62.6% (109/174) of studies that reported using a framework. Among reviews from the software engineering sector that reported using a framework, frameworks by Kitchenham and Charters ( 2007 ) (40.0%; 14/35) and Petersen et al . ( 2008 ) (51.4%; 18/35) were most commonly employed. The use of a framework increased over time, from 31.6% (6/19) of reviews published from 2000 to 2004, to 42.5% (37/87) of reviews from 2005 to 2009, and to 55.3% (131/237) of reviews published from 2010 onward.

Methodological characteristics of included reviews ( n = 344)

Following the search, 79.7% (174/344) of reviews used defined inclusion and exclusion criteria to screen out studies that were not relevant to the review question(s). Among these, only six reviews explicitly reported that criteria were redefined or amended on a post hoc basis during the review process (While et al. , 2005 ; Marsella, 2009 ; Crooks et al. , 2010 ; Johnston et al. , 2010 ; Snyder et al. , 2011 ; Victoor et al. , 2012 ). The selection criteria in a few reviews were unclear due to ambiguous wording such as ‘real paper’ (Saraiva et al. , 2012 ), ‘scientific papers’ (Victoor et al. , 2012 ), and ‘culling low-interest articles’ (Catts et al. , 2010 ). Compared with the study selection process, fewer details were generally reported about the data characterization (or charting) of individual studies. Nearly a quarter of reviews (23.8%; 82/344) did not report any detail as to how the included studies were characterized, and it was unclear in 33.4% (115/344) as to how many reviewers were involved.

The majority of included reviews (77.7%, 267/344) did not assess the methodological quality of individual studies. A number of these studies reported that quality assessment was not conducted as it is not a priority in scoping reviews or part of the scoping review methodology. Two studies reported the use of publication in a peer-reviewed publication as a proxy for good quality (Baxter et al. , 2008 ; Pita et al. , 2011 ) and another reported using studies included in existing reviews or meta-analyses to ‘overcome’ the lack of quality assessment (MacDougall, 2011 ). Of the 22.4% (77/344) of articles that reported a critical appraisal step, the rigor with which it was conducted ranged from the reviewer's subjective assessment using a scale of high, medium, or low (Roland et al. , 2006 ), to the use of published tools such as the Jadad scale (Jadad et al. , 1996 ) for randomized control trials (Deshpande et al. , 2009 ; Borkhoff et al. , 2011 ).

The level of detail reported about the search strategy varied considerably across the reviews. Table ​ Table3 3 displays information about the search strategy reported in the included reviews by time. Overall, the detail of reporting for the search increased numerically over time. For example, 78.06% of reviews published after 2009 reported complete strings or a complete list of search terms, compared with 57.89% of reviews published between 2000 and 2004 and 67.82% of reviews published between 2005 and 2009.

Search strategy details reported in included reviews, by year

Table ​ Table4 4 summarizes how some of the results of the included reviews were reported and ‘charted’. A flow diagram was used to display the flow of articles from the initial search to final selection in 35.8% of reviews (123/344). Characteristics of included studies were often displayed in tables (82.9%; 285/344), ranging from basic tables that described the key characteristics of each included study, to cross-tabulation heat maps that used color-coding to highlight cell values. Study characteristics were also mapped graphically in 28.8% (99/344) of reviews, often in the form of histograms, scatterplots, or pie charts. Reviews from the software engineering sector frequently used bubble charts to map the data (Figure ​ (Figure2 2 is an example of a bubble chart). In summarizing the reviewed literature, 77.6% (267/344) of reviews noted gaps where little or no research had been conducted, and 77.9% (268/344) recommended topics or questions for future research.

Reporting of results the included scoping reviews

Bubble plot of scoping reviews published by year and sector. The size of a bubble is proportional to the number of scoping reviews published in the year and sector corresponding to the bubble coordinates.

Stakeholder consultation is an optional sixth-step in the Arksey and O'Malley ( 2005 ) framework and was reported in 39.8% (137/344) of reviews. This optional step was reported in 34.9% (38/109) of reviews that used the Arksey and O'Malley framework, compared with 42.13% (99/235) of reviews that did not. Stakeholders were most often consulted at the search phase to assist with keyword selection for the search strategy or help identify potential studies to include in the review (74.5%; 102/137). Stakeholders were less frequently involved in the interpretation of research findings (30.7%; 42/137) and in the provision of comments at the report writing stage (24.1%; 33/137). Ongoing interaction with stakeholders throughout the review process was reported in 25.9% (89/344) of all reviews. Comparing between sectors, the proportion of reviews that reported consulting with stakeholders was highest in the social sciences sector (71.4%; 10/14) and lowest in the software engineering sector (2.4%; 1/41).

3.4. Reported challenges and limitations

Limitations in the study approach were reported in 71.2% (245/344) of reviews. The most frequent limitation reported in the reviews was the possibility that the review may have missed some relevant studies (32.0%; 110/344). This limitation was frequently attributed to database selection (i.e., searching other databases may have identified additional relevant studies), exclusion of the gray literature from the search, time constraints, or the exclusion of studies published in a language other than English. In comparison with systematic reviews, one review noted that it was ‘unrealistic to retrieve and screen all the relevant literature’ in a scoping review due to its broader focus (Gentles et al. , 2010 ), and a few noted that all relevant studies may not have been identified as scoping reviews are not intended to be as exhaustive or comprehensive (Cameron et al. , 2008 ; Levac et al. , 2009 ; Boydell et al. , 2012 ).

The balance between breadth and depth of analysis was a challenge reported in some reviews. Brien et al. ( 2010 ) and Cronin de Chavez et al . ( 2005 ) reported that it was not feasible to conduct a comprehensive synthesis of the literature given the large volume of articles identified in their reviews. Depth of analysis was also reported to be limited by the time available to conduct the review (Freeman et al. , 2000 ; Gulliford et al. , 2001 ; Templeton et al. , 2006 ; Cahill et al. , 2008 ; Bostock et al. , 2009 ; Brodie et al. , 2009 ).

The lack of critical appraisal of included studies was reported as a study limitation in 16.0% (55/344) of reviews. One review commented that this was the primary limitation of scoping reviews (Feehan et al. , 2011 ), and others noted that without this step, scoping reviews cannot identify gaps in the literature related to low quality of research (Hand and Letts, 2009 ; Brien et al. , 2010 ). Additionally, two reviews reported that their results could not be used to make recommendations for policy or practice because they did not assess the quality of included studies (Bostrom et al. , 2011 ; Churchill et al. , 2011 ). Conversely, Njelesani et al . ( 2011 ) noted that ‘by not addressing the issues of quality appraisal, this study dealt with a greater range of study designs and methodologies than would have been included in a systematic review’, and McColl et al. ( 2009 ) commented that ‘the emphasis of a scoping study is on comprehensive coverage, rather than on a particular standard of evidence’.

4. Discussion

In this paper, we provided an overview of scoping reviews identified in the gray and published literature. Our search for scoping reviews in the published and gray literature aimed to be comprehensive while also balancing practicality and available resources. It was not within the remit of this scoping review to assess the methodological quality of individual scoping reviews included in the analysis. Based on the characteristics, range of methodologies and reported challenges in the included scoping reviews, we have proposed some recommendations for advancing the scoping review approach and enhancing the consistency with which they are undertaken and reported.

4.1. Overview of included scoping reviews

Our results corroborate that scoping reviews are a relatively new approach that has gained momentum as a distinct research activity in recent years. The identified reviews varied in terms of terminology, purpose, methodological rigor, and level of detail of reporting; therefore, there appears to be a lack of clarity or agreement around the appropriate methodology for scoping reviews. In a scoping review that reviewed 24 scoping reviews from the nursing literature, Davis et al. ( 2009 ) also reported that the included scoping reviews varied widely in terms of intent, procedural, and methodological rigor. Given that scoping reviews are a relatively new methodology for which there is not yet a universal study definition, definitive procedure or reporting guidelines, the variability with which scoping reviews have been conducted and reported to date is not surprising. However, efforts have been made by scoping review authors such as Arksey and O'Malley ( 2005 ); Anderson et al. ( 2008 ); Davis et al. ( 2009 ); Brien et al. ( 2010 ); Levac et al. ( 2010 ) and Daudt et al. ( 2013 ) to guide other researchers in undertaking and reporting scoping reviews, as well as clarifying, enhancing, and standardizing the methodology. Their efforts seem to be having some impact given the increase in the number of scoping reviews disseminated in the published and gray literature, the growth in the use of a methodological framework, and the greater amount of detail and consistency with which scoping review processes have been reported.

4.2. Recommendations

Levac et al. ( 2010 ) remarked that discrepancies in nomenclature between ‘scoping reviews’, ‘scoping studies’, ‘scoping literature reviews’, ‘scoping exercises’, and so on lead to confusion, and consequently used the term ‘scoping study’ for consistency with the Arksey and O'Malley framework. We agree that there is a need for consistency in terminology; however, we argue that the term ‘scoping review’ should be adopted in favor of ‘scoping study’ or the other terms that have been used to describe the method. Our review has found that ‘scoping review’ is the most commonly used term in the literature to denote the methodology and that a number of the other terms (i.e., scoping study, scoping exercise, and systematic mapping) have been used to describe a variety of primary research study designs. Furthermore, we find that the word ‘review’ more explicitly indicates that the term is referring to a type of literature review, compared with ‘study’ or ‘exercise’.

As scoping reviews share many of the same processes with the more commonly known systematic review, many of the included reviews compared and contrasted the two methods. We concur with Brien et al. ( 2010 ) that scoping reviews are often misinterpreted as a less rigorous version of a systematic review, when in fact they are a ‘different entity’ with a different set of purposes and objectives. We contend that researchers adopting a systematic review approach but with concessions in rigor to shorten the timescale, refer to the process as a ‘rapid review’. Scoping reviews are one method among many available to reviewing the literature (Arksey and O'Malley, 2005 ), and researchers need to consider their research question or study purpose when deciding which review approach is most appropriate. Additionally, given that some of the included reviews took over 1 year to complete, we agree that it would be wrong to necessarily assume that scoping reviews represent a quick alternative to a systematic review (Arksey and O'Malley, 2005 ).

There is an ongoing deliberation in the literature regarding the need for quality assessment of included studies in the scoping review process. While Arksey and O'Malley stated that ‘quality assessment does not form part of the scoping (review) remit’, they also acknowledged this to be a limitation of the method. This may explain why quality assessment was infrequently performed in the included reviews and why it was reported as a study limitation among a number of these reviews. In their follow-up recommendations to the Arksey and O'Malley framework, Levac et al. ( 2010 ) did not take a position on the matter but recommended that the debate on the need for quality assessment continue. However, a recent paper by Daudt et al. ( 2013 ) asserts that it is a necessary component of scoping reviews and should be performed using validated tools. We argue that scoping reviews should include all relevant literature regardless of methodological quality, given that their intent is to present an overview of the existing literature in a field of interest without synthesizing evidence from different studies (Arksey and O'Malley, 2005 ). In doing so, scoping reviews can provide a more complete overview of all the research activity related to a topic. However, we also recognize that some form of quality assessment of all included studies would enable the identification of gaps in the evidence base—and not just where research is lacking—and a better determination of the feasibility of a systematic review. The debate on the need for quality assessment should consider the challenges in assessing quality among the wide range of study designs and large volume of literature that can be included in scoping reviews (Levac et al. , 2010 ).

The lack of consistency among the included reviews was not surprising given the lack of a universal definition or purpose for scoping reviews (Anderson et al. , 2008 ; Davis et al. , 2009 ; Levac et al. , 2010 ; Daudt et al. , 2013 ). The most commonly cited definition scoping reviews may be the one set forth by Mays et al . ( 2001 ) and used by Arksey and O'Malley: ‘scoping studies aim to map rapidly the key concepts underpinning a research area and the main sources and types of evidence available and can be undertaken as standalone projects in their own right, especially where an area is complex or has not been reviewed extensively before’. However, we believe that a recently proposed definition by Daudt et al . ( 2013 ) is more straightforward and fitting of the method: ‘scoping studies aim to map the literature on a particular topic or research area and provide an opportunity to identify key concepts; gaps in the research; and types and sources of evidence to inform practice, policymaking, and research’. While we would replace the term ‘scoping studies’ with ‘scoping reviews’, we endorse the Daudt et al . definition because it clearly articulates that scoping reviews are a type of literature review and removes the emphasis away from being ‘rapid’ process.

It has been suggested that the optimal scoping review is ‘one that demonstrates procedural and methodological rigor in its application’ (Davis et al. , 2009 ). We found that some scoping reviews were not reported in sufficient detail to be able to demonstrate ‘rigor in its application’. When there is a lack of clarity or transparency relating to methodology, it is difficult to distinguish poor reporting from poor design. We agree that it is crucial for scoping review authors to clearly report the processes and procedures undertaken—as well as any limitations of the approach—to ensure that readers have sufficient information to determine the value of findings and recommendations (Arksey and O'Malley, 2005 ; Davis et al. , 2009 ). The development of reporting guidelines for scoping reviews would help to ensure the quality and transparency of those undertaken in the future (Brien et al. , 2010 ). Given that reporting guidelines do not currently exist for scoping reviews (Brien et al. , 2010 ), researchers conducting scoping reviews may want to consider using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses ( http://prisma-statement.org/ ) as a guide, where applicable.

4.3. Strengths and limitations of this scoping review

This scoping review used rigorous and transparent methods throughout the entire process. It was guided by a protocol reviewed by a research team with expertise in knowledge synthesis and scoping reviews. To ensure a broad search of the literature, the search strategy included four electronic bibliographic databases, the reference list of eighteen different articles, two internet search engines, the websites of relevant organizations, and the snowball technique. The relevance screening and data characterization forms were pretested by all reviewers and revised as needed prior to implementation. Each citation and article was reviewed by two independent reviewers who met in regular intervals to resolve conflicts. Our use of a bibliographic manager (RefWorks) in combination with systematic review software (DistillerSR) ensured that all citations and articles were properly accounted for during the process. Furthermore, an updated search was performed in October 2012 to enhance the timeliness of this review.

This review may not have identified all scoping reviews in the published and gray literature despite attempts to be as comprehensive as possible. Our search algorithm included nine different terms previously used to describe the scoping process; however, other terms may also exist. Although our search included two multidisciplinary databases (i.e., Scopus, Current Contents) and Google, the overall search strategy may have been biased toward health and sciences. Searching other bibliographic databases may have yielded additional published scoping reviews. While our review included any article published in English, French or Spanish, our search was conducted using only English terms. We may have missed some scoping reviews in the gray literature as only the first 100 hits from each Web search were screened for inclusion. Furthermore, we did not contact any researchers or experts for additional scoping reviews we may have missed.

Other reviewers may have included a slightly different set of reviews than those included in this present review. We adopted Arksey and O'Malley's definition for scoping reviews at the outset of the study and found that their simple definition was generally useful in guiding study selection. However, we encountered some challenges during study selection with reviews that also reported processes or definitions more typically associated with narrative, rapid or systematic reviews. We found that some reviews blurred the line between narrative and scoping reviews, between scoping and rapid reviews, and between scoping and systematic reviews. Our challenges echoed the questions: ‘where does one end and the other start?’ (Arksey and O'Malley, 2005 ) and ‘who decides whether a particular piece of work is a scoping (review) or not?’ (Anderson et al. , 2008 ). For this review, the pair of reviewers used their judgment to determine whether each review as a whole sufficiently met our study definition of a scoping review. On another note, characterization and interpretation of the included reviews were also subject to reviewer bias.

5. Conclusions

This scoping review of scoping reviews characterized and described the nature of scoping reviews in the published and gray literature. Scoping reviews are a relatively new approach to reviewing the literature, which has increased in popularity in recent years. As the purpose, methodological process, terminology, and reporting of scoping reviews have been highly variable, there is a need for their methodological standardization to maximize the utility and relevance of their findings. We agree that the establishment of a common definition and purpose for scoping reviews is an important step toward enhancing the consistency with which they are conducted (Levac et al. , 2010 ); this would provide a common platform from which debates regarding the methodology can ensue, and the basis for future methodological frameworks and reporting guidelines. We hope that the results of our study can contribute to the ongoing collective work of a number of researchers to further clarifying and enhancing the scoping review methodology.

Acknowledgments

Funding for this project was provided by the OMAFRA-University of Guelph Knowledge Translation and Transfer Program (#299514).

We would like to thank our project collaborators Lisa Waddell, Dr. Barbara Wilhelm, and Dr. Ian Young for their expertise and guidance throughout the project. We would also like to acknowledge Dr. Ian Young and Kathleen Gropp for their assistance in screening articles for the review.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

A. R. and S. M. conceived of the study. M. P., A. R., and S. M. participated in the design of the study. M. P., J. G., and A. R. undertook the literature review process. All authors drafted the manuscript. All authors read and approved the final manuscript.

Supporting Information

Additional supporting information may be found in the online version of this article at the publisher's web site.

Supporting info item

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Scoping Reviews

• Formulate Question
• Find Existing Reviews
• Searching Systematically
• Saved Searches and Alerts
• Organizing & Exporting Results
• Supplementary Searching
• Screening & Sorting Results
• Tools & Guides
• Librarian Support

Types of Research Questions for Scoping Reviews

Scoping Reviews are broad by nature. As the name suggests, their purpose is to identify the scope of the literature on a topic. Therefore, the research questions that a Scoping Review can answer are also broad. Questions appropriate for Scoping Review methodology include:

• What has been done?
• What populations have been included?
• What progress has been made in the research?
• Does enough literature exist to conduct a systematic review?

What is known from the literature about the use of animal-assisted therapies in people with mood disorders?

Developing your Research Question

Formulating a research question (RQ) may require some initial searching on your topic, especially if it is one you haven't already researched. There are three primary elements of a Scoping Review RQ. However, not all RQs need to include all 3:

• Intervention

As you develop your research question, it is helpful to define your key concepts. This will help with the development of your inclusion criteria as well as your search strategy.

For example, what do you mean by adolescent? What age range are you including?

If you would like further help formulating your RQ, there are frameworks that can help as well as provide the foundational elements for your search strategy. Most of these frameworks were developed for the more specific RQs involved in Systematic Reviews, but they can also be helpful in thinking through your Scoping Review RQ.

• Find frameworks
• Last Updated: Nov 22, 2023 12:45 PM
• URL: https://guides.lib.utexas.edu/scopingreviews

Literature reviews: Scoping and planning

• Reviewing for research
• Stand-alone review
• Scoping and planning
• Screening and appraising
• The process of reviewing
• Planning a search strategy

On this page:

“Organization and planning are the key factors to successfully completing a systematic review.” Boland et al., Doing a systematic review: a student's guide.

It's crucial to initially scope your review before starting. Consider whether a systematic review is necessary and whether you have the time and resources to conduct one. You need to establish whether one has been done on your topic already, or is about to be conducted. 

Scoping searches

Once you've identified a topic area that interests you, you will need to conduct an initial scoping search . This will help identify the body of literature that has been written on the topic and identify whether systematic reviews have already been conducted in your topic area. Unfortunately it is often the case that you have your heart set on a specific topic only to find that it has already been done or that there is very limited literature available. Better to find out at this stage before you do any further work on it though!

Whilst running your scoping searches on the electronic database you will notice if a systematic review has already been conducted . Protocols of new reviews will be registered on  PROSPERO so you would also need to check there in addition to databases such as the Cochrane Library and Campbell Collaboration to establish if any have been published.

Once you have conducted these initial searches you are ready to start to formulate your own research question based on your findings. Make sure it is not too wide that there is too much literature and not too specific so that there is not enough literature.

Use your scoping searches to help formulate your search strategy by identifying different terminology, spellings, alternative terms and appropriate subject headings.

Formulating a research question

The development and refinement of the question is the most important phase. The question will determine the nature and scope of the review; will identify the key concepts to be used in your search strategy; and will guide which papers you are searching for. The question needs to be clear, well defined, appropriate, manageable and relevant to the outcomes you are seeking. As your question should be comprehensive and specific, it should only include one question and ideally have three for four elements.

There are many frameworks available to help formulate your research question such as PICO, PICOS, PICOT, SPIDER etc. One example is given below: 

P atient - the person affected by what you are researching - what are their defining characteristics and what is the condition they are experiencing?

I ntervention -   how are they being treated?

C omparison -   is there another treatment method that you would like to compare the intervention to?

O utcome -  what is the result of the intervention? These can be primary and secondary outcomes?

The breadth of your review

The breadth of the review will depend on the nature of the literature, your aims, time constraints, and pragmatics. If an undergraduate or masters student then the topic will need to be quite narrow to make it achievable. PhD students or other researchers may work with a team over a much longer period of time allowing for a much broader review to be conducted. It's useful to determine which kind of studies you wish to include in your review before starting the search and this will help with your decisions around inclusion and exclusion criteria.

The table below gives an outline of the types of studies you might come across:

Inclusion and exclusion criteria

Once you have your research question you need to consider your inclusion and exclusion criteria.

Inclusion criteria define the attributes studies must have to be included, sometimes also known as eligibility criteria.

Exclusion criteria identify which papers you want to specifically exclude from your results. These should map onto your review question and contain sufficient detail to help you screen through the results.

Create an initial list that will help you to:

• specifically address the research question
• ensure the quality and similarity of included studies
• clearly define the boundaries of the review

Developing a review protocol

Now you have your question you need to write a review protocol. This will outline how you will answer your question. Every piece of quality research is guided by a research protocol.

A good protocol

• describes the current evidence base
• identifies the question addressed
• outlines the methods that will be used to answer the question

It typically includes:

• Research question

Examples of published protocols can be found on the PROSPERO site. Students doing training or mini-reviews should not register their own on this site however. Students can use the system to create and store a record by saving but not submitting.

Creating record keeping systems

It is strongly recommended that you create a record keeping system to document your decisions at different stages of the review.

Record keeping allows you to keep an up-to-date and accurate account of what you have achieved at different stages of the review.

If you need to repeat or check anything this record will save you time in the future. You can use this information to help write the Methods section of the review.

Record keeping options

There are many ways to keep records from pen and paper to saving searches and papers within a folder in the electronic databases. Keeping tables of decisions on excluded papers can help you further down the line if you need to revisit these. Keep your files in order and importantly make back-ups!

You should make a record of the details of the searches you conduct and a list of the number of studies excluded at the screening stage. Adhere to recommended reporting standards such as  PRISMA .

Reference management software

Use reference management software to help you organise, annotate and integrate the required references into your text. RefWorks or EndNote are both support by the University and can help with this.

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• UNC Libraries
• HSL Academic Process
• Scoping Reviews
• Step 3: Conduct Literature Searches

Scoping Reviews: Step 3: Conduct Literature Searches

Created by health science librarians.

• Step 1: Complete Pre-Review Tasks
• Step 2: Develop a Protocol

Partner with a librarian

Systematic searching process, choose a few databases, search with controlled vocabulary and keywords, acknowledge outdated or offensive terminology, helpful tip - building your search, use nesting, boolean operators, and field tags, build your search, translate to other databases and other searching methods, document the search.

• Step 4: Manage Citations
• Step 5: Screen Citations
• Step 6: Assess Quality of Included Studies (Optional)
• Step 7: Extract Data from Included Studies
• Step 8: Write the Review

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About step 3: conduct literature searches.

Click an item below to see how it applies to Step 3: Conduct Literature Searches.

For PRISMA, there are specific items you will want to report from your search.  For this step, review the PRISMA-S checklist.

• PRISMA-S for Searching
• Specify all databases, registers, websites, organizations, reference lists, and other sources searched or consulted to identify studies. Specify the date when each source was last searched or consulted. Present the full search strategies for all databases, registers and websites, including any filters and limits used.
• For information on how to document database searches and other search methods on your PRISMA flow diagram, visit our FAQs "How do I document database searches on my PRISMA flow diagram?" and "How do I document a grey literature search for my PRISMA flow diagram?"

For this step of the review, in Covidence you can:

• Document searches in Covidence review settings so all team members can view
• Add keywords from your search to be highlighted in green or red while your team screens articles in your review settings

Librarian's Role

When designing and conducting literature searches, a librarian can advise you on :

• How to create a search strategy with Boolean operators, database-specific syntax, subject headings, and appropriate keywords 
• How to apply previously published systematic review search strategies to your current search
• How to test your search strategy's performance 
• How to translate a search strategy from one database's preferred structure and syntax to another

The goal of a scoping review search is to retrieve all results that are relevant to your topic in order to map (ie, report on the scope), and to identify themes and gaps in the literature. Because scoping review searches can be quite extensive and retrieve large numbers of results, an important aspect is limiting the number of irrelevant results that need to be screened. Librarians are experts trained in literature searching and scoping review methodology. Ask us a question or partner with a librarian to save time and improve the quality of your review. Our comparison chart detailing two tiers of partnership provides more information on how librarians can collaborate with and contribute to scoping review teams.

Search Process

• Use controlled vocabulary, if applicable
• Include synonyms/keyword terms
• Choose databases, websites, and/or registries to search
• Translate to other databases
• Search using other methods (e.g. hand searching)
• Validate and peer review the search

Databases can be multidisciplinary or subject specific. Choose the best databases for your research question. Databases index various journals, so in order to be comprehensive, it is important to search multiple databases when conducting a scoping review. Consider searching databases with more diverse or global coverage (i.e., Global Index Medicus) when appropriate. A list of frequently used databases is provided below. You can access UNC Libraries' full listing of databases on the HSL website (arranged alphabetically or by subject ).

Generally speaking, when literature searching, you are not searching the full-text article. Instead, you are searching certain citation data fields, like title, abstract, keyword, controlled vocabulary terms, and more. When developing a literature search, a good place to start is to identify searchable concepts of the research question, and then expand by adding other terms to describe those concepts. Read below for more information and examples on how to develop a literature search, as well as find tips and tricks for developing more comprehensive searches.

Identify search concepts and terms for each

Start by identifying the main concepts of your research question. If unsure, try using a question framework to help identify the main searchable concepts. PICO is one example of a question framework and is used specifically for clinical questions. If your research question doesn't fit into the PICO model well, view other examples of question frameworks and try another!

View our example in PICO format

Question: for patients 65 years and older, does an influenza vaccine reduce the future risk of pneumonia, controlled vocabulary.

Controlled vocabulary is a set of terminology assigned to citations to describe the content of each reference. Searching with controlled vocabulary can improve the relevancy of search results. Many databases assign controlled vocabulary terms to citations, but their naming schema is often specific to each database. For example, the controlled vocabulary system searchable via PubMed is MeSH, or Medical Subject Headings. More information on searching MeSH can be found on the HSL Pubmed Ten Tips Legacy Guide .

Note: Controlled vocabulary may be outdated, and some databases allow users to submit requests to update terminology.

View Controlled Vocabulary for our example PICO

As mentioned above, databases with controlled vocabulary often use their own unique system. A listing of controlled vocabulary systems by database is shown below.

Keyword Terms

Not all citations are indexed with controlled vocabulary terms, however, so it is important to combine controlled vocabulary searches with keyword, or text word, searches. 

Authors often write about the same topic in varied ways and it is important to add these terms to your search in order to capture most of the literature. For example, consider these elements when developing a list of keyword terms for each concept:

• American versus British spelling
• hyphenated terms
• quality of life
• satisfaction
• vaccination
• influenza vaccination

There are several resources to consider when searching for synonyms. Scan the results of preliminary searches to identify additional terms. Look for synonyms, word variations, and other possibilities in Wikipedia, other encyclopedias or dictionaries, and databases. For example, PubChem lists additional drug names and chemical compounds.

Display Controlled Vocabulary and Keywords for our example PICO

Combining controlled vocabulary and text words in PubMed would look like this:

"Influenza Vaccines"[Mesh] OR "influenza vaccine" OR "influenza vaccines" OR "flu vaccine" OR "flu vaccines" OR "flu shot" OR "flu shots" OR "influenza virus vaccine" OR "influenza virus vaccines"

Social and cultural norms have been rapidly changing around the world. This has led to changes in the vocabulary used, such as when describing people or populations. Library and research terminology changes more slowly, and therefore can be considered outdated, unacceptable, or overly clinical for use in conversation or writing.

For our example with people 65 years and older, APA Style Guidelines recommend that researchers use terms like “older adults” and “older persons” and forgo terms like “senior citizens” and “elderly” that connote stereotypes. While these are current recommendations, researchers will recognize that terms like “elderly” have previously been used in the literature. Therefore, removing these terms from the search strategy may result in missed relevant articles. 

Research teams need to discuss current and outdated terminology and decide which terms to include in the search to be as comprehensive as possible. The research team or a librarian can search for currently preferred terms in glossaries, dictionaries, published guidelines, and governmental or organizational websites. The University of Michigan Library provides suggested wording to use in the methods section when antiquated, non-standard, exclusionary, or potentially offensive terms are included in the search.

Check the methods sections or supplementary materials of published scoping reviews for search strategies to see what terminology they used. This can help inform your search strategy by using MeSH terms or keywords you may not have thought of. However, be aware that search strategies will differ in their comprehensiveness.

You can also run a preliminary search for your topic, sort the results by Relevance or Best Match, and skim through titles and abstracts to identify terminology from relevant articles that you should include in your search strategy.

Nesting is a term that describes organizing search terms inside parentheses. This is important because, just like their function in math, commands inside a set of parentheses occur first. Parentheses let the database know in which order terms should be combined. 

Always combine terms for a single concept inside a parentheses set. For example: 

( "Influenza Vaccines"[Mesh] OR "influenza vaccine" OR "influenza vaccines" OR "flu vaccine" OR "flu vaccines" OR "flu shot" OR "flu shots" OR "influenza virus vaccine" OR "influenza virus vaccines" )

Additionally, you may nest a subset of terms for a concept inside a larger parentheses set, as seen below. Pay careful attention to the number of parenthesis sets and ensure they are matched, meaning for every open parentheses you also have a closed one.

( "Influenza Vaccines"[Mesh] OR "influenza vaccine" OR "influenza vaccines" OR "flu vaccine" OR "flu vaccines" OR "flu shot" OR "flu shots" OR "influenza virus vaccine" OR "influenza virus vaccines" OR   (( flu OR influenza ) AND ( vaccine OR vaccines OR vaccination OR immunization )))

Boolean operators

Boolean operators are used to combine terms in literature searches. Searches are typically organized using the Boolean operators OR or AND. OR is used to combine search terms for the same concept (i.e., influenza vaccine). AND is used to combine different concepts (i.e., influenza vaccine AND older adults AND pneumonia). An example of how Boolean operators can affect search retrieval is shown below. Using AND to combine the three concepts will only retrieve results where all are present. Using OR to combine the concepts will retrieve results that use all separately or together. It is important to note that, generally speaking, when you are performing a literature search you are only searching the title, abstract, keywords and other citation data. You are not searching the full-text of the articles.

The last major element to consider when building systematic literature searches are field tags. Field tags tell the database exactly where to search. For example, you can use a field tag to tell a database to search for a term in just the title, the title and abstract, and more. Just like with controlled vocabulary, field tag commands are different for every database.

If you do not manually apply field tags to your search, most databases will automatically search in a set of citation data points. Databases may also overwrite your search with algorithms if you do not apply field tags. For scoping review searching, best practice is to apply field tags to each term for reproducibility.

For example:

("Influenza Vaccines"[Mesh] OR "influenza vaccine"[tw] OR "influenza vaccines"[tw] OR "flu vaccine"[tw] OR "flu vaccines"[tw] OR "flu shot"[tw] OR "flu shots"[tw] OR "influenza virus vaccine"[tw] OR "influenza virus vaccines"[tw] OR ((flu[tw] OR influenza[tw]) AND (vaccine[tw] OR vaccines[tw] OR vaccination[tw] OR immunization[tw])))

View field tags for several health databases

For more information about how to use a variety of databases, check out our guides on searching.

• Searching PubMed guide (HSL) Guide to searching Medline via the PubMed database
• Searching Embase Guide
• Searching Scopus guide Guide to searching Scopus via scopus.com
• Searching EBSCO Databases guide Guide to searching CINAHL, PsycInfo, Global Health, & other databases via EBSCO

Combining search elements together

Organizational structure of literature searches is very important. Specifically, how terms are grouped (or nested) and combined with Boolean operators will drastically impact search results. These commands tell databases exactly how to combine terms together, and if done incorrectly or inefficiently, search results returned may be too broad or irrelevant.

For example, in PubMed:

(influenza OR flu) AND vaccine is a properly combined search and it produces around 50,000 results.

influenza OR flu AND vaccine is not properly combined.  Databases may read it as everything about influenza OR everything about (flu AND vaccine), which would produce more results than needed.

We recommend one or more of the following:

• put all your synonyms together inside a set of parentheses, then put AND between the closing parenthesis of one set and the opening parenthesis of the next set
• use a separate search box for each set of synonyms
• run each set of synonyms as a separate search, and then combine all your searches
• ask a librarian if your search produces too many or too few results

View the proper way to combine MeSH terms and Keywords for our example PICO

Question: for patients 65 years and older, does an influenza vaccine reduce the future risk of pneumonia , translating search strategies to other databases.

Databases often use their own set of terminology and syntax. When searching multiple databases, you need to adjust the search slightly to retrieve comparable results. Our sections on Controlled Vocabulary and Field Tags have information on how to build searches in different databases.  Resources to help with this process are listed below.

• Polyglot search A tool to translate a PubMed or Ovid search to other databases
• Search Translation Resources (Cornell) A listing of resources for search translation from Cornell University
• Advanced Searching Techniques (King's College London) A collection of advanced searching techniques from King's College London

Other searching methods

Hand searching.

Literature searches can be supplemented by hand searching. One of the most popular ways this is done with scoping reviews is by searching the reference list and citing articles of studies included in the review. Another method is manually browsing key journals in your field to make sure no relevant articles were missed. Other sources that may be considered for hand searching include: clinical trial registries, white papers and other reports, pharmaceutical or other corporate reports, conference proceedings, theses and dissertations, or professional association guidelines.

Searching grey literature

Grey literature typically refers to literature not published in a traditional manner and often not retrievable through large databases and other popular resources. Grey literature should be searched for inclusion in scoping reviews in order to reduce bias and increase thoroughness. There are several databases specific to grey literature that can be searched.

• Open Grey Grey literature for Europe
• OAIster A union catalog of millions of records representing open access resources from collections worldwide
• Grey Matters: a practical tool for searching health-related grey literature (CADTH) From CADTH, the Canadian Agency for Drugs and Technologies in Health, Grey Matters is a practical tool for searching health-related grey literature. The MS Word document covers a grey literature checklist, including national and international health technology assessment (HTA) web sites, drug and device regulatory agencies, clinical trial registries, health economics resources, Canadian health prevalence or incidence databases, and drug formulary web sites.
• Duke Medical Center Library: Searching for Grey Literature A good online compilation of resources by the Duke Medical Center Library.

Scoping review quality is highly dependent on the literature search(es) used to identify studies. To follow best practices for reporting search strategies, as well as increase reproducibility and transparency, document various elements of the literature search for your review. To make this process more clear, a statement and checklist for reporting literature searches has been developed and and can be found below.

• PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, Moher D, Peters MDJ, Horsley T, Weeks L, Hempel S, Akl EA, Chang C, McGowan J, Stewart L, Hartling L, Aldcroft A, Wilson MG, Garritty C, Lewin S, Godfrey CM, Macdonald MT, Langlois EV, Soares-Weiser K, Moriarty J, Clifford T, Tunçalp Ö, Straus SE. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018 Oct 2;169(7):467-473. doi: 10.7326/M18-0850. Epub 2018 Sep 4. PMID: 30178033.
• JBI Manual for Evidence Synthesis Chapter 11: Scoping Reviews Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis, JBI, 2020. Available from https://synthesismanual.jbi.global. https://doi.org/10.46658/JBIMES-20-12

At a minimum, document and report certain elements, such as databases searched, including name (i.e., Scopus) and platform (i.e. Elsevier), websites, registries, and grey literature searched. In addition, this also may include citation searching and reaching out to experts in the field. Search strategies used in each database or source should be documented, along with any filters or limits, and dates searched. If a search has been updated or was built upon previous work, that should be noted as well. It is also helpful to document which search terms have been tested and decisions made for term inclusion or exclusion by the team. Last, any peer review process should be stated as well as the total number of records identified from each source and how deduplication was handled. 

If you have a librarian on your team who is creating and running the searches, they will handle the search documentation.

You can document search strategies in word processing software you are familiar with like Microsoft Word or Excel, or Google Docs or Sheets. A template, and separate example file, is provided below for convenience. 

• Search Strategy Documentation Template
• Search Strategy Documentation Example

*Some databases like PubMed are being continually updated with new technology and algorithms. This means that searches may retrieve different results than when originally run, even with the same filters, date limits, etc.

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• Last Updated: May 16, 2024 3:24 PM
• URL: https://guides.lib.unc.edu/scoping-reviews

• Research article
• Open access
• Published: 19 June 2014

Scoping review of patient-centered care approaches in healthcare

• Marissa K Constand 1 ,
• Joy C MacDermid 1 ,
• Vanina Dal Bello-Haas 1 &
• Mary Law 1  

BMC Health Services Research volume  14 , Article number:  271 ( 2014 ) Cite this article

79k Accesses

292 Citations

9 Altmetric

Metrics details

The purpose of this scoping review was to describe how three tenants of patient-centered care provision: communication, partnership, and health promotion are addressed in patient-centered care models/frameworks across the literature.

A scoping review of literature published in English since 1990 was conducted using Medline, CINAHL, and EMBASE. A key term search strategy was employed using “patient-centered care”, “client-centered care”, “framework” and “model” to identify relevant studies.

Application of the search strategy resulted in a hit total of 101 articles. Nineteen articles met inclusion criteria, of which 12 were review articles; 5 were qualitative research papers; one was a randomized control trial; and one was a prospective study. From these articles, 25 different patient-centered care frameworks/models were identified.

Conclusions

The fact that all identified approaches to patient-centered care incorporated strategies to achieve effective communication, partnership, and health promotion indicates that clinicians can select a patient-centered approach from the literature that best suits their patient’s needs, and be confident that it will satisfy the three core elements of patient-centered care provision. While empirical literature on specific patient-centric frameworks and models was limited, much empiric evidence was sourced for the most consistently defined component of patient-centered care, communication.

Peer Review reports

Patient-centered care in healthcare is defined as care provision that is consistent with the values, needs, and desires of patients and is achieved when clinicians involve patients in healthcare discussions and decisions [ 1 ]. The Patient Centered Clinical Method identifies that patient-centeredness is achieved in part by understanding patients experiences with illness and disease as well as understanding patients holistically [ 2 ]. Patient-centered care is thought to have many benefits and has been proposed as a means of achieving better health outcomes, greater patient satisfaction, and reduced health costs [ 2 ]. For example, Cooper and colleagues [ 3 ] have identified that in a population of patients receiving physiotherapy for the treatment of chronic low back pain, the provision of patient-centered care helped the physiotherapists to “better understand and manage” their patient’s needs. Furthermore, Cott [ 4 ] identified that an improved understanding of patient needs stems from clinicians acknowledging patient perspectives on recovery.

In a multi-site study conducted in primary care physician’s offices servicing members of both urban and rural communities, Little et al. [ 5 ] surveyed patient preferences for patient-centered care and suggested that the three main objectives of patient-centered care provision should include effective communication, partnership, and health promotion. Effective communication has been defined as the exploration of the patient’s disease and illness to develop an understanding of the patient’s healthcare experiences [ 1 , 2 ]. Developing a partnership with patients occurs when clinicians and patients find common ground upon which a healthcare plan can be developed mutually [ 1 , 2 ]. Finally, effective health promotion, defined in this study as tailoring healthcare plans based on reflections on the patient’s past health history and current health context, helps ensure that healthcare plans are developed from an understanding of previous healthcare experiences. This approach reduces the risk of failed treatments and ensures optimal use of resources [ 1 , 2 ]. While these three components of patient-centered care have been identified as the elements that are most valued by patients receiving medical attention [ 5 ], the extent to which different patient-centered care frameworks and models embrace these three components as core elements, and their application across different disciplines has not been studied. Although rehabilitation is an area of practice where patient-centered care is seen as “the way forward” [ 6 ], even here a consistent conceptual framework or model of patient-centered care has yet to be accepted. Clarity on definitions, frameworks, and essential ingredients of patient-centered care is a prerequisite for developing rigorous empirical evidence evaluating patient-centred care and for insuring fidelity when it is implemented. A scoping review approach provides a methodology for determining the state of the evidence on a topic that is especially useful where issues require clarification before rigorous empirical studies are conducted. Therefore, the purpose of this study is to use Arskey and O’Malley’s scoping review methodology to determine the following with respect to patient-centered care frameworks and models:

What is the extent and nature of published scientific literature on patient-centered care frameworks and models including the research designs used, areas of clinical practice, and conceptualization of patient-centered care?

To what extent do the frameworks and models address the three core components of patient-centered care: effective communication, partnership, and health promotion?

A secondary purpose was to reflect on the depth of evidence surrounding a key component of patient-centered care, effective communication, by charting the published systematic reviews on effective communication practices. This review was conducted as a secondary review in order to identify evidence supporting patient-centered communication that may not be associated with a patient-centered framework or model since effective communication is the most definable and consistent component of patient-centered care.

Identifying relevant studies

Literature published in English between 1990 and 2012 was collected from three databases: Medline, CINAHL, and EMBASE. A key term search strategy was employed using the words “patient-centered care”, “client-centered care”, “framework” and “model”. The terms “framework” and “model” were selected to classify the approaches to patient-centered care provision because they provide standardized methods that can be easily followed and reproduced. A similar search was conducted for systematic reviews that included communication as a title word to identify the most easily accessible systematic reviews addressing communication.

Study selection

Articles were eligible for inclusion in this review if they described a patient-centered care framework or model being applied to an adult population receiving healthcare. Only articles published since 1990 and written in English were eligible for inclusion in this review. Articles were excluded if they did not pertain to a patient-centered care framework or model, or if did not address a healthcare context. Titles and abstracts of articles were independently reviewed by two authors (MKC and JCM). If articles were representative of the inclusion criteria, the articles went through two full-text independent reviews by two authors (MKC and JCM). If disagreements arose, a third party reviewer would be consulted. A second search was conducted using communication as a keyword, and limiting the retrieval to systematic reviews using Clinical Queries in Medline, and the term systematic review in other databases. Articles were included from the secondary review of the literature if they were systematic reviews identifying effective communication strategies in any healthcare discipline. Studies were excluded if they did not identify communication strategies between clinicians and patients or families.

Charting data

If an article was eligible for inclusion in this study, data related to the patient-centered care framework or model presented in the article was extracted by the lead author and reviewed by a second author (JCM). Data extracted from the reviewed patient-centered care frameworks and models was entered into data extraction records and synthesized in summary format. Data were systematically charted using the data charting form developed in Microsoft Excel. Information on authorship, article type, population, and patient-centered care approach were recorded on this form. A second data charting form was developed to chart data on the communication systematic reviews identified. Information on clinical context, patient-centered care focus, number of studies reviewed and key findings were recorded on this form.

Collating, summarising and reporting results

Information that was organized on the data charting forms was employed to collate and report the articles’ approaches towards achieving effective communication, partnership, and health promotion.

From an original hit total of 101 articles, 60 articles were excluded after reading the article title, and 22 articles were excluded after they were read fully (Figure  1 ). Nineteen articles were selected for inclusion in this review. Twelve of these articles were narrative review articles. The remaining studies included four qualitative research papers, one randomized control trial, and one prospective study. Of the 19 included articles, 25 unique patient-centered care frameworks or models were identified (Table  1 ). The secondary review conducted on communication strategies yielded a hit total of 69 systematic review articles, 25 of which met inclusion criteria (Table  2 ).

Scoping review process.

Content analysis of all patient-centered care frameworks and models included in this review revealed that all frameworks and models included approaches to achieving the three essential components of patient-centered care: effective communication, partnership, and health promotion (Table  3 ).

Communication

Three components of communication were commonly discussed in the articles reviewed: a) sharing information, b) compassionate and empowering care provision, and c) sensitivity to patient needs.

Sharing information

Creation of an effective learning environment was cited as a method for supporting patient-centered care in 89.5% of articles reviewed. Many articles discussed effective communication of healthcare information from the clinician to the patient, but also included approaches to effective patient information uptake by the clinician. Effective information uptake was seen as being an essential step in tailoring information to suit patient needs, vulnerabilities, and capacities [ 11 , 12 ]. Active listening, asking open ended questions, and developing functional goals were strategies cited by review articles to achieve effective information uptake [ 11 , 12 , 15 ].

Compassionate and empowering care provision

Providing compassionate and empowering care was cited as a component of achieving effective communication in 53% of articles reviewed. Such care is described as being attentive and altruistic, and was emphasized by several review articles and by the sole randomized control trial included in this review [ 14 , 16 ]. As well, these articles described compassionate and empowering care as contributing to the development of a strong clinician-patient relationship based upon patient feelings of autonomy and trust [ 14 , 16 ].

Sensitivity to patient needs

Strategies on how to be sensitive to patient needs were primarily discussed in the qualitative research articles included in this review. Such strategies included acknowledging and adapting to unique patient identifiers [ 19 , 24 , 25 ]. For example, clinicians are urged to observe and reflect on fluctuating levels of patient alertness, patient comfort levels in the presence or absence of family members, and different communication barriers such as hearing loss, in order to facilitate clinical interactions [ 15 , 19 , 22 ]. Of the articles reviewed, 58% identified that careful observation of unique patient characteristics is necessary to providing care that will lead to optimal patient receptiveness and positive health outcomes.

Partnership

Two components of partnership development were commonly discussed in the articles reviewed: a) relationship building and b) inter-professional collaboration.

Relationship building

Relationship building was discussed by all article types included in this review. Of the articles reviewed, 74% identified that building relationships with patients and families contributes to understanding what problems the patient is most concerned with and how their illness or injury has affected their life [ 15 , 18 , 23 ]. The involvement of patients and families in their care builds trust and encourages mutual problem solving [ 17 ].

Inter-professional collaboration

Engaging in inter-professional collaboration to decentralize health care provision was cited as a method of achieving partnership among healthcare professionals in 79% of the articles reviewed. These articles were primarily review articles that described decentralization as a team-based approach to care provision that contributed to efficient and focused care provision [ 7 – 10 , 13 , 21 ].

Health promotion

Achieving health promotion in a patient-centered context requires reflection on how to best support optimal health and care provision through reflection on the patient’s history. The two components of health promotion that were commonly discussed in the articles reviewed as being effective ways to achieve patient-centered care were: a) effective case management and b) efficient use of resources.

Effective case management

Effective case management was identified by 79% of articles reviewed as being a necessary component of health promotion. Effective case management involves the evaluation of past successes and failures of care in order to best tailor future health initiatives and reduce risk of adverse health outcomes [ 26 ]. This process is facilitated by discussions with patients about previous healthcare experiences in order to develop an understanding of how patients respond to certain types of care, such as care requiring follow-up appointments or self-directed home exercises [ 17 , 19 , 20 ].

Efficient use of resources

Appropriate organization of resources around patients was cited by 47% of articles included in this review as a way to achieve health promotion. By using resources that best suit patient needs and values, clinicians can tailor treatment plans to best represent how patients are likely to respond to certain interventions [ 16 ].

Secondary review analysis of communication strategies

The secondary review of systematic review articles on communication strategies in healthcare revealed that the majority of articles (68%) explicitly related communication strategies to patient-centered care. Articles that did not explicitly state this relationship through the use of the terms “patient-centered” or “client-centered” care, implied this relationship by identifying how effective communication between patients and healthcare professionals impacts patient satisfaction and health outcomes. The breadth of disciplines from which this literature was found is consistent with the diverse nature of the literature found on patient-centered care frameworks and models. Exploration of key findings revealed that effective communication strategies surrounding information provision and uptake by the healthcare professional, as well as respect for patient autonomy were the main facilitators of a positive clinical interaction.

This scoping review provides an overview of how patient-centered care is conceptualized in the current literature and suggests that the three components of patient-centered care valued by patients are predominantly featured in patient-centered care models and frameworks across different settings, populations, and applications. These core components were approaches to achieving effective communication, partnership and health promotion. While some of the articles reviewed pertained to specific target populations, the frameworks and models that they described were based on similar components of patient-centered care provision. This suggests that the models can be broadly applied. These components were clearly defined by authors, which made common approaches to communication, partnership, and health promotion easily identifiable during the progression of this scoping review’s analysis.

Epstein et al. [ 26 ] identify that while patient-centered care is acknowledged by clinicians as an ideal approach to care provision, “what it is and how to measure it” [ 26 ] is not clear to clinicians. They suggest that additional research is needed to strengthen the evidence supporting patient-centered care in healthcare [ 26 ]. This scoping review provides a foundation for future research by collating and summarizing the theoretical and empirical evidence regarding effective approaches to achieving patient-centered care provision. There is clearly a need for greater emphasis on empirical testing of the health and system impacts of providing patient-centered care in different contexts since the literature reviewed primarily addressed this topic theoretically, and only one randomized control trial was identified. Despite this finding, the consensus around inclusion of communication, partnership, and health promotion, across frameworks identified through this scoping review provides preliminary support that these key features of patient-centered care should be specifically included and evaluated in future studies or in clinician training.

The use of theoretical foundations is considered important in in complex health care issues, but theory has been operationalized more conceptually than empirically within the literature on patient-centered care, as indicated by the fact that only one randomized control trial was identified. This is consistent with findings of how theory has been applied to knowledge translation within the field of rehabilitation. Colquhoun et al. [ 27 ] found theoretical frameworks were more commonly used in a generic way rather than as a specific operational tool for defining interventions, processes, expected outcomes or evaluation strategies. Charting the nature of the evidence with respect to the use of patient-centered care frameworks and models suggests a greater need for empirical studies that test the value of providing patient-centered care versus alternatives in a rehabilitation context. Explicit use of the theory would ideally be integrated throughout training processes, materials that operationalize patient-centered care, evaluative instruments that assess its implementation, and all research that seeks to understand how it affects the process and outcomes of care.

Having found a consensus that communication, partnership and health promotion are key aspects to providing patient-centered care, it is important to have rigorous definitions and clear descriptions of what these processes entail, as well as evidence about how to operationally optimize these elements in different contexts and with different patient populations. This study highlighted a rich body of evidence to inform our understanding of communication. However, health promotion and partnership have a generic meaning that is quite broad, as they have been divided as having specific characteristics within patient-centered care. This may cause confusion for clinicians who believe that they are practicing these components of patient-centered care, as their approach may be consistent with the generic meaning of patient-centered care, but inconsistent with the specific steps and components required to operationalize them in a patient-centered way. Thus, fidelity in patient-centered processes may be lost when the concept is disseminated or scaled-up. Furthermore, the lack of consistency between the meaning of health promotion within patient-centered care and other aspects of healthcare warrants further consideration.

It may be that a more inclusive but specific definition would improve this component of patient centered care. For example, health promotion has been defined by the World Health Organization as “the process of enabling people to increase control over their health and its determinants, and thereby improve their health” [ 28 ]. However, within the patient-centered care literature it has been defined as developing healthcare plans based on reflection on patient histories for the purposes of health enhancement, risk reduction, and early detection of illness [ 5 ]. There are areas of conceptual consensus across these definitions that suggest they promote a common approach [ 29 – 53 ]. However, the patient-centered care definition implicitly refers to the clinical interaction and goals; whereas, the World Health Organization places greater emphasis on determinants of health. Differences in conceptual framing of health promotion make it difficult to isolate studies that investigate the effect of this component of patient-centered care on outcomes. Conversely, there are a substantial number of systematic reviews that name communication as a key focus (in their title) suggesting that communication strategies can be improved by accessing high quality, empirical evidence. This reflects the importance of communication in most aspects of healthcare, and that it is studied as an important concept even where not framed within a patient-centered care framework. From these studies, we were able to determine that the majority of articles published on effective communication strategies in healthcare have a patient-centered focus and that improved outcomes can be expected when health services are designed to implement such strategies.

While no unifying patient-centered care framework/model was found, a consensus among frameworks and models of different disciplines suggest that three components of patient-centered care have been consistently recognized as critical to the process. Health promotion, communication and partnership have been considered across multiple areas of clinical practice although rarely through empirical studies. This consensus suggests a broadly applicable framework/model of patient-centered care is feasible and together with appropriate operational definitions might advance future empirical studies addressing whether patient-centered care improves outcomes. Studies that attest to the implementation and empirical evaluation of the outcomes of patient-centered care are needed and should at minimum include and measure the three tenets of patient-centered care: communication, partnership, and health promotion.

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This study was completed as part of the graduate thesis work of MKC who was the principal investigator in this study. MKC and JCM collaborated to create a study design to answer the research questions posed. MKC conducted the scoping review and JCM acted as the second reviewer. VDBH and ML assisted in the review and feedback process during the final production of this manuscript and also acted as supervisory committee members of MKC. JCM served as MKC’s graduate supervisor. All authors read and approved the final manuscript.

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Constand, M.K., MacDermid, J.C., Dal Bello-Haas, V. et al. Scoping review of patient-centered care approaches in healthcare. BMC Health Serv Res 14 , 271 (2014). https://doi.org/10.1186/1472-6963-14-271

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Protocol for a scoping review study on learning plan use in undergraduate medical education

• Anna Romanova   ORCID: orcid.org/0000-0003-1118-1604 1 ,
• Claire Touchie 1 ,
• Sydney Ruller 2 ,
• Victoria Cole 3 &
• Susan Humphrey-Murto 4  

Systematic Reviews volume  13 , Article number:  131 ( 2024 ) Cite this article

Metrics details

The current paradigm of competency-based medical education and learner-centredness requires learners to take an active role in their training. However, deliberate and planned continual assessment and performance improvement is hindered by the fragmented nature of many medical training programs. Attempts to bridge this continuity gap between supervision and feedback through learner handover have been controversial. Learning plans are an alternate educational tool that helps trainees identify their learning needs and facilitate longitudinal assessment by providing supervisors with a roadmap of their goals. Informed by self-regulated learning theory, learning plans may be the answer to track trainees’ progress along their learning trajectory. The purpose of this study is to summarise the literature regarding learning plan use specifically in undergraduate medical education and explore the student’s role in all stages of learning plan development and implementation.

Following Arksey and O’Malley’s framework, a scoping review will be conducted to explore the use of learning plans in undergraduate medical education. Literature searches will be conducted using multiple databases by a librarian with expertise in scoping reviews. Through an iterative process, inclusion and exclusion criteria will be developed and a data extraction form refined. Data will be analysed using quantitative and qualitative content analyses.

By summarising the literature on learning plan use in undergraduate medical education, this study aims to better understand how to support self-regulated learning in undergraduate medical education. The results from this project will inform future scholarly work in competency-based medical education at the undergraduate level and have implications for improving feedback and supporting learners at all levels of competence.

Scoping review registration:

Open Science Framework osf.io/wvzbx.

Peer Review reports

Competency-based medical education (CBME) has transformed the approach to medical education to focus on demonstration of acquired competencies rather than time-based completion of rotations [ 1 ]. As a result, undergraduate and graduate medical training programs worldwide have adopted outcomes-based assessments in the form of entrustable professional activities (EPAs) comprised of competencies to be met [ 2 ]. These assessments are completed longitudinally by multiple different evaluators to generate an overall impression of a learner’s competency.

In CBME, trainees will progress along their learning trajectory at individual speeds and some may excel while others struggle to achieve the required knowledge, skills or attitudes. Therefore, deliberate and planned continual assessment and performance improvement is required. However, due to the fragmented nature of many medical training programs where learners rotate through different rotations and work with many supervisors, longitudinal observation is similarly fragmented. This makes it difficult to determine where trainees are on their learning trajectories and can affect the quality of feedback provided to them, which is a known major influencer of academic achievement [ 3 ]. As a result, struggling learners may not be identified until late in their training and the growth of high-performing learners may be stifled [ 4 , 5 , 6 ].

Bridging this continuity gap between supervision and feedback through some form of learner handover or forward feeding has been debated since the 1970s and continues to this day [ 5 , 7 , 8 , 9 , 10 , 11 ]. The goal of learner handover is to improve trainee assessment and feedback by sharing their performance and learning needs between supervisors or across rotations. However, several concerns have been raised about this approach including that it could inappropriately bias subsequent assessments of the learner’s abilities [ 9 , 11 , 12 ]. A different approach to keeping track of trainees’ learning goals and progress along their learning trajectories is required. Learning plans (LPs) informed by self-regulated learning (SRL) theory may be the answer.

SRL has been defined as a cyclical process where learners actively control their thoughts, actions and motivation to achieve their goals [ 13 ]. Several models of SRL exist but all entail that the trainee is responsible for setting, planning, executing, monitoring and reflecting on their learning goals [ 13 ]. According to Zimmerman’s SRL model, this process occurs in three stages: forethought phase before an activity, performance phase during an activity and self-reflection phase after an activity [ 13 ]. Since each trainee leads their own learning process and has an individual trajectory towards competence, this theory relates well to the CBME paradigm which is grounded in learner-centredness [ 1 ]. However, we know that medical students and residents have difficulty identifying their own learning goals and therefore need guidance to effectively partake in SRL [ 14 , 15 , 16 , 17 ]. Motivation has also emerged as a key component of SRL, and numerous studies have explored factors that influence student engagement in learning [ 18 , 19 ]. In addition to meeting their basic psychological needs of autonomy, relatedness and competence, perceived learning relevance through meaningful learning activities has been shown to increase trainee engagement in their learning [ 19 ].

LPs are a well-known tool across many educational fields including CBME that can provide trainees with meaningful learning activities since they help them direct their own learning goals in a guided fashion [ 20 ]. Also known as personal learning plans, learning contracts, personal action plans, personal development plans, and learning goals, LPs are documents that outline the learner’s roadmap to achieve their learning goals. They require the learner to self-identify what they need to learn and why, how they are going to do it, how they will know when they are finished, define the timeframe for goal achievement and assess the impact of their learning [ 20 ]. In so doing, LPs give more autonomy to the learner and facilitate objective and targeted feedback from supervisors. This approach has been described as “most congruent with the assumptions we make about adults as learners” [ 21 ].

LP use has been explored across various clinical settings and at all levels of medical education; however, most of the experience lies in postgraduate medical education [ 22 ]. Medical students are a unique learner population with learning needs that appear to be very well suited for using LPs for two main reasons. First, their education is often divided between classroom and clinical settings. During clinical training, students need to be more independent in setting learning goals to meet desired competencies as their education is no longer outlined for them in a detailed fashion by the medical school curriculum [ 23 ]. SRL in the workplace is also different than in the classroom due to additional complexities of clinical care that can impact students’ ability to self-regulate their learning [ 24 ]. Second, although most medical trainees have difficulty with goal setting, medical students in particular need more guidance compared to residents due to their relative lack of experience upon which they can build within the SRL framework [ 25 ]. LPs can therefore provide much-needed structure to their learning but should be guided by an experienced tutor to be effective [ 15 , 24 ].

LPs fit well within the learner-centred educational framework of CBME by helping trainees identify their learning needs and facilitating longitudinal assessment by providing supervisors with a roadmap of their goals. In so doing, they can address current issues with learner handover and identification as well as remediation of struggling learners. Moreover, they have the potential to help trainees develop lifelong skills with respect to continuing professional development after graduation which is required by many medical licensing bodies.

An initial search of the JBI Database, Cochrane Database, MEDLINE (PubMed) and Google Scholar conducted in July–August 2022 revealed a paucity of research on LP use in undergraduate medical education (UGME). A related systematic review by van Houten–Schat et al. [ 24 ] on SRL in the clinical setting identified three interventions used by medical students and residents in SRL—coaching, LPs and supportive tools. However, only a couple of the included studies looked specifically at medical students’ use of LPs, so this remains an area in need of more exploration. A scoping review would provide an excellent starting point to map the body of literature on this topic.

The objective of this scoping review will therefore be to explore LP use in UGME. In doing so, it will address a gap in knowledge and help determine additional areas for research.

This study will follow Arksey and O’Malley’s [ 26 ] five-step framework for scoping review methodology. It will not include the optional sixth step which entails stakeholder consultation as relevant stakeholders will be intentionally included in the research team (a member of UGME leadership, a medical student and a first-year resident).

Step 1—Identifying the research question

The overarching purpose of this study is to “explore the use of LPs in UGME”. More specifically we seek to achieve the following:

Summarise the literature regarding the use of LPs in UGME (including context, students targeted, frameworks used)

Explore the role of the student in all stages of the LP development and implementation

Determine existing research gaps

Step 2—Identifying relevant studies

An experienced health sciences librarian (VC) will conduct all searches and develop the initial search strategy. The preliminary search strategy is shown in Appendix A (see Additional file 2). Articles will be included if they meet the following criteria [ 27 ]:

Participants

Medical students enrolled at a medical school at the undergraduate level.

Any use of LPs by medical students. LPs are defined as a document, usually presented in a table format, that outlines the learner’s roadmap to achieve their learning goals [ 20 ].

Any stage of UGME in any geographic setting.

Types of evidence sources

We will search existing published and unpublished (grey) literature. This may include research studies, reviews, or expert opinion pieces.

Search strategy

With the assistance of an experienced librarian (VC), a pilot search will be conducted to inform the final search strategy. A search will be conducted in the following electronic databases: MEDLINE, Embase, Education Source, APA PsycInfo and Web of Science. The search terms will be developed in consultation with the research team and librarian. The search strategy will proceed according to the JBI Manual for Evidence Synthesis three-step search strategy for reviews [ 27 ]. First, we will conduct a limited search in two appropriate online databases and analyse text words from the title, abstracts and index terms of relevant papers. Next, we will conduct a second search using all identified key words in all databases. Third, we will review reference lists of all included studies to identify further relevant studies to include in the review. We will also contact the authors of relevant papers for further information if required. This will be an iterative process as the research team becomes more familiar with the literature and will be guided by the librarian. Any modifications to the search strategy as it evolves will be described in the scoping review report. As a measure of rigour, the search strategy will be peer-reviewed by another librarian using the PRESS checklist [ 28 ]. No language or date limits will be applied.

Step 3—Study selection

The screening process will consist of a two-step approach: screening titles/abstracts and, if they meet inclusion criteria, this will be followed by a full-text review. All screening will be done by two members of the research team and any disagreements will be resolved by an independent third member of the team. Based on preliminary inclusion criteria, the whole research team will first pilot the screening process by reviewing a random sample of 25 titles/abstracts. The search strategy, eligibility criteria and study objectives will be refined in an iterative process. We anticipate several meetings as the topic is not well described in the literature. A flowchart of the review process will be generated. Any modifications to the study selection process will be described in the scoping review report. The papers will be excluded if a full text is not available. The search results will be managed using Covidence software.

Step 4—Charting the data

A preliminary data extraction tool is shown in Appendix B (see Additional file 3 ). Data will be extracted into Excel and will include demographic information and specific details about the population, concept, context, study methods and outcomes as they relate to the scoping review objectives. The whole research team will pilot the data extraction tool on ten articles selected for full-text review. Through an iterative process, the final data extraction form will be refined. Subsequently, two members of the team will independently extract data from all articles included for full-text review using this tool. Charting disagreements will be resolved by the principal and senior investigators. Google Translate will be used for any included articles that are not in the English language.

Step 5—Collating, summarising and reporting the results

Quantitative and qualitative analyses will be used to summarise the results. Quantitative analysis will capture descriptive statistics with details about the population, concept, context, study methods and outcomes being examined in this scoping review. Qualitative content analysis will enable interpretation of text data through the systematic classification process of coding and identifying themes and patterns [ 29 ]. Several team meetings will be held to review potential themes to ensure an accurate representation of the data. The PRISMA Extension for Scoping Reviews (PRISMA-ScR) will be used to guide the reporting of review findings [ 30 ]. Data will be presented in tables and/or diagrams as applicable. A descriptive summary will explain the presented results and how they relate to the scoping review objectives.

By summarising the literature on LP use in UGME, this study will contribute to a better understanding of how to support SRL amongst medical students. The results from this project will also inform future scholarly work in CBME at the undergraduate level and have implications for improving feedback as well as supporting learners at all levels of competence. In doing so, this study may have practical applications by informing learning plan incorporation into CBME-based curricula.

We do not anticipate any practical or operational issues at this time. We assembled a team with the necessary expertise and tools to complete this project.

Availability of data and materials

All data generated or analysed during this study will be included in the published scoping review article.

Abbreviations

• Competency-based medical education

Entrustable professional activity

• Learning plan
• Self-regulated learning
• Undergraduate medical education

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Acknowledgements

Not applicable.

This study will be supported through grants from the Department of Medicine at the Ottawa Hospital and the University of Ottawa. The funding bodies had no role in the study design and will not have any role in the collection, analysis and interpretation of data or writing of the manuscript.

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Anna Romanova & Claire Touchie

The Ottawa Hospital Research Institute, Ottawa, Canada

Sydney Ruller

The University of Ottawa, Ottawa, Canada

Victoria Cole

The Ottawa Hospital – Riverside Campus, Ottawa, Canada

Susan Humphrey-Murto

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Contributions

AR designed and drafted the protocol. CT and SH contributed to the refinement of the research question, study methods and editing of the manuscript. VC designed the initial search strategy. All authors reviewed the manuscript for final approval. The review guarantors are CT and SH. The corresponding author is AR.

Authors’ information

AR is a clinician teacher and Assistant Professor with the Division of General Internal Medicine at the University of Ottawa. She is also the Associate Director for the internal medicine clerkship rotation at the General campus of the Ottawa Hospital.

CT is a Professor of Medicine with the Divisions of General Internal Medicine and Infectious Diseases at the University of Ottawa. She is also a member of the UGME Competence Committee at the University of Ottawa and an advisor for the development of a new school of medicine at Toronto Metropolitan University.

SH is an Associate Professor with the Department of Medicine at the University of Ottawa and holds a Tier 2 Research Chair in Medical Education. She is also the Interim Director for the Research Support Unit within the Department of Innovation in Medical Education at the University of Ottawa.

CT and SH have extensive experience with medical education research and have numerous publications in this field.

SR is a Research Assistant with the Division of General Internal Medicine at the Ottawa Hospital Research Institute.

VC is a Health Sciences Research Librarian at the University of Ottawa.

SR and VC have extensive experience in systematic and scoping reviews.

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Correspondence to Anna Romanova .

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The authors declare that they have no competing interests.

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Supplementary Information

Additional file 1. prisma-p 2015 checklist., 13643_2024_2553_moesm2_esm.docx.

Additional file 2: Appendix A. Preliminary search strategy [ 31 ].

Additional file 3: Appendix B. Preliminary data extraction tool.

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Romanova, A., Touchie, C., Ruller, S. et al. Protocol for a scoping review study on learning plan use in undergraduate medical education. Syst Rev 13 , 131 (2024). https://doi.org/10.1186/s13643-024-02553-w

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Received : 29 November 2022

Accepted : 03 May 2024

Published : 14 May 2024

DOI : https://doi.org/10.1186/s13643-024-02553-w

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